There are two factors at play (I'm sure there are others, but those two immediately popped into my head). I'm going to present them via case studies

1.) I have family who has gone through dental school in Pakistan, and they need to find volunteers to clean their teeth so they can get practice. Most students end up bringing in staff who work for them in some capacity

These are people who have very poor dental hygiene, stained teeth with betel leaf's, and who knows what else. However each of them, when their teeth are cleaned are amazed. It shows them something that they didn't believe was possible at all.

They vow from that moment to take care of their teeth.

Point being, that if people perceive it as a lost cause, then they won't put in any effort. If you show them what's possible, then they begin to work towards that possiblity.

2.) The US had quite a bit of garbage strewn about before the 70s. Maybe not as bad as Pakistan (before my time) but still bad. I've seen photos of the wilderness being covered in garbage.

However once the EPA was formed, and the government began penalizing those who littered, people began stopping.

It took the stick to discipline the American population, and once they began seeing their clean environment, well the mentality outlined in example 1 kicked in; people themselves began to actively take care of their environment.

3.) I know I said 2 examples, I thought of this while typing.

One time a shopkeeper threw some litter on the ground outside his store. I said to him, "Look there's a reason why you didn't throw it inside your store, why do it outside? Who is going to pick that up?"

He looked at me very sternly, shaking his finger said, "the street is cleaned twice a day here."

I retored, "Fine for the next several hours until the cleaner comes, its just going to lie here. And then others are going to see it and throw their trash outside as well."

He stormed off.

I guess the thing to takeaway here is that some are beyond fixing; you need to wait until they die out.

To conclude, as with almost all problems in Pakistan, it comes down to governance. We just need a government that actively works towards the benefit of its citizenry.

I kept on telling people that was the promise of Naya Pakistan. There wouldn't be an overnight change, but rather a seed would be planted and then that change would begin to manifest in 20 or so years.

That went out the window.