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This book explains how some entities can survive and flourish in an institutional environment that is both fragile and hostile. Despite daunting odds, some institutions have managed to succeed and effectively deliver core services, earn legitimacy in the eyes of the citizenry, and forge resilience in the face of an otherwise tumultuous and prohibitive operational context. A review of some case studies demonstrates that it is possible for a society such as Pakistan's to have effective organizations even in the face of a dismal overall picture. Nine Pakistani institutions from the public and private sector, which are generally regarded as successful have been selected for the purpose of this research. These are: Lahore University of Management Sciences (LUMS), Institute of Business Administration (IBA), Motorway Police, Benazir Income Support Program (BISP), National Database and Registration Authority (NADRA), Punjab Education Foundation, Edhi Foundation, Shaukat Khanum Memorial Cancer Hospital, and Rescue 1122.