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Toorpakia, Maria & Holsten, Katharine. A Different Kind of Daguhter: The Girl Who Hid from the Taliban in Plain Sight. Hatchette Book Group 2016.

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Maria's parents came together through an arranged marriage. Her mother was educated more than most women and her father was said to be a madman because he spoke his mind to his tribe. It was said that their marriage would settele a blood feud between her mothers and fathers tribes. After their marriage ceremony her mother and father were alone at their home. Her mother had only heard rumour about her new husband and feared him. She soon learned that night that he was a gentel and just man who would not allow harm to be brought to her.

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Waziristan ( Pashto and Urdu: , "land of the Wazir") is a mountainous region covering the former FATA agencies of North Waziristan and South Waziristan which are now districts of Khyber Pakhtunkhwa province of Pakistan. Waziristan covers some 11,585 square kilometres (4,500 sq mi). The area is populated by ethnic Pashtuns. It is named after the Wazir tribe. The language spoken in the valley is Pashto, predominantly the Waziri dialect. The region forms the southern part of Pakistan's Federally Administered Tribal Areas, which is now part of Khyber Pakhtunkhwa province.

The 16th-century Pashtun revolutionary leader and warrior-poet Bayazid Pir Roshan, who wrote the oldest known book in Pashto, was based in Kaniguram, Waziristan.

Waziristan is Derived from the word ("Land of the Wazir") or "Land of Ministers" or " Loya Jirgas " respectively.

Waziristan lies between the Kurram river to the north and the Gomal River to the south. It is bordered by Bannu and Tank Districts, FR DI Khan, and Kurram Agency to the east and northeast, Sherani and Musakhel Districts of Baluchistan to the south in Pakistan and Khost, Paktia, and Paktika Provinces of Afghanistan to the west and north.

Waziristan is divided into two agencies now districts of Khyber Pakhtunkhwa province of Pakistan, North Waziristan and South Waziristan. According to 2017 census of Pakistan, the population of North Waziristan is 543,254 while that of South Waziristan is 674,065. The two parts have quite distinct characteristics, though both are inhabited by the Wazir tribe. They have a reputation as formidable warriors.

British Era

The British entered Waziristan in 1894, when the boundary with Afghanistan, so-called Durand Line was determined. They divided Waziristan into two agencies, North Waziristan and South Waziristan; they also introduced a regular system of land record and revenue administration for the most fertile part of the Tochi valley. After the British military operations, a Political Agent for South Waziristan was permanently appointed with its headquarters at Wanna; another was appointed for North Waziristan with headquarters at Miramshah.

Waziristan Revolt (1919-1920)

In the rugged and remote region of Waziristan on British India's northwest border with Afghanistan, mountain tribes of Muslim fighters rebelled against the British Indian Army in numerous operations. The Waziristan Revolt of 1919-1920 was sparked by the Afghan invasion of British India in 1919. Though the British made peace with the Afghans, the Waziri and Mahsud tribesmen gave the imperial (almost entirely Indian) forces a very difficult fight. Some of the tribesmen were veterans of the British-organised local militias that were irregular elements of the British Indian Army, and used some modern Lee-Enfield rifles against the British Indian forces sent into Waziristan. One aspect of this conflict was the effective use of air power against the Waziris and Mahsuds. This is similar to Royal Air Force tactics in suppressing the Arab Revolt in Iraq in 1920 and 1921.

Faqir of Ipi

In 1935-36, a Hindu-Muslim clash occurred over a Hindu girl of Bannu, who was abducted and forced to convert to Islam. The tribesmen rallied around Mirzali Khan, a Tori Khel Wazir, who was later given the title of "the Faqir of Ipi" by the British. Jihad was declared against the British. Mirzali Khan, with his huge lashkar (force), started a guerrilla warfare against the British forces in Waziristan.

In 1938, Mirzali Khan shifted from Ipi to Gurwek, a remote village on the Durand Line, where he declared an independent state and continued the raids against the British forces. In June 1947, Mirzali Khan, along with his allies, including the Khudai Khidmatgars and members of the Provincial Assembly, declared the Bannu Resolution. The resolution demanded that the Pashtuns be given a choice to have an independent state of Pashtunistan, composing all Pashtun majority territories of British India, instead of being made to join Pakistan. However, the British Raj refused to comply with the demand of this resolution. After the creation of Pakistan in August 1947, Mirzali Khan and his followers refused to recognise Pakistan, and launched a campaign against Pakistan. They continued their guerilla warfare against the new nation's government. He didn't surrender to the government of Pakistan throughout his life. However, his popularity among the people of Waziristan declined over the years, with many jirgas in Waziristan deciding to support Pakistan. He died a natural death in 1960 in Gurwek.

US War on Terror

In the early stage of the U.S. invasion of Afghanistan, when the Taliban started fleeing into Pakistan, the local leaders, or Maliks, began a campaign among their locals to host the foreigners. Since then, around 200 Maliks have been assassinated by local Taliban through targeted killings.[citation needed ]

To end the Waziristan war, Pakistan signed the Waziristan Accord with chieftains from the self-styled Islamic Emirate of Waziristan on 5 September 2006. The Islamic militants in Waziristan are said to have close affiliations with the Taliban. Waziristan is often mentioned as a haven for al-Qaeda fighters. There is speculation that some al-Qaeda leaders have found refuge in the area controlled by the Emirate, which is a staging ground for militant operations in Afghanistan.

On 4 June 2007, the National Security Council of Pakistan met to decide the fate of Waziristan and take up a number of political and administrative issues in order to control the "Talibanization" of the area. The meeting was chaired by President Pervez Musharraf and attended by the Chief Ministers and Governors of all four provinces. They discussed the deteriorating law and order situation and the threat posed to state security. The government decided to take a number of actions to stop the "Talibanization" and to crush the armed militancy in the Tribal regions and the NWFP.

Due to the ongoing military operations against the Taliban, nearly 100,000 people have already fled to Afghanistan's Khost province to seek shelter. The UN and other aid agencies are helping more than 470,000 people who have been displaced from Pakistan's North Waziristan region due to the ongoing military operations.

The Ministry of the Interior has played a large part in the information gathering for the operations against the militants and their institutions. The Ministry of the Interior has prepared a list of militant commanders operating in the region and they have also prepared a list of seminaries for monitoring. (Waziristan is a tribal area, and in any tribal area of Pakistan, no body can deploy police. There are other options like frontier corps (militia) and khasadar (local tribesmen force).) The government is also trying to strengthen law enforcement in the area by providing the NWFP Police with weapons, bullet-proof jackets, and night-vision devices. The paramilitary Frontier Corps is to be provided with artillery and APCs. The state agencies are also studying ways to jam illegal FM radio channels.

The US drone strikes programme has been responsible for numerous bombings in Waziristan, carried out with the approval of the Pakistani government.

The Wazir tribes are divided into clans governed by male village elders who meet in a tribal jirga. Socially and religiously, Waziristan is an extremely conservative area. Women are carefully guarded, and every household must be headed by a male figure. Tribal cohesiveness is also kept strong by means of the so-called Collective Responsibility Acts in the Frontier Crimes Regulations, which has since been repealed following the merger of FATA to Khyber Pakhunkhwa in May, 2018.

Taliban presence in the area has been an issue of international concern in the War on Terrorism particularly since the 2001 invasion of Afghanistan. In 2014, about 929,859 people were reported to be internally displaced from Waziristan as a result of Operation Zarb-e-Azb, a military offensive conducted by the Pakistan Armed Forces along the Pakistan - Afghanistan border.

North Waziristan's capital is Miranshah. The area is mostly inhabited by the Dawar Tribe and the Utmanzai branch of the Darwesh Khel Waziris, who are related to Ahmedzai Waziris of South Waziristan, who live in fortified mountain villages, including Razmak, Datta Khel, Spin wam, Dosali, Shawa and Shawal. The Dawars (also known as Daurr or Daur), who live in the main Tochi Valley, farm in the valleys below in villages including Miranshah, Hamzoni, Darpakhel, Muhammadkhel, Boya, Degan, Banda, Ngharkali, Palangzai, Mirali, Edak, Hurmaz, Mussaki, Hassukhel, Ziraki, Tapi, Issori, Haiderkhel and Khaddi irrigated by the river Tochi.

The South Waziristan has its district headquarters at Wanna. South Waziristan, comprising about 6,500 square kilometres (2,500 sq mi), is the most volatile agency of Pakistan. Not under the direct administration of the government of Pakistan, South Waziristan is indirectly governed by a political agent, who has been either an outsider or a Waziri-a system inherited from the British Raj. In south Waziristan Agency, there are three tribes, Wazir, Maseed and Burki. Burki and Urmarh is the same tribe.

Fürstenberg, Kai (2012) Waziristan: Solutions for a Troubled Region in Spotlight South Asia, No. 1, ISSN 2195-2787 (http://www.apsa.info/wp-content/uploads/2012/10/SSA-1.pdf Archived 7 September 2015 at the Wayback Machine)

Roe, Andrew M. Waging War in Waziristan: The British Struggle in the Land of Bin Laden, 1849-1947 (Lawrence: University Press of Kansas, 2010) 313 pages

Operations in Waziristan 1919-1920, Compiled by the General Staff, Army Headquarters, India, 1923 (Reprinted by Naval & Military Press and Imperial War Museum, ISBN 1-84342-773-7)

Systems of Survival (1992) by Jane Jacobs. Jacobs cites a story from the 16 July 1974 issue of The Wall Street Journal in which a Pathan husband in Waziristan reportedly cut off his wife's nose because he was jealous. Thinking the better of it, he took her to a surgeon to have the injury repaired. Upon finding out that an operation would cost thirty rupees, he called it off, saying he could buy a new wife for eighty rupees. Jacobs cites this incident as evidence contradicting the platitude that society is based on the family. Instead, each family is based on whatever society it finds itself in. (Jacobs' discussion in her book is viewable on Amazon.com. Search for "Pathan".)

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Waziristan ( Pashto and Urdu: , "land of the Wazir") is a mountainous region covering the former FATA agencies of North Waziristan and South Waziristan which are now districts of Khyber Pakhtunkhwa province of Pakistan. Waziristan covers some 11,585 square kilometres (4,500 sq mi). The area is populated by ethnic Pashtuns.

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When Maria was four, she would stay at home while her siblings and mother were at school and her father at work. Her neighbors would check up on her to see if she was alright and Maria would spend most of her time on the roof of her house. While up there, one day, she saw a group of men playing a game with a white ball and it fastinated her enough to lure her off the roof. She watched at a distance, hidden, and would copy their motions. One of the hits led the ball in her direction and she picked it up and hit it back. The men were shocked and walked over to her and Maria had said, " 'I would like to play,' I said, half smiling, no idea at all how wrong I was about that"(30). The men laughed and one of them walked over and hit her 3 times which was enough to draw blood and leave a bruse.

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Maria was more of a tom-boy and was always watching the neighborhood boys play their games. One day Maria had a sudden surge of anger and grabbed all her dresses and took them outside. She lit them on fire with kerosene. As the fire died down, her father stood next to her but said nothing. "When I finally turned and caught sight of him standing there, I could see that he was stunned but not angry; I saw in his face a recogonition of the very thing he always hoped I would harness-pure Wazir courage"(56). Her father understood that she did what needed to be done. From then one she was know to be Ganghis Khan as a way for her to embrace her more masculen side without judgment of others.

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Maria Toorpakia had thought all the roles were set in life, but she learned differentley when her family started to do what they believed to be right. Round the age of 5 years Maria cut her hair short like a boy, her mother went to school and her father had no problem with this. The people of their community did not accept this and Maria's family became outcasted. Since then they lived moving town from town. Maria made her appearance to look of a boy and would go to shops to collect food. One night, after the sun set and during Ramadan, she was in a shop when a group of men walked in and killed 3 others in the store. The killers took the bodies and left the shop owner and Maria in shock. That day Maria said some of her childhood was lost.

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Maria and her sister's only and biggest influencer was Benazir Bhutto- her father was the former priminister during the time. Ayesha, Marai's sister, was to be a polititain and at the age of 9 was giving speaches to crouds of men. The day Benazir Bhutto was killed, Maria and her family were watching the tv as Bhutto returned to Pakistan again. The next few week, the government had been trying to cover up the incident and call it an accident. Maria wondered why it even mattered how the death happened and her father responded, "Maria, everything is in the how. A gunshot makes a martyr, An accident makes a fool"(73).

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Maria was close to the age of 8 and would always be running around in her free time, all over the roofs. One day she saw a group of boys playing with a kite and chased after it with them. At some point the kite came down low enough to reach and out of sudden, unexpected anger, Maria reached out and ripped it apart. The group of boys were angered and chased after her- but she easily out ran then as well as the fact that she ran across roofs. When she stopped she ended up at a refugee camp think that their blue tents was the ocean of water. She came down from the roof seeing starved children and women and suddenly she was surrounded by a group of hungry and agressive boys. They beat her up and ripped up her bag of fruits and her cloths, they took her shoes and ran. After this encounter, Maria had nightmares of those boys returning again.

