In Karachi, with a population of around 20 million people, ambulance drivers are on the front lines of this megacity’s shifting conflicts. Samira Shackle joins one of these drivers, Muhammad Safdar, on his relentless round of call-outs. As a first-responder for more than fifteen years, Safdar has witnessed Karachi wracked by gang wars, political violence and terrorism. At the height of the unrest, the number of fatalities was often overwhelming.