Punching and slapping herself in the face, Nadia, commonly known as a rat-child, sat swaying in front of a begging box outside the Dola Shah shrine in the Punjabi city of Gujrat. She is just one of thousands of abnormal or deformed children in the country who are abandoned to destitution.
Arriving daily at the shrine at the crack of dawn, Nadia, who is mentally disturbed, doesn't speak to anyone. She wails and has occasional fits of laughter. Anyone who tries to get close to her is physically pushed away as she swears and screams at them.
"We don’t know where her parents are," Asif, a boy looking after worshippers' shoes outside the shrine, told IRIN. "She cannot be treated by a doctor," he added. The disturbed girl was left at the shrine when she was a baby and is now being looked after by descendants of Dola Shah, a Sufi saint.
According to tradition, people visit the shrine, which dates back to the 1800s, to pray for children. When conceived they give away their first child to the shrine as a sign of respect. "I’ve come here to thank the saint and pay my respects. I came here two years ago to pray for a child, and I was blessed with one," Fazilat, a worshipper at the shrine, told IRIN. "People still come here with their first-borns, but we don’t take them," Asif said.
However, all the children left at the shrine grow up with abnormalities and have been dubbed "rat-children" by votaries at the shrine. There is a continuing controversy over the how their deformities are caused. Some say it is genetic, and others believe them to be deliberately caused by human intervention. "It is most likely a genetic deformity," Dr Ijaz, a paediatric specialist at the Shifa hospital in the capital, Islamabad, Dr Ijaz, told IRIN. "It could be due to some deficiency," he added.
Another argument is that the children are made to wear metal caps which constrain the normal growth of the head, rendering them physically handicapped and mentally challenged. This cruel act is done so that the children can beg for a living, which can prove a lucrative trade. This theory was established and researched by one of Pakistan's top scientists, who was then banned from talking about the issue following media exposure several years ago.
Others believe that theory to be false. "We believe this is not really possible," Anushay Hussain, the director of Sahil, a Pakistani NGO dealing with disadvantaged and abused children, told IRIN in Islamabad. "We think it is a mix between Down's syndrome and mongoloid children," she added, saying that it could be caused by inbreeding, common in South Asia.
She highlighted the importance attached to partially-disabled children under Islam, but noted that they were being exploited. "These youngsters are a major target for sexual abuse, because those who abuse them know they will never tell," she said, asserting they were an invisible group of people in Pakistan.
Hussain also said that the children were at least fed and clothed by their keepers. "We hear horror stories of children in other countries who are locked up in rooms and chained to beds due to their disabilities."
There are still allegations that children are being kept at the shrine for begging, an accusation strongly denied by Pir Aslam Sayed, who looks after the shrine. "Let me ask you something, would you ever leave your children here?" he asked an IRIN reporter.
"People have accused us of keeping these children locked up in a room at the shrine so they can be used for begging, but to this day no one has been able to prove this myth," he maintained, adding that Nadia would have been forced to live on the streets if they had not taken her in. Asked if the girl had been taken to hospital, the pir (elder) replied: "What for? She cannot be cured and we cannot mess with nature."
There is an annual weekly income of almost US $700 from donations made at the shrine, which is collected by the local authorities ever since they took control of the shrine in 1996. "There is a special department which oversees shrines within the government, and they make sure that there is no maltreatment of these people," the district coordinator for Gujrat, Aga Nadeem, told IRIN. "There are no rat-children at the shrine begging," he said.
But critics accuse government officials of turning a blind eye. "It seems that it is in everyone's interest to keep this shrine going, because they get a cut out of it," Hussain maintained.
A boy at the shrine told IRIN that people would go from house to house to look for rat-children and take them away, saying that they belong to the shrine and use them for begging.
Pir Sayed Nasir Mahmud Gilani, a direct descendant of Dola Shah, also argued that the saint's name was being tainted by some people who were using it to make money from the disabled youngsters. "Everyone knows when a child is born into a family in a particular village. When they find out it is a rat-child, they take it away saying that it belongs to the shrine." He said there had been a time when those who could not afford children used to leave them at the shrine, but that this stopped some 40 years ago.
Hussein argued that the government should take more action to prevent the abuse of disadvantaged youngsters. "Care for children with special needs is pretty pathetic in Pakistan. It's quite atrocious," she said, adding that they were seen as a burden.
Furthermore, the impoverished country was riddled with social problems, making it difficult for the government or NGOs to handle all of them, she said. "The NGO sector is also still in a process of growth and the prioritisation of issues is different to that in other developing nations."
Sahil was set to launch an awareness programme for children with special needs in the country, which would include the rat-children. "Most people don't even know how to deal with normal children never mind those with special needs," Hussein added.