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Maria was arriving at the age of 10 when her family moved to a new city. This city was known for the making and exporting of guns. After an incident that occurred at home, Maria's father had her carry a gun. She did as her father asked and kept it with her when she went exploring around the city. On these trips, this boy would always follow but would leave when he tired. This day he didn't and continued to pursue Maria until she stopped and gave in to her tire. She feared the worst from him and pull her gun out but the boy only wanted to ride her bike. She put her gun away and walked him to her house but couldn't help but wonder what she might have ended up having to do. She though, "For a moment it seemed that I'd stepped out of my own skin."(109).

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Maria had visited her neighbors home and came back home with many questions. Once her father arrived home, she began to ask about why there were so many paintings and books all over the neighboring woman's home. Her father understood her curiosity and told her that the women must be a religious scholar. He then went on to explain how there are many other religions around the world who worship similarly but call their God by another name.

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When Maria was 10, her family moved to a city that was very loud. Maria did not have the same freedom as she did in the other places she lived before but she made it work. She would go on bike rides and one day decided to look for a fight. After the fight she relised that she enjoyed the power she felt when she stood over her opponent in victory and they lay in fear and weakness. After her second fight, she was hurt badly and her father took her to the hospital and reminded her of what her fighting inspiration once said, "You gotta be a moron to want to be a fighter"(143).

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Maria continued her street fights till her father caught her in a fight on the streets at the age of 12. He then entered her- and her 16 year old brother so he can watch over her- in the sport of weight lifting. After 8 months, they both entered a competition but had to make sure Marias' true gender stayed hidden. They thought that Maria would have to step down from this chance when they faced the problem of weighing themselves in public but were spared when they were permitted to keep their clothes on. After the competition was over Maria won a silver medal but realized her brother had been tense the whole trip out of fear that his sister would be discovered. He told her, "If they ever find out what you did in Lahor, Maria, beating them that way, they'll hunt you down, believe me- they'll hunt you down, and they will kill you"(160).

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HBO The Chosen One from Cassandra Rosenthal on Vimeo.

Pakistan's Maria Toorpakai had to live as a boy to play sports under the Taliban rule. Now she is one of the top female squash players in the world. Real Sports premiered on HBO.

Chingaiz Khan was an unknown quantity when he arrived for a junior weightlifting tournament in South Waziristan nine years ago. Chaotic and intensely religious, the Pakistani region is known by locals as "the most dangerous place in the world." The 12-year-old Chingaiz, with his short, jet-black hair and smooth, unblemished skin, looked younger than the other boys. But, despite it being his first ever tournament, he was still stronger than everyone else.

For his father Shams-Ul Wazir, a local college lecturer, the decision to register his son for the tournament paid off handsomely.

Chingaiz was crowned the junior boys' weightlifting champion, the first step on a journey that would take him into the world of professional sport. Except Chingaiz wasn't really his name. Chingaiz was actually called Maria Toor Pakay.

Chingaiz was a girl. "I suggested the name of Chingaiz Khan for her since she had always been like a boy," explained Al Wazir in an interview with HBO. "She liked the name very much."

This isn't a story of deception, but rather a tale of necessity. Maria Toor Pakay is Pakistan's number one squash player, ranked 49th in the world. She also comes from an ultra conservative region in Pakistan that is home to the Taliban.

Female participation in any form of public life is strongly discouraged, by both words and deeds. Education, working, sports; anything involving women leaving the house unaccompanied by a male relative was seen as the work of the devil.

But Pakay had talent. Her weightlifting triumph gave her access to a world of sporting options that would otherwise have been out of bounds to her as a female, and she discovered the discipline where she would make her name. Squash is one of Pakistan's most popular games and Pakay excelled at it. By the age of 21 she had gone pro and broken into the world top 50, an incredible rise up the world rankings. She is one of only three Pakistani women in the top 200; by contrast the nation has 15 men in the same strata. Yet her success has come at a price. Pakay and her father have been threatened with retribution by the local Taliban for insulting their culture and their religion.

"My area, my tribal regions are called the hub of terrorism and extremism," said Pakay. "It's the home to the Taliban, and it's called the most dangerous place in the world. But I have a big vision for my country, and for my people it will be stopped. I always thought that maybe I'm the chosen one."

Pakay realized at a young age that she was different to other people she saw in her community. "When I was four and a half, I told my parents that I want clothes like my brother," she said. "I want to play with boys, there's more freedom, I felt. And I am not like girls who play with dolls. I want the toy guns and things like that." Such behavior was anathema to the deeply conservative community she was born into. But her father agreed. Rather than forcing his daughter to conform, he thought about how best to realize his daughter's talent. It was he who came up with the plan to cut his daughter's hair and enter into competitions with the boys.

"They (religious elders) sent me to a mental asylum 'cause they thought that I had deviated from the culture, and that I was crazy supporting women's rights," he recalled. "They said I was spoiling the whole environment and that all women would want the same rights." With the boys' junior weightlifting title under her belt, Pakay decided to enter a boys' squash tournament. Her disguise was scuppered by bureaucracy. "My dad said, 'This ... that's my son,' " Pakay recalled of the moment her father presented her to be registered. But the official dropped a bombshell. "He said, 'OK, we need the birth certificate, too.' "

After defeating boys in weightlifting at age 12, Toorpekai turned to squash and having to produce a birth certificate gave up pretending to be a boy. She became the first tribal Pakistani girl in international squash tournaments, turning professional in 2006. In August 2007, the President of Pakistan bestowed the Salaam Pakistan Award upon her. She was threatened by the Taliban and locked herself in her house for the following 3 years. In 2009, she won third place in the world junior women's squash championship. In 2011 she arrived in Toronto, Canada to train. As of 2012 she was Pakistan's No. 1 female squash player, and as of May 2016 she is ranked 56th among female players in the world.

Early life and education

Maria Toorpakay was born into a Pashtun family on November 22, 1990 in South Waziristan, a tribal region in northwest Pakistan, bordering Afghanistan. Her parents are teachers who are committed to women's rights despite the presence of the Taliban in the region. She credits her father's time spent with and learning from German and Icelandic hippies visiting the area in his youth for his autodidactic education and supportive attitude toward women's education, which included education of her mother. Her father's name is Shamsul Qayum Wazir, also spelled Shamsul Qayyum Wazir. Her sister is Aisha Gulalai, a Pakistani politician working to empower women in tribal areas.

As a child, Toorpakay loved to play outside, even though girls are not allowed to go outside the house in the highly conservative tribal area. At age 4, her parents allowed her to dress in boys' clothes and by age 7 she lived as a boy. Before fifth grade she burnt all her dresses. Her father saw parallels to his tomboy sister, who "just collapsed one day and he thought she died basically of a broken heart, because she wasn't allowed to live the life that she wanted to live."

In 2002, Toorpakay's father put her into weightlifting in Peshawar to "channel her negative energies" and introduced her with the name Genghis Khan. She trained and competed as a boy with the explicit support of her father. At age 12 she won a junior championship in Lahore, and manged to keep her clothes on for the mandatory weighing, because her brother refused to take off his clothes and created a protective precedent. She became captivated by squash after observing it, where she was weightlifting, and saw it as her next challenge. Her father took her to a squash academy and after needing to produce a birth certificate, gave up pretending that she was a boy. The truth about her gender leaked out, and she had neither training partners nor coach and trained by herself for hours. She was harassed and bullied by other players, boys and men.

Career

In 2006, Toorpakay turned professional. As a female athlete who played without a veil and in shorts, her actions were perceived as "un-Islamic". It was in 2007, she recalls, two years before Malala Yousafzai was shot, that the Taliban threatened to kill her and her family. The Pakistani national squash federation provided security by "snipers around my house, all the way to the squash court and on the squash court". She recalls "There was a bomb blast every day. [...] terrible things [...] happening all around me."

Toorpakay decided it was safer for everyone if she found an opportunity to train internationally. She wrote to clubs, players, and schools and received no response; for three and a half years she "locked herself in a room in [her] house." She said she kept playing squash, hitting balls against her wall, until her neighbors complained one day. "I had to switch the wall. But I kept going". Eventually former professional squash player Jonathon Power replied and in 2011, she arrived to train in his academy in Toronto, Canada.

As of 2012 Toorpakay was ranked as Pakistan's top female squash player. In 2013 she was one of three Pakistani women in the top 200. and as of May 2016, she ranked 56th of female squash player in the world.

In 2013, she gave a speech for Tedxteen called 'Squashing Extremism'.

Awards

In August 2007 the President of Pakistan gave her the Salaam Pakistan Award, alongside tennis player Aisam Ul Haq Qureshi and footballer Muhammad Essa.

In late August 2007, at almost 17, she lost a five-game semi-final in the POF Women's International Squash Players Association Wah Cantt Open at the Jahangir Khan Squash Complex in Wah Cantt, Pakistan, missing out on a maiden appearance in a WISPA World Tour final; she was nominated as "Young Player of the Year 2007". In 2009, she won third place in the World Junior Women's Squash Championship. In October 2012 she won the first annual Voice of Hope Award from Canadian First Lady Laureen Harper.

Personal life

Since 2011 Toorpakai has resided in Toronto, Canada, and has a home in Pakistan. She lives alone "but I don't go out to party or drink, because I want to set a standard for the girls back home."In May 2016, she published her memoir, for which she was interviewed by Terry Gross on National Public Radio's Fresh Air.

Toorpakai is an advocate for women's rights in Pakistan to "overcome discrimination and cultural obstacles". She has set up a foundation encouraging families to educate girls and allow them to play sports.

She has said she hopes to get academic training in music.

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HBO The Chosen One from Cassandra Rosenthal on Vimeo. Pakistan's Maria Toorpakai had to live as a boy to play sports under the Taliban rule. Now she is one of the top female squash players in the world. Real Sports premiered on HBO.

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Maria grew bored quickley of the consistencey of weight lifting. Her father took notice in this and guided and encouraged her to look for something else that might catch her eye, and she did. She found the game of squash and told her father all about it. The next day, they both went to regester her and when the man behind the desk asked for her birth certificate, they both grew scared. In the end, they told the man Maria's true gender. The man reacted well and was excited for her to start.

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Maria became almost obsessed with squash because she knew she would have to be better than all the boys who were to be on the team, to prove her place to them. There was one boy who was the leader of the group and he would throw insults at Maria saying how she played like a girl and couldnt run. The next time she saw him, she decided she would go against each of the boys there, all 14, to see them lose. When the "leader" went against her, Maria surved first but when she hit the ball, she hit it so hard it broke in two. When she got a new ball and began again, the boy feared her strength. In the end as the boy walked off the court he turned to Maria and said, "I will pray for your father. No man, whatever his sins, should have a slut like you for a daughter"(192). Maria got so mad and asked if he wanted to fight her and was yelling at him. He was practically shaking with fear as he backed away from her.

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Maria put squash to rest because of the continuous harassment and tried school again. She stopped that too because she could never focus. Maria would roam the streets on her bike and saw a man one day. He seemed to be high and had a pistol similar to the one she used to have. She slowed and the man reached out and grabbed her bike by the wheel, telling her he had seen her around before. Maria was very scared and when she felt the strong man's grip loosen, she fight away from him and went home. She eventually told her father because the man would not stop stalking her. Her father talked to the man in a calm manner telling him to leave his family alone and the man nodded along, apologized, and left. Maria was angered her father did not hurt him for what he did but her father said, "The scorpion venom that man smoked is not nearly as dangerous as the poison in his mind"(213). Her father knew that man was dangerous and if he was messed with, there were people who would come out and cause harm to their family.

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Maria picked up raquet again and when she went back to the training complex, she did not worry about being accepted by the boys, she only wanted to play. They boys eventually did because of the long hours she practied. Her coach found a tournament she could play in against other girls and when she walked up the counter for regestration, her coach had to step outside for a little while, so she was alone. The man behind the counter did not believe her when she told him she was a girl and brought lots of attention to her. The other girl who she would play against were watching her but at some point her coach came back and showed her birth certificate and she was saved. The man was unbelievably shocked.

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Maria entered in another competition in Punjab against other girls. There she lost every match and was about to leave when her coach convinsted her to come back and stay for the next days to come. Maria stayed but she never won. During the trial days, they were told that they were postponing because of war between Iraq and USA. Maria believed this was a sign from Allah and that Allah is giving her another chance. When the trials began again, Maria won every game and went home with a huge money prize. Her coach never let her walk off the court during the first trials and her father was forever greatful that he gave Maria such faith in herself.

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In 2006 the violence in Pakistan grew. Maria's father was a professor and would teach college students but his school was looted and bombed. Maria came home and found him sitting in his chair, missing a shoe, cuts all over his hands, face covered in dust and his shirt ripped. Her mother was a principle and she arrived at school one day with all of the girls standing outside, looking at the chalkboard on the walls of the school. The chalkboard said that they would bomb the school and whoever entered, was writing their own death. Her mother told her,"We were all scattered all over the gorund like seeds. What could we do? We saw the smoke. We all cried. The girls went home." Maria asked if her mother say who had done it. "There is no who, Maria-there is just a them. No faces, no souls- they are bombs adn bullets and cries to Allah in the mountains"(262).

