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6-2002

AKU Newsletter : June 2002, Volume 3, Issue 1Aga Khan University

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Recommended CitationAga Khan University, "AKU Newsletter : June 2002, Volume 3, Issue 1" (2002). AKU Newsletters. Book 25.http://ecommons.aku.edu/aku_newsletter/25

THE AGA KHAN UNIVERSITY

NewsletterJUNE 2002 VOL 3. NO.1

Government Forms Steering Committee on Higher EducationAKU President Appointed ChairmanPresident General Pervez Musharraf appointed Dr. ShamshKassim-Lakha, President, AKU, as Chairman of the SteeringCommittee on Higher Education, in March 2002 .

As Chairman, Dr. Kassim-Lakha has the status of aMinister of State and reports directly to the Presidentof Pakistan on matters relating to the working of theCommittee.

In accepting this responsibility, Dr. Kassim-Lakha observedthat his appointment was a recognition of AKU's achieve­ments and would enable the University to share its experiencefor the benefit of higher education across Pakistan.

The key functions of the Committee include the developmentof a plan to improve the quality of education of publicuniversities through such measures as faculty development,restructuring of the governance and management of publicuniversities and improvement of their financial managementand information systems, as well as the development ofsystemic linkages with other institutions, including industryin the private sector. Increasing the funding for highereducation and building capacity for supporting education andresearch, including for science and technology, de­politicisation of campuses, and curriculum reforms are otherpriority objectives of the Committee.

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Siblings Return Home with Doctoral Degrees from Oxford and Toronto Universities

Helping to Bring Change in Educational SystemAs they resume teaching at AKU's Institute for EducationalDevelopment (AKU-IED), both the sisters are gearing up topartcipate in a much needed change in the country'seducational system.

Dr. Nelofer Halai and her younger sister Dr. Anjum Halaihave recently completed their doctoral studies from theOntario Institute for Studies in Education, University ofToronto, and the Department of Educational Studies, OxfordUniversity, respectively.

Dr.Nelofe r Halai (left) andDr.Anjum Halai (MEd. '96)(right) envisage a changein the countryseducational system.

Dr. Nelofer Halai as a faculty member and Dr. Anjum Halai(M.Ed. '96) as a graduate of AKU-IED, received fullsponsorships from the Institute for their doctoralprogrammes. They hope that their insight into educationalissues and a broader vision of teaching will provide a superiorlearning experience for their students at AKU-IED .

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NATIONAL SYMPOSIUM

Fifth International Symposium on Typhoid Fever and other Salmonelloses

Over 200 National and International Delegates RecommendIncreased Public Health Spending on Preventive StrategiesDespite major advances in understanding the risk factors fortyphoid fever, the disorder is still widely prevalent throughoutthe developing world . It is estimated that typhoid fever accountsfor almost 16 million cases and over 600,000 deaths annuallyworldwide, according to World Health Organisation (WHO).

The focus of the fiflh international symposium organised byAK U in February 2002 was Typhoid Fever and otherSalmonelloses. The three-day workshop and symposium washeld in collaboration with WHO, the Wellcome Trust,International Center for Genetics and Biotechnology (lCGEB)(Trieste), Internation al Vaccine Institute (Seoul), and NationalInstitute for Biotechnology and Genetic Engineering (NIBGE)(Faisalabad). It was attended by speakers and delegates fromUK, US, Switzerland, Australia, Indone sia, India, Malaysia,Korea and several other countries.

Over 200 national and international delegates attended thesymposium and workshop on molecular methods in theepidemio logy and diagnosis of typhoid, and stronglyrecomm end ed an increase in public health spending onpreventive strateg ies such as provision of clean water,sanitation and vaccination programmes.

The inaugural sess ion of the sympos ium featured a keynoteaddress by the chief guest, Prof. Atta-ur-Rahman, FederalMinister for Science and Technology who, while describingtyphoid as a poor man' s disease, said that because mostpharm aceutical companies found it difficult to invest in thedevelopment of anti-typhoid drugs due to diminished returns,the progres s in curbing typhoid had been slow. He proposedthe use of biotechnology in fighting typhoid, especially thedevelopment of vaccine s and biodiagnostic tools, and said thatthis technology was one of the areas the government hadidentified for its focu s. In his keynote lecture on Global Statusand Preventive Strategies for Typhoid Fever, Dr. BernardIvanoff of WHO stated that typhoid fever was a globaldisease, occurring endemically throughout the developingworld. Dr. Ivonhoff stated that , "Although available data fromdeve loping countries are probable estimates of the true burden,there are indications that the true incidence of typhoid inSouth Asia may exceed 500 cases per 100,000 population."Referr ing to a recent survey in Delhi and Karachi, hesugges ted that the disease was much more common in pre­schoo l children.

In the opening plenary session, Dr. Chris Parry from Oxfordpresented an overview of treatment strategies for typhoid andhighlighted that although fluoroquinolones are still veryeffective in the treatment oftyphoid, there are worrying trends ofincreasing resistance in different parts of the world. Dr. RuminaHasan, Associate Professor in the Department ofMicrobiology atAKU, echoed this further in a presentation on increasingquinolone-resistance among typhoid isolates in Karachi .

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In his presentation on clini cal and therapeutic aspects oftyphoid fever in Pakistan, Dr. Zulfiqar A. Bhutta, Professor ofPaediatrics at AK U, highli ghted the growing importanceof typhoid as a publi c health problem in Pakistan. Heexplained, "Available information indicates that the disease ispredominantly a paediatric disorder with almo st 70% of allculture proven cases occurring in children." He added that theseverity of disease and rates of hospitalization also appearedto be higher in this population. Referring to a study amongurban community setting in Karachi using passivesurveillance, Prof. Bhutta said that high rates of typhoid feverwere seen in children. Explaining further , he said that byusing a simple system of clinical screening and decisionmaking in community settings, the investigators were able torecognise almost 75% of cases of typhoid success fully andtreat almost 80-85 % with the right choice of antibi otics.

