Pakistans

Islamabad, Pakistan – Staff nurse Razia Noreen was at a medicine cupboard on the nursery ward of the Pakistan Institute of Medical Sciences (PIMS), Islamabad’s largest public-sector hospital. She was two doors from the babies in her care, preparing the morning’s injections.

As she shut the cupboard door, she saw through the nursery’s glass panel a light too sharp and too red to be anything ordinary. She did not wait to understand what it was.

It was 6:38am on Wednesday, August 26. Elsewhere in the ward, her colleague, Sister Nasreen, was already running out, shouting for help.

At 56 seconds past 6:38am, according to security camera timestamps later logged by a government inquiry committee, Noreen rushed into the nursery.

Eight seconds later, she emerged carrying a baby. She tried to go back in. She could not. By 6:40am, the room was gone, swallowed by smoke so thick that the security cameras could no longer see through it.

Noreen was recalling this eight days later, in a plain office beside the hostel warden’s room at PIMS, dressed in a pale pink shalwar kameez, her dupatta loose over one shoulder.

“There was a proper blast,” she told Al Jazeera. “Everything turned to smoke.”

Fifteen newborns had been in that nursery. Fourteen died. The baby Noreen carried out was the only one who lived.

On Thursday, Noreen was given an award by Prime Minister Shehbaz Sharif for her courage. But for the nurse, the trauma of that Wednesday morning was still raw.

Barely two hours after meeting the prime minister, she sat down and talked, at length, about what happened inside.

‘Save the babies’

Noreen had been on duty since 8pm the previous night, working a routine dawn medication round with Sister Nasreen, with less than two hours left before the end of her shift.

When she saw the light through the nursery glass, she says she did not stop to work out what it was.

“I just told my sister nurse, save the babies,” she told Al Jazeera. “I went in. I didn’t think about what would happen next.”

Noreen said the fire was coming out of the side of the air-conditioning unit facing her.

“The AC was right in front of me, and the fire was coming out of its side,” she said. “We don’t know what was happening behind it. That’s just what I saw.”

The government’s interim inquiry, submitted on August 28, states that the precise cause of the fire “is not yet conclusively established”, with evidence pointing variously to the air conditioner, an incubator or an electrical short circuit.

Inside the nursery, Noreen reached the nearest baby. There was no time to choose between 15. She carried the infant out and handed her to Dr Abdul Rehman, a doctor who had been inserting a feeding tube in the next room and emerged into the corridor moments after her. Then she turned back.

“I thought I’d get five, six, seven, eight more of them out,” she said. “But the fire was moving faster than I was.”

A second doctor, Dr Rimsha, who had been doing rounds nearby and saw the same light Noreen had, followed her in.

The two of them, and later Sister Nasreen, tried to crawl back through the smoke below the worst of the heat. A sudden loss of power plunged the room into darkness. They could not get through.

Noreen’s phone, left behind on the medication table when she ran in, sat inside the burned ward overnight. Hospital guards found it and returned it to her the next afternoon. Its case is still scorched and cracked.

Noreen, Dr Rimsha and Sister Nasreen instead moved to where a separate rescue team was lowering babies from an adjoining gynaecology ward. They stood there catching newborns and running them to the neonatal intensive care unit until the smoke became too thick to remain.

The government’s inquiry later found that the available evidence “does not support generalised allegations that front-line medical and nursing staff simply abandoned the newborns”.

Ask Noreen what a nurse is to a newborn separated from its mother, and she has one answer: its first mother.

“A mother who gives birth endures a pain no one else can stand in for,” she said. “But once a baby is in our hands, no one else is watching over it the way we are, checking their oxygen, their feeding, whether they’re breathing right, every two hours, whatever else is happening around us. That is why we are their first mother.”

‘I am very happy with the children’

Noreen, 38, has spent 21 years in government nursing, the last 17 of them at PIMS. She trained in Karachi right after school, at the age of 17, before a transfer brought her to PIMS in 2009. She has never married.

“Thank God, I am very happy with the children,” she said, when asked about it directly.

Born in Punjab’s city of Sahiwal, she was one of seven children. Her father, Victor John, was a pastor; he died when she was in the eighth grade. Two of her sisters have died; a third, also a nurse, lives in Lahore.

