Global Outpouring to Help Pakistani Schoolgirl

Whatever they chose, a medical jet from the United Arab Emirates was waiting to take her to hospitals abroad. Pakistani and American officials had talked about arranging treatment for her at the giant American military hospital at Landstuhl, Germany.

A well-developed offer came from former Representative Gabrielle Giffords and her husband, Mark E. Kelly, who had gone through their own treatment ordeal after she was shot in the head last year. They had gone as far as to line up a noted neurosurgeon and had even arranged a transportation option of their own to the United States — with a television celebrity offering to quietly foot the fuel bill.

Those were among dozens of offers from across the world. But when the time came to fly the wounded schoolgirl out of Pakistan, in the early hours of Monday, a deal from Britain to accept Malala at a specialized hospital in Birmingham proved hard to beat.

But first, to get her there.

Out of worry that the Taliban would fulfill their promise to take a second shot at the teenage activist, the dawn run from the military hospital in Rawalpindi, Pakistan, to the airport was shrouded in secrecy, said Rehman Malik, Pakistan’s interior minister.

“I directed the airport staff to remain incognito, because there was an alert, threats from the Taliban that they would kill her,” he said. “We were very careful.”

When the Emirati jet carrying her and a team of doctors landed in Birmingham on Monday afternoon, most agreed that the decision made both medical and diplomatic sense.

Britain and Pakistan have a long history stretching back to British rule on the subcontinent; doctors at the hospital, the Queen Elizabeth II Memorial Center, have treated hundreds of British soldiers wounded in fighting against the Taliban in southern Afghanistan.

“We do, unfortunately, have a considerable expertise in treating that sort of bullet injury,” Dr. David Rosser, the hospital’s medical director, told reporters.

Pakistani, British and American officials took pains on Monday to emphasize that the final decision about Ms. Yousafzai’s treatment had been based on medical grounds above all else.

“We never saw this in a political light,” one senior American official said on the condition of anonymity. “This was a humanitarian story, not a political one.”

Yet there was little doubt that each of the possibilities, especially given the diplomatic tensions between Pakistan and America, carried its own political risk.

Initially, Pakistani officials had approached the American Embassy for help, officials from both countries said.

Two options were discussed, Interior Minister Malik said: the possible use of an American military facility in Oman, and evacuation to the Landstuhl Regional Medical Center in Germany. “We scrambled like hell,” one American official said. “We were standing by, ready to do anything.”

There were also private American offers — from Ms. Giffords and Mr. Kelly, plus at least three other “serious” parties, the American official added. One came from an American businessman with ties to senior figures in the Pakistan government; another came from a constituent of Senator John Kerry, who has longstanding political ties to the country.

Meanwhile Ms. Giffords’s doctor, Dr. Dong Kim, the head of neurosurgery at the Memorial Hermann-Texas Medical Center, got ready to travel to Pakistan. Mr. Kelly, a former astronaut, said he had recruited an American celebrity, whom he declined to name, to finance the fuel costs of an emergency plane trip from Peshawar to Houston.

“We were just trying to offer the best help available, as we understand it from being down this road,” Mr. Kelly said.

Mr. Kelly also pressed political contacts in the White House, State Department and Pakistan to help push the offer through. He said that Johns Hopkins University made a similar offer.

But over the weekend, Mr. Kelly was told by a senior State Department official that “Pakistan has decided to solve this domestically.”