President Ramzan Merchant,
It is a special and very welcome occasion for me to be amongst such distinguished representatives of government, of foreign countries and of international agencies here today: special because my family and I are deeply involved in social welfare in the widest sense and I particularly appreciate being amongst those who commit their time, resources and efforts for the benefit of mankind.
When I assumed the responsibilities of the Imamat 25 years ago I too became involved, as leader of the Ismaili community, in that most vital business, the well-being of ordinary people.
Islam, as I scarcely need to remind an audience here, is an all-encompassing faith. It gives direction to Man’s life, urging the individual to achieve a balance between material progress and spiritual well-being. But no man, woman or child can hope to achieve such a balance in sickness, illiteracy or squalor.
My grandfather, Sir Sultan Mahomed Shah, initiated education and health services on this sub-continent in the 1880’s because he believed that basic education and health are crucial stepping-stones towards mankind’s self-realisation and growth.
Today, members of my community are spread through 25 countries. We have many hundred health care units, ranging from teaching hospitals down to village dispensaries and more than 300 education establishments from pre-primary to university. These are on their way to becoming an internationally linked system of voluntary non-profit, Muslim institutions serving all communities, which through their welfare activities are contributing to improving the quality of life in many parts of the Third World.
These institutions are also beginning to fulfil an aspiration which I have always had for them: namely that they should help bridge the gulf between the developed and the developing worlds. This role is particularly appropriate to the Ismaili Imamat because of its commitment to broad social objectives without political connotations, save in its concern for the fundamental freedom of its followers to practice their faith.
At the apex of both our medical and our educational institutions is the Aga Khan University in Karachi, the charter of which was granted to us by His Excellency the President last Wednesday. The first faculty of this University, the Faculty of Health Sciences, will form part of a major medical complex, including the School of Nursing which opened in 1980, a medical college and a 721-bed teaching hospital.
The project as a whole is associated with the Universities of Harvard, McGill and McMaster in North America, and generous grants have been made by the Canadian International Development Agency towards the training of nurses and staff at the nursing school.
One of my greatest aspirations has been that the people of Pakistan would consider the University as an institution of their own and that all segments of the population would give it their support. I am, therefore, particularly gratified by the very generous donations we have been receiving for the University from numerous institutions and individuals in this country, and I am happy to confirm that we have now established an Aga Khan University Foundation to administer the corpus of funds being provided for the University, to reinforce its financial stability, and provide for its future operating costs.
The overall aim of the University, as I told those present at last week’s ceremony, will be to make clear and rational judgements as to which foreseeable needs of the developing countries require new educational programmes and, having identified those openings, to address them by the appropriate means, setting the highest standards possible whether in teaching, in research, or in service.
To do this, the University needs to be an international one and we plan for it to have faculties in other countries.
Viewing problems in an international perspective has become an increasingly strong characteristic of the Imamat’s activities. Indeed this is fundamental to the work of the Foundation, which now has affiliates in eight countries. It was officially recognised by the United Nations Development Programme in 1980 and by the World Health Organisation this year. It is today among the largest when measured in terms of its yearly commitments in the Third World.
The Aga Khan Hospital and University has been the largest project sponsored by the Foundation. But although its other activities range widely, it would be impossible for the Foundation to address the complete spectrum of Third World needs. Indeed, rather than diffuse its activities by disposing them too widely, it has selected four major themes to pursue. This also means that, since the Aga Khan University is oriented towards specific themes and towards problem solving, the two institutions have a degree of shared purpose and may in the future contribute to each other’s expertise.
The first theme inspiring the foundation is seeking new, cost effective ways to improve the quality of education in developing countries.
Population and budget pressures on schools in the Third World have led to overcrowded classes and a scarcity of textbooks. Teachers have low social status and poor pay. The result is a serious dilution of the education provided for most children, especially in the rural areas and a decline in standards, often resulting in a refusal by industrialised nations to recognise academic qualifications given in the Third World.
The ways in which the Foundation is tackling this problem are numerous. They include efforts to make curricula more relevant to the local environment and the improvement of teaching standards, for example by giving technical assistance to schools in Tanzania.
The second theme centres on community oriented health development.
Because of high cost, the majority of people in developing countries do not have access to conventional medical and health services. The Foundation promotes community-based health, nutrition and medical programmes which emphasise what communities and families can do to improve their health.
