She convinced the government this was their responsibility.
In a country where autism care once existed almost nowhere in the public system, one specialist spent a decade building what was missing — not as charity, but as infrastructure. Irum Rizwan, honored this May with Pakistan's Tamgha-i-Imtiaz at Karachi's Governor House, transformed a barren landscape of unmet need into a network of six free, government-run centers across Sindh serving over three thousand individuals. Her work asks a quiet but insistent question of every society: when a population is invisible to its own healthcare system, who bears the cost of that absence — and who chooses to end it?
- For years, Pakistani families navigating autism did so entirely alone — no public diagnosis, no tailored education, no route toward independence or employment existed within the state system.
- Rizwan returned from training in the UK and US to find a gap so vast it demanded not a clinic but a movement, beginning with the first autism department in a Pakistani teaching hospital in 2013.
- The Government of Sindh eventually recognized the scale of unmet need and tasked her with building C-ARTS, a network that expanded from one Karachi facility to six centers across the province by 2024.
- Every center operates free of charge, offering diagnosis, rehabilitation, education, and vocational training — including Pakistan's first café run entirely by individuals with autism.
- The Tamgha-i-Imtiaz, conferred by Governor Syed Nehal Hashmi on behalf of President Zardari, signals that a decade of quiet institution-building has now been recognized as a national public health achievement.
On a Wednesday afternoon in May, Irum Rizwan stood in Karachi's Governor House to receive the Tamgha-i-Imtiaz — one of Pakistan's highest civilian honors — conferred by Governor Syed Nehal Hashmi on behalf of President Asif Ali Zardari. The moment was official acknowledgment of what thousands of families across Sindh had already come to know firsthand.
Rizwan had trained at the University of Birmingham and in both the UK and the US before returning to Pakistan, where she found a healthcare landscape almost entirely without specialized autism services. No dedicated hospital departments. No government rehabilitation networks. Families managing alone, without diagnosis, therapy, or any pathway toward independence for their children.
In 2013, she established the first autism department within a Pakistani teaching hospital at Dow University of Health Sciences in Karachi. Five years later, the Government of Sindh tasked her with building something larger. The Center for Autism and Rehabilitation Training Sindh — C-ARTS — began as a single facility in Gulistan-e-Johar and grew methodically: a second center in Orangi Town in 2023, facilities in Sukkur, Gambat, and Hyderabad in 2024, and a dedicated center for autistic adults in Korangi in 2022. All six operate free of charge, offering diagnosis, rehabilitation, education, and employment training under one comprehensive model.
More than three thousand individuals have passed through these centers, gaining access to services that simply did not exist for them before. Among the most visible expressions of this work is Pakistan's first café managed entirely by individuals with autism — a functioning business and a daily demonstration of capability and independence.
What Rizwan built is not philanthropy subject to donor cycles. It is public infrastructure — the kind that, once established, can be sustained and expanded. The award she received honors not a single act but a decade-long effort to make autism care a matter of public health rather than private burden.
Irum Rizwan stood in the Governor House in Karachi on a Wednesday afternoon in May, receiving one of Pakistan's highest civilian honors. The Tamgha-i-Imtiaz—a recognition reserved for exceptional service to the nation—was conferred on her by Governor Syed Nehal Hashmi, acting on behalf of President Asif Ali Zardari. The award marked official acknowledgment of what had already become clear to thousands of families across Sindh: that this one woman had fundamentally altered what autism care looked like in Pakistan.
Rizwan arrived at this moment with credentials that set her apart. She held a postgraduate degree from the University of Birmingham and had trained in both the United Kingdom and the United States, absorbing world-class approaches to autism diagnosis and treatment before returning home to apply them. What she found was a landscape almost entirely barren of specialized services. There were no dedicated autism departments in teaching hospitals. There were no government-run rehabilitation networks. There were families managing autism in isolation, without access to diagnosis, therapy, education tailored to their children's needs, or any pathway toward employment or independence.
In 2013, she established the first autism department ever created within a Pakistani teaching hospital—at Dow University of Health Sciences in Karachi. It was a single foothold in an enormous gap. Five years later, recognizing both her expertise and the scale of unmet need, the Government of Sindh tasked her with building something larger. The Center for Autism and Rehabilitation Training Sindh, or C-ARTS, began as one facility in the Gulistan-e-Johar neighborhood. What followed was methodical expansion. By 2024, the network had grown to six centers: the original in Gulistan-e-Johar, a second in Orangi Town opened in 2023, facilities in Sukkur and Gambat and Hyderabad all launched in 2024, and a dedicated center for autistic adults in Korangi that opened in 2022. Each center offered the same comprehensive approach—diagnosis, rehabilitation, education, skill training, and employment support—and each operated without charge.
The scale of impact is concrete. Over three thousand individuals with autism have moved through these centers. They have received diagnoses that were previously unavailable to them. They have accessed therapies and educational programs designed specifically for their needs. They have learned vocational skills and found pathways into employment. Some of this work happens in conventional settings. Some of it happens in spaces Rizwan pioneered—most notably Pakistan's first café managed entirely by individuals with autism, a working business that serves as both employment and a daily assertion of independence and capability.
C-ARTS represents something without precedent in Pakistan: a government-run network of autism services, free to all users, operating at international standards. It is not a charity dependent on donor whims or philanthropic cycles. It is infrastructure. It is the kind of thing that, once built, can be sustained and expanded. The award Rizwan received was recognition not just of her individual achievement but of a decade-long effort to make autism care a public health priority rather than a private burden borne by families who could afford it.
Citas Notables
She has transformed the lives of over 3,000 individuals with autism, reshaping the landscape of autism care in the country.— Governor House ceremony citation
La Conversación del Hearth Otra perspectiva de la historia
When you look at what Rizwan built, what strikes you most—the scale of it, or the fact that it's government-run?
Both, but the government piece is crucial. A private clinic can serve hundreds. A network owned by the state can serve thousands and doesn't disappear when funding dries up.
She trained abroad and came back. That's not uncommon. What made her different?
She didn't just bring back techniques. She built infrastructure for them. She saw a gap and didn't fill it with a charity—she convinced the government this was their responsibility.
The café managed by autistic workers—is that symbolic, or does it actually change lives?
It's both. Symbolically, it says these are people who can work, who can contribute. Practically, it's employment. For someone with autism, that's everything.
Three thousand people. How do you measure what that means?
You don't, really. You just know that three thousand families have access to something they didn't have before. That's the measure.