[I]n the last decades I have come to an important conclusion about governance, about the fragility of governance in the developing world, and what people can do to protect themselves from governance which is not effective. And I think that history is beginning to show that civil society, in its complexity but also in its ability to impact the way people live, is probably the most important, single feature that I know. And building civil society is a complex exercise, needs multiple input and that multiple input, again, I hope we develop with your institutions in Alberta.

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People coming together around a common purpose are much stronger, for example, in eliminating corruption. When an individual faces corruption, that’s a problem. When a village community faces corruption it’s a totally different issue. And in fact, corruption in civil society is probably one of the most damaging forces that we are trying to deal with everyday…. And what we’ve found is that the community organisations, when they come together, what do they look at? It’s very exciting. Their whole basis of hope is built around best practice. They reject all the things that have damaged them individually and they come together and say we want a new future built around new people whom we choose because we trust them. [Emphasis original]

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There is one more dimension of our future vision that deserves to be mentioned before we conclude. I refer to an exciting plan to create, on the land adjacent to this site, a great new Kabul International Medical Centre — a Centre of Excellence for providing tertiary care services and medical education of the highest quality. This new complex will be an intellectual and service hub for an integrated health delivery system serving the entire Central Asian region.

The region includes the neighbouring countries of Tajikistan, Kyrgyzstan, Northern Pakistan, Kazakhstan and even Western China, where the Integrated Health System would impact over 100 million people. The success of this regional initiative, in my view, is predicated on public-private partnerships that sustain the institutions through best practice. Indeed the relationship we have established with this hospital and those in Bamyan and Faizabad are models of such partnerships.

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[W]e are looking at quality of life indicators — indicators that are not the same as those of the World Bank, indicators we have tried to develop through our own experience. We are looking at things like security, longevity, disposable income, access to education and employment. We are looking at what really affects people’s attitudes to their own understanding of quality of life. We did discover that communities around the world don’t have the same value systems. They will interpret their own qualities of life very differently from one part of the country to the other….

Imams around the world have businesses, not just the Shia Ismaili Imam. We do not see a conflict and indeed if we lived in an attitude of conflict, I don’t believe we would be living within the ethics of Islam. Islam doesn’t say that a proper practice of the faith means you have to ignore the world. What it says is: Bring to the world the ethics of your faith. If you have wealth, use it properly. But the actual ownership of wealth is not in any way criticisable unless you have acquired it through improper means or you are using it for improper purposes. It is seen as a blessing of God. So this whole notion of conflict between faith and world is totally in contradiction to the ethics of Islam….

Creating energy can be a source of environmental damage. The question is what is the most cost-effective way of creating this energy with minimum damage. I believe the partners in Bujagali have gone through massive environmental analysis and come to the conclusion that this is one of the least environmentally damaging initiatives in East Africa, because it impacts a very, very small area of land and a small percentage of the population, who were all relocated in good conditions. I have seen situations where energy has been produced by windmills, by solar batteries and the damage that they have done to the environment is simply incredible. Because these types of energy creation don’t work everywhere. And when they don’t work, they get written off in three years but nobody pulls them down. So they stay there and they are awful. We still don’t really know a great deal about the technology of these new energy sources.

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Today’s inauguration of the Heart and Cancer Centre follows in this long tradition — and points the way to broader, future horizons. We are planning for the day when this Faculty will include undergraduate education in medicine, nursing and allied health professions, as well as post-graduate nursing and medical studies — and a 600-bed hospital. We plan to award bachelors and masters degrees in medicine, surgery and nursing, and, in due course, to offer Ph. D. degrees as well….

For all of us, the medical frontier represents a compelling priority. A recent study by the International Finance Corporation, working with McKinsey & Company, describes what they call a “global travesty”: the fact that Sub-Saharan Africa — with 11 percent of the world’s population — bears 24 percent of the global burden of disease. And yet Sub-Saharan Africa presently accounts for only one percent of global health expenditures. A “global travesty” indeed! …

Let us put behind us the day when young Africans thought they had to go to other parts of the world for quality medical education … Similarly, let the day also pass when African patients think they must go to other parts of the world to find quality medical care.

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[Why have our development] efforts over five decades not borne greater fruit? Measured against history, where have things gone wrong? Given the progress we have made in so many fields, why have we been so relatively ineffective in sharing that progress more equitably, and in making it more permanent?

My response centres on one principal observation: I believe the industrialised world has often expected developing societies to behave as if they were similar to the established nation states of the West, forgetting the centuries, and the processes which moulded the Western democracies. Forgotten, for one thing, is the fact that economic development in Western nations was accompanied by massive urbanisation.

Yet today, in the countries of Asia and Africa where we work, over 70 percent of the population is rural. If you compare the two situations, they are one and a half to two and half centuries apart. Similarly, the profound diversity of these impoverished societies, infinitely greater than that among nascent European nation states, is too often unrecognised, or under-estimated, or misunderstood. Ethnic, religious, social, regional, economic, linguistic and political diversities are like a kaleidoscope that history shakes every day.

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[The Aga Khan University is] planning a number of new post-graduate schools in Pakistan and Eastern Africa, to meet important needs in both areas. Amongst these Graduate Schools will most probably be “Architecture and Human Settlement”, “Media and Communications”, “Tourism and Leisure”, “Management” and “Government, Public Policy and Civil Society”….