Her mother, 83, a retired government school teacher who is hard of hearing, lives in Lahore with one of Noreen’s brothers.

Noreen herself has lived in the PIMS staff hostel, across from the ward where she works, for most of the past two decades.

With her own phone trapped inside the burning ward, Noreen could not call her family herself.

Noreen’s niece happened to be staying with her that week. It was the niece the warden found, and who got word to the family in Lahore: Noreen was safe.

‘It’s always the two of us’

On the morning of the fire, Noreen and Sister Nasreen were the only two nurses on duty in a nursery holding 15 babies, backed by two doctors, one of them two rooms away. She says it was not an unusual night.

“Sometimes there are 20 babies, sometimes 25,” she said. “It’s always the two of us.”

Doctors on her ward work 36-hour shifts, she said, arriving at 8am and going off duty at 2pm the following day.

Handover between nursing shifts, checking each baby’s medication, feeding and vital signs, takes roughly 45 minutes given the numbers involved. The cost of drugs can also run to tens of thousands of Pakistani rupees per injection, all provided by PIMS to its patients.

“Sometimes we get a break, sometimes we don’t,” she said. “When the workload is heavy, even the water we carry with us goes back home untouched.”

No fire drill had been run in the nursery before August 26, not even after an earlier fire at a nearby PIMS hostel in July.

Asked what is required after an incident like this, she does not hesitate.

“We should all have proper drills. If a fire starts, everyone needs to already know what to do.”

She lists what should follow: extinguishers within reach, cross-ventilation to clear smoke, and a rehearsed evacuation route for babies who cannot walk or call out for help.

‘Golden letters in history’

Until the fire, almost nobody outside her own ward knew her name, Noreen says.

“I have almost no presence in the main hospital,” she said. “Nobody there knows who I am. I work in the nursery, in my own department. I never imagined that saving one baby would take me this far.”

She travelled on Thursday to meet the prime minister in a car the government sent.

During the meeting, Sharif called her “the nation’s daughter” and said her act would be remembered “in golden letters” in Pakistan’s history.

He confirmed Noreen will formally receive the country’s Sitara-i-Khidmat (Star of Service) award at a ceremony on March 23, and handed her a cheque for 10 million Pakistani rupees ($36,000).

She used the meeting to say what she had already told her own colleagues privately.

“My fellow nurses work with just as much dedication,” she said. “This was a very heartbreaking incident.”

‘I haven’t slept since that day’

Eight days on, Noreen is unwell. She has had a fever of 102 to 103 degrees Fahrenheit (38.9C to 39.4C) on and off, and a cough she says came from smoke she breathed in from the fire that morning — a morning she will never forget. She takes an antibiotic and sleeping tablets at night. Neither has worked as it should.

“I haven’t slept, not since that day,” she said. “I take the tablets, I drink the cough syrup, but sleep doesn’t come. I close my eyes, and I open them again.”

Asked whether the same dawn shift keeps replaying in her mind, she did not need the question finished.

“The whole incident. The same babies. The mothers’ screams, and the babies’ screams, how they must have screamed. Those are the things that don’t let me sleep.”

She was signed off on medical rest only the day before this interview. Colleagues have been steadying her since.

“I would just start crying, sitting there,” she said. “They supported me like I was a child.”

But the nights are still hers alone.

“It comes back to the same thing,” she said. “When I’m in the hostel, when I’m alone, it all comes back.”

‘That, I regret’

The baby Noreen carried out — she hasn’t been named yet, according to the nurse — remains in the neonatal intensive care unit a week on.

Born preterm at just over a kilogramme (2 pounds, 3 ounces), the baby was already unwell before the fire. She remains critical.

Noreen met the baby’s parents for the first time the day before the meeting with the prime minister.

“She [the baby’s mother Asifa] hugged me and thanked me, and cried, and I cried with her,” Noreen said, “because for the rest of the children, my heart is still exactly where it was.”

She has told the mother the same thing she tells herself.

“I said, look, your child survived such a huge storm, she will survive what comes next, too. You pray, and I will pray.”

Asked what she would tell other nurses, Noreen urged them to work with honesty and without conditions.

