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KARACHI, PAKISTAN - APRIL 2011 While her half-naked young daughter crawls in the dirt, a displaced woman washes dishes and utensils outside her ramshackle shelter beside the busy roadside on the edge of Karachi city. Nine months on from the floods that devastated much of Pakistan, an estimated four thousand IDPs - Internally Displaced Person - from Jabobabad and Meher are still squatting in a single urban camp known as "Super Highway One", without the means to return home or rebuild their lives. MSF have been helping long-term climate refugees in Karachi, providing tents, water supplies and medical facilities to eight camps around Karachi including those on the Super Highway.

KARACHI, PAKISTAN- APRIL 2011 Herding his goats through piles of strewn rubbish, an urban farmer, makes his way along the disused railway line in Machar Colony. Located on the edge of Lyari town, the port side slum is home to an estimated 700,000 inhabitants; nearly double the population a decade ago.

KARACHI, PAKISTAN - APRIL 2011 Dressed in her old dirty, orange school uniform, displaced four year old Farzana crouches in the dirt of her family's makeshift roadside shelter at the edge of a three kilometre long camp known as Super Highway One on the periphery of Karachi. Along with her mother and younger sister, Farzana attends a weekly nutritional clinic every Monday where women and children from the camp receive medical attention and supplementary food. In addition to the clinic, MSF has been providing the stranded four thousand residents of the Super Highway camps with tents, safe water, sanitary items and medical assistance.

KARACHI, PAKISTAN- APRIL 2011 Under her family's shack constructed from wood covered with a PPP (Pakistan People's Party) campaign banner featuring a picture of President Asif Ali Zadari, a displaced girl from Jacobabad drinks a cup of water from a clay urn. Squatting for the past nine months in squalid conditions on the periphery of Karachi following the floods that devastated Pakistan in July, the three kilometer long camp known as Super Highway One, is supported by MSF who provides medical facilities and potable water to the estimated four thousand Internally Displaced Persons there.

KARACHI, PAKISTAN - MAY 2011 Tidying away blankets into a pile, seven months pregnant Radha cleans the shack that she shares with fifteen members of her extended family at the Super Highway camp on the periphery of Karachi city where they have spent the past nine months since being left homeless by last year's floods. Radha's husband Sultan has found work with MSF taking care of the camp's tented clinic and water supply and assisting the doctors who have been providing medical care for the displaced population. "I'm expecting my first baby and was in great pain so my family rushed me to the hospital where they said I was cursed. When the MSF doctors came to the camp they told me that such pains can be quite normal in pregnancy and have advised me to eat a better diet with less oily food and I'm feeling better now".

KARACHI, PAKISTAN - MAY 2011 In a small ragged encampment of largely Hindu IDPs - Internally Displaced Person - know as "Super Highway Two", a woman gathers thorny twigs from a pile of firewood as dusk settles. Nine months on from Pakistan's worst ever floods, more than four thousand climate refugees remain camped in squalid conditions along a three kilometer stretch of Karachi's Super Highway without the means to return home or rebuild their lives.

KARACHI, PAKISTAN- APRIL 2011. Displaced by the floods which destroyed their villages in interior Sindh nine months ago, a group of children aged between five and twelve years from Karachi's Super Highway Camp attend an informal school in a derelict building on the edge of the city. Run by a young teacher who lost his home during the deluge, approximately fifty girls and boys attend the morning classes despite the school having no facilities and there being no means for the pupils to afford writing materials.

KARACHI, PAKISTAN- APRIL 2011. Carrying their children in their arms, a group of women balance one gallon plastic jerry cans full of drinking water as they make their way from taps provided by MSF at Karachi's Super Highway One IDP camp. Home to four thousand IDPs from interior Sindh left homeless after floods devastated Pakistan last summer, stranded residents at the three kilometre long camp receive assistance from MSF who provide them with medical facilities, shelter and potable water.

