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First off, Pakistan is a Muslim country. Islam does not define adoption the way Western countries do. Under Shaaria, Islamic law, adoption is something like foster parenting or guardianship in the U.S. The parental rights of the birthparents are NOT terminated, as they are in the West. The child retains the surname of the birthparents, as well as inheritance rights and so on, and may return to the birthparents if the birthparents' circumstances change and if it is deemed to be in the best interests of the child. The adoptive parents are expected to consult with the birthparents regarding the child's religious education, and other important matters.
Because there is no "full and final adoption", the way it is construed in the U.S. -- where there must be complete termination of the birthparents' rights and the full assumption of parental obligations by the adoptive family -- most Islamic countries do not allow adoption of a Muslim child by an American, and the USCIS cannot grant an adoption visa for a child to enter the U.S. unless the prospective parents were granted a full and final adoption overseas or unless the adoptive family was given a decree of guardianship that makes it clear that the child will have a full and final adoption in the U.S.
Pakistani law generally follows Shaaria. It states that Muslims may receive guardianship of Muslim children or children abandoned at a Muslim orphanage with no information about their birthparents' faith, and that Christians may receive guardianship of Christian children. People who are neither Christian nor Muslim cannot take guardianship of a child. There are very few Christian children available for adoption; many children in orphanages are not actually adoptable, but are housed there while their parents work through issues such as loss of a job, marital problems, or severe illness of a spouse.
While a decree of guardianship will be issued if a Muslim American wishes to adopt a Muslim child, or if a Christian American wishes to adopt a Christian child, and that decree is normally not acceptable to the USCIS, it has "occasionally" been possible to get the decree of guardianship from the Pakistani courts worded in such a way that the USCIS is willing to grant a visa. It is not all that common, however, and most of the people who bother to try are relatives in the U.S., trying to adopt a family member. Of course, the child must qualify as an "eligible orphan", must be under age 16, and must have valid paperwork, in addition to having an acceptable decree of guardianship.
In 2011, the latest year for which information is available, only 25 children were adopted from Pakistan by Americans. Most of these were probably relative adoption cases. Very few American agencies will even attempt to work with people trying to adopt from Pakistan, and if you go through an attorney, he/she needs to be one who is highly familiar with both U.S. immigration and adoption law and Pakistani adoption law. Unfortunately, there have been cases in which Americans have worked with unscrupulous agencies or facilitators and have lost thousands of dollars and been unable to bring home a Pakistani child.
My suggestion is that, if you are not hugely committed to Pakistan for one reason or another, you should choose another country -- preferably one that has a stable, ethical adoption program and one that does not have religious issues to complicate the process.
Sharon