Inauguration of the Faculty of Health Sciences
and Aga Khan University Hospital, Pakistan
November 11, 1985
Your Excellency the President,
Your Excellency the Governor of Sind,
Honourable Chief Minister of Sind,
Mr President, your unfaltering encouragement has enabled us to bring the Aga Khan University into being. To give the first private University in Pakistan your support was a bold initiative and one to which I wish to offer the fullest recognition. If Pakistan and the Ummah one day have occasion to be thankful for the existence of this institution, then first and foremost they will have to render honour to the leader who, in answer to my question about the possibility of turning our proposed Medical College into a University, replied without hesitation, “yes”. This is your University. Without your help the task of all those hundreds and indeed thousands of others who have been involved with its foundation would have been immeasurably more difficult, if not impossible.
It is my strong personal wish to give a permanent form of expression to the gratitude which everyone connected with this institution feels to you. I should therefore like to mark this most auspicious occasion by announcing the establishment of named endowment funds for both institutions, one of 10 million rupees to provide scholarships for medical students, the other for a similar amount to support health care for the poor at the Hospital. With your approval these funds will be named in honour of your gracious wife Begum Shafiq Zia ul-Haq. They will also, I hope, serve as some recognition of the contribution which her own charitable and humanitarian activity has made to this country.
It may be appropriate today to recall some of the challenges we have faced since the announcement of the project in 1964.
Those 21 years have been turbulent ones throughout the world. Inflation has ravaged currencies. The pattern of health problems on the sub-continent has altered. Pakistan itself has been scarred by war and its land torn by earthquakes.
Necessarily, planning for the University has had to take these influences into account. Major cities are liable to be prime targets in war, while this year’s Mexico City tragedy underscores that in time of disaster hospitals above all other buildings must remain intact. The destructive potential of bomb blasts and Karachi’s seismic vulnerability forced us to re-evaluate the architecture of these structures in 1975.
During those two decades health experts gradually came to appreciate that the most pressing health problems for 80 percent of Third World populations are ones involving primary health care. Few hospitals had taken this into account, because it had taken so long to come fully into focus. Our planners adapted the project accordingly and we have greatly benefited from those advisers who improved our comprehension of what was required. As a result our original concept of a small medical college with its own 120 bed hospital attached to an existing university and training doctors for work in urban hospitals was abandoned to be replaced by an independent university, with its own Faculty of Health Sciences and a 721 bed University Hospital devoting one third of its resources to primary health care. These profound changes caused delays and a substantial escalation of the cost of the project, which rose from $ 10 million at 1964 prices to $ 300 million in 1980.
The Medical Complex we are inaugurating is profoundly different, and a much more sophisticated project than that which we conceived in 1964.
If the Campus and the Hospital possess an atmosphere of peace and calm, and are aesthetically pleasing, then that is in fact the outcome of hundreds of thousands of man-hours of debate, and sometimes of confrontation, on how Pakistan’s changing needs could best be addressed.
These buildings represent the endless travels of experts on hospital architecture and management, on teaching and on health care. They have provoked moments of inspiration, but also of disillusion, exhaustion and even despair, as the project staff analysed and re-analysed what would constitute the most effective deployment of the resources available. You hold in your hands the statistics of physical area, student enrolment, hospital beds and departments, down to a 75,000 volume medical library. What those figures cannot show are the human commitment and endeavour which enabled the Aga Khan University and the University Hospital to evolve in such an exhilarating way. I sincerely hope that those who gave so unstintingly of their efforts, who may have felt they would never witness the projects’ completion, will feel themselves rewarded today, and forgive any moments when the stresses may have seemed unbearable, or my own leadership too demanding. When a team of climbers assault a mountain, it is inescapable that the leader determines the route, however arduous it may prove.
To my team goes my deepest gratitude and my prayer that Allah should shower His Blessings upon them.
