YOU CAN SEE THEM WHEREVER THERE IS rubbish dumped in tips on the streets of Quetta; children as young as five poring through the filth, trying to avoid syringes thrown out by the city hospital and the shit of goats and sheep that gather to feed on the garbage. They are children surrounded by countless, swarming flies in the burning, endless heat.

They are too poor to go to school, their families unable to put food on the table without the paltry sums of money the children raise by selling garbage to depots that recycle the waste of a teeming city plucked from the Middle Ages and dumped without warning in the 21st century.

They are children such as 12-year-old Wakeel, who has more than once been found lying unconscious on a garbage dump. Wakeel is one of 2000 refugees who fled from Afghanistan to Pakistan in the wake of the September 11 terror attacks. They joined two million refugees already in Pakistan, mostly settling in urban areas such as Quetta and all living in almost unbelievable poverty.

The children of Quetta's garbage dumps start working as soon as they can walk. Neither they nor their parents have the luxury of choice: if the children don't bring in money, the family will not eat. In Pakistani society, Afghan refugees have little status. Quetta does not want them and does nothing to make them comfortable or safe. The province of Balochistan, geographically the largest in Pakistan, has enough problems, constantly arguing for an increase in its meagre portion of the federal budget as it contributes significant proportions of oil and gas supplies. Independence fighters are rarely strangers to using violence in pressing their case.

Quetta is the Balochistan's main city. It is a multicultural assault on the senses, where donkeys pull over-flowing carts past billboards advertising dotcom companies amid a bewildering mishmash of centuries and traditions. It's a city with no refuse collection system, where the rubbish is piled high on street corners; broken glass and used syringes lurking in the tips where children including Wakeel make their living. It's dangerous work,'' he says. "But I have to take money home to my mother.'' He is not alone. Children can be seen on virtually every rubbish dump. Many are barefoot and all of them are trying to find enough garbage to sell for the 60 US cents that is about the most they can expect to earn in a day.

Their stories are all depressingly similar - large families, little money, living in slums. Some are orphans while many have lost at least one parent to illness. Some have been taken in by relatives, who often run the depots that buy the collected garbage. I do not like this work for children,'' says Abdul Bari, who has been running a garbage depot since arriving from Afghanistan two years earlier. "It involves a lot of difficulties and hazards. I provide help and support for these children. I encourage them to learn and to improve themselves.'' You want those who run these depots to be villains. They are paying a pittance for the garbage and pocketing a profit. In Quetta, though, things are never that simple. Some of the depot owners encourage the children to attend drop-in centres in the city to learn how to keep themselves clean, basic reading and writing, and other skills. They are part of the problem and part of a solution, both at the same time.

At one depot we visit, seven-year-old Abdullah says the owner of the garbage depot where he works makes sure he goes to religious school before he starts work. He explains his love for reading and desire to become a doctor. Like most of the children we talk to, he would prefer not to work among the city's waste but recognises there are few other options. Others actually like the lifestyle. I like the liberty,'' says six-year-old Israel. I can go anywhere and do anything whenever I want.'' Israel is one of a number of garbage pickers who joined together to run their own depot. It's a small sign that at least some of these children might one day find a way out of the grinding poverty that keeps them working on the streets every day, from sunrise until the last shard of light disappears.

Noorbibi, a pretty 10-year-old girl who has seen too much for a child of her years, tells how her parents moved to Quetta from Afghanistan before she was born. Any hopes they had of finding a better life ended with a knock on their door two years ago. When the police came into their home in Quetta's slums, it was to arrest Noorbibi's father on a theft charge. It had been hard enough feeding three children while Noorbibi's father worked as a dried bread collector, but once he was jailed the task became impossible.

Noorbibi was sent to work on the city's garbage dump and her life now is split between searching for rubbish to sell and helping her mother with domestic duties to care for her two sisters and brother.

Today, Noorbibi sits in a drop-in centre set up for children like her by the Water, Environment and Sanitation Society (WESS) - one of the organisations in Pakistan partnered by Concern Worldwide. The centre offers a break from a life that might otherwise be too much to bear.

I like it here very much,'' Noorbibi says. I love meeting my friends here and watching cartoons.'' The centre is just off the busy Quetta streets. Each day, more than 800 children use it and two outreach centres in the city. They learn how to protect themselves from infection and disease, how to read and write, and they receive training in various other skills. The boys are helped to become plumbers, electricians, mechanics or tailors, while the girls are taught embroidery and arts and crafts. In Pakistan, there is little point in arguing about sexual stereotyping.

This city is becoming a more dangerous place to live. The economic crunch is biting hard, poverty is getting worse and violence is growing. There are now two or three murders in the city every week. Research suggests 48 out of every 1400 people suffer Hepatitis B and, although HIV figures are much lower, there are suspicions they are not entirely accurate. More than 500,000 people live in Quetta's slums - dwellings made from mud, without sanitation, electricity or running water. Quetta may be famed as the fruit basket of Pakistan", but there is something rotten at its core.

The children at the drop-in centre are encouraged to visit whenever they can and stay as long as they like. It's free - unlike the local schools - it's clean and it's friendly. Noorbibi says she would like to stop picking garbage. She says she worries about the cuts and bruises she picks up along with the rubbish. She knows she runs the risk of falling victim to disease and exhaustion. She'd prefer to go to school. She never will.

Her peers at the centre sit in disciplined rows while the teacher talks through today's lesson. In an adjoining room, young girls make pretty flowers to pin up on the wall alongside colourful posters and other objects they have made in the arts and crafts class. The girls are quiet and shy; the boys next door anything but. They love cricket and reading and writing. Most of all, they love English and are keen to show off their skills at the language.

Upstairs in the skills centre, young men strip engines and others make clothes. Once they have picked up tailoring skills, they are each given the use of a machine - they can't take it home as they would have to sell it to eat - in the hope they might one day make enough to survive.

Abdullah has been coming to the centre for about four years. In some ways, he's one of the lucky ones. His father owns a garbage depot at which Abdullah works, rather than on the streets. But after leaving the centre each day, Abdullah has to start work and remain there until sunset. It is hard and difficult work,'' he says. But thanks to the centre I am learning to read and write and I know about hygiene ... it has changed my life.'' The drop-in centre will not take Quetta's garbage pickers off the streets. It does not even want to. If these children were denied the chance to make this money - if the depot owners decided tomorrow they would no longer exploit this child labour - a desperate situation would be worse. There are no easy answers to problems as profound as those you find on every street corner in a city that seems on the verge of being consumed by chaos. There are only small acts that make lives better.