Thus in Bangladesh it is supporting the field testing of a new rice based formula for the oral re-hydration treatment for intestinal disorders, the major cause of infant mortality in the Third World, it organises a highly successful goitre control programme in the northern areas of Pakistan, through the distribution of iodised salt, in Kenya, it is working with the government and other international agencies to plan and operate a comprehensive primary health care scheme in Nyanza Province. The latter project is a direct outcome of the seminar on ‘The Role of Hospitals in Primary Health Care’ which the Foundation and the World Health Organisation co-sponsored in 1981 in Karachi.
The third theme is that of generating employment and income in rural areas. If rural populations are to have hope for the future and not drift in despair to the already overcrowded cities, more productive job opportunities must be created for them. The Foundation has initiated wide-ranging rural support programmes both in Pakistan and in India.
The Foundation’s fourth theme is improving the management of the Third World’s natural resources, for example by helping a large-scale re-afforestation scheme in India.
All four of these themes are directed to improving the qualities of life in those developing countries in Asia and Africa where populations are under the greatest pressure and living in the most straightened circumstances. Frequently the practical application of the themes interlocks, as it does in the ambitious community basic services programme currently being undertaken here in the northern areas in co-operation with UNICEF and the Pakistan Government.
Along other elements, this programme will provide drinking water supplies and basic sanitation to 150 villages over the next few years. As well as contributing to the funding, the Aga Khan Institutions are concerned in the educational, health and building aspects. The central health board is training traditional birth attendants, our central education board is holding teacher refresher courses, and the housing board will be training artisans for self-help construction.
The rural support programme is helping underpin the whole project by identifying and promoting new income generating opportunities for the villagers, so that they are better able to contribute to their own welfare. Thus a whole family of contributing institutions is involved, including an international agency and government.
Nearly all the Foundation’s programmes involve integrating resources from different parts of the World in collaboration with governments, with such international agencies as UNICEF and the World Health Organisation and with other private agencies.
Inevitably, and rightly, this experience has led us to certain conclusions about ways of handling international aid. Indeed we are learning all the time.
Our conclusion is that in the past too much investment has gone into capital assets and not enough into making people productive. Not least, investments has gone into projects which have a high public relations value to the donor and appear to confer prestige on the recipient country, but have little relevance either to identified needs or to the rural inhabitants who make up 80 percent of the Third World’s population.
In the end, when the donor agencies’ teams have departed, the assets they have supplied will have to be run by local people and funded locally. Yet have we not all seen projects initiated without proper research into their future validity? Schools are built without sufficient thought being given to how the operating costs will be met, where the teachers will come from: or whether the proposed curriculum will contribute to the future manpower needs of the country. Hospitals are constructed without regard for the very high operating costs and without demographic surveys to ascertain the profile of the populations in the hospitals catchment area, or of likely changes in that profile. The question of how expensive equipment is to be renewed when it becomes obsolete or worn out may be disregarded entirely.
One corollary of this that more men and women of wide experience are needed to train local leaders, men and women who are motivated to come to grips with all aspects of a development proposal and who will not start implementing it simply, or even naively, out of goodwill and blind faith in the future, or as a result of political pressure, until the project has been fully evaluated.
Many thousands of people in Pakistan care deeply about the life of their fellows and an immense amount of voluntary action is undertaken here, but it often lacks coordination. To be effective and avoid wasteful duplication of effort, different agencies, both governmental and non-governmental, must work together. This is not to denigrate the service given by voluntary workers. Far from it. The volunteer is the lifeblood of our own central institutions. However, voluntary effort does need to be set in a professional frame, in order for it to be as effective as possible.
In my view, it might also be desirable for non-government organisations with a proven track record to be allowed wider scope by governments, for example by permitting them more direct relationships with international agencies. Both governments and philanthropic agencies would benefit from a more complete understanding of what problems are being addressed by what agencies in a given land. In the countries of the developing world with which I am familiar it is impossible to obtain even a simple but complete list of the agencies addressing a specific problem, such as health, education or rural development. Such information would greatly help non-governmental organisations in getting together to exchange and make better use of scarce and expensive expertise, possibly to exchange manpower.
In conclusion, I would like to reiterate that the resources available to any developing country, whether human or material, are so limited that the maximum effective use must be made of them.
In this time of world recession, when both governments and non-governmental agencies are rigorously scrutinising aid budgets, it is an inescapable fact that aid will first go to those who are prepared to help themselves.
The Aga Khan Foundation aims to make professional analyses of local development needs in areas where the will exists among the inhabitants to contribute to their own future: to produce viable project plans on the basis of these analyses: to ensure that the plans fulfil identified national requirements: and then to marry them to outside funding.
I believe this integrated approach is a dependable way forward both Pakistan and for the Third World as a whole.