Many people from many walks of life have contributed to this achievement, including the donors from whom there has been a massive response. A response from individuals and institutions, from Ismailis and other Muslims and non-Muslims, both inside and outside Pakistan. Their generosity has been an object lesson to us. As Muslims we talk about living our lives in an Islamic context, guided by the Faith. We seek this goal and try to achieve it. When I asked who would help me with this project, which was not of their conception but mine, the answer given was affirmative and empathic. These donors have demonstrated that one of our Faith’s most fundamental and inspiring concepts – giving for the benefit of others – is still deeply influential. I can say without exaggeration that this response has been a source of inspiration to me. It has given me confidence in the future and further heightened my gratitude to all those who, with me, battled to bring this University into being.
This week we have had the pleasure of appointing a distinguished Board of Trustees under the chairmanship of Shahabzada Yaqub Khan, whose eminence needs no further tribute from me. We are honoured at his hand and the other members willingness to serve our cause. I can affirm that the Aga Khan University and its Hospital will endeavour, with every resource available to us, and under the direction of the Board, to match the high expectations of all those who have made the University’s realisation possible.
However, developing a new university into an effective and respected centre of learning demands a far greater span of commitment and time than can ever be available from one man’s views, one man’s resources and the allotted years of one man’s life. In particular, if it is to become an institution whose excellence and longevity are assured, then it must be guaranteed the capability of meeting its future material requirements. Otherwise it will be merely like a passing comet, which illuminates the sky for a few seconds of eternity, and then is gone.
If the Aga Khan University is unique in Pakistan for self-government accorded by its Charter, I am happy to affirm that it is now no less unique in Asia through being endowed with a corpus of funds, mobilised from many parts of the world, which will ensure that it has the means to fulfil its present objectives. Through the generosity of our donors, targets to be achieved by 1993 have already been attained. The income from this corpus will in part be re-invested each year, so that its earnings will grow, thus enabling the institution to better meet its expanding needs.
Your Excellency, the Charter given us by you on March 16, 1983 laid down the principles which would govern the functioning of the University and identified the constituencies to which it would be encouraged to respond: the Pakistan Nation, the Ummah, including my own Community, and the Third World countries of Asia and Africa.
Whilst open to all, the Aga Khan University is to be an Islamic institution. It will draw upon the great historical tradition of Muslim’s learning, the heritage of such philosophers and scientists as Ar-Razi and Al-Biruni, Ibn Sina and Ibn Rushd. In the true spirit of this tradition, it will also address the higher educational needs of Muslims as they face this new fifteenth century of the Hijra.
This inaugural day is therefore an appropriate moment to reflect upon the nature of those needs and on what the role of this University should be, situated as it is in an Islamic country of world importance, at the heart of the Ummah. The relationship between the intellect of Man and the Faith has always been of fundamental importance to Muslims. How can a modern University respect and reinforce that relationship?
The divine intellect, “Aql Qul”, both transcends and informs the human intellect. It is this intellect which enables man to strive towards two aims dictated by the Faith: that he should reflect upon the environment Allah has given him and that he should know himself. It is the light of intellect which distinguishes the complete human being from the human animal, and developing that intellect requires free enquiry. The man of Faith who fails to pursue intellectual search is likely to have only a limited comprehension of Allah’s creation. Indeed, it is man’s intellect that enables him to expand his vision of that creation.
Eleven hundred years ago, Al-Kindi wrote “no-one is diminished by the truth, rather does the truth ennoble all”.
I quote that great Muslim scientist and thinker because his words are as relevant to higher education today as they were during the first flowering of Islamic civilisation. There was not then, and is not now, any conflict between intellectual attainment and the Faith of Islam. If the frontiers of physics are changing, it is due to scientists discovering more and more about the Universe, even though they will never be able to probe its totality, since Allah’s creation is limitless and continuous.
I apprehend that in certain educational institutions respect for tradition has restricted academic study to the accomplishment of the past. However, our Faith has never been restricted to one place or one time. Ever since its revelation the fundamental concept of Islam has been its universality and the fact that this is the last revelation, constantly valid, and not petrified into one period of man’s history or confined to one area of the world.