The central challenge of this new [Faculty of Health Sciences in Nairobi] will be to address the crucial health care priorities of the East African population — and indeed all of sub-Saharan Africa — from Sudan to Mozambique, from the Indian Ocean to the Atlantic.

The new Faculty of Health Sciences will educate future generations of professional leaders in the evidence-based practise of medicine. Emphasising both teaching and research, it will be accompanied by a major expansion of the Aga Khan University Hospital here, including a new Heart and Cancer Centre, which is scheduled to begin construction this year. What we envision here in the coming years is an institution of some 1,000 students and 175 faculty members, admitting students on a merit basis. Our new facilities, including a teaching hospital of 500 beds, will eventually occupy some 80,000 square meters. The total investment over the next fifteen years will be about 250 million dollars. When the project is complete, the Aga Khan University in Kenya alone will employ over 4,000 people.

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I should especially emphasise the significance of this Institute in the reconstruction of Afghanistan. This Institute was created through a Public-Private Partnership to establish a new medical institute through a strategic collaboration: The support of the French Government, that of the Afghan Government, the participation of the French Non-Governmental Organisations La Chaine de l’Espoir, and Afghan Children, and the Aga Khan University. This collaboration is today unique in Afghanistan and will bring to the Afghan population a new high quality hospital that will be accessible to the underprivileged….

[We] are highly desirous that this hospital develops into a high level university hospital tertiary care centre which will offer new specialisations — essential for Afghanistan — such as neuroscience, cardiology, oncology and many other fields of medicine, which best meet the needs of the country.

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Through linkages between the Schools of Medicine and Nursing of the Faculty of Health Sciences of the Aga Khan University, and the Aga Khan teaching hospital in Nairobi, we are building here in Dar-es Salaam a regional hub of quality medical and nursing services. This hospital will be part of what amounts to a regional teaching hospital network….

Post Graduate Medical Education programmes are already in place between here and the Aga Khan teaching hospital in Nairobi. The family medicine post graduate programme has been placed at this hospital, in part because of the important links to our five up-country community health clinics. Other post-graduate medical programmes will be established here in future. These programmes will be opened to physicians from our own and other hospitals to gain greater regional synergies. The hospital already has a partnership with the Muhimbili College of Health Sciences at the University of Dar es Salaam. Rotations for specialising physicians help them gain valuable clinical experience.

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Aswan and the people of Aswan, have a place of deep affection in my heart and within my family…. The programmes announced today intend to both continue, and also to build significantly on, the work begun by Begum Sultan Mahomed Shah. Our objective is to strengthen civil society at the grassroots by helping to improve community development organisations and by bringing to bear on critical needs in this area, the panoply of experience and resources of the Aga Khan Development Network.

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More than twenty-five years ago, these were some of the central concerns that led to the establishment of the Aga Khan University in Karachi and its School of Nursing…. Given the state of health services in Pakistan at that time, I felt it particularly important to create an institution in the country that could offer education in the health professions at international standards. This would ensure that the teaching and research programmes would be of the highest quality, but would also be grounded in local needs and realities, and that, if properly funded and led, could make a distinctive contribution on a permanent basis. In addition, a successful national institution would have the potential to provide leadership directly and through its graduates that would be felt in the professions and also in society more generally.

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The Aga Khan thanked the CEC and the British Overseas Development Administration for co-funding the Chitral programme and acknowledged the role of the Government of Pakistan in facilitating the co-operation of national and international agencies in contributing to the development of the region. He underlined that the Rural Support Programme has various dimensions. It is designed to develop the ability of the people of this isolated part of the country to generate rapid increases in their productive capacity and assist them in the provision of self-sustaining primary health care and education activities, all of which would enhance the quality of life for the population of the area.

MISSING: We regret that remarks made to the press at this event are not available in the Archive and we would be very grateful if any of our readers who may have a copy would kindly share it with us. Please click here for information on making submissions to NanoWisdoms; we thank you for your assistance.

In the seamless web we call national development, housing is only one factor influencing the quality of human life. But how vital it is to health and human safety, still more fundamentally, the state of a person’s home touches deep chords in the human spirit.

It can make him proud or ashamed; give him light and a sense of hope or deepen his despair. It is his statement to his children and to the world about his control over his life, and his aspirations for the future. It is not too much to say that to the extent a man is a householder, he is also a citizen, with a permanent interest in the stability and progress of his country. Still more important, housing has historically been created by families. The African or Asian village, like most other traditional settlements, is not an abstraction, but an architectural expression of a social reality, the way people relate one to another — often as an extended family. These settlements reflect human bondings and community spirit. They can foster families and their ties to other human beings; or they can express human alienation as the extended family disaggregates….

[C]onfronted by the appalling magnitude of the problem of inadequate housing — estimates that one-fifth of the human race is without decent housing, of whom one hundred million do not even have a roof over their heads — one must avoid the trap of the mass solution. Government resources and political commitment to a solution are indispensable: but they will be effective only to the extent that they mobilise as part of the solution the people for whom housing will not be merely shelter but a source of community and of a better life. This will take infinite care and powerful imagination, for the institutional models will vary with regions and cultures, but I deeply believe there is no substitute for them.

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