Karima was once a computer engineer before her husband, Danny, the previous administrator of Overlook, was pushed into the town grinder by Hyperion agents. The burden of leadership then fell to Karima, who painfully tries to keep the town going while enduring her disorder and misogynistic insults from Dave.
Karima is the administrator of Overlook and tries to help her small town by offering three missions to the Vault Hunters. These missions involve obtaining medication to combat the effects of the skull-shivers and then building a defensive shield to keep the townsfolk safe from Hyperion moonshot attacks. She also has the Vault Hunters kill Dave with a mortar strike for insulting her while testing the shield.
The Vault Hunters also interact briefly with Karima while experiencing Claptrap's memories in the Claptastic Voyage DLC for Borderlands: The Pre-Sequel. She is met in person and asks Claptrap to take a collection of first aid equipment to her husband.
- As Karima suffers from skull-shivers, she speaks with a stutter and sometimes has problems saying certain words until she receives the medicine during The Overlooked: Medicine Man.
- Despite her house not being one of the places the Vault Hunters deliver medicine to, she appears to be cured at the end of the mission.
- In Borderlands: The Pre-Sequel, there is a major inconsistency: Karima already has the skull-shivers at the time of the DLC's events. Additionally, as Hyperion had not expanded their ventures in Pandora yet, their drilling would not have caused Overlook's citizens to suffer from skull-shivers.