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Insurgency in Khyber Pakhtunkhwa

Part of the War on terror and the
spillover of the War in Afghanistan (2001-2021)

Intelligence map: Navy intelligence maps shows the districts of the FATA in blue and Khyber-Pakhtunkhwa in green.

Belligerents

Pakistan

Insurgents

ISIL-aligned groups

Commanders and leaders

Pervez Musharraf
Ashfaq Kayani
Asif Ali Zardari
Nawaz Sharif
Mamnoon Hussain
Arif Alvi
Raheel Sharif
Qamar Javed Bajwa
Imran Khan
Masood Aslam
Tariq Khan
Rao Qamar Suleman
Tahir Rafique Butt
Sanaullah Niazi †

Noor Wali Mehsud
Maulana Fazlullah †
Khan Said 'Sajna' †
Adnan Rashid
Mangal Bagh †
Hakimullah Mehsud †
Abdullah Mehsud †
Baitullah Mehsud †
Maulvi Nazir †
Faqir Mohammed (POW)[25]
Nek Muhammad Wazir †
Abdul Rashid Ghazi †
Sufi Muhammad (POW)[26]
al-Qaeda
Ayman al-Zawahiri
Osama bin Laden †
Ilyas Kashmiri †
Mohammad Hasan Khalil al-Hakim †
Atiyah Abd al-Rahman †
Abu Laith al-Libi †
Abu Yahya al-Libi †
Abu-Zaid al Kuwaiti †
Fahid Mohammed Ally Msalam †
Sheikh Ahmed Salim Swedan †
Sheikh Fateh † [27]
Adnan Gulshair el Shukrijumah † [28]

ISIL
Abu Bakr al-Baghdadi †
Hafiz Saeed Khan † [29]
Abdul Rahim Muslim Dost (2014-2015)[30][31]
Usman Ghazi † [4][32]
IMU Group
Usman Ghazi †
Tohir Yuldashev †
Najmiddin Jalolov †
Abu Usman Adil †
Mirzazhanov Atoyevich (WIA)

Strength

Pakistan
200,000 Pakistani troops[33][34]
Unknown no. of air squadrons of Navy and Pakistan Air Force fighter jets, including JF-17 and F-16 jets[35]
~10,000 Frontier Corps
United States
UAV drones
CIA operatives
U.S. Special Forces[36]

~25,000 TTP militia[37]
~2,000 Lashkar-e-Islam militia[38]
~1,000 TNSM militia[39]
300-3,000 al-Qaeda militants[40]

ISIL

Casualties and losses

Pakistan:
4,631 soldiers and LEAs killed (per SATP)[21][22]
8,214 killed soldiers and LEAs and 14,583 wounded (per the Watson Institute; by mid-2016)[42]
United States:
15 soldiers killed (2010)[43]
29,398 militants killed (per SATP)[21][22]
31,000 killed (per the Watson Institute; by mid-2016)[42]

9,394 civilians and 1,946 unidentified killed (per SATP)[21][22]
22,100 civilians killed (per the Watson Institute; by mid-2016)[42]
45,369 killed overall (per SATP)[21][22]
61,549 killed overall (per the Watson Institute; by mid-2016)[42]
41,819 killed overall all over Pakistan (Uppsala Conflict Data Program; 1989-2019)[44]

Over 3.44 million civilians displaced (2009)[45]
Over 6 million civilians displaced (2003-2019) [46]

The insurgency in Khyber Pakhtunkhwa, also known as the War in North-West Pakistan and Pakistan's war on terror, is an ongoing armed conflict involving Pakistan, and Islamist militant groups such as the Tehrik-i-Taliban Pakistan (TTP), Jundallah, Lashkar-e-Islam (LeI), TNSM, al-Qaeda, and their Central Asian allies such as the ISIL-Khorasan (ISIL), Islamic Movement of Uzbekistan, East Turkistan Movement, Emirate of Caucasus, and elements of organized crime. Formerly a war, it is now a low-level insurgency as of 2017.

The armed conflict began in 2004 when tensions rooted in the Pakistan Army's search for al-Qaeda fighters in Pakistan's mountainous Waziristan area (in the Federally Administered Tribal Areas) escalated into armed resistance. Pakistan's actions were presented as its contribution to the international War on Terror. Clashes further erupted between unified Pakistan Armed Forces and the Central Asian militant groups, allied with the Arab fighters, in 2008-2010. The foreign militants were joined by Pakistani non-military veterans of the Afghan War to the west, which subsequently established the TTP and other militant umbrella organizations, such as Lashkar-e-Islam.

The war depleted the country's manpower resources, and the outcomes outlined a deep effect on its national economy, since Pakistan had joined the United States-led War on Terror. According to the Ministry of Finance (MoF) statistics and mathematical data survey collections, the economy has suffered direct and indirect losses of up to $67.93 billion since 2001 due to its role as a "frontline state." According to the MoF-issued Pakistan Economic Survey 2010-2011, "Pakistan has never witnessed such a devastating social and economic upheaval in its industry, even after dismemberment of the country by a direct war with India in 1971."

By 2014, the casualty rates from terrorism in the country as a whole dropped by 40% as compared to 2011-2013, with even greater drops noted in Khyber Pakhtunkhwa despite the province being the site of a large massacre of schoolchildren by TTP terrorists in December 2014. The reduction in hostilities eventually changed the conflict from a war to a relatively low-level conflict.

In the aftermath of Battle of Tora Bora (lit. Black Caves), formal troop deployment was begun by the Pakistan Army, at the behest of the Pakistan Government, in 2002. The conservative parties, most notably the Pakistan Muslim League, were very critical of such troop deployments in the region. The XI Corps, under its commander Lieutenant-General Jan Aurkzai, entered the Tirah Valley in the Khyber Agency for the first time since Pakistan's independence in 1947. The army troops later moved into the Shawal Valley of North Waziristan, eventually entering South Waziristan. A monitoring reconnaissance base was established by the Special Service Group [Navy] in 2003. Criticism of Musharraf and the United States grew in Peshawar by a massive communist party in 2003, demanding an end to the operations.

In 2003, the troubles mounted as the Tribes began to see military's deployment and repeated PAF's flights in the region as an act of subjugation. In 2003-04 public speeches, Musharraf repeatedly called for the eviction of the foreign fighters from the South Waziristan and justified the army deployments in the region despite the concerns. In December 2003, at least two assassination attempts against President Pervez Musharraf were traced to South Waziristan. The government responded by intensifying military pressure on the area. However, the fighting was costly: government forces sustained heavy casualties throughout 2004 and into early 2005, when the government switched to a tactic of negotiation instead of direct conflict.

On 16 March 2004, a bloody mountainous battle between the Pakistan Army troops and the foreign fighters of al-Qaeda was fought in the White Mountains of South Waziristan. The Pakistani media speculated that Pakistan Army had surrounded a "high value target" in the mountainous region, possibly al-Qaeda's then-second-in-command Ayman al-Zawahiri. According to the military intelligence in 2004, all militants were Chechens, Uzbeks, and Tajiks who were trying to flee Black Caves ( Tora Bora of Afghanistan). After a week of the battle, the entire area was captured and as many as 400 al-Qaeda operatives were apprehended by the Pakistan Army. In spite of its success, the army failed to capture Zawahiri. The ISPR later admitted that it was Soviet Uzbek Tohir Yo'ldosh who was surrounded, not Zawahiri.

By 2004, additional battalions were stationed by General Musharraf to help curb infiltration into Pakistan through its porous border. The Military Intelligence, Covert Action Division (CAD) and army troops found many caves and tunnels in White Mountain range used by the foreign fighters before the military action took place. The Military Intelligence accounts maintained that the tunnels were led into Afghanistan, possible Tora Bora region. Though it is difficult to know how effective the cordon was on the first night of the military suspension but the military intelligence accounts did confirm that many high-value foreign fighters might have escaped through these tunnels and caves back to Afghanistan.

In April 2004, the Government of Pakistan signed the Shakai agreement, first of three peace agreements with militants in South Waziristan. It was signed by militia commander Nek Muhammad Wazir, but was immediately abrogated once Nek Muhammad was killed by an American Hellfire missile in June 2004.

The second one, Sararogha Peace Agreemen, was signed in February 2005 with Nek's successor Baitullah Mehsud, which brought relative calm in the South Waziristan region. This deal would later, in September 2006, be mimicked in the neighboring North Waziristan territory as the third and final truce, Miranshah Peace Accord, between the government and the militants. However, all of these truces would not have a substantial effect in reducing bloodshed. The latter two deals were officially broken in August 2007 with the start of Operation Silence which was initiated by Islamabad, and resulted in a tenfold increase in suicide attacks on Pakistan Armed Forces.

Transition in tribal areas: 2005-06

The ISI's Covert Action Division (CAD) and the Special Services Group conducted a secret paramilitary operation to capture a high-ranking al-Qaeda operative Abu Faraj al-Libbi on 4 May 2005, after a raid outside the town of Mardan, 50 kilometres (30 mi) northeast of Peshawar. His arrest was confirmed by the Government sources and noted as " al-Libbi was a high ranking al-Qaeda official, rumored to be third after Osama bin Laden and Ayman al-Zawahiri." Al-Libbi replaced Khalid Shaikh Mohammed after his arrest in March 2003 in connection with the 11 September attacks. The Pakistan government arrested al-Libbi and held him on charges in relation to being a chief planner in two assassination attempts on the life of President Pervez Musharraf in December 2003.

On 13 January 2006, the United States Air Force launched an airstrike on the village of Damadola. The attack occurred in the Bajaur tribal area, about 7 km ( mi) from the Afghan border, and killed at least 18 people. The attack again targeted Ayman al-Zawahiri, but later evidence suggests he was not there.

In 2006, the government witnessed the successful implementation of the peace deal between two tribes in Kurram Agency over the issue of distribution of irrigation water. Promptly, the government accepted the tribal recommendation to sign a peace deal with the militants in North Waziristan. Signed on 5 September 2006, the agreement was called the " Waziristan Accord"- an agreement among tribal leaders, militants, and the Pakistan government was signed in Miranshah, North Waziristan. to end all fighting. The agreement includes the following provisions:

The Pakistan military will help reconstruct infrastructure in tribal areas of North and South Waziristan.

The Pakistan military will not tolerate any assistance to intruders in North Waziristan, and will monitor actions in the region.

The Pakistan government is to compensate tribal leaders for the loss of life and property of innocent tribesmen.

"Foreigners" (informally understood to be foreign jihadists) are not allowed to use Pakistani territory for any terrorist activity anywhere in the world.

2,500 foreigners who were originally held on suspicion of having links to the Taliban were to be detained for necessary action against them.

The agreement, dubbed the Waziristan accord, has been viewed by some political commentators as a success for Pakistan. Even the military commander of the Pakistan Army, Lieutenant-General Ali Jan Aurakzai, also welcomed the peace agreement as "unprecedented in tribal history" and credited the intertribal jirga with amicably resolving a complicated issue within a few weeks.

On 30 October 2006, United States conducted a deadly missile airstrike on a madrassa in the Bajaur region bordering Afghanistan. The strike killed 82 seminary students. Long War Journal blamed U.S. for the air strike as only U.S. was able to conduct precision night strikes in the region.

Sahibzada Haroonur Rashid, MNA from Bajaur Agency, resigned from the National Assembly on Monday to protest against the bombing of a madressah in his constituency.

In retaliation for the attack the militants unsuccessfully fired a series of RPG rockets on the heavily fortified security camp of Governor and Lieutenant-General Jan Aurkzai; though his convey escaped unharmed on 8 November 2006. The same day, the militants coordinated a successful suicide bomb attack on military base in Dargai, about 100 km north of Peshawar. The suicide attack killed nearly 42 Pakistani soldiers and wounding 20 others. Military intelligence investigators later testified in media that suicide bombing had a direct link with the air strike.

Insurgency in the north, 2007

As early as 2007, the northern region had been suffering with an insurgency and President Musharraf was increasingly under great pressure from the militants when several army operations outlined mixed results. In March, his government signed a peace treaty with Fakir Mohamad, the main militant leader in Bajaur. Militant groups then held three districts in the Federally Administered Tribal Areas: South Waziristan, North Waziristan and Bajaur Agency.

Waziri-Uzbek tensions

In South Waziristan, the Uzbek militancy had been growing as many former Soviet fighters-turned militants were reportedly seen encircling in the area; many of the military intelligence reports indicated the movements of former Soviet fighters in the region, mostly Uzbeks and Chechens from the troubled areas of the Russian Federation.

In 2007, the fighting sparked between the Uzbek fighters and the native militant groups by the killing of Arab fighter Saiful Adil, an al-Qaeda operative, blamed on the Uzbeks fighters by Maulvi Nazir, described as a top pro-Taliban militant commander in the region. According to the other version, the fighting started after Maulvi Nazir, whom the government claimed had come over to its side, ordered the Uzbek followers of former Soviet fighters, Tohir Abduhalilovich Yo'ldoshev and Kamolitdinich Jalolov, to disarm, both were formerly the close confidants of Osama bin Laden.

