Pakistani authorities say at least 18 women and children were killed in a stampede in the southern city of Karachi, where they were waiting to get free flour.
Medical officials say at least 25 others were injured in the crush in the city's crowded Khori Garden neighborhood.
A private charity group was giving out the flour in honor of the Muslim holy month of Ramadan.
Dozens of impoverished women and children had gathered in the narrow lanes and alleys outside the distribution point. Witnesses say some people on line started pushing, and panic ensued when a security guard used force to restore order.
Officials say most of the victims died of suffocation.
Pakistani Prime Minister Yousuf Raza Gilani ordered medical treatment for the injured and an investigation into the incident.
Police have detained the event's organizer, saying they were not notified of the planned distribution.
Some information for this report was provided by AFP, AP and Bloomberg.