During the symposium. D,: Zulfiqar A. Bhutta highlighted the gm\\'ing importanceoftyphoid as a public health problem in Pakistan

In a session on diagnostics, Dr. John Wain from London'sImperial College reviewed the available options for micro­biological detection of typhoid, highlighting the need forbetter quality contro l and adequate culture methods. Dr. PakLeong Lim from Chinese University, Hong Kong , describedavailable serological 'diagnostic tests and discussed newermethods that appeared promising. Other speakers in thesess ion included Dr. Abdul Haque from NIBGE (Faisalabad),who described experience with the new PCR test for thedetection of typhoid, and Dr. Tariq Mahmood, who shared hisexperience at JPMC in the use of ultrasound in the diagnosisof typhoid fever .

Other leading national and international speakers repeatedlyhighlighted the need for greater indigenous research into thisdisease and international collaboration in improving theunderstanding of the pathogenesis, spread, increasing drugresistance and effective vaccination strategies againsttyphoid. It was also suggested that WHO and other majorinternational funding organisations of research needed toplace much greater emphasis on this disease . _

MEDICAL COLLEGE

Dr. Dodani Receives Pakistan Academy of Medical SciencesJunior Gold Medal for Research on Chronic Diseases

Dr. Sunita Dodani (M.B.,B.S.'92), Assistant Professor in theFamily Medicine division ofthe Department of CommunityHealth Sciences at AKU, wasthe recipient of the prestigiousPakistan Academy of MedicalSciences Award for the year2000, conferred in December2001 .

Dr. Dodani is one of only fouryoung scientists from theentire country to have beenselected for this award.Focusing mostly on commonchronic diseases seen often in

family practice, particularly heart diseases, Dr. Dodani isnow a senior author of five journal publications, and co­author of several others, which brings the total number ofher publications in the last five years to 12, with three in theyear in which she clinched the gold medal. It was this effortand her ongoing interest and work in research that qualifiedher for the gold medal.

Supported by a grant from the Aga Khan Foundation, Canada,Dr. Dodani is currently pursuing her Master of Science degreein Community Health and Epidemiology at Canada'sDalhousie University.

She is conducting her thesis work at AKU on the prevalenceand comparison of cardiovascular risk factors in Karachi,consistent with her aim of developing skills in the field ofclinical epidemiology. _

US National Institute of Health Grant of $ O.5m for Environmental and

Occupational Health Research Training Initiative in Pakistan

Community Health Sciences to Lead ProgrammeAKU , in collaboration with the University of Alabama atBirmingham (UAB), USA, has been awarded a grant ofUS $0.5 million from the Fogarty International Center of theUnited States National Institute of Health, to co-developresearch training courses in Karachi and abroad for Pakistanihealth professionals wishing to advance their expertise inoccupational and environmental health.

The programme is to be led at AKU by Dr. Franklin White,Chair, and Dr. Masood Kadir, Assistant Professor at theDepartment of Community Health Sciences, and at UAB byDr. Nalini Sathiakumar and Dr. Elizabeth Delzell, withsupport from other colleagues at both centres. The total valueof the grant is approximately half a million US dollars,spread over a period of five years.

The grant will be used in the first instance to bring expertsfrom UAB to AKU to help the Department of CommunityHealth Sciences build upon its own developing capacity inthis critical area of public health research and development,as well as to sponsor selected trainees for advancededucation abroad.

The Department has already conducted landmark studies inenvironmental lead exposure and the adverse health impactsof water quality. The grant will assist it in developing furtherstudies in these areas, as well as develop expertise in otherpriority areas such as vector control, pesticide exposure,noise and air pollution, and the assessment of workplace

health and safety. In 200 I, AKU concluded a study of bloodlead levels in a large representative sample of Karachichildren, revealing that 80% have levels above thatrecognised internationally to be associated with risk ofneurological impairment and, in some instances, moreserious toxic effects.

A study of diarrhoea in remote northern villagesdemonstrated the critical importance of water, sanitation andhygiene interventions in reducing the incidence of thisleading cause of child mortality throughout the country.

Both studies emphasize that medical care is an inadequateresponse to such health problems, and that the root causes ofenvironmental contamination must be tackled through publichealth measures, such as eliminating lead in petrol andensuring access to safe potable water.

Initially AKU and UAB will launch short courses, targetingparticipants from universities, industry, regulatory agenciesand environmental NGOs. They will also co-host twoworkshops per annum on priority topics and develop forPakistanis at both institutions medium and longer termdegree training options, that go beyond the usual limits oftraditional medical education.

The long -term aim is to develop indigenous capacity withinPakistan for all levels of training relevant to these criticallyimportant aspects of public health . _

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MEDICAL COLLEGE

Seminar on Asthma

'Fruits and VegetablesPrevent Asthma Attacks'Children whose diet includes fruits and vege tables havedecreased chances ofdeve loping asthma in later life. Thi s wasstated by Prof. Javaid Khan, Cons ultant Chest Physician atAKUH . He was speaking at the first of a series of educationalseminars on asthma held at the Unive rsity in January 2002, incollaboration with the Global Initiative for Asthma.

Consultant chest physicians and paediatricians at AKU addressing theaudience during one of the ongoing series ofseminars on Asthma organisedby the University,

Elaborating on the role of diet in asthma, Dr. Khan said thatfruits and vegetables contain certain substances which protectthe lungs from damage caused by air pollution. Dr. Khanadvised that patients should eat a balanced diet and "contraryto common belief, there is no need to avoid rice, milk andyogurt." Dr. Javaid said that asthma is on the rise in variousparts of the world , and it is mainly the changing lifestyles thatare to blame for the recent jump in asthma. He also termedsmoking, active or passive, as a major factor that worsenedthe condition of asthma patients.

