In the cool interior of a mental ward in Karachi, a short, powerfully built man with a flowing snow-white beard and penetrating dark-brown eyes is standing at the bedside of a distraught young woman. She has covered her head with a sheet and is pleading for news of the two children her husband took from her.

"I know you are suffering terribly, but this is no way to bring back your children," says the man with stern compassion. "You have a college degree. You can do many things to help the other patients."

Outside the room's windows of latticed stone, several hundred other women stroll and lounge under pipal trees scattered around a courtyard as big as several football fields. All are here because their families cannot-or will not-cope with their mental illnesses.

"Self-help," says the man as he walks away from the young mother's bedside. "That's the best way to get back on your feet."

For more than half a century, Abdul Sattar Edhi, now 76 years old, has been living proof that a determined individual can mobilize others to alleviate misery and, in so doing, knit together the social fabric of a nation. Firmly refusing financial support from both government and formal religious organizations, this self-effacing man with a primary-school education has almost single-handedly created one of the largest and most successful health and welfare networks in Asia. Whether he is counseling a battered wife, rescuing an accident victim, feeding a poor child, sheltering a homeless family or washing an unidentified and unclaimed corpse before burial, Edhi and Bilquis, his wife of 38 years, help thousands of Pakistanis each day.

Starting in 1951 with a tiny dispensary in Karachi's poor Mithadar neighborhood, Edhi has steadily built up a nationwide organization of ambulances, clinics, maternity homes, mental asylums, homes for the physically handicapped, blood banks, orphanages, adoption centers, mortuaries, shelters for runaway children and battered women, schools, nursing courses, soup kitchens and a 25-bed cancer hospital. All are run by some 7000 volunteers and a small paid staff of teachers, doctors and nurses. Edhi has also personally delivered medicines, food and clothing to refugees in Bosnia, Ethiopia and Afghanistan. He and the drivers of his ambulances have saved lives in floods, train wrecks, civil conflicts and traffic accidents. After the September 11 attacks on the World Trade Center, he donated $100,000 to Pakistanis in New York who lost their jobs in the subsequent economic crisis.

Abdul Sattar Edhi in his Karachi office

Remarkably, the lion's share of the Edhi Foundation's $10-million budget comes from private donations from individual Pakistanis inside and outside the country. In the 1980's, when Pakistan's then-President Zia ul-Haq sent him a check for 500,000 rupees (then more than $30,000), Edhi sent it back. Last year, the Italian government offered him a million-dollar donation. He refused. "Governments set conditions that I cannot accept," he says, declining to give any details.

Usually dressed in a simple tunic over gray pajamas, scuffed sandals on his feet and his trademark astrakhan hat on his head, Edhi outlines his philosophy in the Mithadar dispensary where he launched his charity more than five decades ago. "I tell people that, because I am working for you, the money must come from you," he says. For years, this meant that Edhi would take to the streets to beg on behalf of his growing social programs. Even in his 70's, he still occasionally begs on the streets, generally for the sake of severely ill individuals in urgent need of expensive medical care that his clinics cannot provide.

Generally, however, donors come in person to one of the 300 centers and clinics across Pakistan. One, who declined to give his name, explained that he gives money regularly to the Edhi Foundation because an Edhi ambulance once rescued his sister from an automobile accident. (The cost of an ambulance call-one of the few services for which the foundation charges-is less than 50 rupees, or around 85 us cents.) "When I give this 1400 rupees to Edhi, I know it goes to people who need it," says the donor.

Some donors have been very generous. One family donated two villas in the wealthy Karachi suburb of Clifton for use as a residence and school for around 250 girls. A Pakistani expatriate in the UK donated office buildings worth £1.4 million ($2.5 million) that became the British headquarters of the foundation, which organizes local charity services both for expatriates and in support of the foundation's work in Pakistan. In addition to money and property, contributors donate clothes, appliances, furniture-even goat and chicken meat, sometimes by the ton. The organization uses a portion of these gifts to feed and clothe residents of the homes; the rest is given away to other hospitals, prisons and disaster victims.

For this, Edhi may well be the most widely admired man in Pakistan. In 1986 he received the Ramon Magsaysay Award for Public Service, sometimes referred to as "the Asian Nobel Prize." In 2000, he was awarded the International Balzan Prize for Humanity, Peace and Brotherhood. In 2002, he joined former us President Bill Clinton, Nobel Prize winner Elie Wiesel and others as an honorary board member of the newly founded Daniel Pearl Foundation, created in honor of the murdered Wall Street Journal correspondent. Typically, Edhi pays his own way to receive awards and participate in conferences.

"What Edhi is doing is nothing short of a miracle," explains Z. A. Nizami, former director-general of the Karachi Development Authority.

Hemmed in by a labyrinth of fabric shops, food markets and dusty, cart-filled lanes, Edhi's three-story Mithadar center is a hive of activity. In the crowded front offices, men and women sit behind donated desks taking ambulance calls, ordering medicines and checking the accounts of clinics and centers across the country. In one room, three women are filling out adoption papers. Bilquis Edhi, who oversees adoptions, has placed more than 16,000 children in adopted homes. Outside every Edhi center there is a cradle-shaded from the sun-where unwanted babies can be left anonymously.

Upstairs, a dozen infants and well-fed toddlers, some rattling across the floor in walking strollers, play and doze as Bilquis chats with a woman who has come to adopt a child for her son and daughter-in-law in the United States.

"The baby she's adopting was starving when it arrived," Bilquis remarks. "When you nurse a child back to life, it really hurts to see her go, even after you've gone through the process thousands of times. Finding her a loving home makes it worth the feeling of loss."

Bilquis tells of the 32-year-old woman who showed up recently at the Mithadar clinic looking for her. The woman explained that her parents had just revealed that they had adopted her as an infant from the Edhi center. "I'm a doctor now, with four children of my own," she told Bilquis. "And I wanted to show my gratitude to the woman who nursed me."

"We both broke down in tears," Bilquis recalls.

With her head loosely covered by a brightly patterned yellow scarf and eyes that twinkle behind black-framed glasses, Bilquis's sunny, lighthearted disposition contrasts with her husband's severe, sometimes impatient manner. The pair met at the clinic when she arrived as an 18-year-old nurse in 1965. A year or so later, they were married.

Their wedding night set the tone for the relationship. Dropping by the dispensary after the ceremony, Edhi found a 12-year-old girl with severe head injuries. The newlyweds rushed her to the hospital and spent the night supervising blood transfusions and calming down distraught relatives.

"I didn't mind at all," Bilquis told Reader's Digest for an article published in 1989. "Today that girl is married with children; that's what is really important."

Even so, Bilquis acknowledges in a playful way, life with Edhi can be trying. "Sometimes I wonder how I stayed my whole life with this man who is a mental case," she says with a smile. "He won't even attend the weddings of his own children, but if there's an emergency somewhere he'll dash out to help in an instant."