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"Are we being punished by God because we’d been too proud to have two sons".

An electrician, he survives on odd jobs to put bread on the table.

Shahid Kouser, 30, felt blessed when wife Shezana gave birth to son Ahesem in 2006 and then Abdullah two years later. But their happy world was torn apart when daughter Mursleen was born just a year later quickly followed by another daughter Muntaha.

Both girls were born with cleft lips and palates, caused when the roof of the mouth and the lips fail to fuse together properly in the womb, causing disfigurement, speech problems and often malnutrition because children with the condition struggle to feed properly.

And all this on top of Pakistan’s already high child mortality rates, where one child in every 10 will die before their fifth birthday.

Both Mursleen and Muntaha had severe forms, facing a lifetime of being shunned by the many here who see cleft conditions as curses on the family. 

“We had never seen a child like this,” says Shezana, 28. “People started asking different questions, that maybe we had done bad things and this was our punishment.

“Some said we were being punished by God because we’d been too proud to have two sons.

“We were just worried about what would happen. Every day we were worried.”

The family live in the remote village of Pahdanwaliin in the district of Mandi Bahauddin. It’s a pitifully poor place but humanity and generosity are in abundance. 

Visitors are showered with rose petals and invited into people’s homes where meager provisions are laid out on polished wooden tables like banquets. The people here, people like Shezana and Shahid, have nothing but what little they have, they will be happy to share with you.

Open sewers run down warren-like streets. Walls between buildings are so close, you can reach out and touch both. Even in March, the heat of the day creates a dustbowl swirling about the feet of the children, playing next to the sewers.

There is no money here. But there is a sense of kinship, where people rally together. When a visiting doctor saw the faces of the girls, he told Shezana and Shahid about the Cleft Hospital 40 kilometers away in the city of Gujrat. 

With the support of their families and friends, the couple gathered every penny they could for the bus fare to the hospital. But there was not a single rupee left to pay for treatment for one daughter, let alone two.

Instead, Overseas Plastic Surgery Appeal, an East Yorkshire based charity working with hospital medical director Dr Ijaz Bashir to treat Pakistan’s poorest people for free, stepped in.

Its plastic surgeons and teams of medics ensured both girls underwent surgery on the same day. They’ve had a succession of follow-up treatment and appointments.

 Today, the little girls, now aged six and four, have a chance of a better future. They sit in their classroom at Arqam Model High School, no different from the rest of the children.

“Our lives would have been very bad if this hadn’t happened,” said Shahid. “We would have been so worried about our daughters if we hadn’t gone to the hospital.

“We thank everyone at the hospital for helping us. We feel much better and we’re not worried anymore.”