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ISLAMABAD, Pakistan - Journalists in Pakistan live under the constant threat of murder, torture, and violence against their families in what has become one of the most hostile environments on the planet, according to a new report.

At least 34 journalists have been killed as a direct result of their work since the country's democratic government was reinstated in 2008, a study published Tuesday by human rights group Amnesty International highlighted.

These figures make Pakistan one of the world's deadliest countries for reporters.

Umar Cheema was stripped naked, tied upside down, beaten with a leather strap and a wooden rod and tortured.

Reporters are as much at risk from armed groups such as the Taliban as they are from mainstream political parties and the Directorate for Inter-Services Intelligence (ISI).

"No state actor is more feared by journalists than the ... ISI," the report said of the country's powerful and fearsome intelligence apparatus.

Entitled "A Bullet Has Been Chosen For You," the 67-page report comes just days after leading journalist Hamid Mir narrowly escaped with his life after his car was sprayed with bullets in a premeditated attack in Karachi.

Pakistani journalists hold placards and photographs bearing the image of shooting victim and colleague Hamid Mir during a protest in Islamabad on April 23.AAMIR QURESHI / AFP - Getty Images

Mir was in serious but stable condition in the hospital late Tuesday, having sustained six bullet wounds to the abdomen, pelvis and thigh. His attackers were not identified, but within hours the journalist's brother, Amir, appeared on Mir's popular cable network Geo News and claimed ISI Director General Zaheer-ul-Islam was responsible.

The ISI did not respond to Amnesty International's request for comment on the report, but authorities have repeatedly denied any links to violence on media personnel.

"Pakistan’s media community is effectively under siege," said David Griffiths, Amnesty International’s deputy Asia-Pacific director. "Journalists, in particular those covering national security issues or human rights, are targeted from all sides in a disturbing pattern of abuses carried out to silence their reporting."

He added: "The constant threat puts journalists in an impossible position, where virtually any sensitive story leaves them at risk of violence from one side or another."

Another journalist who said he has been targeted by government officials is Umar Cheema, an investigative reporter for The News, one of Pakistan's largest English-language daily papers.

"Once you step into the profession, you must be mindful of the consequences."

In 2010, he was dragged from his car by men in commando uniforms, stripped naked, tied upside down, beaten with a leather strap and a wooden rod and tortured. He said the men shaved his eyebrows and mustache and photographed him in humiliating positions.

"You've been writing against the government," the men told him, according to Amnesty's report. "You should stop this if you want to stop these attacks in the future."

Cheema said he is in no doubt that he was targeted in response to articles which were critical of the military and intelligence agencies. He told NBC News that the constant threat of violence from all sides now dominates Pakistani journalists' outlook on their profession.

"In Pakistan, you're on your own," said Cheema, who is a colleague of Mir at Geo News. "Once you step into the profession, you must be mindful of the consequences."

Umar Cheema accepts the International Press Freedom award at New York's Waldorf Astoria in November 2011.Michael Nagle / Getty Images, file

Cheema added: "Journalists put themselves at risk everyday here. Unfortunately, the laws here fail to inspire. They don't have the power to punish. The corrupt enjoy immunity and killers enjoys impunity."

Amnesty conceded in its report that it "remains difficult to verify many of the cases of alleged violations of human rights by the ISI."

But case studies chronicled by the organization paint a consistent picture of journalists critical of the spy agency being attacked by masked men telling them to stop their work or be murdered.

One journalist, who declined to be identified, told Amnesty that he was contacted by an ISI official after he filmed an interview with a separatist leader.

"[The official] threatened that if the video is telecast it would be very dangerous for me," he said. The journalist did not file a police report because "no one can touch the agencies." His company chose not to publish the video.

Pakistan’s government and its armed forces maintain an uneasy relationship after a decade of military rule was brought to an end with elections in 2008. Since 9/11, the U.S. government has given billions of dollars in aid to Pakistan and worked with the ISI, the military’s main intelligence organ, to combat the Taliban.

However, a 336-page internal Pakistani government report leaked last year which examined the security lapses that led to Osama bin Laden’s stay in the country noted the "possibility of some such direct or indirect and ‘plausibly deniable’ support cannot be ruled out, at least, at some level outside formal structures of the intelligence establishment."

That report also highlighted the ISI's "lack of commitment to eradicating extremism, ignorance and violence which is the single biggest threat to Pakistan."

Rameeza Nizami, publisher of the Nawa-e-Waqt group of newspapers, said that many journalists felt utterly powerless.

"The problem is that there's no one to ask for help," he said. "If you get a threat from a banned organization, who do you call? For their own reasons,the people you call might not disagree with 'teaching the press a lesson' as a way of responding to criticism."

Reza Rumi, a columnist and TV anchor who was targeted by assassins in a deadly attack last month, said "journalists who want to report and reveal facts have been left to fend for themselves."

He added: "Pakistan's journalists are insecure ... because the state is not willing to take effective steps to reduce the risks and the tackle the groups that cause such threats. A human life was lost during the attack on me and I doubt if there will be justice given the state of criminal justice system."

However, it is not just Pakistani nationals who are at risk. Wall Street Journal reporter Daniel Pearl was murdered in 2002 by al Qaeda militants. The New York Times' Pakistan bureau chief Declan Walsh was expelled without explanation last May. Even now neither he nor the Times have been been told why.

Wall Street Journal reporter Daniel Pearl was killed in Pakistan by al Qaeda militants in 2002.Wall Street Journal via AP

And security services aren't the only ones to have been implicated in the violence. The Muttahida Quami Movement, a political party known as the MQM, and the Ahle Sunnat Wal Jamaat religious group are just two non-state actors in Karachi accused of violence against journalists.

The MQM was implicated in the Jan. 2011 murder of another Geo News journalist. Wali Khan Babar was shot dead while driving home from work having just filed a report alleging links between the MQM and a gambling syndicate in the city.

His killing outraged the journalism community, but the subsequent trial was undermined when, one by one, the police officers and witnesses in the case were assassinated.

"The climate of fear has already had a chilling effect on freedom of expression."

Amnesty said that offenders knowing they will likely escape justice is one of the main reasons for this continued persecution. In 70 cases studied by the group only one ended in a prosecution.

The organization pointed out that police were also in the firing line: "A significant hurdle to the protection of journalists is that law enforcement authorities are themselves subjected to abductions, targeted killings and other abuse to prevent them from investigating cases against political actors and armed groups."

According to Karachi police figures cited by Amnesty, 166 officers were killed across the city of 10 million people last year. To put this in perspective, 105 police officers were killed across the entire U.S. in 2013, according to figures from the Officer Down Memorial Page.

Amnesty urged Pakistan to set an example by investigating the allegations pointing to its own military and security forces.

"Without these urgent steps, Pakistan’s media could be intimidated into silence," Griffiths said. "The climate of fear has already had a chilling effect on freedom of expression and the broader struggle to expose human rights abuses across Pakistan."

Alexander Smith reported from London. Wajahat S. Khan occasionally freelances for Geo News.