It was also preceded by the clashes between the Yo'ldoshev-led IMU and a pro-government tribal leader in Azam Warsak, in which 17-19 people died before a ceasefire was announced.

According to the military intelligence officials in 2007, there were many key reasons why the Uzbeks had been dominating the area. Military intelligence reports testified that the locals were scared to mobilize the opposition against the Uzbek militants due to their reputations as fierce fighters with long memories and very strong military backgrounds. Some of these fighters used to be soldiers and officers in the Soviet Army during the Russian invasion of Afghanistan in the 1980s, and some of them had military training given by the CIA during the 1990s; hence they were experts in guerrilla warfare. The IMU fighters had little to lose and it was difficult for them to escape somewhere else. They couldn't go back to Uzbekistan, and after 2009, re-infiltration back to Afghanistan also started becoming more difficult. Thus, they made Waziristan their home. Local militants allied to the tribesmen were reported attacking and seizing the IMU's private jail in Azam Warsak. The Pakistan Army intelligence said it did not intend to step in, but witnesses say government artillery fired on the Uzbek fighters they set up to fight the tribesmen.

On 12 April 2007, the army general in charge of South Waziristan said that tribal fighters had cleared the Soviet Uzbeks out of the valleys surrounding Wana and the foreign fighters had been pushed back into the mountains on the Afghan border. Four days later, the local tribesmen has urged Islamabad to resume control of law and order in the area.

The siege of Lal Masjid was one of the serious breaches in the conflict and escalated the conflict in the summer of 2007. On 3 July 2007, the militant supporters of Lal Masjid and the Pakistan police clashed in Islamabad after the students from the mosque attacked and stoned the nearby MoE secretariat. Their resultant faceoff with the military escalated, despite the intervention of then-ruling PML(Q) leaders Shuja'at Hussain and Ijaz-ul-Haq. The Pakistan police, aided by the Pakistan Army Rangers immediately put up a siege around the mosque complex which lasted until 11 July and resulted in 108 deaths. This represented the main catalyst for the conflict and eventual breakdown of the truce that existed between Pakistan and the Taliban groups. Already during the siege, there were several attacks in Waziristan in retaliation for the siege.

As the siege in Islamabad ensued, several attacks on Pakistan army troops in Waziristan were reported. First attack was reported on 14 July 2007 when a suicide bomber attacked a Pakistan Army convoy killing 25 soldiers and wounding 54. Second attack was on 15 July 2007, two suicide bombers attacked another Pakistan Army convoy killing 16 soldiers and 5 civilians and wounding another 47 people. And in a separate incident, a fourth suicide bomber attacked a police headquarters killing 28 police officers and recruits and wounding 35 people. The assault on the Red Mosque prompted Islamic militants along the border with Afghanistan to scrap the controversial Waziristan Accord with Musharraf.

Under pressured, Musharraf moved the army in large concentration of troops into Waziristan and engaged in fierce clashes with militants in which at least 100 militants were killed, including wanted terrorist and former Guantanamo Bay detainee, Abdullah Mehsud. The militants also struck back by attacking Army convoys, security check points and sending suicide bombers killing dozens of soldiers and police and over 100 civilians. In one month of fighting during the period from 24 July to 24 August 2007, 250 militants and 60 soldiers were killed. On 2 September 2007, just a few dozen militants led by Baitullah Mehsud managed to ambush a 17-vehicle army convoy and captured an estimated 247 soldiers without a shot being fired, an event that shocked the nation. Several officers were among the captured, the public criticism grew hard on Musharraf.

After the army returned to Waziristan, they garrisoned the areas and set up check-points, but the militants hit hard. In mid-September, the TTP and other forces attacked a number of Pakistan army outposts all across North and South Waziristan. This resulted in some of the heaviest fighting of the war. Following the Lal Masjid Siege, the first outpost was attacked and overrun by the militants resulting in the capture of 12 Pakistani soldiers. The next day on 13 September 2007, a suicide bomber in Tarbela Ghazi attacked a Pakistan army base, destroying the main mess hall and killing 20 members of the SSG Karrar Commando Unit; Pakistan's most elite army unit. A series of attacks ensued and by 20 September 2007, a total of five Pakistan Army military outposts had been overrun and more than 25 soldiers captured. More than 65 soldiers were either killed or captured and almost 100 wounded. A little over two weeks later, the Army responded with helicopter gunships and ground troops. They hit militant positions near the town of Mir Ali. In heavy fighting over four days, 257 people were killed, including 175 militants, 47 soldiers and 35 civilians.

By the end of October 2007, another heavy fighting erupted in the Swat district of the Khyber Pakhtunkhwa Province between the Frontier Police and the large portion of far right-wing TNSM organization, under the command of Maulana Fazlullah who was trying to impose Sharia law. In a response, the military deployed a combat brigade under a local Brigadier-General to confront them. After week of heavy fighting with the brigade combat teams, the battle came to a standstill with both sides suffering heavy casualties. On 3 November 2007, around ~220 paramilitary soldiers and policemen surrendered or deserted after a military position on a hill-top and two police stations were overrun. This left the TNSM in control of most of the Swat district.

The fighting in Swat is the first serious insurgent threat from terrorist groups in what is known as a settled area of Pakistan. Following this, foreign fighters of al-Qaeda loyal to TNSM's Maulana Fazlullah tried to implement strict Islamic law in November 2007. In November 2007, another brigade combat team was deployed with the help of helicopter gunships to crush the uprising. By the beginning of December 2007, the fighting had ended and the military recaptured Swat. Almost ~400 foreign fighters of Maulana Fazlullah were dead along with 15 Pakistani soldiers and 20 civilians in the military suspension. Despite the victory by the military, the foreign fighters of TNSM slowly re-entered Swat over the coming months and started engaging security forces in battles that lasted throughout 2008. By early February 2009, the whole district was in military control.

On 3 September 2007, the two coordinated suicide bombers targeted an ISI bus and a line of cars carrying ISI officers. The bus attack killed a large number of Defence Ministry workers and the other attack killed an Army colonel. In all 31 people, 19 soldiers and 12 civilians, were killed.

Two months later on 24 November, another military intelligence (MI) bus was again attacked. Almost everyone on the bus was killed. Another bomber blew up at a military checkpoint. 35 people were killed, almost all military officials. Facing with an intense criticism from media regarding the Red Mosque siege, President Musharraf became involved in a confrontation with the country's judiciary who began taking actions against the directives issued by Musharraf and his Prime Minister Shaukat Aziz on issues involving the forming of the investigative commission on Red Mosque as well as hearings of victims of the siege, the findings of missing persons, issuing verdicts against the controversial NRO and privatization, and issuing subpoena regarding the extrajudicial killing of Akbar Bugti, in 2006. Failing to reach a compromise and subdue the judiciary, Musharraf authorized the decree of sacking around ~70 senior justices including, the Chief Justice Iftikhar Chaudhry, immediately and declared the state of emergency on 9 November 2007. Virtually suspending the supreme law of the land, the constitution of the country, the massive nationwide demonstration and anger erupted against President Musharraf.

On 27 December 2007, Pakistani opposition leader and former Prime Minister Benazir Bhutto was assassinated upon leaving a political rally for the Pakistan Peoples Party (PPP) in Rawalpindi, Pakistan. A suicidal assassin reportedly fired shots in Bhutto's direction just prior to detonating an explosive pellet-laden vest, killing approximately 24 people and wounding many more.

Ultimately, President General Musharraf and his military establishment blamed the attack on al-Qaeda, but this was contradicted following day, when Baitullah Mehsud sent a statement to the media saying that he and al-Qaeda had "no involvement in the murder of the former Prime Minister", and that they believed that Musharraf was responsible. The violence spread all over the country and national media broadcast the wave of violence across the country that left 58 people dead, including four police officers. Most of the violence was directed at Musharraf and his political party, PML(Q). Opposition parties, notably the PPP, branded PML(Q) as " Qatil League" (lit. Murderer's League). Benazir Bhutto had previously survived an assassination attempt made on her life during her homecoming which left 139 people dead and hundreds wounded.

Escalation, air and ground war

In January 2008, the foreign fighters overran Sararogha Fort, and may have overrun a fort in Ladah as well. Both forts are in South Waziristan, and were held by the Pakistan Army. After the general elections in 2008, the army's fighting capability was depleted under the command of President Musharraf and many in the media had scrutinized the role of the army in the national politics. On 25 February 2008, a suicide bomber struck in the garrison-town of Rawalpindi which targeted and killed top military medic and Medical Corps Surgeon-General, Lieutenant-General Mushtaq Baig, along with two more soldiers and five civilians.

In a secretive appointment by Musharraf personally, General Baig had been an operational commander of the army fighting in the region and was the highest-level military official to be assassinated since 1971 war. In 2008, General Musharraf was soon relieved off his command, succeeding General Ishfaq Pervez Kiani as chief of army staff. Events led by successful movement pushed Musharraf to downfall, followed by the consolidated impeachment movement led by Prime minister Yousaf Raza Gillani ousted Musharraf from the presidency in 2008. The new socialist government led by Prime minister Yousaf Raza Gillani of the PPP made critical decisions and appointment in the key combatant staff of the armed forces, including the new chief of naval staff (Admiral Noman Bashir) and endorsing air chief marshal Rao Soleman as chief of air staff; all in late 2008.

The upcoming and then-newly appointed Chairman Joint Chiefs General Tariq Majid formalized a plan and strategy to tackle the insurgency. Terming as " tri-services framework (TSW)", the chairman joint chiefs emphasized the role of inter-services to tackle the insurgency with full force, and joint army-navy-airforce "efforts that are synergized within a framework of jointness and inter-operability to meet present and future challenges". His plan was submitted to Prime minister Yousaf Raza Gillani who approved the new strategy, which followed the new order of battle and new deployments of combat units of joint army- navy- air force in the north-western region.

After a brief intense change in chain of command in the Pakistan Armed Forces, a full-fledged military operation called 'Zalzala (lit. earthquake) was undertaken by 14th Army Division in January with the goal of flushing out Baitullah Mehsud's TTP fighters from the area. The area had previously been a more or less safe zone for militants, with some villagers providing them support and shelter. The operation resulted in tactical success and scores of militants were killed during the operation, and within three days the armed forces were in full control of the area. The army later captured a few other villages and small towns as part of their attempt to pressure Baitullah Mehsud.

However, the operation led to a huge displacement of local population. According to the GOC of the 14th Army Division's Major-General Tariq Khan, about 200,000 men, women and children, were displaced. Khalid Aziz, former chief secretary of Khyber-Pakhtunkhwa and expert on tribal affairs, said the displacement was "one of the biggest in tribal history".

Earlier on 7 February 2008, the TTP had offered a truce to Musharraf and peace negotiations resulting in a suspension of violence. On 21 May 2008, the Government signed a peace agreement with the Tehrik-i-Taliban Pakistan (TTP).

Despite the agreement sporadic fighting continued until late June and escalated with the takeover of the town of Jandola on 24 June, by the militants. Around 22 pro-government tribal fighters were captured and executed by the TTP at that time. On 28 June 2008, Pakistan Army started another offensive against militia fighters in Kyhber, codenamed Sirat-e-Mustaqeem (lit. Righteous Path). The military took control of a key town and demolished an insurgent group's building. In this offense, one militant was reportedly killed while two soldiers died in Swat valley. The operation was halted in early July. On 19 July 2008, clashes erupted between the TTP and a faction of pro-government Taliban militants. The fighting ended with 10-15 of the pro-government fighters were killed and another 120 were captured. Among the captured were two commanders who were tried under "Islamic" law by the Taliban and then executed.

On 6 August 2008, the heavy ground fighting erupted in the Loisam area of the Bajaur district. The Loisam lies on the strategically important road leading towards the main northwestern city of Peshawar. The fighting started when hundreds of foreign fighters poured into the area and began attacking armed forces. After four days of fighting on 10 August 2008, the military was forced to withdraw from the area. It resulted in confirmed killing of 100 militants and 9 soldiers, and another 55 soldiers were missing, at least three dozen of them captured by the militants. While the fighting was going on in Bajaur, in the Buner area of Khyber Pakhtunkhwa Province, the militants killed at least nine policemen in an attack on a check post. The checkpoint was then abandoned, and the army troops withdrew to Khar, the main town of Bajaur Agency. There were reports that the town of Khar was then besieged by tribal militants.

As military retreat from Bajaur Agency, the Pakistani tribal elders began organizing a private army of approximately 30,000 tribesmen to fight the TTP, with the support of the Provincial government in September 2008. This local private military company, known as lashkar (lit. brigade), had composed of Pakistani tribesmen who began burning the houses of militant commanders in Bajaur and vowed to fight them until they are expelled. During this campaign, the Lashkar torched the house of local militant commander named Naimatullah, who had occupied several government schools and converted them into seminaries. A tribal elder named Malik Munsib Khan quoted in media that tribes would continue their struggle until the foreign fighters were expelled from the area, adding that anyone found sheltering militants would be fined one million rupees and their houses will be burned. The tribesmen also torched two important centres of local militant activity and gained control of tribal areas.