KARACHI, PAKISTAN - APRIL 2011 As dusk falls and the lights of the Super Highway come on for the night, Ali Muhammad and his nine children gather outside their roadside shack for an evening meal of daal (lentils) as his wife cooks bread on an open fire. More than four thousand IDPs - Internally Displaced Person - have been squatting for the past nine months in squalid conditions on the periphery of Karachi following the floods that devastated Pakistan in July. Unable to return home to their villages in interior Sindh, residents at the three kilometer long camp known as Super Highway One, are supported by MSF who provide medical facilities and potable water.

KARACHI, PAKISTAN - APRIL 2011 Crouching down next to a polluted sewage canal filled with garbage, sixteen year old Gul Zada sits watching a burning pile of rubbish outside the ice stall where he works on the edge of Karachi's Machar (mosquito) Colony. Home to waves of refugees and economic migrants who have settled over the past two decades in the former fishing village, the illegal slum houses an estimated population of 700,000 who live in terrible conditions without access to safe water or medical facilities.

KARACHI, PAKISTAN - APRIL 2011 Outside her tent pitched next to Karachi's busy Super Highway, a woman rinses a drinking saucer as she transfers water collected from nearby taps into a traditional clay urn to keep it cool. Squatting in squalid conditions for the past nine months, the three kilometer long camp on the edge of Pakistan's biggest city is home to an estimated four thousand displaced flood affectees from interior Sindh. Without the means to return home or rebuild their lives, MSF have been helping long-term climate refugees in Karachi, providing safe drinking water, tents and medical facilities to eight camps around Karachi including those on the Super Highway.

KARACHI, PAKISTAN- APRIL 2011 As the lights come on at dusk along Karachi's Super Highway, a displaced mother and daughter fill a jerrycan from a water point provided by MSF that supplies some of the 4,000 residents of the three kilometer long roadside camp. Without the means to return home or rebuild their lives, MSF have been helping long-term climate refugees in Karachi, providing water, tents and medical facilities to eight camps around Karachi including those on the Super Highway.

KARACHI, PAKISTAN- MAY 2011. At a sprawling camp on Karachi's Super Highway, a girl runs alongside a shack constructed from pieces of bamboo, straw and old advertising banners. Squatting for the past nine months in squalid conditions on the periphery of Pakistan's largest city following the floods that devastated interior Sindh in July, the three kilometre long camp is supported by MSF who provide medical facilities and potable water to the estimated four thousand IDPs there.

KARACHI, PAKISTAN- APRIL 2011. Surrounded by shacks built of straw and wood, two men work shoveling stones and debris from the back of a truck as they reclaim land from the sea at the edge of the sprawling Machar (mosquito) Colony. Home to an estimated population of 70,000 migrants, the densely packed illegal slum has some of the worst living conditions in Karachi.

KARACHI, PAKISTAN- MAY 2011 Working his second job on a day off from peeling garlic in the local vegetable market, Munni's twelve year old Shaan helps out serving customers at a small grocery store located in the grounds of Karachi's Super Highway Two camp. Displaced from his rural home for the past nine months, Shaan is falling in love with the bright lights of Pakistan's largest city. "I have never gone to school. I used to work on a farm in Kotri but now that we're in Karachi, I work at Subzi Mandi and I sort garlic there. When we came here, we set up the tents. We used iron bars we found and covered them with cloth. I like living here in Karachi - my life is better here".

KARACHI, PAKISTAN- APRIL 2011 As her four year old daughter Faiza sits crying, mother of four Rabia tries to stop young children stealing sweets and crisps from the shop she runs in her shack as she cooks a dinner of spinach. Displaced from Sajadkot by the floods that devastated the region in August, Rabia and her family were displaced some twelve hours away to a camp at the edge of the Super Highway in Karachi. Along with the estimated 4,000 other residents, they have found themselves trapped in the city without the means to return to their damaged homes and rebuild their lives.

