Incest is a problem in countries all around the world. It's also the least likely form of sexual abuse to be reported.
That's because the victim's relatives are often reluctant to tarnish their family's reputation. An official reluctance to investigate incest allegations is also to blame in some countries. Both of those factors are part of the problem in Pakistan.
According to estimates from the United Nations, around 36% of girls and 29% of boys have suffered child sexual abuse.
Zoya is a slim woman in her late 30s. We meet in Karachi inside the home of one of the few people who she has trusted with a dark secret that has haunted her for years. She asks us not to use her real name because of reprisal from her family.
"It's very difficult topic to talk about it's something very hard for me and I am extremely nervous right now," Zoya says.
Zoya's voice shakes at times. Dressed in a white shalwar kameez her shoulder length hair is pulled back. And then she begins to tell her story.
"My father had been abusing me since the time I was little kid," Zoya says.
Zoya recalls details of the sexual abuse she faced for years at the hands of her own father, at times tears roll down her eyes.
When sexual abuse happens in Pakistan, she says, adults and even relatives are reluctant to get involved. That's especially true when the abuse comes at the hands of another family member.
Incest and child abuse happens all over the world, but Zoya says in Pakistan it's even worse, because no one wants to help.
"In the society that we pretend it's not happening majority of people. …Even if people know it happening they'll turn their face say, we don't want to get involved," she says.
Zoya says told her mother about the abuse but it didn't stop. In fact, it made the situation even worse.
"I told my mother…and after that my father would not let me talk to anybody anyone at all not even my family, not anybody the moment somebody came and stood with me for a second or I stood with someone talking And that way he managed to keep me rest of life…I was always afraid," Zoya says.
Manizeh Bano is the executive director of Sahil, a group working against child sexual abuse and exploitation. Bano and her organization track reported cases of child sexual abuse in the country. In 2010 a total of 2252 cases were reported, almost a 12% increase from the previous year.
And among those cases, she says incest is the least likely form of child sexual abuse to be reported.
Bano says cases like Zoya's aren't uncommon. She says the lack of support that exists for women in Pakistan makes them often unable to help their daughters get out of the situation.
"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," Bano said.
Zoya says every time she would turn to her family, including her uncles for help, she was given the same false promises.
"Oh don't worry about it your father won't do it," she says.
And she wasn't alone.
"My father didn't spare my sisters either."
After years of abuse, her sisters committed suicide two weeks apart when Zoya was 18. Their deaths haunt her. She says she still feels guilty that she wasn't able to protect her younger sister from her father.
Experts say there is another reason why stopping incest has been particularly difficult in Pakistan, because no one wants to admit that that can happen in an Islamic country.
"There is this state of denial that this cannot happen in our family, it cannot happen in our country," says Zohra Yousuf, the chairperson for Human Rights Commission of Pakistan. "I think it's really under reported because again it's linked to a family's honor in many ways. It's a crime that's covered up by the family."
Yousuf says if a child does go to the police in Pakistan, she's rarely believed. Often the police won't even file a complaint. Instead they'll send the woman home saying that she is immoral for saying such things against her own father.
And Yousuf says after that, child victims who speak out are often ostracized by their families for tainting the family's honor.
"Absolutely …that's totally taboo and totally denied here because it's not supposed to exist in Islamic society," Yousuf says.
Not everyone thinks the situation is so grim. Tauqeer Fatima Bhutto, minister of women development for the province of Sindh, defends the work her government has done on the issue.
"The government has continued to work on legislation dealing with sexual abuse and domestic abuse of women and children," Bhutto said. "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."
To look for creative solutions to the problem, the group Sahil has started to create animated films and to distribute them to public schools. The films, titled "Meri Hafazit" which means "My Protection" in Urdu, tackle the issue of incest.
Back at Zoya's house, she tells me her sexual abuse only came to an end with the death of her father.
Habiba Nosheen: "How did he finally pass away?"
Zoya: "He died pretty violent I rather than not talk about it. He was murdered."
Habiba Nosheen: "By family member or you don't know?"
Zoya: "I don't know. 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."
Support for this reporting was provided by The Fund for Investigative Journalism. A version of this story has been published by The Atlantic.