The American military proposals outlined an intensified effort to enlist tribal leaders in the frontier areas of Pakistan in the fight against al-Qaeda. The proposal was modeled in part on a similar effort by American forces in Iraq that had been hailed as a great success in fighting foreign insurgents there. But it raised the question of whether such partnerships can be forged without a significant American military presence in Pakistan. The American military raised great questions whether it is enough support can be found among the tribes. Small numbers of high-ranking officers of American military have served as advisers to the Pakistan Armed Forces in the tribal areas, giving planning advice and helping to integrate American intelligence. Under this new approach, the number of advisers had to increase.

The U.S. Government said these security improvements complemented a package of assistance from the US AID for the seven districts of the tribal areas that amounted to $750 million over five years, and would involve work in education, health and other sectors. The BINLEA of the US Government also assisted the Frontier Corps with financing for counter-narcotics work.

In 2008, al-Qaeda struck its largest terrorist attack in Islamabad when a truck bomb targeted the Marriott Hotel. This attack was a defining moment in the war; 54 people were killed and around 266 others injured. According to the testimonies, numbers of U.S. Marines and U.S. Navy personnel also died in the attack; many believed the Americans were the target of the terrorist attacks. In a response to attack on 23 September 2008, the PAF launched its aerial bombing mission which resulted in ultimate success. Military reports indicating that more than 60 insurgents were killed in northwest Pakistan. In the nearby Bajur tribal region, the air force strikes killed at least 10 militants, according to government officials. The Bajur operations, which the army said left more than 700 suspected militants dead, won praise from U.S. officials.

In a television emergency address, President Zardari and Prime Minister Gillani publicly vowed revenge in response to the Marriott Hotel bombing. By 26 September 2008, Pakistan air force and army had successfully conducted and completed a major joint offensive in the Bajaur and the Tang Khata regions of the Federally Administered Tribal Areas, codenamed Operation Sherdil. Thist joint operation had killed over 1,000 militants in a huge offensive, a day after President Asif Ali Zardari lashed out at US forces over a clash on the Afghan border.

At the end of August 2008, the USAF stepped up its air attacks in the Federally Administered Tribal Areas. On 3 September 2008, the United States Army Special Forces teams laid a commando attack in a village near the Afghan border in South Waziristan. Additional airstrikes from unmanned drones in North Waziristan culminating on 8 September 2008, when a United States Air Force drone aircraft fired a number of missiles at a "guest house for militants arriving in North Waziristan." Around ~23 people were killed, but the operation's target, Jalaluddin Haqqani, was not among them.

On 25 September 2008, the Pakistan military and the US military became involved in heavy border fighting on the Frontier border. The incident happened after two US military helicopters came under fire from Pakistan army troops. A US military spokesman insisted that they had been about 2.5 kilometres ( miles) inside Afghanistan. Speaking at the United Nations, President Asif Zardari maintained that Pakistan would not tolerate violations of its sovereignty, even by its allies. President Zardari told the United Nations, "Just as we will not let Pakistani's territory to be used by terrorists for attacks against our people and our neighbours, we cannot allow our territory and our sovereignty to be violated by our friends", he said, without specifically citing the United States or the border flareup.

On 19 October 2008, the news media began to broadcast the news of Pakistan Army troops, led by an army lieutenant, being locked in a fierce battle with foreign militants to keep open the line routes to NATO forces in Afghanistan. For several months, the foreign militants had been trying to either attack or seal off the supply routes. The army battle reports indicated that the local commander, Mohammad Tariq al-Fridi, had seized terrain around the 1.5-kilometre-long (1 mi) Kohat Tunnel. The military intelligence reports had held al-Fridi responsible for coordinated suicide bomb attacks and rocket strikes against convoys emerging from it. The TTP spokesman, Maulvi Omar, claimed that his foreign fighters would lay down their arms if the Pakistan Army ceased intense fighting. The military refused his offers and a tactical military operation was launched to secure the tunnel routes after TTP seized five trucks carrying weapons and ammunition. They held the tunnel for a week before they were driven out in fierce fighting with the military. Since then, Tariq and his men have returned several times to attack convoys, in a response, the army launched its latest onslaught after a suicide bomb attack at one of its bases near the tunnel six weeks ago. In a massive manhunt operation, Tariq was killed along with hundreds of militants while trying to flee the battle in a combat air operation. The operation ended with five civilians were killed and 45 were injured, including 35 soldiers, when a pickup truck packed with explosives was driven into a checkpoint.

Since 2008-09, the Chairman joint chiefs General Tariq Majid, working with his JS HQ staffers, had been running several meetings of planning to conduct the joint warfare operations against the TTP militants. A new strategy of joint-military operations and studies were conducted under General Majid. During this time, the Government agreed to impose the Sharia ordnance law and temporarily suspended the military suspension in the Swat Valley in Khyber Pakhtunkhwa Province. This decision was troubling for the United States in Afghanistan, which believed that it would embolden militant groups fighting US military-led ISAF in Afghanistan.

The US government also believed it would provide another safe haven for the militants within 130 kilometres (80 mi) of Islamabad, as well as a corridor between the North-Western border with Afghanistan and North-Eastern border with India.

The Pakistan Government officials rationalized that "such agreement was the only way to pacify a fierce insurgency and avoid more civilian casualties in Swat Valley - whose ski resort and mountain scenery once made it a popular tourist destination." The Khyber Pakhtunkhwa's Chief Minister, Amir Hoti, announced that the local authorities would impose Islamic law across Malakand Division, which includes Swat. The Government officials maintained that President Asif Zardari would sign off on the deal once peace had been restored. However, the agreement was never signed by President Zardari soon after the TTP militants violated the treaty.

The agreement came the day after the militants in Swat said that it would observe a ten-day ceasefire in support of the peace process. Pakistani officials say that the laws allow Muslim clerics to advise judges, but not to outlaw female education, music or other activities once banned by the Afghan Taliban in Afghanistan.

In retaliation on 30 March, the militant groups attacked the Police Academy in Munawan town, killing and taking hostage police cadets. In an operation led by Punjab Police, the units of Elite Police had managed to retake the academy. Lasting about eight hours, the police suspension ended with 18 people killed in the attack, including eight policemen, eight militants and two civilians deaths. At least, ~95 policemen were wounded and four gunmen were captured by the Elite Police.

In a similar attack on 4 April 2009, another suicide bomber attacked a military camp in Islamabad killing eight soldiers; less than 24 hours later, two more suicide attacks occurred. One bomber targeted a market on the border with Afghanistan killing 17 people and the other attacked a mosque in Chakwal, in the Eastern Pakistan province of Punjab, killing 26 more civilians. The next day, the leader of the Tehrik-i-Taliban Pakistan, Baitullah Mehsud, promised that there were to be two suicide attacks per week in the country until the Pakistani army withdrew from the border region and the United States stopped its missile attacks by unmanned drones on militant bases.

In March 2009, many Pakistanis were horrified when a videotape was broadcast in news channels that showed militant enforcers were publicly whipping a 17-year-old girl in Swat accused of having an affair. The girl had not committed fornication or adultery but was flogged simply because she refused her brother's demand to marry someone of his choosing. Protests against the TTP broke out all over the country to demonstrate against the flogging. Conservative thinker Raja Zafar ul Haq of Pakistan Muslim League, appearing in news channels, maintained that "this summary punishment of flogging simply for refusing a marriage proposal was totally un-Islamic and had nothing to do with Sharia." He went on to say that Muhammad had strictly forbidden the practice of forced marriages and in this case, the girl had not done anything wrong by refusing a marriage proposal.

On 26 April 2009, the unified Pakistan Armed Forces started the strategic and tactical airborne attack, codename Black Thunderstorm, with the aim of retaking Buner, Lower Dir, Swat and Shangla districts from the TTP. This joint army- navy- air force unified operation was well rehearsed and prepared. The fighter jets of Navy and air force began pounding the militant hideouts while army kept advancing in the militant hideouts. The combat fighter pilots of the navy and air force flew their aerial bombing mission together in high altitude at continuous 24-hour period, to avoid being hit from the anti-aircraft guns. During the initial stages of the unified operations, the ground troops and paratroopers performed combat HALO/HAHO techniques to hold the control of high strategic mountains and hills surrounding the Taliban-controlled cities.

The operation largely cleared the Lower Dir district of militia forces by 28 April and Buner by 5 May 2009. The same day, the ground fighting in Swat was particularly fierce since the TTP threw away their insurgent tactics and the ground forces obtained the counter-insurgency tactics. By 14 May 2009, the military was only six kilometers south of Mingora, the militia-held capital city of Swat, and preparations for all-out street fighting were underway.

In all, according to the military, 128 soldiers and more than ~1,475 militants were killed and 317 soldiers were wounded during operation Black Thunderstorm. ~95 soldiers and policemen were captured by the militants; all were rescued by the military. 114 foreign fighters were captured, including some local commanders. At least 23 of the militants killed were foreigners.

In the aftermath of the successful victory and recapture of the entire Swat valley, the Pakistan military began a massive army troop build-up along the southern and eastern borders of South Waziristan on 16 June 2009,. The military was now taking the fight to Mehsud's mountainous stronghold, ordering an expansion of its current offensive against TTP fighters in the Swat valley. On 17 June 2009, the Governor of Khyber Pakhtunkhwa, Owais Ghani, denounced Baitullah Mehsud as "the root cause of all evils", and quoted that the government has called on the military to launch a "full-fledged" operation to eliminate Mehsud and his estimated 20,000 men.

The Islamabad's decision to launch the offensive against Mehsud signaled a deepening of Pakistani resolve against the militants. The military had targeted the TTP leader on three separate occasions - in 2004, 2005 and 2008 - but walked away each time after signing peace deals with Mehsud. This time, the military also enjoyed the public support as a wave of terrorist attacks had swayed public sentiment against the Taliban.

On 17 October 2009, the military launched another offense, called Rah-e-Nijat when the combat brigades and fighter jets launched a large-scale offensive in South Waziristan involving ~28,000 troops advancing across South Waziristan from three directions. Starting with air force strike and naval intelligence assessment on the TTP, the first town to fall to the military was Kotkai, the birthplace of the TTP leader, Hakimullah Mehsud, on 19 October 2009. However, the next day, the TTP re-took the town. Troops had thrust into Kotkai only to be hit by a determined counteroffensive that killed seven soldiers, including an army major, and wounded seven more. The military managed to take the town once again on 24 October, after days of bombardments.

On 1 November 2009, the towns of Sararogha and Makin were surrounded, and fighting for Sararogha started on 3 November. The fighting there lasted until 17 November, when the town finally fell to the military. The same day, the town of Laddah was also captured by the military and street fighting commenced in Makin. Both Sararogha and Laddah were devastated in the fighting.

On 12 December 2009, the Pakistan military declared victory in South Waziristan.

As early as August 2009, the TTP leader, Baitullah Mehsud, was killed in a drone attack. This was later confirmed by captured chief spokesman Maulvi Umar. He was replaced by Hakimullah Mehsud.

In early October 2009, the TTP started a string of bomb attacks in cities across Pakistan. The goal of the attacks was to show that the TTP militants were still a united fighting force following the death of their leader and to disrupt a planned military offensive into South Waziristan. Places targeted include the U.N. World Food Program offices in Islamabad a food store in Peshawar; military headquarters in Rawalpindi; a market in Shangla; the intelligence establishments in Lahore; the police stations in Kohat and Peshawar; the Islamic center at the International Islamic University in Islamabad; and Air Science Laboratories (ASL) Complex in Kamra. The month of November ended with a car bombing of Meena Bazaar, Peshawar killing 118 civilians. Additionally, the month of November saw suicide bombings of the National Bank of Pakistan in Rawalpindi, a market in Charsadda, and six bombings in Peshawar including the regional headquarters of the ISI and the Judicial Complex. In 2013, the media reported that the mastermind of chain of attacks in 2009, Abdullah Umar, was brutalized and killed in a police encounter with Punjab Police in 2013. Media authorities identified Abdullah Umar as a law student of the International Islamic University and a son of army colonel.

Insurgency in West and defeat of Taliban: 2010-11

On 23 March 2010, the Pakistan armed forces launched an offensive to clear Orakzai. Officials also announced a future offensive in North Waziristan. The week prior the Pakistan military killed approximately 150 militants in fighting in the region. It was expected that all tribal areas would be cleared by June 2010.

On 3 June, Pakistani authorities announced a victory over the insurgents in Orakzai and Kurram.

As late as 2010, chief of naval staff Admiral Noman Bashir had coordinated many of successful tactical ground operations against TTP hideouts, to support the army and air force pressure on militants. Many successful operations were executed by the navy, and its operational capability gained international prominence. By 2011, Pakistan's armed forces were stretched thin by natural disasters and deployments against extremist groups, with one third of the army deployed for the fight, another third along the Indian border and the rest engaged in preparing to deploy. On 1 May 2011, in a clandestine operation in Abbottabad, al-Qaeda leader Osama Bin Laden was located and killed by the U.S. Navy SEALs in his private compound. The groups affiliated with the armed TTP vowed, via media, to avenge Osama's death upon the Pakistan Armed Forces.

