Aga Khan University Hospital, A magnum opus!

Senior Correspondent

Sep 24 - 30, 2007

Aga Khan University Hospital is a growing organization with a 25 years vision of healthcare system development across Pakistan, Afghanistan, Central Asia, Egypt, Syria and East Africa. Following this vision AKUH, K has developed a major network of laboratories to provide diagnostic facilities across Pakistan and today 150 laboratory stations located in 67-68 cities of Pakistan and Afghanistan are operational. Aga Khan University Hospital, Karachi, (AKUH) started its operations in 1985, as an integrated, health care delivery component of Aga Khan University (AKU). We met the Chief Operating Officer, Outreach Services AKUH,K Mr. Aslam Jindani and talked in detail about the Aga Khan University Hospital, AKDN and its development throughout the country.

PAGE: Tell me a bit about yourself and your association with Aga Khan University Hospital (AKUH)

AJ: I am a long serving employee of Aga Khan University Hospital (AKUH) and this is my 29th year in service. My entire working career has been dedicated to AKUH,K. I have an MBA from San Francisco and I have seen the Aga Khan University (AKU) in the planning, commissioning, operations and growth phases.

PAGE: Having observed the overall development of the University and Hospital, how do you see this development and what milestones do you think it has achieved since its inception?

AJ: The hospital has six or seven missions which are focused on access, patient welfare, supporting the academic mission of the University etc. The hospital (AKUH,K) has successfully achieved the scope of its mission statements. In the first five years of the hospital since 1985 when we started service, the hospital focused on being a good general care hospital, in the 90's it focused on tertiary services such cardiac angiographies, cardiac surgery, neurosurgery etc. and now in the first decade of the new millennium it is evolving to become a health system whereby the care of the university hospital is available at the doorsteps of the community whom we serve. Looking forward, the hospital has ambitious growth plans both for main hospital on Stadium Road and off campus. At the main hospital we plan to expand the scope and services by introducing high tech equipment and new treatment techniques, move towards electronic health record, build new buildings and focus strongly on development of human resources. Off campus, our plans are to build a donor funded state-of-the-art Integrated Medical Service in Lahore which provides a one-stop ambulatory care services to the population of Punjab, integrate the four hospitals of our sister organization into the University Hospital network and continue to develop the laboratory network. Overall our focus is provide quality services at affordable prices and subsidize care for the poor patients.

PAGE: What sort of communication development do you see regarding the vastness and expansion plans, do you think there are any difficulties in transmission?

AJ: The AKU of which the hospital is one unit is chartered in Pakistan, and it has mandate to be an international University. AKU has its programs in eight countries and on three continents. The coordination is assured by a governance and management model under which we have one Chancellor who is His Highness the Aga Khan, the founder of the university as well a the spiritual leader of Shia Imami Ismaili Muslims, there is one Board to oversee the University functions and we one President to lead and guide the operations. Each function of the University has its own management structure and on common issues there is unity of focus. Large organizations which are diverse and located in multiple countries do face the challenge of coordination but the burden of the management is to ensure the unity of operations. We have three hospitals in the University network—Karachi, Nairobi and Kabul. The objective is that the competence of care in the institutions are in sync with the international expectations. The Karachi Hospital last year secured the Joint Commission International Accreditation (JCIA), which is given to the hospitals which subscribe to the highest standard of quality care and service.

PAGE: Tell me a bit about the Aga Khan Development Network, how it is helping the economic, social and cultural life in Pakistan specially its presence in Northern Areas?

AJ: We have a network called Aga Khan Development Network (AKDN), which is led by His Highness the Aga Khan and the network has three major arms. The first arm is the economic arm which is called the Aga Khan Fund for Economic Development (AKFED), the second is the social arm which has health, education and housing and third arm is the cultural arm which has the Aga Khan Cultural Services, the restoration of heritage sites and Aga Khan Architecture Award. These three arms function in the Northern Areas and Chitral and focus on development of life or the mountain communities. Each arm of the AKDN has its own mandate, goals and objectives and parameters for measuring success. There is an AKDN Committee which integrates all the functions of network. The AKDN has very strong relationship with the Government of Pakistan and mandate of the AKDN is to complement and supplement the government's effort.

PAGE: Mentioning the role of government, how it helped AKU towards its establishment and how positive do you think it has been from that time onwards?

AJ: In the early sixties His Highness the Aga Khan announced the intent to develop a hospital, medical college and nursing school in Karachi which later was escalated to a University. There were expectations which the Government was requested to meet which the Government complied to. We are very happy that the Government of Pakistan has played a very responsible, positive and supportive role by providing fiscal benefits which facilitates the University to function successfully.

PAGE: Health has been a major issue in the developing countries around the world, what awareness programs do you think we need to educate ourselves and how AKU is working towards that goal?

AJ: One of our mission is 'patient education'. Universities by their very nature are responsible for creation of knowledge and this has many facets. First facet is to diagnose and cure diseases, second facet is to prevent diseases and the third facet is to research cure for diseases. The AKUH has a major focus on patient education which is resident in the nursing and medical services ands some of our patient education programs are the 'Sign, Symptom and Care', interviews of our physicians and nurses on radio and TV channels, plethora of printed materials which is shared with patients to help them recover etc. The other means are the articles and columns that our faculty contributes in the newspapers and magazines.

PAGE: There is this perception in the lay man that the AKHU is pricey as compared to the other hospitals and low to middle income groups find it hard to enjoy the same health facilities because of that factor, how true is this perception?

AJ: The ground reality is that 75% of the hospital patients are middle to low middle income and last year the hospital gave direct patient welfare of 25 crore rupees by direct reduction in the charges. Indirect welfare is even larger, as we provide our services on reduced prices to subside care. In y our medical college only 20-25% of the cost is recovered from fees and the gap is subsidized by the University.

Now to answer the question of being pricy, in any part of the world a product of high quality is always expensive. AKUH provides the best care and the best care requires major investments in human resources, technology and infra-structure. The small surplus of the hospital is re-invested in purchasing new equipment, building new buildings, increasing welfare to poor patients etc.

Perceptions are very difficult human concepts and it takes time and track record to correct false perception. As an example in our early years the perception was that the hospital is restricted to Ismailis, which was a false perception and with time and track record this perception has changed. Today we are perceived as a national hospital which provides care to all segments of society irrespective of color, creed and caste.

PAGE: If I ask you which area in health needs much more attention for promoting better health prospects, what would you say?

AJ: I think the biggest area that needs the attention is 'preventive medicine', which is preventing the disease from occurring. This is a subject of world-wide discussion, and requires huge investment of time and resources. The money saved by patients by engaging in preventive care can used by families on their other needs which can enhance the economic status of the family.

When you don't look after yourself, you end up sick. Certain percentage of diseases is God given and certain percentage is self-inflicted. With the help of preventive medicine, we can equip ourselves to combat the self inflicted diseases.

PAGE: Your message to the readers?

AJ: AKU is a national institution. It is committed to service, education and research and it will continue to serve the needs of Pakistan. It is my humble request to my fellow country men is to treat AKU as their University by supporting and encouraging it's development.