Speaking on the occasion, Dr. Majeed Memon, a ChestConsultant at AKUH, said , "a good history and use of peakflow metre are sufficient to confirm the diagnosis of asthma;there is no need for any blood test." Yasmin Mithani, a seniornurse at AKUH, spoke about the var ious misconceptionsregarding asthma that exist in the public mind in Pakistan. Shesaid that asthm a is "not a psychological disorder and patientswith this disease can live a normal life, provided they receiveappropriate treatment."

Dr. Nas eeruddin Mahmood, Lecturer, Department ofPaediatrics, highlighted the importance of breastfeeding forprevention of asthma in children. He strongly advised thatchildren should be protected from tobacco smoke . Dr. AsifImam, an allergy expert from AKUH , said that most asthmapatients in Pakistan are allergic to house dust mite, a tinyinsect which thrive s in carpets, pillows and mattresses. He

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strongly recommended that carpets be removed from at leastthe bedrooms. Use of special allergy-free covers for pillowsand mattresses has been shown to reduce the chances ofexposure to various allergens, responsible for precipitatingasthma attacks. Dr. Fayyaz Hussa in, Head of the PulmonarySection at AKUH, accentuated the importance of inhalers inthe treatm ent of asthma. He said, "inhalers are much saferthan tablets or syrups in the management of asthma." He alsoassured the patients and participants that inhalers do notmake a person habituated to them as is commonly believedin Pakistan.

Dr. Mohd . Irfan, a fe llow in respiratory diseases,demo nstrated the correct technique for the usage of inhalers,spacers and nebu lizers to the asthma patients. Later, a videoon asthma was shown and patient education material wasdistributed to the attendees.

Earlier, Nadeem Mustafa Khan, Director General and CEO ofAKUH, highlighted the role AKU is playing in impartingmedica l education to the public. Others who spoke on theoccasion were Dr. Wasi m Jafri, Chair, Department ofMedici ne; Dr. Gaffar Billoo, Chair, Department ofPaediatrics; and Khurshid Khowaja, Director NursingDivis ion. •

Guest Lecture Series

Stanley Wolpert on Jinnah'sVision of Pakistan

To commemorate the 125th birth anniversary of the foun der ofthe nation,Quaid-e-Azam Mohammad Ali Ji nnah, AKU invited world-renownedhistorian Prof essor Stanley Wolpert fro m the University of California. LosAngeles. to speak on "Quaid-e-Azam Mohammad Ali Jinnah's Vision ofPakistan", The lecture was organised as part of the University policy ofbroadening the education ofits students. fac ulty and staff by giving. them anopportunity to benefit fro m interaction with national and international.distinguished speakers,

During his talk, Prof essor Wolpert highlighted the Quaid's leadership,quoting fro m his book the decisions Jinnah had taken at criticaljunctures inthe history of the Muslims of South Asia, He illustrated to the audience theimportance Jinnah place d on education, economic uplift and politicaltraining.

In a hall packed with people from all walks oflife, Prof Wolpert reaffirmed theQuaid's vision of Pakistan as a secular Muslim welfare state, and urged thepeople of Pakistan to work towards the realisation ofthis vision, •

UNIVERSITY HOSPITAL

AKUH's First Representative Office in Dubai InauguratedAKUH's first international Representative Office wasinaugurated in May, 2002 by H.E. Sheikh Mohammed BinSaqr AI Qassimi, Assistant Under Secretary and Director ofSharjah Medi cal District. Officials of the UAE Ministry ofHealth , th e Co ns ul General of Pakistan, cardiologists,prominent members of the Pakistani community and mediareprese ntatives were present on the occasion. The AKU teamfrom Karach i was led by Dr. Shamsh Kassim-Lakha, S.l .,President of the Aga Khan University, and included NadeemMustafa Khan , Director General and Chief Executive Officerof the Hospital , Asif Fancy, Senior Director, ResourceDevelopment and Public Affairs, and Talaat Tyabji , DirectorMarketing and Public Affairs.

AKUH:,jirst international Representat ive Ojjice in Dubai was inauguratedby H.E. Sheikh Mohammed Bin Saqr Al Qassim i, Assis tant Under Secretaryand Director of Sharjah Medical District (right), in the prese nce ofDr. Shamsh Kassim-Lakha, AKU President (centre) and Mr. AmanullahLarik, Consul Genera l ofPakistan (Ieji).

Address ing the select gathering at the inauguration ceremony,H.E. She ikh Mohammed Bin Saqr Al Qassimi appreciated theefforts of the Univers ity for providing an opportunity for cost­effective health care options to the UAE population andassured his continued support. He said, " We appreciate theeffort s of the Aga Khan University for providing good qualitymed ical treatments such as open heart surgery and oncologycare and for opening an opportunity for cost-effective healthcare options to the UAE population and to assist patients inobtaining feedback from AKUH con sultants on their medicalreports and diagno sis. With deep-rooted relations between ourtwo coun tries and mutual benefits, our friendship will flourishespecially when we plant the seeds today. The co-operationbetween the UAE Ministry of Health and AKUH will getstronge r with branches all over the Gulf and this friendshipwill flouri sh in the future with sweet fruit."

Thanking the chief gue st, Dr. Shamsh Kassim-Lakha,informed the gathering that after the successful operation ofthe AKUH Pati ent Referral and Information Desk inHyderabad, AKUH Repre sentative Office in Dubai wa s thefirst repr esentative office outs ide Pakistan. Commenting onthe objective of thi s Office, he said, "It is established to

provide convenience and easy accessibility to AK UH's high­quality, cost-effective services to patients in UAE. The officewill not on ly provide information about the facilities availableat the Hospital but will also assist patients in obtainingfeedback from AKUH consultants on their med ical reports,scheduling appointments, providing cost estimates fortreatment required and making transportation and lodgingchoices in Karachi ."

Delivering the vote of thanks, Nadeem Mustafa Khan saidthat as a teaching institution, AKUH is committed toproviding the best possible options for diagnosis of diseaseand team management of patient care that is comparable tothe best medical centres in North America. The UniversityHospital provides a high quality of patient care covering alarge spectrum of medical and surgical dia gno ses andtreatment, such as open heart surgery, hip replacementsurgery, neurology, and oncology.