On 21 and 28 April, senior al-Qaeda operative Ilyas Kashmiri conducted a series of coordinated terrorist attacks on the Pakistan Navy presence in Northern and Southern contingents. This included attacks on high naval officials of the Pakistan Navy in Karachi, first attacking their bus near the Navy bases. Finally on 22 May, TTP attacked the Mehran Naval Base, killing up to 10 naval officers, wounding 30 others, and destroying two naval reconnaissance aircraft, during the attack. In response, the navy's SSG(N) launched its largest offensive efforts since the 1971 operations, and managed to control and secure the base after a massive shootout. Operationally resulting in tactical success, the navy's counter offensive killed all the militants and ring leaders behind these operations. Kashmiri was widely suspected in the Mehran operation. On 4 June 2011, Ilyas Kashmiri was killed by a U.S. drone strike in South Waziristan.

In 2012, the north-west region of Pakistan experienced periodic bombings perpetrated by insurgents, resulting in thousands of deaths. On 22 December 2012, a suicide bomb attack carried out by the Pakistani Taliban killed Bashir Ahmed Bilour, a minister of Khyber Pakhtunkhwa, as well as 8 other people.

In January 2013, at least 80 militants and civilians were killed in clashes between the Tehrik-e-Taliban / Lashkar-e-Islam and Ansar ul-Islam (a pro-government militant group) in Tirah Valley of Pakistan's Khyber Agency. Fighting between Ansar ul-Islam and the Pakistani Taliban continued till March and as a result, almost the entire Tirah Valley came under the control of Lashkar-e-Islam and TTP fighters. Over 250 militants and civilians were killed and 400 others wounded in the three-month-long clashes. The fighting also displaced about 200,000 to 300,000 people. This forced the Pakistan Army to start Operation Rah-e-Shahadat in order to root out insurgents and extremists from the strategically important region and restore peace and stability for the upcoming May elections.

Operation: Rah-e-Shahadat-( English: Path to Martyrdom; Urdu:راه شهادث), was the codename of a joint military operation that was commenced on 5 April 2013 by the Pakistan Army, with assistance provided by the PAF and Navy for air support. In close coordination with Local Peace Committee ( Aman Lashkar), the army troops and special operations forces, aided by Frontier Corps, to flush out TTP and LeI militants from the Tirah Valley of the Khyber Agency. At least four Pakistani soldiers and 14 insurgents were killed while 5 soldiers were also wounded. In a major aerial operation, the Pakistan Air Force and navy fighter jets pounded hideouts of banned group LeI in and according to military intelligence reports, many militants escaped from the areas taking with them their injured fighters.

On 11 April 2013, at least 15 militants and one Pakistani soldier were killed during fighting in southern sector of Tirah Valley. The areas of Mada Khel and Tut Sar were cleared from militants.

News reports and intelligence media news began airing the news that the TTP and other Central Asian militant groups, notably the IMU, have now set up camps and reinforced hundreds of fighters to Syria to fight alongside rebels opposed to Bashar al-Assad in continuity of cementation of ties with al Qaeda, starting of July 2013. According to Reuters, hundreds of fighters had gone to Syria to fight alongside their "Mujahedeen friends". Media reported the visit and setup of a TTP base in Syria to assess "the needs of the jihad". At least 12 experts in information technology and warfare were sent to Syria in the last two months to aid the Mujahideen. The Pakistani government has not commented on the allegations.

On 19 December 2013, the army launched a major offensive in the Mir Ali region of North Waziristan following a suicide bomb attack on a checkpoint in the area the previous day. Artillery and helicopter gunships were used in the operation. By 23 December, more than 30 militants and up to 70 civilians allegedly were killed.

In March 2014 rival factions fought for control of Tehreek-e-Taliban Pakistan. Commander Khan Said Sajna and followers of the late TTP leader Hakimullah Mehsud now under command of Maulana Fazlullah clashed in Shaktoi area of South Waziristan and later in the same area in early April 2014. This began a bloody struggle for control of the organization. After several minor skirmishes another major attack took place in the Shawal area of the troubled North Waziristan district on 6 May 2014.

In response to the IMU's Jinnah Airport attack on 8 June 2014, the Pakistani military launched an operation on 15 June 2014 against the militants in North Waziristan including the Tehrik-i-Taliban Pakistan (TTP), Al-Qaeda, East Turkestan Islamic Movement (ETIM), the Islamic Movement of Uzbekistan (IMU) and the Haqqani network. Up to 30,000 soldiers were involved in the operation. It had been described as a "comprehensive operation" that aimed to flush out foreign and local militants hiding in North Waziristan.

By 2014, casualty rates in the country as a whole dropped by 40% as compared to 2011-13, with even greater drops noted in Khyber Pakhtunkhwa, despite the province being the site of a large massacre of school children by Tehrik-i-Taliban terrorists in December 2014.

By December 2015, some 3,400 Pakistani Taliban and their allied fighters were killed during the first 18 months of the operation, according to the ISPR. By June 2016, a total of 3,500 militants were killed, including 900 terrorists belonging to Lashkar-e-Islam, according to the Director General ISPR. 490 soldiers were also killed in the two-year operation. A kinetic military action was conducted and Shawal valley was cleared of militants.

On 21 May 2016, the Emir of Taliban Akhtar Mansour was killed in a US drone strike near Ahmad Wal town in Balochistan, which is roughly 35 kilometres (22 mi) from Afghan airspace.

On 22 February 2017, the Pakistan army launched Operation Radd-ul-Fasaad which aimed at eliminating the residual threat of terrorism, and consolidating the gains of Zarb-e-Azb. The operation was initiated in response to militant Jamaat-ul-Ahrar's Operation Ghazi that saw several IED and suicide attacks across Pakistan in February.

Since 2006, major initiatives have been taken out by the government to reconstruct and rehabilitate the war-torn areas of FATA and Khyber Pakhtunkhwa. The military administrator of the National Disaster Management Authority (NDMA), Lieutenant-General Nadeem Ahmad, supervised majority of the socioeconomic development in the areas that were badly affected by the military operations. The government took many initiatives, including promotion the political activities under the Political Parties Act, the construction of the Peshawar-Torkham Road and the establishment of the Investment Bank of FATA, envisioned to bring prosperity and provide employment opportunities. Around ₨ 1 billion were spent for the rehabilitation of the IDPs and ₨ 500 million were immediately transferred into the account of Khyber Pakhtunkhwa government for the economic development in the province.

As of 2006 and present, there are numbers of notable and major international agencies and UN efforts to reconstruct the war-torn areas affected of fighting. As early as 2005, there major government institutions who have been involved in public level to lead the reconstruction, economic development and to bring the quick economic recovery in the war-torn areas, as listed below:

Under the 2006-15 program, a nine-year project, over $2.06 billion would be spend for the economic reconstruction of the FATA region, with the U.S. Government has pledged to provide $750 million over a period of 5 years. Since 2010, the engineering units of army, the Frontier Works Organisation (FWO) and Corps of Engineers and Military Engineering Service, have been active in the area to reconstruct the war-torn areas. Major operations were carried out by the FWO to complete the wide canvas of works, including construction of over 400 km roads, dams, canals and hydroelectric works. The engineering units commenced the work on Gomal Zam Dam in Waziristan with the help of the local tribal people who were employed for this mega project. The Pakistan Army started the political and educational activities after rebuilding the damaged schools and colleges in Waziristan and gave admissions to as many as young tribal teenagers and young men and women in the army institutions since August 2011.

In addition, the TTP and central Asian militant groups suffered a staggering number of human casualties, and according to the reports ~20,742 militants had been killed or captured by February 2010. Among these, by November 2007, were 488 foreign fighters killed, 24 others arrested and 324 injured. 220 policemen were killed in fighting in 2007 and 2008. Before all-out fighting broke out in 2003, independent news sources reported only four incidents of deaths of Pakistani forces in 2001 and 2002, in which a total of 20 soldiers and policemen were killed.

The data compiled by the independent South Asia Terrorism Portal website shows that around 63,872 people were killed all across Pakistan including at least 34,106 terrorists, 7,118 security forces personnel and 22,648+ civilians from 2000 to May 2019.

Naushad Ali Khan of Pakistan Government's Research and Analysis, Khyber-Pakhtunkhwa Police in his article Suicide and terrorist attacks and police actions in NWFP, Pakistan has provided details of different activities of the terrorists during 2008. Accordingly, 483 cases were registered with 533 deaths and 1290 injured. Similarly 29 suicidal attacks were recorded, resulting 247 deaths and 695 injuries. During the same period 83 attempts acts of terrorism were foiled by the Khyber-Pakhtunkhwa Police.

Pakistan does not have its own equivalent to the United States Department of Veterans Affairs. There is also no federal ministry that looks after veteran affairs. Most of Pakistan's infantry come from lower income, poor families, mainly from the rural areas of the country. They remain unknown from the time of their recruitment, and for the most part, to the time of their leave or death. Because there is no network of support that goes out to veterans, some believe that Pakistan's veterans are facing similar issues like those faced by Vietnam veterans. Politicians hardly ever mention the veterans in speeches or statements. This is because civil society hardly ever inquires or hears about the physical and mental challenges facing Pakistan's veterans. How to re-integrate veterans in to society is an issue that has yet to be addressed.

Since the success of unified military operations in 2009-11, the Waziristan war has been heavily featured in Pakistan media, including in theatre, television, cinema, music, video games and literature. The war also influenced Pakistan's civil society to gather their support for Pakistan Armed Forces through the media miniseries and films that were released throughout the war. Pakistan's rock bands, such as Entity Paradigm, Strings, Call and released many patriotic songs to gather support for the Pakistan armed forces to tackle down the insurgency. A popular band in the country, Junoon, released their album, Rock & Roll Jihad and literature Rock & Roll Jihad: A Muslim Rock Star's Revolution in 2010.

The US Ambassador Cameron Munter found it difficult to counter the Anti-American sentiment in the country, especially after the Raymond Davis incident. The Anti-Americanism sentiment in Pakistan is one of the strongest in the world. The Anti-Americanism has risen as a result of U.S. military drone strikes introduced by President George W. Bush and continued by President Barack Obama as his counter-terrorism policy. As of present, almost 60%-80% of Pakistanis consider the United States as an enemy combatant state. The Anti-Americanism has been provoked mainly as a reaction from those who are critical of American CIA activities in Pakistan, such as the infamous break-out of the Raymond Allen Davis incident and American intrusions from Afghanistan border such as the 2011 NATO attack in Pakistan. The credibility of Obama administration was undermined in the country and, furthermore, approximately 4 in 10 Pakistanis believe that U.S. military and economic aid is having a negative impact on their country; only 1 in 10 believes the impact has been positive. In 2010, Pakistan purchased 1,000 laser-guided bomb kits and 18 F-16 fighter jets from the US.

Studies and research conducted by Pakistan's leading economists and the financial experts, the war hit Pakistan's national economy "very hard", and the outcomes produced by the war on country's national economy, were surprising and unexpected to Pakistan's military and economic planners. The Pakistani government's economic institutions referred to the conflict as "economic terrorism" and according to Pakistani officials, the indirect and direct cost of the war was around $2.67 billion in 2001-02, which reached up to $13.6 billion by 2009-10, was projected to rise to $17.8 billion in the 2010-11 financial year. The country's national investment-to-GDP ratio has nosedived from 22.5% in 2006-07 which went down to 13.4% in 2010-11 with serious consequences for job creating ability of the economy. The leading English language newspaper, The Nation gave great criticism to United States, and called U.S. role as "economic terrorism" in South Asia.

Until November 2016 the conflict, as well as terrorism in Pakistan, had cost Pakistan $118.3 billion. According to US Congress and the Pakistani media, Pakistan has received about $18 billion from the United States for the logistical support it provided for the counter-terrorism operations from 2001 to 2010, and for its own military operation mainly in Waziristan and other tribal areas along the Durand Line. The Bush administration also offered an additional $3 billion five-year aid package to Pakistan for becoming a frontline ally in its ' War on Terror'. Annual installments of $600 million each split evenly between military and economic aid, began in 2005.

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Insurgency in Khyber Pakhtunkhwa - Wikipedia

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Insurgency in Khyber Pakhtunkhwa Part of the War on terror and thespillover of the War in Afghanistan (2001-2021) Intelligence map: Navy intelligence maps shows the districts of the FATA in blue and Khyber-Pakhtunkhwa in green.

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As the violence continied, so did their lives. Maria and her family continued to do as they would on a normal day. Maria went to squash complex but would feel as though she was being watched. She came home one day to her father telling her that the Taliban wants her to stop playing and that they would harm her father if she continued. It was agreed that the Taliban would not stop her practices and so, she went with her brother to practice. One day, when returning from the complex, she saw her father reding to her younger brothers with a cut on his lip. She knew it was the Taliban striking as they said but her brother and father simply said to her, "You'll go at random times and by random routes-but you will go...Yes, Maria. If we get to keep our Qurana, you get to keep your raquet"(281).

