Introduction HANDS: Transforming Lives for Over Four Decades HANDS was founded in 1979 by Professor A.G. Billoo (Sitara-e-Imtiaz). Over the past 45 years, it has grown into one of Pakistan’s largest non-proï¬t organizations. In the last year alone, our initiatives have positively impacted 9.1 million individuals. Furthermore, our programs—spanning Health, Education, Livelihood, WASH (Water, Sanitation, and Hygiene), PI&T (Physical Infrastructure & Technology), and Inclusive Development & Disaster Management—are accessible to 36.7 million people. Our extensive operational network comprises over 11,500 personnel across Pakistan, managed through 36 branch ofï¬ces. This dedicated workforce is supported by countless volunteers who help advance our mission: improving the quality of life for all. Addressing Pakistan’s Multidimensional Challenges As a developing nation, Pakistan faces complex, interrelated challenges. Weak healthcare infrastructure and low awareness contribute to one maternal death every hour during childbirth. Additionally, 21.9% of the population lives below the national poverty line, struggling for basic survival. The education crisis is equally dire, with more than 22.8 million children out of school, perpetuating cycles of illiteracy. Access to clean water remains a critical issue, affecting over 21.7 million people, while 79 million lack basic sanitation facilities, exacerbating health and hygiene risks. Furthermore, approximately 20 million families