The Hospital's professional staff and facilities are among thebest in the region . It has the distinction of being the first inPakistan and among the first few teaching hospitals in theworld to receive ISO 9002 certification for developing andmaintaining consistent international standards of qualityservice. The Hospital receives a large number of patientreferrals every year from East Africa and the Middle East. TheAKU team had a productive meeting with Mini ster of Health ,H.E. Hamad Abdul Rahman AI-Midfa. They discussed variousopportunities that could be available for co-operation andcollaboration between AK U and the Ministry of Health in UAE.

Accompanied by the Ambassador of Pakistan, His ExcellencyMaj. Gen. Retd. Salim Ullah, Dr. Shamsh Kassim-Lakha alsocalled on the Minister for Higher Education and ScientificResearch, His Highness Sheikh Nahyan Bin Mubarak al Nahyan.

To mark the inauguration ofAKUH sfirs t international Representative Officein Dubai, two public health awareness programmes, "Signs, Symptoms andCare ", were organised, one each in Dubai and Abu Dhabi. The programmesreceived excel/ent encouragement and response from members ofthe public,and included presentations by D,: Shahid Sami, Assoc iate Professor andHead ofthe Section ofCardiothoracic Surgery (left), and D,: Ata-ur-RehmanQuraishi, Ass istant Professor ofthe Section ofCardiology (right). •

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UNIVERSITY

Caring for ChildrenA branch of medicine devoted to diseases of children, infantsand newborns, paediatrics, has a long and rich tradition ofattracting the medical profession's best and brightest.

Looking at the crowds of children of all ages flocking toAKU's Department of Paediatrics, it is clear that thistradition is alive and well on campus. AKU's paediatricianscombine the time-honoured medical ideals of service,education and research with a remarkable awareness ofchildren's needs, making it the leading paediatricsdepartment in the country.

Assistant Professors are Dr. Shahnaz Ibrahim , neurologist,and Dr. Zehra Fadoo (M.B., B.S . '91), a haematologist­oncologist. The faculty rolls also include Senior InstructorsDrs . Ayesha Mirza and Sohail Sal at , InstructorsDrs. Shabina Arif and Nasir Rashid, and as many as 18 non­full-time consultants.

The Department of Paediatrics has distinguished itself bybeing pioneers in conducting academic research at AKU. Acentral theme of paediatrics research at AKU is community­based scientific investigations which aim at reducing

AKU has cared for children from the time the UniversityHospital first opened its doors in 1985 . "We are one of thelargest departments of the University, with intensivecommitments in all areas of modem paediatrics, includinggeneral and subspeciality care, residency and fellowshiptraining, and research ," notes Dr. Gaffar Billoo, theKamruddin M. Jessani Professor of Paediatrics andDepartment Chairman . Dr. Billoo's positive assessment isechoed in the activities of the department's highlyaccomplished faculty. Dr. Zulfiqar Bhutta, the HuseinLaljee Dewraj Professor of Paediatrics, has become world­famous for scientific contributions in the areas of micro­nutrient research, typhoid fever and neonatal infections.Professor Qamaruddin Nizami and Associate ProfessorsDrs . Iqtidar Khan and Mehnaz Atiq are also highly regardedacademics, with contributions in nephrology, paediatricpublic health and paediatric cardiology. A recent addition isAssistant Professor Dr. Anita Zaidi (M.B., B.S. '88), aninfectious disease specialist who has returned after serv ingon the faculty of the Harvard Medical School. The other

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neonatal and childhood mortality in Pakistan . TheDepartment is the recepient of multiple grants totallingmore than US$ 4.5 million in the last five years . Currentresearch projects include World Health Organi zation(WHO) sponsored studies of treatment of meningitis andsepsis; International Vaccine Institute-funded studies ofthe burden of cholera, shigella, and typhoid , as well asassessment of the public health impact of a typhoidvaccination programme. A major cluster randomisedcontrolled trial of community-based perinatal interventionsin rural Pakistan recently received funding from WHO andSaving Newborn Lives initiatives of the Gates Foundation.With its prolific and widely cited academic output, theDepartment has already begun to influence national policyon paediatric care in the country.

The paediatrics faculty oversees a busy inpatient servicewith close to 100 beds spread in different areas includinggeneral care, special care, intensive care and neonatalintensive care. Bed occupancy is usually around 80%. The

outpatient facilities are equally busy, with regular clinicsscheduled from 9 A.M . to 8 P.M ., Monday through Saturday.As part of a comprehensive philosophy of care, there is closelia iso n with paediatric surgeons as well as withpaediatri cian s practising outside AKU. The Departmenttakes specia l pride in its teaching programmes, which trainmedical students and residents, and also provide advancedfellows hip training to paediatricians who have alreadycompleted residency education . Inspired by their paediatricsrotations, many AK U medical graduates have gone on totake up the spec ia lity, a testimony to the high teaching

Helping to Bring Change inEducational SystemCunld. from page I

Dr. Nelofer joined AKU in 1983 as a part-time instructor toteach scienc e and mathematics courses in the Faculty ofHealth Sci ences, becoming a full -time faculty member sixyears lat er. On completion of her Masters in ScienceEducation from the USA , she went to AKU-IED "on loan" tohelp teach the Science Education component to the firstM. Ed. cohort, which also included her sister Anjum. In 1996,she opted to transfer to AKU-IED to work in the field ofTeacher Education, and later proceeded to Canada for herdoctorate in Sci ence Education. Her doctoral dissertation wasa single case study titled, "Munazza's story: UnderstandingScience Teaching and Conceptions of the Nature of Science inPakistan Through a Life History Study." At AKU-IED,Dr. Nel o fer enjoys teaching both at graduate andundergraduate levels .