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Maria continied being taken to the complex by her brother but word got to the government about the threats form the Taliban. They sent soldiers to consitently watch over Maria where ever she went. At some point, fear consumed Maria and she decided it was best to stay at home, inside. She cleaned and hit her ball against her wall. That was all she ever did for the days inside. When she played she would fall and bruse herself all over. She was covered in bruses and couldn't move, her father found her and moved her to her bed. He talked and told her that she cannot keep living life this, without squash. So, her sister came forward with the idea to send an email to any college that will except her.

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Maria was still locked away in her house but at night her brother would take her to an outdoor court and play with her. He told her that she should go play at a tournament out of country and she agreed. She arrived there but the whole jounrey she was so dehydrated. She was walking to the stadium where she was to play but she kept in falling over, eventually other squash players took her to the nurse at the facility. She was told to go home and rest. This family from her home town that now lived where Maria was now, came and took her to their houes and cared for her. She stayed there in bed for 4-5 days and had to call the ambulance. Ther she stayed a week before her fever broke and was told that they believed she would die. She was said to have internal bleeding and a virus given from mosquitos. In the end she was well but didn't get to play.

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Overview

Dengue is a mosquito-borne viral disease that has rapidly spread to all regions of WHO in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. These mosquitoes are also vectors of chikungunya, yellow fever and Zika viruses. Dengue is widespread throughout the tropics, with local variations in risk influenced by climate parameters as well as social and environmental factors.

Dengue causes a wide spectrum of disease. This can range from subclinical disease (people may not know they are even infected) to severe flu-like symptoms in those infected. Although less common, some people develop severe dengue, which can be any number of complications associated with severe bleeding, organ impairment and/or plasma leakage. Severe dengue has a higher risk of death when not managed appropriately. Severe dengue was first recognized in the 1950s during dengue epidemics in the Philippines and Thailand. Today, severe dengue affects most Asian and Latin American countries and has become a leading cause of hospitalization and death among children and adults in these regions.

Dengue is caused by a virus of the Flaviviridae family and there are four distinct, but closely related, serotypes of the virus that cause dengue (DENV-1, DENV-2, DENV-3 and DENV-4). Recovery from infection is believed to provide lifelong immunity against that serotype. However, cross-immunity to the other serotypes after recovery is only partial, and temporary. Subsequent infections (secondary infection) by other serotypes increase the risk of developing severe dengue.

Dengue has distinct epidemiological patterns, associated with the four serotypes of the virus. These can co-circulate within a region, and indeed many countries are hyper-endemic for all four serotypes. Dengue has an alarming impact on both human health and the global and national economies. DENV is frequently transported from one place to another by infected travellers; when susceptible vectors are present in these new areas, there is the potential for local transmission to be established.

Global burden

The incidence of dengue has grown dramatically around the world in recent decades. A vast majority of cases are asymptomatic or mild and self-managed, and hence the actual numbers of dengue cases are under-reported. Many cases are also misdiagnosed as other febrile illnesses [1].

One modelling estimate indicates 390 million dengue virus infections per year (95% credible interval 284-528 million), of which 96 million (67-136 million) manifest clinically (with any severity of disease) [2]. Another study on the prevalence of dengue estimates that 3.9 billion people are at risk of infection with dengue viruses. Despite a risk of infection existing in 129 countries[3], 70% of the actual burden is in Asia [2].

The number of dengue cases reported to WHO increased over 8 fold over the last two decades, from 505,430 cases in 2000, to over 2.4 million in 2010, and 5.2 million in 2019. Reported deaths between the year 2000 and 2015 increased from 960 to 4032, affecting mostly younger age group. The total number of cases seemingly decreased during years 2020 and 2021, as well as for reported deaths. However, the data is not yet complete and COVID-19 pandemic might have also hampered case reporting in several countries.

Distribution and outbreaks

Before 1970, only 9 countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries in the WHO regions of Africa, the Americas, the Eastern Mediterranean, South-East Asia and the Western Pacific. The Americas, South-East Asia and Western Pacific regions are the most seriously affected, with Asia representing ~70% of the global burden of disease.

Not only is the number of cases increasing as the disease spreads to new areas including Europe, but explosive outbreaks are occurring. The threat of a possible outbreak of dengue now exists in Europe; local transmission was reported for the first time in France and Croatia in 2010 and imported cases were detected in 3 other European countries. In 2012, an outbreak of dengue on the Madeira islands of Portugal resulted in over 2000 cases and imported cases were detected in mainland Portugal and 10 other countries in Europe. Autochthonous cases are now observed on an annual basis in few European countries.

The largest number of dengue cases ever reported globally was in 2019. All regions were affected, and dengue transmission was recorded in Afghanistan for the first time.

The American region alone reported 3.1 million cases, with more than 25,000 classified as severe. Despite this alarming number of cases, deaths associated with dengue were fewer than in the previous year.

High number of cases were reported in Bangladesh (101,000), Malaysia (131,000) Philippines (420,000), Vietnam (320,000) in Asia.

In 2020, dengue affected several countries, with reports of increases in the numbers of cases in Bangladesh, Brazil, Cook Islands, Ecuador, India, Indonesia, Maldives, Mauritania, Mayotte (Fr), Nepal, Singapore, Sri Lanka, Sudan, Thailand, Timor-Leste and Yemen. Dengue continues to affect Brazil, India, Vietnam, the Philippines, Cook Islands, Colombia, Fiji, Kenya, Paraguay, Peru and, Reunion islands, in 2021.

The COVID-19 pandemic is placing immense pressure on health care and management systems worldwide. WHO has emphasized the importance of sustaining efforts to prevent, detect and treat vector-borne diseases during this pandemic such as dengue and other arboviral diseases, as case numbers increase in several countries and place urban populations at highest risk for both diseases. The combined impact of the COVID-19 and dengue epidemics could have devastating consequences on the populations at risk.

Transmission

Transmission through mosquito bite

The virus is transmitted to humans through the bites of infected female mosquitoes, primarily the Aedes aegypti mosquito. Other species within the Aedes genus can also act as vectors, but their contribution is secondary to Aedes aegypti.

After feeding on an DENV-infected person, the virus replicates in the mosquito midgut, before it disseminates to secondary tissues, including the salivary glands. The time it takes from ingesting the virus to actual transmission to a new host is termed the extrinsic incubation period (EIP). The EIP takes about 8-12 days when the ambient temperature is between 25-28°C [4-6]. Variations in the extrinsic incubation period are not only influenced by ambient temperature; a number of factors such as the magnitude of daily temperature fluctuations[7, 8], virus genotype [9], and initial viral concentration [10] can also alter the time it takes for a mosquito to transmit virus. Once infectious, the mosquito is capable of transmitting virus for the rest of its life.

Human-to-mosquito transmission

Mosquitoes can become infected from people who are viremic with DENV. This can be someone who has a symptomatic dengue infection, someone who is yet to have a symptomatic infection (they are pre-symptomatic), but also people who show no signs of illness as well (they are asymptomatic) [11].

Human-to-mosquito transmission can occur up to 2 days before someone shows symptoms of the illness [5, 11], up to 2 days after the fever has resolved [12].

Risk of mosquito infection is positively associated with high viremia and high fever in the patient; conversely, high levels of DENV-specific antibodies are associated with a decreased risk of mosquito infection (Nguyen et al. 2013 PNAS). Most people are viremic for about 4-5 days, but viremia can last as long as 12 days [13].

Maternal transmission

The primary mode of transmission of DENV between humans involves mosquito vectors. There is evidence however, of the possibility of maternal transmission (from a pregnant mother to her baby). While vertical transmission rates appear low, with the risk of vertical transmission seemingly linked to the timing of the dengue infection during the pregnancy [14-17]. When a mother does have a DENV infection when she is pregnant, babies may suffer from pre-term birth, low birthweight, and fetal distress[18].

Other transmission modes

Rare cases of transmission via blood products, organ donation and transfusions have been recorded. Similarly, transovarial transmission of the virus within mosquitoes have also been recorded.

Vector Ecology

The Aedes aegypti mosquito is considered the primary vector of DENV. It could breed in natural containers such as tree holes and bromeliads, but nowadays it has well adapted to urban habitats and breeds mostly in man-made containers including buckets, mud pots, discarded containers and used tyres, storm water drains etc., thus making dengue an insidious disease in densely populated urban centers. Ae. aegypti is a day-time feeder; its peak biting periods are early in the morning and in the evening before sunset [19] Female Ae. aegypti frequently feed multiple times between each egg-laying period leading to clusters of infected individuals [20]. Once a female has laid her eggs, these eggs can remain viable for several months in dry condition, and will hatch when they are in contact with water.

Aedes albopictus, a secondary dengue vector and, has spread to more than 32 states in the USA, and more than 25 countries in the European Region, largely due to the international trade in used tyres (a breeding habitat) and other goods (e.g. lucky bamboo). It favors breeding sites close to dense vegetation including plantations which is linked to increased risk of exposure for rural workers such as those in rubber and palm oil plantation, but it is also found to be established abundantly in urban areas. Ae. albopictus is highly adaptive. Its geographical spread is largely due to its tolerance of colder conditions, as an egg and adult [21, 22]. Similar to Ae. aegypti, Ae. albopictus is also a day biter and ithas been implicated as the primary vector of DENV in a limited number of outbreak, where Aedes aegypti is either not present, or present in low numbers [23, 24]

Disease characteristics (signs and symptoms)

While majority of dengue cases are asymptomatic or show mild symptoms, it can manifest as a severe, flu-like illness that affects infants, young children and adults, but seldom causes death. Symptoms usually last for 2-7 days, after an incubation period of 4-10 days after the bite from an infected mosquito [25]. The World Health Organization classifies dengue into 2 major categories: dengue (with / without warning signs) and severe dengue. The sub-classification of dengue with or without warning signs is designed to help health practitioners triage patients for hospital admission, ensuring close observation, and to minimize the risk of developing the more severe dengue[25] .

Dengue

Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms during the febrile phase (2-7 days):

severe headache

pain behind the eyes

muscle and joint pains

nausea

vomiting

swollen glands

rash.

Severe dengue

A patient enters what is called the critical phase normally about 3-7 days after illness onset. During the 24-48 hours of critical phase, a small portion of patients may manifest sudden deterioration of symptoms. It is at this time, when the fever is dropping (below 38°C/100°F) in the patient, that warning signs associated with severe dengue can manifest. Severe dengue is a potentially fatal complication, due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.

Warning signs that doctors should look for include:

severe abdominal pain

persistent vomiting

rapid breathing

bleeding gums or nose

fatigue

restlessness

liver enlargement

blood in vomit or stool.

If patients manifest these symptoms during the critical phase, close observation for the next 24-48 hours is essential so that proper medical care can be provided, to avoid complications and risk of death. Close monitoring should also continue during the convalescent phase.

Diagnostics

Several methods can be used for diagnosis of DENV infection. Depending on the time of patient presentation, the application of different diagnostic methods may be more or less appropriate. Patient samples collected during the first week of illness should be tested by both methods mentioned below:

Virus isolation methods

The virus may be isolated from the blood during the first few days of infection. Various reverse transcriptase-polymerase chain reaction (RT-PCR) methods are available and are considered the gold standard. However, they require specialised equipment and training for staff to perform these tests.

The virus may also be detected by testing for a virus-produced protein, called NS1. There are commercially-produced rapid diagnostic tests available for this, and it takes only ~20 mins to determine the result, and the test does not require specialized laboratory techniques or equipment.

Serological methods

Serological methods, such as enzyme-linked immunosorbent assays (ELISA), may confirm the presence of a recent or past infection, with the detection of anti-dengue antibodies. IgM antibodies are detectable ~1 week after infection and remain detectable for about 3 months. The presence of IgM is indicative of a recent DENV infection. IgG antibody levels take longer to develop and remains in the body for years. The presence of IgG is indicative of a past infection.

Treatment

There is no specific treatment for dengue fever. Patients should rest, stay hydrated and seek medical advice. Depending on the clinical manifestations and other circumstances, patients may be sent home, be referred for in-hospital management, or require emergency treatment and urgent referral[25].

Supportive care such as fever reducers and pain killers can be taken to control the symptoms of muscle aches and pains, and fever.

The best options to treat these symptoms are acetaminophen or paracetamol.

NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen and aspirin should be avoided. These anti-inflammatory drugs act by thinning the blood, and in a disease with risk of hemorrhage, blood thinners may exacerbate the prognosis.

For severe dengue, medical care by physicians and nurses experienced with the effects and progression of the disease can save lives - decreasing mortality rates to less than 1% in majority of the countries.

Vaccination against dengue

The first dengue vaccine, Dengvaxia® (CYD-TDV) developed by Sanofi Pasteur was licensed in December 2015 and has now been approved by regulatory authorities in ~20 countries. In November 2017, the results of an additional analysis to retrospectively determine serostatus at the time of vaccination were released. The analysis showed that the subset of trial participants who were inferred to be seronegative at time of first vaccination had a higher risk of more severe dengue and hospitalizations from dengue compared to unvaccinated participants. As such, use of the CYD-TDV vaccine is targeted for persons living in endemic areas, 9-45 years of age, who have had at least 1 episode of dengue virus infection in the past. Several additional dengue vaccine candidates are under evaluation.