“When you work somewhere with honesty, the reward comes eventually,” she said. “It came to me after 21 years. Work with the same loyalty. That is our real strength.”

Then, unprompted, she returned to the 14 babies who died.

“I do regret it,” she said. “I could not save the rest of the children. That, I regret.”

Islamabad, Pakistan — Pakistani Field Marshal Asim Munir spent Monday moving through the power corridors of Tehran: the presidency, parliament, the Supreme National Security Council, and the foreign and interior ministries.

He met Iranian President Masoud Pezeshkian, as well as Parliament Speaker Mohammad Bagher Ghalibaf, who is Tehran’s chief negotiator in talks with the United States to end their now six-month-long war.

But amid a deadlock in those peace negotiations, many analysts say that Munir’s true test as mediator will lie in his ability to use his position as one of the region’s most powerful military leaders to convince his Iranian counterparts in olive uniforms to agree to a return to talks with Washington.

Days before Munir’s visit, Iranian President Masoud Pezeshkian told a gathering of doctors in Tehran that it was time to end the war while Iran held the advantage, a message aimed as much at Tehran’s own security establishment as at Washington.

“It is better that we bring the war to an end now as we are in a position of power and dignity,” he said, adding that “the whole world acknowledges our victory”.

Hours later, on August 21, the chief of the general staff of Iran’s armed forces, Major-General Ali Abdollahi, promised “revolutionary, crushing, regret-inducing and devastating” responses to any American miscalculation.

It was a sharp illustration of the gap between Iran’s president and the men now running its military — one that Munir will need to also navigate, analysts say.

And that’s why Munir’s most significant meeting on Monday might have been with General Mohsen Rezaei, a representative of Iran’s Supreme Leader Mojtaba Khamenei and the newly appointed secretary of the Supreme National Security Council. Rezaei is essentially the bridge between the military and Khamenei.

State of the war

Munir’s visit to Tehran came on a day when the region and the world were bracing for US President Donald Trump’s threatened “economic D-Day” sanctions against Iran, accompanied by a threatened punishment for all countries that continue to trade with Tehran.

Later in the day, US Treasury Secretary Scott Bessent unveiled “Operation Economic Outcast“, a sweeping sanctions campaign targeting Iran’s digital assets, gold, aviation, technology and shipping networks.

But while warning other countries to sever trade ties with Iran, he held back from actually announcing any penalties for those nations, acknowledging that such a step would “blow up the global financial system”.

Meanwhile, Defense Secretary Pete Hegseth, speaking the same day, kept the option of renewed strikes open.

“If we need to use kinetic strikes, we’ll use them. If Iran is foolish enough to overplay their hand or mess with the American military, we’ll do what we need to do,” he said.

It’s unclear whether Munir’s visit helped stave off broader US action against Iran and its trading partners.

But the timing was significant, analysts point out. Munir travelled to Tehran days after taking a phone call from United States President Donald Trump, who reportedly asked Islamabad to use its influence to bring Iran back to the table.

Pakistan’s Inter-Services Public Relations (ISPR) said the one-day visit had produced “comprehensive discussions” on reopening the Strait of Hormuz and ending the war.

Iranian officials, the ISPR added, “appreciated Pakistan’s constructive role and sincere efforts”.

Pakistan’s Interior Minister Mohsin Naqvi, who travelled with Munir, went further, calling the talks “very positive and productive” and saying “significant progress was made”.

A reshuffled Iranian military

This was his fourth visit to Tehran this year, but his first since Iran’s military hierarchy changed earlier this month.

On August 10, Supreme Leader Mojtaba Khamenei installed Abdollahi as chief of the general staff and moved Rezaei into the Supreme National Security Council. Ahmad Vahidi, commander of the Islamic Revolutionary Guard Corps (IRGC), has held his post since March, when his predecessor was killed in the war’s opening strikes.

It is these military men that analysts say are now shaping Iran’s war moves, potentially giving a fellow man in uniform an edge over traditional diplomats in convincing Tehran to get back to talks.

“It is increasingly the IRGC and the wider security establishment driving decisions on war and peace during this crisis,” Ahmed Saeed, a former vice admiral in Pakistan’s navy and a defence analyst, told Al Jazeera.

