This increased US support has coincided with a dramatic escalation of the conflict between local Pakistani insurgents and their government. It is difficult to know how many have died in Pakistan since 2004 due to the violence and how many of those are civilians.
Most of the fighting is concentrated in the Northwest, near the border with Afghanistan, but the bloodshed not infrequently affects civilians throughout Pakistan. Sectarian conflict targeting the country’s minority Shia population has been on the rise in recent years. A March 2013 car bombing in Karachi killed 45 and wounded 146.
At least 50,000 Pakistanis (combatant and non-combatant) have been killed since 2004 and more than 40,000 have been injured during that period by the various parties to the conflict. This does not include the likely deaths of tens of thousands more combatants — both insurgents and Pakistani government forces. Given the pace of the fighting in 2011, several thousand more have likely already been killed and wounded.
The US began its semi-covert campaign of drone strikes in 2004 to kill Al Qaeda and Taliban forces based in Northern Pakistan. These strikes have killed about 3,000 people, including many civilians, as of March 2014. The arguments about how many of the dead are civilians are nearly as intense as the disputes about the legality of the strikes. Many legal scholars regard them as clear violations of international law.
The Taliban, Al Qaeda, and members of other militant organizations have killed thousands of civilians in Pakistan using suicide attacks, assassination, and ambushes.
The Pakistani Security Forces have also killed civilians with mortars, direct fire, and with bombs as they target militants in several major offensives in the Swat Valley and neighboring districts. In some years, it appears that Pakistani security forces were responsible for the majority of civilian killings.
The US has provided direct and overt security aid and reimbursement to Pakistan since the September 11 attacks to a total of more than $14 billion. The US has also trained Pakistani military forces and provided military equipment to Pakistan including tanks, missiles and helicopters which have been used in these offensives.
The burden of war is also evident in the number of Pakistanis who are both internally displaced and who have sought refuge in other countries. Although the exact numbers are difficult to determine, millions of Pakistanis have been pushed from their homes in the last several years. Specifically, in 2012, a half million Pakistanis are reported internally displaced in the northwest region of Pakistan, because of fighting, many staying in the many camps for internally displaced people there. (Text updated as of March 2014)