Islam is for all places and all time. This is why there is a role for a modern Islamic University which can draw inspiration from the Faith and from the past in addressing the opportunities of the future.
The Holy Koran’s encouragement to study nature and the physical world around us gave the original impetus to scientific enquiry among Muslims. Exchanges of knowledge between institutions and nations and the widening of man’s intellectual horizons are essentially Islamic concepts. The Faith urges freedom of intellectual enquiry, and this freedom does not mean that knowledge will lose its spiritual dimension. That dimension is indeed itself a field for intellectual enquiry.
I cannot illustrate this interdependence of spiritual inspiration and learning better than by recounting a dialogue between Ibn Sina, the Philosopher, and Abu Said Abul-Khayr, the Sufi Mystic. Ibn Sina remarked “whatever I know, He sees”, to which Abu Said replied “whatever I see, He knows”.
Today more than ever, the Ummah of nearly one billion believers, spread across so many lands, needs the leadership in education which universities most particularly can provide. Unhappily many Islamic institutions of higher learning, operating under severe pressures of numbers or of financial constraints, are unable to articulate relationships with their equivalents in other Islamic countries. We must seek to open windows, not only upon other civilisations, but also between peoples of our own Faith in different lands.
It is therefore appropriate that in establishing the curriculum of the Faculty of Health Sciences we have consulted with academics both inside and outside Pakistan: with the College of Physicians and Surgeons of Pakistan; with institutions in other countries of the Ummah; with Harvard, McGill and McMaster Universities in America and Canada. Through them the Faculty will, I hope, be able to draw upon whatever available resources of contemporary knowledge are relevant to our pursuit of excellence.
Many difficult decisions have already marked the history of this young University, but there is one which deserves to be spelt out publicly. Numerous colleges and universities provide undergraduate education to substantial student numbers in the Islamic world. Should we attempt the same, or endeavour to expose a relatively few students, to the best that is internationally available in the belief that we will assist both Pakistan and our wider constituencies more effectively by seeking to train leadership for the future?
We have taken a purposeful decision, based on considerable discussion and research, to pursue the latter course: to aim to help raise the standards of medical education. At the time of your decision to grant our Charter, Your Excellency was not only President: you also held the portfolio for Health and you were uniquely well placed to appreciate how the erosion of those standards was affecting Pakistan. You pressed our objective upon us. You agreed that excellence would only be achieved in an institution where the faculty was not overwhelmed by the administrative burdens which large numbers would create and you requested me to ensure that the University should have sufficient resources to underwrite the maintenance of the highest educational standards. Without demonstrable excellence we could neither prepare the next generation for its tasks, nor create an atmosphere of vibrant activity which would stimulate the Faculty, nor encourage research, not by example persuade other teaching institutions to set themselves higher targets.
This policy has already attracted back some outstanding academics who had earlier left this country. They had departed in search of improved facilities, rewards and –most important – personal and professional fulfilment. They returned when the intellectual stimulation they had sought became available here. I hope many more will do the same. Pakistan needs the skills of its own sons and daughters.
Hitherto, many medical schools in Pakistan have trained doctors for western secondary care in cities. This will never cease to be needed. In the near future, we shall introduce graduate training in the College and we are considering a degree course in nursing. However, the vast majority of the Third World’s inhabitants live either in the rural areas or in deprived urban ones. The Faculty of Health Sciences is therefore introducing an innovative curriculum to prepare physicians for work at the community level, which will give student doctors and nurses practical field training, often in demanding circumstances, at small rural and urban health centres. Conversely, those centres will send their own health professionals, such as midwives and health visitors, to the Hospital for further training and refresher courses. Through such interchanges we shall seek to understand more completely and address two of the most intractable problems encountered in providing qualified health care for those many millions of the Third World citizens who live on the land. First, how to prepare urban trained medical staff for rural work, and secondly how to establish stable and satisfying careers for them in those rural environments.
