The deaths in the Karachi stampede came during the Muslim holy month of Ramadan, a traditional time for charitable acts including giving away food. At times, however, the giveaways have turned rowdy and dangerous in this largely impoverished nation.
Monday's stampede occurred in a small building with narrow passages. As more women entered to get the flour, some began to panic and guards began using strong-arm tactics to clear the place, officials and witnesses said.
Karachi police chief Wasim Ahmad said at least 18 women and girls died in the ensuing rush. Mohammad Amin Khan of Karachi Civil Hospital said some of the women had suffocated and that there were at least 20 bodies.
"Hundreds of women were pushing to enter into the small hall, and guards started beating us to get the place cleared," said 30-year-old Kulsoom, who gave only one name and ended up among the many wounded. "I fell down and was being crushed. My heart was missing beats and I thought I was dying."
Panicked relatives streamed into the hospital, while others brought limp bodies in the backs of trucks or in their arms. Some women wailed while laying on stretchers.
The flour giveaway was organized by a private donor who Ahmad said was detained for not giving police prior notice of the event.
"Poverty is on the rise, there is a desperation among people," local government official Javed Hanif said. "Naturally, when people are frustrated, whenever they get such an opportunity, they try to grab the maximum."
Air Strike on Suspected Militant Vehicle Kills 4
A missile fired from a suspected unmanned U.S. drone slammed into a car in a Pakistani tribal region close to the Afghan border Monday, killing four people, intelligence officials and residents said.
The apparent American missile strike was the latest of more than 50 in the northwest region since last year aimed at killing top al Qaeda and Taliban leaders. Last month, the head of the Pakistani Taliban was killed in one such strike.
Monday's attack took place about 1.5 miles from the town of Mir Ali in North Waziristan, killing four people, two officials and witnesses said. The officials spoke on condition of anonymity, saying they need to remain unnamed to do their job effectively.
The identities of the victims were not known.
Witnesses Ikramullah Khan and Mohammad Salim said the missile hit a vehicle with blacked-out windows - a style associated with Taliban fighters in the region.
Pakistan protests the U.S. missile strikes as violations of its sovereignty and says they fan support for the insurgents, but Washington has shown no sign of abandoning a tactic that it says has killed several ranking militants and disrupted their operations.
Islamist militants with roots in the border region launch near-daily attacks on Pakistan's U.S.-backed government and security forces. The mountainous, lawless area is also used as a safe haven from which to stage attacks on foreign forces in Afghanistan.
Under pressure from the West, Pakistan in May launched an offensive in the northwestern Swat Valley, which had fallen largely under Taliban control. It claims to have cleared most of Swat of the militants and killed more than 1,800 of them, although sporadic militant attacks continue.
The army announced the capture last week of five top Swat Taliban commanders, and Interior Minister Rehman Malik said Sunday authorities were now closing in on Swat Taliban chief Maulana Fazlullah.
"Fazlullah is surrounded, and he cannot escape us," Malik told reporters in Islamabad.
Pakistan's army said Monday to have killed 16 suspected militants in its latest operations in Swat and neighboring Dir district. One soldier died and another was wounded, an army statement covering the previous 24-hour period added.
Military officials also said 159 alleged militants had surrendered to security forces Monday. They include six boys recruited by the Taliban to be suicide bombers, Col. Amir Khan told reporters in Piochar, a main insurgent base in Swat.
In recent weeks, the army has reported an increasing flow of insurgents voluntarily surrendering.
The information provided by the military could not be independently confirmed because of limited access to the region.