WHO position on the CYD-TDV vaccine[26]

As described in the WHO position paper on the Dengvaxia vaccine (September 2018)[26] the live attenuated dengue vaccine CYD-TDV has been shown in clinical trials to be efficacious and safe in persons who have had a previous dengue virus infection (seropositive individuals). For countries considering vaccination as part of their dengue control programme, pre-vaccination screening is the recommended strategy. With this strategy, only persons with evidence of a past dengue infection would be vaccinated (based on an antibody test, or on a documented laboratory confirmed dengue infection in the past). Decisions about implementing a pre-vaccination screening strategy will require careful assessment at the country level, including consideration of the sensitivity and specificity of available tests and of local priorities, dengue epidemiology, country-specific dengue hospitalization rates, and affordability of both CYD-TDV and screening tests.

Vaccination should be considered as part of an integrated dengue prevention and control strategy. There is an ongoing need to adhere to other disease preventive measures such as well-executed and sustained vector control. Individuals, whether vaccinated or not, should seek prompt medical care if dengue-like symptoms occur.

Risk factors

Previous infection with DENV increases the risk of the individual developing severe dengue.

Urbanization (especially unplanned), is associated with dengue transmission through multiple social and environmental factors: population density, human mobility, access to reliable water source, water storage practice etc.

Community's risks to dengue also depend on population's knowledge, attitude and practice towards dengue, as well as the implementation of routine sustainable vector control activities in the community.

Consequently, disease risks may change and shift with climate change in tropical and subtropical areas ,and vectors might adapt to new environment and climate.

Prevention and control

If you know you have dengue, avoid getting further mosquito bites during the first week of illness. Virus may be circulating in the blood during this time, and therefore you may transmit the virus to new uninfected mosquitoes, who may in turn infect other people.

The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for dengue. At present, the main method to control or prevent the transmission of dengue virus is to combat the mosquito vectors. This is achieved through:

Prevention of mosquito breeding:

Preventing mosquitoes from accessing egg-laying habitats by environmental management and modification;

Disposing of solid waste properly and removing artificial man-made habitats that can hold water;

Covering, emptying and cleaning of domestic water storage containers on a weekly basis;

Applying appropriate insecticides to water storage outdoor containers;

Personal protection from mosquito bites:

Using of personal household protection measures, such as window screens, repellents, coils and vaporizers. These measures must be observed during the day both inside and outside of the home (e.g.: at work/school) because the primary mosquito vectors bites throughout the day;

Wearing clothing that minimises skin exposure to mosquitoes is advised;

Community engagement:

Educating the community on the risks of mosquito-borne diseases;

Engaging with the community to improve participation and mobilization for sustained vector control;

Active mosquito and virus surveillance:

Active monitoring and surveillance of vector abundance and species composition should be carried out to determine effectiveness of control interventions;

Prospectively monitor prevalence of virus in the mosquito population, with active screening of sentinel mosquito collections;

Vector surveillance can be combined with clinical and environment surveillance.

supports countries in the confirmation of outbreaks through its collaborating network of laboratories;

provides technical support and guidance to countries for the effective management of dengue outbreaks;

supports countries to improve their reporting systems and capture the true burden of the disease;

provides training on clinical management, diagnosis and vector control at the country and regional level with some of its collaborating centres;

formulates evidence-based strategies and policies;

support countries in the development of dengue prevention and control strategies and adopting the Global Vector Control Response (2017-2030)

reviews the development of new tools, including insecticide products and application technologies;

gathers official records of dengue and severe dengue from over 100 Member States; and

publishes guidelines and handbooks for surveillance, case management, diagnosis, dengue prevention and control for Member States.

In addition, there is ongoing research amongst many groups of international collaborators in search of novel tools and innovative strategies that will contribute in global efforts to interrupt transmission of dengue. The integration of vector management approaches is encouraged by WHO to achieve sustainable, effective locally adapted vector control interventions.

WHO response

WHO responds to dengue in the following ways:

Cited references

[1] Waggoner, J.J., et al., Viremia and Clinical Presentation in Nicaraguan Patients Infected Wi1. Waggoner, J.J., et al., Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus. Clinical Infectious Diseases, 2016. 63(12): p. 1584-1590.

[2] Bhatt, S., et al., The global distribution and burden of dengue. Nature, 2013. 496(7446): p. 504-507.

[3] Brady, O.J., et al., Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLOS Neglected Tropical Diseases, 2012. 6(8): p. e1760.

[4] Tjaden, N.B., et al., Extrinsic Incubation Period of Dengue: Knowledge, Backlog, and Applications of Temperature Dependence. Plos Neglected Tropical Diseases, 2013. 7(6): p. 5.

[5] Siler, J.F., M.W. Hall, and A.P. Hitchens, Dengue: Its history, epidemiology, mechanism of transmission, etiology, clinical manifestations, immunity and prevention. 1926, Manila: Bureau of Science.

[6] Watts, D.M., et al., Effect of Temperature on the vector efficiency of Aedes aegypti for Dengue 2 virus. American Journal of Tropical Medicine and Hygiene, 1987. 36(1): p. 143-152.

[7] Carrington, L.B., et al., Fluctuations at low mean temperatures accelerate dengue virus transmission by Aedes aegypti. PLOS Neglected Tropical Diseases, 2013. 7(4): p. e2190.

[8] Lambrechts, L., et al., Impact of daily temperature fluctuations on dengue virus transmission by Aedes aegypti. Proceedings of the National Academy of Sciences of the United States of America, 2011. 108(18): p. 7460-7465.

[9] Anderson, J.R. and R. Rico-Hesse, Aedes aegypti vectorial capacity is determined by the infecting genotype of dengue virus. American Journal of Tropical Medicine and Hygiene, 2006. 75(5): p. 886-892.

[10] Ye, Y.X.H., et al., Wolbachia Reduces the Transmission Potential of Dengue-Infected Aedes aegypti. PLOS Neglected Tropical Diseases, 2015. 9(6): p. e0003894.

[11] Duong, V., et al., Asymptomatic humans transmit dengue virus to mosquitoes. Proceedings of the National Academy of Sciences of the USA, 2015. 112(47): p. 14688-14693.

[12] Nguyen, N.M., et al., Host and viral features of human dengue cases shape the population of infected and infectious Aedes aegypti mosquitoes. Proceedings of the National Academy of Sciences of the United States of America, 2013. 110(22): p. 9072-9077.

[13] Gubler, D.J., et al., Viraemia in patients with naturally acquired dengue infection. Bulletin of the World Health Organisation, 1981. 59: p. 623-630.

[14] Basurko, C., et al., Estimating the Risk of Vertical Transmission of Dengue: A Prospective Study. American Journal of Tropical Medicine and Hygiene, 2018. 98(6): p. 1826-1832.
[26] Dengue vaccines: WHO position paper - September 2018 Weekly epidemiological record; No 36, 2018, 93, 457-476
[15] Mazarin, N., J.M. Rosenthal, and J. Devenge, Mother infant dengue transmission during the 2009-2010 dengue epidemic: Observation of four cases. Archives De Pediatrie, 20141. Waggoner, J.J., et al., Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus. Clinical Infectious Diseases, 2016. 63(12): p. 1584-1590.

[16] Sinhabahu, V.P., R. Sathananthan, and G.N. Malavige, Perinatal transmission of dengue: a case report. BMC Research Notes, 2014. 7(795).

[17] Basurko, C., et al., Maternal and foetal consequences of dengue fever during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009. 147(1): p. 29-32.

[18] Pouliot, S.H., et al., Maternal Dengue and Pregnancy Outcomes A Systematic Review. Obstetrical & Gynecological Survey, 2010. 65(2): p. 107-118.

[19] Trpis, M., et al., DIEL PERIODICITY IN LANDING OF AEDES-AEGYPTI ON MAN. Bulletin of the World Health Organization, 1973. 48(5): p. 623-629.

[20] Scott, T.W., et al., Longitudinal studies of Aedes aegypti (Diptera: Culicidae) in Thailand and Puerto Rico: Blood feeding frequency. Journal of Medical Entomology, 2000. 37(1): p. 89-101.

[21] Medlock, J.M., et al., Analysis of the potential for survival and seasonal activity of Aedes albopictus (Diptera: Culicidae) in the United Kingdom. Journal of Vector Ecology, 2006. 31(2): p. 292-304.

[22] Romi, R., F. Severini, and L. Toma, Cold acclimation and overwintering of female Aedes albopictus in Roma. Journal of the American Mosquito Control Association, 2006. 22(1): p. 149-151.

[23] Paupy, C., et al., Comparative role of Aedes albopictus and Aedes aegypti in the emergence of dengue and chikungunya in Central Africa. Vector-Borne and Zoonotic Diseases, 2010. 10(3): p. 259-266.

[24] Metselaar, D., et al., AN OUTBREAK OF TYPE-2 DENGUE FEVER IN THE SEYCHELLES, PROBABLY TRANSMITTED BY AEDES-ALBOPICTUS (SKUSE). Bulletin of the World Health Organization, 1980. 58(6): p. 937-943.

[25] World Health, O., Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. 2009, Geneva: World Health Organization. 1-147.

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Dengue is a mosquito-borne viral disease that has rapidly spread to all regions of WHO in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. These mosquitoes are also vectors of chikungunya, yellow fever and Zika viruses.

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Maria went to the U.S. full of fear but there, she found a Pakistani family that took her in and cared for her. The only probelm was, she felt lost. She found Johnathan Power's number and called him. So then, she went to Canada and was trained by him. In 2012, Maria was in Philidelphia and there she won her the tournament easily. The life Maria lived in Canada made her finally feel free. She was living without the fear and guilt she carred in Pakistan.

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Pakistan's squash player Maria Toorpakai Wazir put her name in the history books by winning the first ever women's event in the Nash Cup in Canada by beating Milou van der Heijden of the Netherlands 13-11, 11-3, 11-9.

The victory gave Maria, who hails from South Waziristan, the third title of her WSA career after she won the Southwest Squash Open and the Liberty Bell Open last year in the US and was another milestone in her journey of immense courage and perseverance.

"When I win a tournament, I feel that I am moving towards my goals. So winning today means a lot to me," Maria said after winning the Nash Cup.

Maria who had faced stiff opposition in her native Bannu for playing sport, often posed as a boy to compete in matches in her conservative hometown. She moved to Peshawar in 1999 to pursue her love for squash.

Upon her move, Maria was immediately inducted into the Hashim Khan Complex, named after the first great player to emerge from a Pakistani dynasty of squash players which dominated the international game for decades.

It was in Peshawar where Maria's father really began to realise the true potential his daughter had. Representing Warsak High School in Peshawar, Maria became the youngest ever winner of the National Women's Squash Championship toppling top seed Muqaddas Ashraf of Punjab in straight sets in the final at Karachi Club squash court in 2004. She was 13 at the time and while the cash prize of Rs. 8,500 and a crystal trophy felt good, it was really the satisfaction of being better than everyone that was to accelerate Maria's drive. She quickly swatted away her competition, winning an Under-15 tournament and then at 15 winning the Under-19 Hashim Khan National junior championship in 2005.

She scaled up the national rankings, Dunlop racquet in hand and Mohammad Ali-like confidence, often calling her self the world's best squash player in some of her post-match press conferences. It was this self belief and great form that finally brought her to the world stage, joining the WISPA in 2006. She was immediately at ease on the international circuit as well, reaching the semi-final stage of the 2nd WISPA International Women's Squash Championship at the POF Jahangir Khan Complex in Islamabad.

In early August 2007 she was given the Salaam Pakistan Award by the President of Pakistan, alongside tennis player Aisam-ul-Haq Qureshi and footballer Muhammad Essa.

The year 2009 saw her win her first international tournament when she beat the same opponent she had defeated as a 13-year-old. Muqaddas Ashraf once again succumbed to Maria's power and agility losing the Chief of Army Staff International squash tournament.

But it was in 2011 that her fortunes really changed.

After learning of a job opening at Canadian squash legend Jonathan Power's National Squash Academy in Toronto, Maria wrote an emotional letter to Power about the difficulty of training freely in Peshawar and about her aspirations of following in the footsteps of Pakistani greats. Moved by the plea, Power immediately took the young talent under his wings and vowed to make her a world champion.

The academy in Toronto gave Maria "10 out of 10" as far as talent was concerned but a lack of proper training meant she had a long way to go before she could compete with the top stars in the world. Her grit and determination, however, meant that it wasn't going to be long until that happened.

Two titles in 2012, qualification in the British Open main draw (a first for Pakistani female players) and now the Nash Cup. For Power, who was in attendance at the London Squash & Fitness Club in Ontario, Maria seems to be headed in the right direction.

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Maria Toor becomes first female Nash Cup champion

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Pakistan's squash player Maria Toorpakai Wazir put her name in the history books by winning the first ever women's event in the Nash Cup in Canada by beating Milou van der Heijden of the Netherlands 13-11, 11-3, 11-9.