Dr. Anjum on completing her Masters in Teacher Education in1996, worked part time at AKU-IED as a professional deve­lopment teacher. Her role involved teaching at certificate andadvanced diploma levels. Two years later, she joined AKU­lED as a full-time faculty member and taught at graduate andundergraduate levels. Anjum completed her doctorate inMathematics Education from the University of Oxford, UK .Her thesis "Role of Social Interactions in Students' learning ofMathematics" has significant and powerful implications forteacher education practice. She believes that her doctoralresearch into students' learning has prepared her for makingsignificant contributions in the field of mathematics educationin particular and teacher education in general.

Dr. Nelofer and Dr. Anjum cherish their long association withAKU, which , they say, has been mutually productive .Dr. Nelofer adds : "I have returned to Pakistan stronglycommitted to making a difference, particularly in how scienceis taught at various levels. Unlike in the West, Pakistanistudents are generally keen to study science. Skilful teaching,using methods that allow students to question and engageactively with the science concepts being taught can improvethe quality of student thinking. This in turn can boost oureconomy by allowing a more skilled and thoughtfulworkforce to emerge." _

- - -UNIVERSITY

standards that AKU paediatrics has maintained over theyears. The Department also enjoys collaborative links fortraining selected individuals in the world's leading medicalcentres, including the Hospital for Sick Children in Torontoand the Karolinska Institute in Stockholm.

Distinguished as the Department is, it still remains veryconscious of the need to keep innovating. Dr. Billoo looksforward to one day realising the dream of a Maternal andChild Health complex at AKU that will provide holisticcare to mothers and children. _

Steering Committee onHigher EducationContd. from page I

The senior level Committee was formed by PresidentMusharraf subsequent to receiving recommendations of theTask Force on the Improvement of Higher Education,established by the Ministry of Education, and the StudyGroup on Higher Education in Science and Technology bythe Ministry of Science and Technology. The reports hadearlier been accepted in principle by the government.

Appointed by the Federal Minister for Education, ZobaidaJalal, in April 2000, the Task Force was co-chaired byDr. Shamsh Kassim-Lakha and Syed Babar Ali , Pro­Chancellor of the Lahore University of ManagementSciences, and included, amongst other members , the FederalSecretary of Education, the Chairman of the UniversityGrants Commission, and eight vice chancellors of publicuniversities and representatives of private universities . Indeveloping its implementation plan to be submitted toPresident Mushrraf by mid-August, the Steering Committeehas already undertaken wide-ranging consultations with vicechancellors, faculty members and students as well as thegovernors and high officials of all four provinces.

Members of the Steering Committee include Dr. IshratHussain , Governor, State Bank of Pakistan ; Dr. AbdulHafiz Shaikh, Minister for Finance , Government ofSindh; Dr . Zulfiqar Gilani , Vice Chancellor, Universityof Peshawar; Dr. Mazhar-ul-Haque Siddiqui, ViceChancellor, Univers ity of Sindh ; Dr. Najma Najam, ViceChancellor, Fatima Jinnah Women's Un ive rs ity,Rawalpindi ; Dr. Tariq Banuri , Senior Research Director,Stockholm Environment Institute , Boston Office; Prof.Riazuddin , Quaid-e-Azam University ; Prof. IqbalChaudhry, HEJ Research Institute of Chemistry, KarachiUniversity; Dr. Sohail Naqvi , Vice President, EnablingTechnologies; Dr. Shaukat Hamid, Director General ,Computer Control, Pakistan Atomic Energy Commission;Dr. Waqar Masood Khan, Additional Secretary, Ministry ofFinance, Federal Government; Ebrahim Sidat, CountryManager and Partner, Sidat, Hyder, Qamar & Company,Karachi; and Mr. Salman Akram Raja, Senior Partner, RajaMuhammad Akram & Company, Lahore. _

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UNIVERSITY

Nurallah Merchant - Actuarial Background Helps MeetMultifaceted and Unique Challenges of a UniversityNurallah A. Merchant is Director General of UniversityAdministration and Chief Financial Officer. He joined AKUas Manager, Budget and Planning, in 1986, and has sinceproven his mettle in all affairs that came within the purviewof his work. His association with AKU speaks ofdedication and untiring efforts towards the Universityachieving higher standards of quality in every sphere of itsoperation.

Apart fromAKU, Mr. Merchant has a rich experience ofhavingworked in a variety of settings - management of insurancecompanies, pension funds, and investments - in Asia, Europeand America, and was once associated with one of the largestactuarial firms in the world, William M. Mercer Inc. Hecompleted the associateship examination of the Institute ofActuaries , London, in 1972 and was awarded a certificate inFinance and Investment in 1976 by the same institute.

He believes that his years of learning and experience on theactuarial ground have equipped him to meet the multifacetedand unique challenges that AKU presents as it expandsacross continents and strives relentlessly for excellence.

How does the University ensure efficient use of resourceswithout compromising on quality?

At AKU's inception, the underlying principle was that therewould be no compromise on quality. At every level , from thestandard of its buildings, equipment and their upkeep, to therecruitment of faculty and staff and their development, theaim has always been quality. The University's financialplanning is targeted to ensure that adequate resources areavailable to support the entire enterprise. Programmeexpansions are initiated once the University has a feasibleplan towards sustaining the operations of new initiatives andexpansions in the long term.

One of the key ingredients for resource planning is theengagement of faculty and staff at all levels . Development ofbudgets and long-term plans are highly consultativeprocesses throughout the University and they help to createawareness and acceptance of responsibilities . Eachdepartmental head or manager is in charge of the resourcesthat are allocated to his or her department. Once you engagegood professionals, put them in charge and hold themaccountable, they will ensure efficient use of the University'sresources.

At a more "macro" level , that is the overall planning level,the University tries to ensure that its organisational set upallows it to achieve economies of scale and retainefficiencies. I am confident that the University will respondto this challenge by continuing to re-evaluate its systems,policies and procedures in order to find better ways of doingbusiness. The same yardstick applies to education, especiallyhigher education. Providing high quality education is achallenge for any educational institution.

