Maryam Bibi, who founded an organization called Khwendo Kor, which carries out education and development programs in Khyber Pakhtunkhwa and the nearby tribal areas, said she and many of her employees live in fear that they will be targeted next.
"I'm really very worried now because our girls go to the field. Our work is in the villages," said Bibi. She said many of the female employees of such organizations are already under pressure from family and a culture that frowns on women working outside the home and mixing with men.
"On top of that, they're shot dead," she said.
In some areas like the northwest, aid groups have had to work to overcome community fears that they are promoting a foreign agenda at odds with local traditions and values.
But many residents in Swabi said the school and medical center provided a vital service to the community, and they mourned those who were killed.
Murad Khan said his daughter was studying at the primary school, which provided free books and uniforms to students. He said many people in the area are worried that the school and clinic will close.
"This school is like a gift for all of us, the poor people of the village," he said. "People in our area are sad."
The NGO director said all projects will be suspended as security measures are reviewed but he vowed that they would resume their work soon.
He said the NGO had not received any threats before the attack.
In the southern city of Karachi, officials said four people were killed when a bomb in a parked motorcycle exploded amid a crowd of buses for political workers returning from the rally held by the Muttahida Qaumi Movement. The MQM is the dominant political party in Karachi.
There was no immediate claim of responsibility for the attack.
Dr. Saghir Ahmed, the provincial health minister, said that in addition to the dead, 41 people were injured.
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Associated Press writers Riaz Khan in Peshawar and Adil Jawad in Karachi contributed to this report.
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