Naqvi, the interior minister, has travelled to Tehran eight times since April without those visits producing a substantial breakthrough.

But unlike him, Munir is not a politician. He’s a general who appears to enjoy the trust of both the Iranian leadership and, crucially, Trump — who has described the Pakistani army chief as his “favourite field marshal”.

“The call [to Munir a few days ago] was initiated by Trump himself, requesting Pakistani leadership use its influence to bring Iran back to the table,” Saeed said.

Warm words, no movement

What Iranian officials actually told Munir, in accounts carried by Iranian state media, differed little from what they have been telling their own broadcasters all week.

“We distrust America, and it must change its behaviour,” Rezaei told Munir, according to IRNA.

Ghalibaf, Iran’s parliament speaker, was blunter.

“We are pursuing the implementation of the terms of the Memorandum of Understanding, and it is America that must adhere to its commitments based on the Memorandum of Understanding,” he told Munir, according to IRNA.

Pezeshkian, meanwhile, pressed Munir to tell Washington to “correct its tone and approach”, warning that “relying on force and bullying will only complicate the process”, according to Tasnim, another Iranian outlet.

Two tracks, one strait

Oman’s Foreign Minister Badr bin Hamad Albusaidi is also expected in Tehran today for a separate round of talks focused specifically on the Strait of Hormuz, a track that has run alongside Pakistan’s mediation for months.

Oman’s involvement is not new. Albusaidi has held recurring talks with Tehran on the strait’s navigation rules.

Ejaz Haider, a Lahore-based defence analyst, said the Omani and Pakistani diplomatic tracks complement each other.

“Oman and Islamabad channels complement, because clause 5 of the Islamabad MoU stresses a bilateral understanding on the strait [between Oman and Iran],” he told Al Jazeera. The Strait of Hormuz passes through the territorial waters of Iran and Oman.

“This [a deal between Iran and Oman to jointly manage the strait] is not in the interest of the US, which is why Trump has threatened to bomb Oman,” Haider said, referring to remarks Trump made on August 17, when he told Fox News he would bomb Oman if it “gets in the way” of reopening the strait, the second time he had threatened the US ally over Hormuz.

Where Islamabad’s advantage as a mediator lay was in its “direct access to Vahidi, Abdollahi and Rezaei, the actual architects of Iran’s decision-making”, Saeed, the former naval official, said.

An Iranian official close to the negotiations, speaking on condition of anonymity, said Albusaidi would be in Tehran “primarily to hear what Iran has decided and what it has discussed with its Pakistani mediator”.

Who holds the leverage?

Andreas Krieg, an associate professor of defence studies at King’s College London, said the differences that had emerged between the Iranian military and civilian leaderships demonstrate a gulf between their understanding of where the war stood.

Pezeshkian and Ghalibaf, Krieg said, were “essentially warning that Iran cannot live indefinitely in this condition”, while “parts of the IRGC believe the opposite and think time is working against Washington”.

But ultimately, he said, “Mohsen Rezaei, Ahmad Vahidi and the IRGC are central to whether any political understanding [to end the war] can be implemented”, referring to Iran’s top military leadership.

“[Iranian Foreign Minister Abbas] Araghchi can negotiate something, and Qatar can broker it, but none of that matters if the security apparatus does not accept the operational consequences.”

For now, Munir appears to be the candidate mediators believe has the best shot at getting Iranian generals from their war room to the board room.

Islamabad, Pakistan — Pakistan’s Chief of Army Staff and Chief of Defence Forces, Field Marshal Asim Munir, is traveling to Tehran on Monday for talks with senior Iranian officials, Iran’s Foreign Ministry announced on Sunday.

It will be Munir’s third visit to Iran this year as Islamabad continues its push to mediate an end to the United States and Israel’s war on Iran.

Pakistani officials, speaking on condition of anonymity, confirmed to Al Jazeera that the trip would take place but declined to elaborate on its agenda.

The Pakistani military’s media wing, the Inter-Services Public Relations (ISPR), as well as the Foreign Ministry and Information Ministry, did not respond to Al Jazeera’s requests for comment on the visit, which was unusually announced by Tehran rather than Islamabad.