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How does AKU respond to this challenge?

Quality education is a total learning experience thatencompasses academics, sports , extra curricular activitiesand, most importantly, the development of a betterunderstanding of societal responsibilities. To achieve theseobjectives, an institution needs to invest heavily in its people- faculty and staff - and its facilities - buildings,infrastructure and equipment. The latter may be somewhatsimpler to manage. The sheer diversity of people with avariety of educational qualifications, knowledge andexperience coupled with the opportunity for continuouslearning and development, truly makes this enterpriseextremely complicated and resource intensive.

The equation would not be complete without emphasising thatstudents are the focal point of a university. A good educat ionalinstitution should be able to attract the brightest and mostpromising students. AKU has a needs-blind policy, whichadmits students to all its educational programmes purely onmerit. This truly responds to the University's commitmenttowards social development and creating opportunities toattract the best minds. Even though the tuition fees are a smallpercentage of the full cost of an AKU medical education ,more than one-third of students receive additional financialassistance from the University.

AKU continues to challenge the content and the delivery of itseducational programmes. The Medical College faculty isengaged in the modification of its curriculum to promoteproblem-based learning. Throughout the campus there is anincreasing emphasis on the use of information technology inlearning. AKU Institute for Educational Development (AKU­lED) is in the second phase of its evolution. Besidesprogramme expansions and new initiatives, the Institute isalso in the mode of programme modifications and alternativ edelivery systems, such as open learning . These are just a fewexamples, all of which are creating their own sets of demandson the University.

Tell us about the fut ure national and inte rn ational plansfor the University.

At the national level, or should I say the regional level, the mostsignificant investment of the University will be in the establish­ment of the Faculty ofArts and Sciences (FAS). We have alreadypurchased 400 acres of land. FAS could support many ofthe critical developments, such as the Institute of HumanDevelopment and the Institutes ofEconomic Growth and Societyas well as Planning and Management of Human Settlements.

The Stadium Road campus is intended to be ded icated tothe further development of Health Sciences related act ivities .This would include academic as well as service programmes.Construction of the Nazerali -Walji Ambulatory Care Buildingwill be compl eted by August 2002, and of Khimji CardiacBuilding in December 2003 . Future buildings in our plansinclude the Women's Residences, an Oncology Building andOffices for faculty and staff. In Health Sciences, futureacademic programmes are likely to be concentrated ingraduate and postgraduate studies . Expansion of research isalso very high on the University's agenda and good progresshas been made towards fostering a research culture .

AKU-IED has equally enjoyed tremendous success in a fairlyshort span of approximately nine years. Besides havingstudents from 14 countries, it is increasingly collaborating

Hepatitis Awareness Day

Doctors Urge VaccinationAgainst Hepatitis BHepatitis B and C are global health problems. Worldwide 350million people are carriers of Hepatitis B. At a reported rateof 5%, the number of Hepatiti s B carriers in Pakistan isestimated at around seve n million. This places a great burdenon the gove rnment and the patients.

With this situation in view, the Gastroenterology Section ofAKUH marked Hepatiti s Awareness Day in Janu ary 2002 ,with a symposi um focussing on the different aspec ts of thesedreaded diseases and their preventi on.

Prof. Wasim Jafri , Head of the Gastroenterology Section andChair of the Department of Medicine, stresse d in his lecturethe importance of vacc ination aga inst Hepatiti s B which is aglobal health issue today. "In Pakistan , out of a population of140 million, there are at least seven mill ion carriers. Thisplaces an enormous burd en not only on the gove rnment butalso on the patients. Millions of rupees are spent on itstreatment, which rema ins unsatisfac tory in the face of limitedtreatment options avai lable. It is actually far better to preventHepatitis B thro ugh timely vacc ination. Hepatiti s B canalmost completely be prevented by providin g vaccinationagainst the infection very early in life, preferably in the firstweek after birth. There is also mother-to-infant transmissionof Hepatitis B which occurs at the time of birth or ju st after,"Dr. Jafri explained. It was further stressed that the greatest

UNIVERSITY

wi th governmen t and non-government institutio ns foraddress ing policy issues while assis ting in the improvementof schoo l education. The Institute will also continue to buildon its successes in research.

Increasingly, the estab lishment of Professional DevelopmentCentres (PDCs) is being seen as an integral part of supportingfuture deve lopment in schools, and to this effect there ismounting pressure on AKU-IED to support new PDCs both inPakistan and in other regions such as East Africa , where theAga Khan Education Services already has a network ofschools to support such initiatives.

The University has recently estab lished the Institute for theStudy of Muslim Civilisations in London , and has alsoinvested in the launching of Advanced Nursing Studiesprogrammes in three East African countries, i.e. Kenya,Tanzania and Uganda. Academic programmes have begun inUganda and will start in other countries as well onceaccreditation has been received. In the forseable future , theUniversity intends to bring medical education programmes toEast Africa after the upgradation of the Aga Khan HealthServices' hospitals in Nairobi, Kisumu and Dar-es-Salaam . Inshort , AKU has truly become an international University asdescribed in its Charter. While planning for internationalprogrammes continues, AKU will invest in the improvementof its infrastructure and communication systems. _

problem with Hepatitis B is that 95% of infants who acquirethis infection very early in life become chronic carriers ofHepatitis B. If this infection is acquired in the first year oflife, it results in chronic liver disease and hepatocellularcancer in adolescents. However, if the infection is acquired inadult life, less than 10% of patients become carriers. "Hence ,it is recommended that all newborns are vaccinated againstHepatitis B. In adults , the vaccine should be offered to peopleat high risk, such as health care workers, phlebotomists,dentists, paramedics and nurses," suggested Dr. Jafri. Headded that the treatment of Hepat itis B availabl e in Pakistanis at par with the rest of the world .