KARACHI, PAKISTAN - MAY 2011 Surrounded by women and children, thirty-five year old MSF Community Health Worker Mithi shows a series of cards and photographs as she describes to displaced residents living among the squalid conditions of Karachi's Super Highway Camp how to keep clean and healthy. Having escaped from her home in Kotri when flood waters devastated he surrounding land, Mithi's husband subsequently died of fever after they were displaced to a camp in Jamshoro. With nothing left of her life, she fled with her three daughters to seek refuge in Karachi, "We were dropped on the Super Highway without shelter, food or water. we cut the bushes and collected small logs, we used any cloth we had to make a shelter. People were dying from disease and in accidents on the busy road". Following MSF's intervention in Karachi's IDP camps, Mithi's new role as a health promoter has given her the courage to rebuild her own life as she helps others, "My husband died and it hurt; I don't want anyone to go through that. Now I am working with the doctors, I pray for everyone and I give advice. If everyone is happy, I'll be happy as well. They will pray for me and my children".

KARACHI, PAKISTAN - MAY 2011 Crouching down on the sandy floor, displaced mother of seven Tina cooks a dinner of daal (lentils) in her smoke filled straw shack located at a camp known as "Super Highway Two" on the edge of Karachi. Displaced for the past nine months after flood waters demolished her home in Kotri, Tina has been struggling to bring up her children in the squalid semi-urban conditions. With her baby son considered at risk of malnutrition and youngest daughter suffering from protracted stomach problems, Tina relies on the MSF doctors who visit the camp each Wednesday and trained Community Health Worker Mithi, to help keep her family healthy.

KARACHI, PAKISTAN - MAY 2011 Displaced women and their young children crowd into a waiting room as they wait to see a doctor at a weekly MSF nutritional clinic held in a tented surgery at Karachi's Super Highway Camp. Serving 4,000 flood affected IDPs living in squalid conditions in a three kilometer long camp along one of the city's main arteries, around 150 women attend the clinic where they can receive supplementary feeding for their children and free medicines every Monday.

KARACHI, PAKISTAN- MAY 2011 Surrounded by second-hand cushions, carpets and blankets, thirteen year old Kastu plays with her cousins at her aunt Munni's ramshackle shelter in Karachi's Super Highway Two camp. Displaced from their rural home in Kotri by the deluge nine months ago, like thousands of other climate refugees, the extended family plan to stay in the city in search of a new life.

KARACHI, PAKISTAN - MAY 2011 Seen through a shelter built of thorny branches and cloth, men crouch down as they drink cups of water amid the squalor of an IDP camp pitched on a patch of wasteland beside Karachi's main Super Highway Camp. Since floods devastated much of rural Pakistan in July and August last year, tens of thousands of climate refugees who were forcibly sent to the city remain, living in terrible conditions on the margins of the country's largest city.

KARACHI, PAKISTAN - APRIL 2011 On their way to class, children make their way through the moldy corridor of the tiny "Iqra Computerised Grammar School" in Karachi's Machar (mosquito) Colony. With no government schools serving the unofficial slum, only a small percentage of the mostly migrant children receive any education. At the fee paying Iqra school, there are no computers, no electricity and just four classrooms in which six hundred pupils are educated in three shifts.

KARACHI, PAKISTAN - APRIL 2011 Amid the chaotic streets of Karachi's Machar (mosquito) Colony slum, a young girl squeezes her way past a vegetable cart. Home to waves of migrants, the estimated 70,000 residents of the densely packed illegal slum have no access to water and live amid some of the worst conditions in Karachi.

KARACHI, PAKISTAN- APRIL 2011. Located on a disused railway platform, a bazaar stretches along the main road that separates Lyari Town from the unofficial Machar (mosquito) Colony slum in downtown Karachi. Home to waves of refugees and economic migrants who have settled over the past two decades around what was a former fishing village, the slum houses an estimated population of 70,000 who live in terrible conditions without access to safe water or medical facilities.