Foreign Ministry spokesperson Esmaeil Baghaei said the trip would build on Pakistan’s efforts to “help strengthen peace and security in the region”.

Munir will hold talks with senior Iranian officials during his stay, Baghaei told reporters in Tehran.

The visit follows two phone calls between Munir and Iranian Foreign Minister Abbas Araghchi within four days, on Wednesday and Saturday.

The two officials discussed “regional developments” and ways to strengthen “peace, stability and security” in West Asia, according to Iranian state media.

A third trip this year

Munir’s first visit to Tehran this year came in April, days after the Islamabad Talks, the first direct US-Iran negotiations in more than four decades, ended without a breakthrough.

He returned in May, arriving hours after US Secretary of State Marco Rubio said there had been “slight progress” in talks between Washington and Tehran.

His latest visit comes as the diplomatic track underpinning the Islamabad MoU has all but stalled, while Washington prepares a new round of sanctions.

The discussions are also expected to touch on this month’s announcement of the Mecca Joint Defence Agreement between Pakistan, Saudi Arabia and Turkiye, which Munir attended in Mecca.

Yemen’s Houthi fighters, whose attacks on shipping lanes have repeatedly threatened to widen the conflict, are also likely to feature in his conversations with Iranian officials. The Houthis are widely believed to receive support from Tehran.

The issue carries particular weight for Islamabad.

Three Pakistani sailors were killed and several others wounded when Houthi forces struck a Tanzania-flagged commercial vessel in the Bab al-Mandeb Strait on August 11.

Deputy Prime Minister and Foreign Minister Ishaq Dar called the attack a violation of international law and “strongly condemned” it at the time.

Munir is expected to meet Iran’s newly appointed senior military leadership during the visit, according to Reza Afzal Samir, an Iranian journalist tracking the talks.

“He is well positioned to meet Iran’s newer senior military leadership, the new IRGC chief, the new Chief of General Staff of the Iranian Armed Forces, and the new Secretary of the Supreme National Security Council,” Samir told Al Jazeera, referring to Munir’s expected meetings with Major-General Ahmad Vahidi, Major-General Ali Abdollahi and Mohsen Rezaei respectively.

The officials were all appointed earlier this month.

A lapsed deal

The visit comes at a fraught moment for Pakistan’s mediation effort, which it has led after the war began six months ago.

The 60-day window set out in the Islamabad Memorandum of Understanding (MoU), signed by Pakistan, Iran and the US on June 17, lapsed in mid-August without either side agreeing to extend it.

Iran has kept the Strait of Hormuz shut, insisting that Washington first lift its naval blockade, end oil sanctions, unfreeze Iranian assets abroad and halt military threats. Tehran says the US has not met those conditions.

Munir’s trip also coincides with a fresh round of US economic pressure.

US Treasury Secretary Scott Bessent is due to detail on Monday what American officials have called the “toughest sanctions in history” against Iran, a package he has said is intended, alongside the continuing naval blockade, to “collapse” the government in Tehran.

Iran’s Foreign Ministry has called the plan “economic warfare”.

The trip also follows a month of regional realignment. Pakistan, Saudi Arabia and Turkiye signed the Mecca Joint Defence Agreement on August 7, a mutual defence pact under which an attack on one signatory would be treated as an attack on all three.

Pakistan’s Interior Minister Mohsin Naqvi travelled to Tehran earlier this month to revive the stalled mediation push but returned without any concrete results.

Tensions elsewhere in the region have sharpened too.

The United Arab Emirates suspended trade and financial transactions with Iran last week after saying it had come under fire from two ballistic missiles launched from Iranian territory, a claim Baghaei denied.

But Munir’s visit, analysts say, signals that key regional mediators have not given up on efforts to revive talks, either direct or indirect, between Iran and the US, even as they try to balance their own relations with Tehran and Washington.

Oman’s Foreign Minister Badr bin Hamad Albusaidi, who, like Munir, has held recent telephone conversations with Araghchi, is scheduled to visit Tehran on Tuesday, Iran’s state-owned IRNA news agency has reported.

What leverage does Islamabad have?