The Chief Guest, Dr. Mohammad Khurshid , MedicalDirector of AKUH and Associate Dean Clinical Affairs,spoke on the importance of Hepatitis B vaccination and urgedawareness of Hepatiti s B at all levels, especially among thegeneral public so that the current carrier rate of Hepatitis B inPakistan is reduced.

Dr. Saeed Hamid, Assoc iate Professor at the Gastro­enterology Section, spoke on the risk of Hepatitis C to healthcare professionals. He said that its prevention is possible withsafe blood transfusion, use of disposable needles and syringes,safe disposa l of hospital waste, as well as using sterilisedsurgical and dental equipment. This requires public awarenessat all levels. Dr. Riaz Qureshi, Head of Family Medicine,stressed timely vaccination in families. Prof. Gaffar Billoo,Chair of the Department of Paediatric s, spoke on Hepatitis Bvaccination in children, while Dr. Hasnain Shah, AssociateProfe ssor at the Gastroenterology Section , gave a lecture onthe general aspects of Hepatiti s C prevention. _

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UNIVERSITY HOSPITAL

Pakistan's First Successful Grafting Operation of PlasticCornea Performed at AKUHAKUH reached yet another milestone in late 200 I, when oneof its ophthalmologists performed the first-ever successfulgrafting operation of plastic cornea in Pakistan.

The operation was carried out by Dr. Asad Abbas (M.B., B.S.'89), Senior Instructor in the Department of Opthalmology, ona patient whose vision had been impaired due to an accidentinvolving acid. Due to the injury to his face and eyes, thepatient had developed a severe scarring response that led tothe development of an opacified and vascularized cornea,which was unsuitable for conventional corneal grafting.

Many inflammatory disorders of the eye, and morespecifically the cornea, cannot be treated well withconventional corneal grafting, as the host ends up destroyingthe grafted tissue. This situation prompted a few pioneeringophthalmologists to think about alternative methods ,including the development of keratoprostheses which aremade with inert plastics and do not get destroyed by thehost's defense mechanisms. Except for AKUH 's graftingoperation, Keratoprosthesis surgery with the Dolmen Type Iand II Keratoprosthesis, has yet to be attempted in thesubcontinent.

Dr. Abbas ' expe rtise in corneal grafting places Pakistan among thedeveloped medical centres ofthe world in the field ofophthalmology.

Prior to Dr. Abbas' successful effort, the grafting of plasticcornea was done only in a few developed countries. Very fewcentres around the world are equipped to perform this surgery,either because of lack of training in this field or lack of accessto the hardware. In the past, such eye patients could only betreated in the USA or Europe , and that also at very substantialcharges, but now they can be offered the same treatment atAKUH at affordable charges .

After obtaining his M.B.,B.S . degree from AKU, Dr. Abbaswas trained in Ophthalmology, and developed specialexpertise in corneal grafting and in the grafting of plasticcorneas. Dr. Abbas' recent successful endeavour has placedPakistan among the medical centres of the developed world,particularly in the speciality of ophthalmology. _

Home-based nursing requires staff /rained in spec ial and basic emergencyprocedures.

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and agitation in patients, and spares them and their familiesthe hassle of going all the way to the hospital for minorprocedures.

Launched as a pilot project for a selected group of patients,the AKUH Home Health Programme has expanded into otherareas near the Hospital following an overwhelming responsefrom patients and their families. The range of care offered inthe pilot project includes administration of intravenousmedications, nebulizer as well as change of dressings. One ofthe key benefits of this programme is that it reduces stress

These services are based on the concept of Home HealthProgramme that has evolved as a challenging and rapidlygrowing field, catering more extensively to the needs ofpatients by continuing to provide them care beyond thehospital setting . It is a concept of nursing care that hasemerged with the recent economic, social and technologicaldevelopment.

In its efforts towards providing greater quality care forpatients, AKUH has initiated home-based nursing services in2002. Through these services, the Hospital aims to extendnursing care to its patients in their homes after they aredischarged.

AKUH's Home-based NursingCare Goes Beyond Campus

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UNIVERSITY HOSPITAL

The patients appreciate that the home-based nursing serviceshave not only obviated the need to wait at the hospitals buthave also proven to be cost-effective as they reduce thepatient's length of stay at the hospital.

"My post-surgery period was not a pleasant experience, butAKUH's nursing care provided to me at home helped meovercome the problem of frequenting the hospital," remarksFiza, a patient who underwent surgery. The programmerequires supporting staff to work closely with the patient's

physician in an efficient and cost-effective manner. Asdealing with the patients in their homes is quite differentfrom tending them at the hospital, the staff working in thisprogramme has been trained in special and basic emergencyprocedures.

With these services in place, AKUH envisages continuousimprovement and additions of other services to theprogramme, all with a view to providing the best possible careto its patients and their families. _

Patient Welfare Programme

Noor Jehan Cured of Acute CholecystitisNoor Jehan's condition improved with proper diagnoses andtreatment. Halfway through the treatment, her medicationshad to be changed due to certain complications.

Noor Jehan recovered fully following her surgery and wasdischarged from the Hospital after ten days . She went back towork, and resumed contributing towards the family incomeand raising her children. _

July 23 - 25

Aug 20 - 22

Sept 23 - 27

Oct 30 - 31

July 6

Aug 3

Sept 7

Date

'Signs, Symptoms and Care' •Publi c Health Awareness Programme

- Children's Limb Deformities

- Paediatrics

- Demen tia - Failing Memory

CME

Programme

- Management of Common Paediatric Diseases

- Fever of Unknown Origin

- Management of Common Medical Conditio ns

- Interpretation of Abdominal X-rays

Rashid expected the charges to stay within the depositedamount, but as treatment continued, charges increasedaccordingly. He mentioned his financial condition to thedoctor attending Noor Jehan . The doctor referred NoorJehan's case to the Patient Welfare Department. An AKUHwelfare officer came to his aid and assured the family offinancial assistance . The Hospital paid the additionalRs. 26,000 (US $434) towards her treatment to which NoorJehan responded well.

