Building empathy through the power of pictures

The Challenge

Why do two neighboring districts have some of the lowest vaccination rates in the world?

The Context

For families in Killa Abdullah and Duki—two districts in the northwestern province of Balochistan—daily life is difficult. Families here have to overcome geographic isolation, distance, poverty, insecurity and malnutrition to secure basic needs. For these parents, solving these daily challenges is more pressing than preventing diseases they may not even have a name for.





IFRC Geneva
Pakistan Red Crescent Society


80% of the populations
in the districts of Duki and Killa Abdullah live in rural areas

Only 11% of children aged 12-23 months in Killa Abdullah and Duki are fully immunised.

In these districts, only 8% of girls are vaccinated, compared to 18% of boys.

Only one in ten women can read or write.

Balochistan has the lowest literacy rate for women in the world.

Nearly a quarter of families in Duki and Killa Abudullah don’t have toilets

Killa Abdullah

What We Heard

We spent time at 8 local health centres to see what immunization services looked and felt like for families in these far flung districts. We talked to mothers, fathers, grandmothers and frontline health workers, capturing insights of their journeys to better health every step of the way.

Rural Balochistan isn’t somewhere most people get to visit, so we also recruited one of Pakistan’s best videographers to help us better understand this remote and rarely seen context.

We found that little things go a long way; a conversation with a father on what to expect after his baby is vaccinated; some paracetamol offered during the visit; heating and electricity in the clinics to make the experience more comfortable for everyone. Sometimes, overcoming hesitation boils down to just getting the basics right.

Motivating just one parent or grandparent on the benefits of vaccination could save large numbers of children from disease in these multi-family households.

Our Solution

Instead of creating a thick strategy, we focused on a-picture- is-worth-a thousand-words approach. Our short film showed policy makers and programme officers just how complex this area is, and just how far these big and small fixes could go for real families and health workers.

We then created two simple roadmaps: one with quick wins to build demand and create goodwill. The second roadmap involved vital, but more intensive adjustments: hiring more women, matching recruitment strategies to local tribal dynamics, and reshaping the clinic experience ever so slightly to yield disproportionate gains.

  1. Killa Abdullah and Duki District Profiles, Government of Balochistan 2014-2015
  2. Community Insights, Common Thread December 2019
  3. Monthly Immunization Coverage Reports, IFRC
  4. Duki and Killa Abdullah District Profiles, Government of Balochistan 2014-2015
  5. Pakistan Demographic and Health Survey (PDHS) 2017-2018
  6. Women’s literacy: In European Journal of Scientific Research 


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