Analysts remain divided on what Munir’s visit can realistically achieve, given Pakistan’s limited ability to enforce any understanding it helps broker.

“Both sides see Pakistan as a country that has helped facilitate dialogue without any personal stake in the outcome, nothing to gain for itself,” said Qamar Cheema, a political analyst and head of the Islamabad-based Sanober Institute. “That gives it a certain clarity, and the ability to offer an off-ramp to everyone involved.”

Javad Heiran-Nia, director of the Persian Gulf Studies Group in Tehran, said Pakistan’s persistence was driven partly by self-interest.

“Pakistan is concerned about escalating tensions and the outbreak of another all-out war between Iran and the United States, which would further destabilise the region,” he told Al Jazeera, pointing to Islamabad’s reliance on energy imports from the Gulf and the risk of disruption to remittances from Pakistani workers there if instability spreads.

Zahid Mehmood, a retired two-star general and Pakistani defence strategist, went further, describing Munir as still carrying Washington’s own offer to Tehran.

“Pakistan is still carrying, in effect, Washington’s off-ramp to Tehran,” he told Al Jazeera. “The country remains the most trusted conduit available.”

Not every analyst sees Pakistan’s role as this central.

Andreas Krieg, an associate professor of defence studies at King’s College London, said Qatar, not Pakistan, remained the primary channel.

“Qatar is leading the political mediation and remains the essential communication bridge between Washington and Tehran,” he told Al Jazeera.

Munir’s contribution, he said, was narrower, a “military-to-military channel into an Iranian system in which the IRGC and wider security establishment have become increasingly important to decisions about war and peace”.

What Munir can deliver, and what he can’t

Iranian journalist Samir said Pakistan had a significant role in Iran’s calculus because of what it could do.

“Why should Iran listen to Pakistan? Because Pakistan still retains the leverage to actually do something and create a real opening for peace, rather than remaining silent and doing nothing,” he said.

Samir also predicted the Munir visit could be followed quickly by movement on Hormuz negotiations. “I think the timeline for a final agreement between Iran and Oman on the Strait of Hormuz is also drawing near,” he said. “If [Munir] succeeds in bringing Iran back to the table, I anticipate a new announcement from Oman and Iran on the strait shortly after.”

Krieg was more cautious about what Munir’s visit could deliver. The most meaningful outcome, he said, would be “confirmation that Iran’s security establishment would abide by a specific Hormuz deconfliction arrangement and restrain escalation through Yemen or Iraq if Qatar can secure reciprocal American movement”.

Without that, according to Krieg, “the communication bridge remains open, but the two sides continue moving towards another coercive cycle”.

Mehmood, the retired Pakistani general, was less equivocal.

“Pakistan is really the only exit card available to either side for their off-ramp,” he told Al Jazeera.

Former leader was escorted from Adiala jail to Shifa International Hospital, following court order, local media reports.

Pakistan’s former Prime Minister Imran Khan has been transferred from jail to hospital by police and security, according to local media reports.

The founder of the opposition Pakistan Tehreek-e-Insaf (PTI) party was escorted by authorities in Islamabad from Rawalpindi’s Adiala jail to Shifa International Hospital in the capital late on Thursday, following the Supreme Court’s order, Pakistan’s Geo News reported.

Sources told Geo that authorities had earlier in the day completed preparations to shift the ousted prime minister, who is 73, to the hospital.

The Supreme Court on Tuesday ordered the shift to be completed within two days.

The government had filed a petition against the decision.

PTI shared a live broadcast of the preparations for his transfer but has not yet released a statement about it. The Pakistani government is also yet to comment.

The transfer fulfils a demand that Khan’s party and family had been making for months, expressing concerns over his health.

Under the order, Khan is to be examined by a medical board that includes his personal physician.

Khan’s next hearing has been scheduled for September 16, and the former leader should remain hospitalised until at least then as per the order, according to one of Khan’s lawyers, Uzair Bhandari.

This would be the longest period Khan would be physically outside jail premises since he was imprisoned in August 2023 and convicted in several corruption-related cases that he and his party insist are politically motivated.

The former cricket-star-turned-politician was ousted in a parliamentary no-confidence vote in April 2022.