One day, while washing clothes at her employer's house,Noor Jehan experienced a searing pain in her abdomen andfainted. The family she was working for took her to a localgeneral practitioner. The medication provided temporaryrelief, however the pain returned at intervals. She triedhomeopathic treatment but her condition grew worse with thepassage of time . Her health deteriorated to the point whereshe could no longer go to work, as she was in constant pain.Her earnings ceased and she could not even afford the painkillers. A friend brought her to AKUH, where she wasdiagnosed with Acute Cholecystitis and advised urgentlaparoscopic cholecystectomy surgery, for which her husbandwas given an estimate of Rs. 50,000 (US $834) .

Noor Jehan's life was a constant battle with poverty andmisery, compounded by a large household. A working motherwith nine children, she tried to make ends meet by workingas a domestic servant in a house in Federal-B Area ofKarachi, while Rashid , her husband, made Rs. 80 per day (US$1.5) by selling candyfloss to kids at a nearby school. It wasa difficult life and the couple barely managed to clothe andfeed their brood .

Even though they were financially challenged, they had theresources and the goodwill to seek assistance and loans fromtheir employers and friends for the initial cost of treatment.

Symposium

- National Symposium: Early Childhood Care

and Development

Sept 23 - 24

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UNIVERSITY

First Academic Presence Abroad Established in UgandaAKU Helps Address Health Care Needs in East AfricaAt the opening of the renovated facilities housing AKU'sAdvanced Nursing Studies (ANS) Programme in February2002 , the Hon. Abel Rwendeire, Minister of Trade andIndustry of Uganda, stated, that "the philosophy ofAKU is tooffer 'excellence' - the establishment should be a yardstick forour standards" and remarked that, "the physical facilitiesbeing offered by AKU are of world class." He added , "Thefuture of the health sector in this country and the region as awhole is being underwritten by this type of vital investment inhuman resource capacity building."

The Hon. Rwendeire, formerly the Minister of State forHigher Education and a long-time campaigner for continuingand higher education for nurses and other healthprofessionals, recalled visiting the University in Pakistan in1999. He remembered examining the curriculum and beingstruck by the fact that it offered nurses opportunities tocontinue their education as they work .

AKU's ANS Programme was developed in response torequests from governments and nursing leaders of Kenya ,Tanzania and Uganda. It is operational in Uganda sinceJanuary 2001 following the accreditation of the University inthis country. Preparations for implementation of theprogramme in Kenya and Tanzania are well advanced. InUganda, the first students in an 18-month Enrolled Nurse-to­Registered Nurse conversion course will complete theirstudies in July 2002 , whilst those on a 30-month post­Registered Nurse, Bachelor of Science in Nursing Programmeare expected to graduate in 2003 . Recognising the value ofwork experience, the ANS Programme offers a flexiblemodule approach and the community-based curriculum willenable the nurses to function effectively both in the hospitaland in the community.

The Hon. Rwendeire described the major regional educationalinitiative as "an example of long-term investment that willaddress a critical need in health sector reform in East Africa.It is further evidence of the Aga Khan DevelopmentNetwork's (AKDN) commitment to social development inUganda." "This institution," he continued, "is remarkable fora number of reasons . It brings professional nursing trainingand tertiary education of the highest international standardshere in Uganda with a focus on our own specific needs . TheProgramme enables working nurses to continue to earn whilethey learn . Most importantly, it permits the knowledge gainedto be readily applied. It also allows both public and privateparticipating health care institutions to benefit from betterqualified personnel, eventually enriching the country'sprofessional resource base in one of its neediest sectors."Conducting the Minister and a small group of seniorgovernment officials on an informal tour of the premisesduring operating hours, Imelda Bagambaki, the ProgrammeAcademic Head, pointed out that the facility will include a

state-of-the-art skills laboratory, a library, lecture space andclassrooms, as well as a computer laboratory.

Nurses constitute the largest percentage of heal th careproviders in East Africa and are active at all levels of thehealth care system, from remote rural centres to sophisticatedtertiary care hospitals in urban areas. Recognising thateffective reform requires a significant investment in personnelwho manage services and provide care, governments aredeveloping plans to improve the competence and confidenceof health professionals, especially nurses.

Conceptualised by the Aga Khan University School ofNursing in Pakistan, one of South Asia's leading academicand research institutions in the Health Sciences , the ANSProgramme will go on to incorporate additional courses thatwill cater to specifically identified needs such as Education,Management, Accident /Emergency and Disaster Nursing .

Since entering into an Accord of Cooperation forDevelopment with the Government of Uganda in 1992,AKDN has successfully completed a number ofendeavours torehabilitate social development projects, particularl y in thearea of education. Notable amongst these are the pre-primary,primary and secondary schools and the Enhanced UniversalPrimary Education in Kampala (EUPEK) resource centre atthe Makerere Road comp lex. AKU's ANS Programme nowbrings to this same complex, an important higher educationcomponent. _

Dr. Robert Baker Appointed Provost

!- Dr. Robert Baker has been appointedl: Provost of AKU . The Provost is the

Chief Academic Officer of theUniversity, reporting directly to thePresident.

Dr. Baker joined AKU as Professorand Director of the Institute forEducational Development in 1997.In 2000, he was appointed DirectorGeneral, Planning with the

responsibility to initiate a planning office at the University.Prior to joining AKU, he worked in South and South EastAsian countries as a consultant and team leader on the designand evaluation of national social sector programmes withvarious international agencies. He has held faculty andmanagement positions at universities in Australia and Canada.

Dr. Baker completed his undergraduate study at theUniversity of Melbourne and Masters and Ph.D. degrees inSociology of Education at the University of Toronto . _

Published quarterly by the Public Affairs Department, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi-74800, Pakistan.Telephone: 493-0051, Fax: (92) 21-493-4294. email: public .affairs@aku.edu http://www.aku.edu Printed at ~ Elite Publishers Limited, Karachi.

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