An alarming number of children, especially girls, are abused by older family members, who know that their country's legal system and social mores make it unlikely that they will be punished.
The slim woman I'll call Zoya is in her late 30s. She sits inside the home of her good friend, one of the very few people who she has trusted with a dark secret that has haunted her for years.
"It's a very difficult topic to talk about it's something very hard for me," she says.
Zoya's voice shakes at times. Dressed in a white shalwar kameez, her shoulder-length hair is pulled back. "My father had been abusing me since the time I was little kid." Tears roll down her face and she recalls the details of her abuse.
She was four when she first came to suspect that what was happening to her might not be normal. One day, "when everyone was sleeping, my father picked me up, took me to another room, undressed me," Zoya says. "I found myself lying in bed naked and I was frightened, I didn't understand why."
Later, Zoya tried to tell her mother.
"I said, 'Papa is taking me -- mama, papa is taking me at night to another room and he takes off my clothes and does things.'" Her mother answered, "Don't tell anybody." It's a common phrase for victims of sexual abuse in Pakistan to hear from their mothers.
Manizeh Bano, Executive Director of a Pakistan-based NGO called Sahil that works against child sexual abuse and exploitation, she says that the country's harsh gender restrictions makes it difficult for mothers to protect their own children. "It is the most difficult because mothers don't have options, they often have to live within that same family, they can't get up and go anywhere," she says.
Cases like Zoya's aren't uncommon, according to Bano, and lack of support that exists for women in Pakistan makes them often unable to help their daughters get out of the situation. In Pakistan most families are still overwhelmingly financially supported by men. Bano says that if a mother learns that her husband is sexually molesting her daughters, she has nowhere to turn because there is little to no state assistance for battered women in Pakistan if they chose not to live with their husbands.
In 2010, a total of 2252 cases child sexual abuse were reported in the news, according to Sahil. That's almost a 12 percent increase from the previous year. The Human Rights Commission of Pakistan (HRCP) states that these numbers are a fraction of the actual problem. It suspects that many cases of sexual violence are simply covered up, especially when they happen at the hands of a family member.
Zohra Yousuf, the chairperson for Human Rights Commission of Pakistan, says that she doesn't suspect that the increase in number of reported cases in the media means that more crime of incest are happening, she says it could be that because Pakistanis are finally starting to come forward and discuss a type of crime that she believes is very prevalent in Pakistan but severely under-reported.
Incest and child abuse happen all over the world. But, according to a report by Equality Now, an international human rights organization, victims of incest in Pakistan face additional barriers in seeking justice.
The report also notes that, in the very few cases where a victim does come forward, the case rarely makes it past the procedural hurdles in the justice system. Even police officers, who are usually the first line of contact for these victims, sometimes refuse to file a complaint, sending the victim home and telling her that she is immoral for saying such things against her own father, according to Bano. The report by Equality Now also notes that perpetrators are never apprehended in most case or are often released without charges.
Prosecuting these abuses can be difficult as there are no specific provisions against the crime of incest in Pakistan's Penal Code. Incest is treated as any other rape, without any additional protection for the victim.
Many young victims are also deterred from coming forward, Bano suggests, especially because rape cases can be unusually slow to prosecute in Pakistan. Even if they do get in front of a court, they are often are encouraged, sometimes even by the judges, to settle the matter out of court for the honor of the family, through a process dubbed as "compromise," by accepting a sum of money in exchange for silence. This compromise, Bano says, has been the biggest challenge her organization faces in bringing the perpetrators to justice. After spending months working with the victim, in most cases, families "compromise," ensuring that the perpetrator is never convicted for his crime.
According to Sahil, incest is the least likely form of child sexual abuse to be reported because the adults most likely to intervene are often complicit or unwilling to turn in their own spouse or family members. Bano has found that families will often throw up their hand and say something like, "What has happened has already happened, what's the point in having someone from our family go to jail."
Sarah Zaman, who heads the Karachi-based NGO War Against Rape, says that combating predatory incest has been particularly difficult in Pakistan, where it can be difficult for political and social leaders to admit that such things could happen in an Islamic country.
"Absolutely!" Yousuf tells me when I ask about this theory. "That's totally taboo and totally denied here because it's not supposed to exist in Islamic society."
"There is this state of denial that this cannot happen in our family, it cannot happen in our country," Yousuf explains. "I think it's really under reported because it's linked to a family's honor in many ways. It's a crime that's covered up by the family."
Every time that Zoya would turn to her family for help, she says, she was given the same false promises: he'll stop abusing you.
"Oh, don't worry about it, your father won't do it," an uncle once told her.
And she wasn't alone. Zoya's two younger sisters weren't spared by their father.
When Zoya was 18, one of her young sisters took her own life by hanging herself. Two weeks later, her other sister did the same. Over a decade later, their deaths haunt her. She said she still feels guilty that she wasn't able to protect them from her father.
"I am still alive although my sisters are gone," Zoya says.
"In this society, we pretend it's not happening," Zoya says, "even if people know it's happening they'll turn their face and say, "We don't want to get involved.'"
The abuse only got worse after she told her mother, Zoya says.
"After that, my father would not let me talk to anybody, anyone at all, not even my family, not anybody," she says. "And that way he managed to keep me isolated for most of my life. I was always afraid."
Tauqeer Fatima Bhutto, the Minister of Women Development for the province of Sindh, says the government is trying to work on the issue.
"The government has continued to work on legislation dealing with sexual abuse and domestic abuse of women and children. If you say, 'Well Pakistan just doesn't have laws,' Pakistan has everything available, but we just need people who will work on these issues," she says.
Sahil, the NGO, is producing animated short videos, which it distributes to public schools as a teaching tool, on the dangers of sexual abuse. The video series, titled Meri Hafazit which means "my protection" in Urdu, teach about various forms of sexual abuse in gentle, kid-friendly language.
Zoya's nightmare finally came to an end with the sudden death of her father. "He died pretty violently. I'd rather not talk about it. He was murdered." She says she doesn't know who killed him.
"I have no idea. The police never found out. As for me I was glad that he was dead. My only regret for he didn't die earlier. That is my only regret."
This story was supported by The Fund for Investigative Journalism. Hilke Schellmann contributed reporting. A version of this story also appears at BBC's The World.