The Aga Khan University

Twenty-five years of conflict and political instability had ravaged Afghanistan’s healthcare system – the ground infrastructure was tattered, the human resource limited and training capacity non-existent.

In the last decade, Aga Khan University along with associate AKDN agencies has worked hard to reverse the trend by playing a central role in training and developing a much-needed pool of qualified nurses, midwives and medical personnel.

The University’s support began through a core group that transformed into the Aga Khan University Programs in Afghanistan, and its initiatives too in nursing education panned out to include midwifery and post-graduate medical education.

AKU-PA actively assists national academic and health institutions in capacity building, including the Ghazanfar Institute of Health Sciences, Kabul, and its regional satellites for nursing and midwifery education; the Kabul Medical University for its baccalaureate program in nursing and post-graduate medical education; and Mental Health and Drug Dependency Resistance Department of the Ministry of Public Health for its human resource redevelopment and also teachers training programs.

Till 2012, AKU-PA had supported the education of 623 nurses and 575 midwives, including scholarships to meritorious Afghan students to study in baccalaureate and master programs in nursing, medicine and education at its Karachi campus. Moreover, over 400 Afghan health and education personnel have attended short courses at AKU Karachi campus and in different provinces of Afghanistan.

Rigorous training has been provided to local practitioners in part through and at the French Medical Institute for Children, a medical centre of excellence and referral, managed by AKUH, Karachi. In a country where one child in four does not reach the age of five, FMIC plays an important role as Afghanistan’s premier paediatric facility and first-ever ISO-certified health care institution.

In the coming years AKU-PA’s scope of work will broaden with five major initiatives in medical, nursing and midwifery education in 2012.

A Post Graduate Medical Education Program has been initiated in two disciplines, paediatric medicine and pediatric surgery, at FMIC.

A first of its kind Training and Policy Unit at GIHS, Kabul has been established to formulate and analyze nursing education policies and standards, review and revise nursing curriculum and strengthen capacities of the nursing faculty GIHS and its five satellites in different provinces.

In the northern province of Badakhshan, a three year Diploma Nursing Education Program has been started while a surveillance system is being established in five clusters to register every pregnancy and birth for a better understanding of maternal and neonatal morbidity and mortality.
The second phase of technical support to the Midwifery Education Program at GIHS has begun too and will include a review of midwifery education curriculum and standards, faculty development and exposure visits, improvement of infrastructure and strengthening clinical teaching for students.

F R E N C H M E D I C A L I N S T I T U T E F O R C H I L D R E N

Regarded as Afghanistan’s premier health care facility and the first-ever ISO certified health care institution in the country – as part of an innovative four-way partnership between the Governments of France and Afghanistan, AKDN and the French NGO, La Chaîne de l’Espoir. To develop a pool of qualified professionals in all areas of health care delivery, leadership and administration, on- and off-site training has been provided by the partners.

Built by La chaîne de l´espoir during 2003 to 2005 with the support of several donators and sponsors the hospital is running in cooperation with the Aga Khan Development Network (AKDN). There is also a close cooperation between the French and Afghan government. Even the German affiliate organisation of La chaîne de l´espoir, RobinAid takes active part in the medical support of FMIC since March 2009.

It was officially opened in April 2006 under the management of Aga Khan University. When it opened its doors, it was already offering healthcare of the highest standard in the country, on a par with the best medical institutions in the region. In its initial phase it provided paediatric surgical care, including general and orthopaedic surgery. It now also provides paediatric medicine and plastic surgery, cardiology, neurosurgery, cardiac surgery and anaesthesia.

Over the period of 6 years, FMIC has provided services to more than 2 million population in Afghanistan. Currently the hospital provides about 85 beds including 15 beds for pediatric intensive care, 4 operation theaters, a department of radiology including CT-Scan and MRI plus a laboratory and children with severe illnesses can be treated as well.

The ISO certification for quality management systems in its third year of operation (March 2009) and the re-certification was done in 2012. FMIC is the first hospital in Afghanistan to have performed open heart surgery; and closed heart surgeries using a local cardiac team without the assistance of any foreign surgeon. Finally, in March 2012 the Post Graduate Medical Education in paediatric medicine and paediatrics surgery was initiated, and the first batch of 6 students/residents inducted.

In the northern Badakhshan province, AKU is managing and expanding eHealth network, which is enabling medical staff at Bamyan Provincial Hospital, Faizabad Provincial Hospital and Khorog Diagnostic Unit – located across the Tajik border – to consult their peers at FMIC and AKU Karachi on a regular basis. In Khorog alone, such consultation is leading to more timely and effective diagnosis and treatment for a community of more than 300,000 rural Afghans and Tajiks.

Since 2012, the new Women’s Wing at FMIC has been underway, marking the start of construction for its new obstetrics and gynaecology wing that will provide high-quality care for mothers and newborns in Afghanistan. The building will offer 52 additional beds for obstetric and gynaecologic care and a 14-bed neonatal intensive care unit. The start of services is planned for early 2015. A dedicated team from FMIC and AKU is overseeing the progress of the project.

In the future, FMIC with its partners is planning to expand the hospital to 250 beds, which will enable delivery of care to adults and children, including maternal care, obstetrics and neonatology, cardiac and neurosurgery and other services to be defined as the hospital grows. This will be a phased approach, with the initial 52 beds of women’s obstetrics and gynaecological wing added to current services by 2014. This will enable the hospital to grow beyond its initial focus on paediatrics, making possible the delivery of medical care to male and female adults and children, including maternal care, obstetrics, neonatology, oncology and other general and specialized services. FMIC is also working toward establishing a comprehensive medical complex in Kabul which will serve not only the Afghan population but Central Asia as well as a medical centre of excellence.

The social circumstances within the population require a welfare program and treatment at no costs for at least 90 % of all patients. The Welfare Fund at FMIC is financed by donations and from revenues raised from hospital services. Total welfare during first six years period is of approximately $11.0M.