Our own health planners believe that a new and more creative role is possible for hospitals in the Third World. They can address the basic health needs of the population directly by acting as a referral resource for local health centres. The Aga Khan University Hospital will do this, providing support for medical and health units both of the Government and of the Aga Khan Health Services, which operate throughout Pakistan from Karachi to the remotest areas of Northern areas as well as elsewhere in Asia and Africa.
Change is woven inescapably into the texture of men’s lives if Universities are to fulfil their roles they must both respond to change and initiate it through research, in the sciences especially.
In the future, the Hospital may broaden its horizons, possibly coupling research carried out at the Faculty of Health Sciences with high technology tertiary care, in health areas determined as being of particular relevance to Pakistan. For example, recent statistics here in Karachi reveal an increase in degenerative diseases. It is the duty of leading institutions always to be aware of such changing patterns.
In what directions, then, might the university as a whole expand?
Of one thing we can be certain: the University will only devote its resources to issues of such importance, size and permanence as demand the most constructive thinking available. More than perhaps any other contemporary type of institution, universities can provide a forum which a creative, enquiring and logical approach can be made to the significant issues of the time. They possess – or should possess – the capacity to bring independent thought and original research to bear on the many challenges facing our civilisation. However, their value is directly proportional to their ability to look further than the immediate landscape of society, to identify which current trends are likely to evolve into major changes and to stimulate thinking about their implications in advance. We must endeavour as much to fly high and see beyond our present horizons as to broaden them.
Two such areas of change can be discerned as of crucial importance to the Ummah and the Third World are the functioning of an Islamic society in the coming century, and the wide ranging issue of development in the Third World.
The relationship of the individual to society constitutes one of the oldest preoccupations of civilised man. I share with other Muslims a sense of frustration that this issue has not been adequately explored in an Islamic context for many decades and I share a desire to react. As your Excellency argued forcefully in your recent speech to Al-Azhar University, we have to ensure that the eternal humanistic values of Islam are properly understood in today’s world.
The new technology of information is embracing a growing proportion of the world. Misrepresentation spreads before it can be countered. Individual privacy is invaded.
In the predominantly rural countries of the Ummah urbanisation pounds the social structure of cities, destroying those traditional human relationships which are so necessary to our culture and threatening to provoke explosive reactions. It is essential that we respond to such pressures, not emotionally and intemperately, but with mature and dispassionate analysis, seeking wise long-term solutions, which will enable our societies to evolve and develop within Islam’s humanistic guidelines. Communications, urban law, the modernisation of education: these are among pressing issues which might justify the Aga Khan University creating a Faculty of Islamic humanities in the future.
Economic and social development is of compelling urgency throughout the non-industrialised world. The formulation of national policy needs to be in the hands of men and women who have been trained in the demanding tasks of allocating priorities that will affect a country for generations to come. Rural development; the better management of voluntary agencies and their collaboration with public institutions; the overall governance of enterprise in both the public and the private sectors; these are among key policy areas. They have become so over recent years and their importance is increasing not diminishing. A faculty concerned with Development Policy and Management, basing an innovative curriculum on prior field research, could provide courses for those already in development jobs, enabling them when they return to contribute more effectively to problem solving, decision making and day-to-day management.
No matter where such Faculties might eventually be situated, however excellent the academic environment on this campus, however accurate the definitions of the issues to be addressed, or the size of the resources available, the success of the Aga Khan University will come from elsewhere. It can only be born from an enlightened intellectual environment, which gives stimulation to everyone involved, from the most recently arrived young student. That will not be easy, it will demand a strong sense of purpose and a sensitive balance between freedom and discipline. At the Charter Ceremony in 1983 I warned that priorities would inevitably alter with the years. That warning was also a statement of intent.
The Aga Khan University will only succeed in providing intellectual leadership if its members are constantly seeking new paths to progress. I pray to Allah that He may give everyone connected with the University, today and in the future, the Faith, wisdom, and courage to stride boldly towards that challenge.
Your Excellency, it is now my privilege to ask you on this day to which I have been looking forward for 21 years of my life, to perform the inauguration ceremony of the Faculty of Health Sciences of the Aga Khan University and of the Aga Khan University Hospital.