Karolinska Institute
Chief Guest
Your Excellency, Mr President, Graduates, Colleagues, Parents and Friends,
assalamu 'alaykum!
First of all: graduates, congratulations and well done!
After all the hard work, days and long nights in often hard clinical situations you do deserve a rest. But there might be no rest for you. The stimulating challenge in front of you is great and I will deal with that challenge and future career opportunities here.
You have chosen to do your training in one of the finest institutions of your own country. There are great advantages in this, as it makes you experts and potential advisors and leaders, well versed in your own culture and health environment. I can tell you that the world needs just that. Do go abroad for further studies if you like, but do not stay too long. You could become strangers to your own facilities and communities and your children might not like the return. Travel in medicine is best performed at a later stage in life, when you are involved in a subspecialty, in a particular health advocacy or have a focus in research activity. Then a visit to a centre of excellence or an international meeting can be most rewarding. Remember that it is greater to be the first in your field in Pakistan, than to be the one-hundred-and-first in the US.
What is needed for your further career? The last decade has seen an expansion of both community orientation and research activity at AKU. It has been achieved by dedicated individuals sacrificing the higher personal income and higher grants of overseas employment. It seems important now to increase the early exposure of interns, residents and fellows to community-based implementation of known necessary health interventions as well as to laboratory based research: to train you in the formulation of research questions in front of the health problems encountered, and to facilitate investigation and academic writing - the start of a research career! This will stimulate and enrich your clinical work, as well as your future teaching.
What are the research areas particularly relevant here at the present time? What is well-known for implementation and what needs more research? What will be your choice, your focus? It has to come from you, based on your personal experience, to bear fruit. The importance of women education and emancipation cannot be overrated and needs your input to ensure health in the next generation. Safe motherhood and delivery and neonatal care, vaccinations, TB detection, prevention and care, improved water and sanitation facilities would make a huge difference to the population's health. We actually know the figures of how much it would mean.
But there are many unanswered research questions for you to involve yourselves in. The recently developed areas of stem cell research, of nutrition in very early life and the epigenetic revolution in biochemistry have a lot of promise in relieving several chronic lifestyle diseases that affect South Asia, like low birth weight, preeclampsia, hypertension, cardiovascular disease, stroke and diabetes.
Seek international cooperation. My home university, Karolinska Institutet in Sweden, is next year 200 years old. Its Nobel Committee has just met and decided about the awards and soon the laureates will receive the prizes from the hands of the Swedish King. There are in the past two South Asian laureates in peace, one in literature, one in economics and indeed one Pakistani in Physics. It is clear that too little funding has gone into medical research.
Karolinska Institutet has already collaborated with AKU in research and research training for 17 years now. Three interim departmental chairpersons have a PhD from Karolinska, three more are faculty and three are being trained in a 'sandwich' type of training between AKU and Karolinska. Karolinska Institutet now shows, like the whole European Union, increased interest in Asian collaboration, for which large Swedish SIDA and European Union grants have very recently been opened. It will pay for AKU to carry on and is increasing support to the scientists on board, and the research training, in order to later more efficiently compete with China and India for these Asian grants - not to dilute or redirect your support at this stage!
The academic standard of AKU already achieved, the international backing as part of the Aga Khan Development network and your base in a developing region, make you unique in the quest for achievements like safe motherhood, child survival, early child development and poverty eradication. The world's eyes are already upon you after this relatively short time of your existence. The AKDN and AKU's outstanding achievements in Central Asia, Afghanistan, the Northern areas, East Africa and Britain can, in my mind, already qualify for a Nobel peace prize!
I suggest you use this position. I do not suggest that AKU should become the best university in the world. I suggest it should become one of the best universities for the world. Please, you young physicians, join in the excellence available here in for example maternal and neonatal survival, paediatric infectious diseases, tuberculosis research and trauma. It is well known to the world and demands further support by AKU, as it speaks for a substantial potential into international excellence.
Who of you wants to be the first Pakistani-programmeme PhD in Public Health?
It is high time for a development in Pakistan of the highest academic training as one of the highest priorities of Pakistan. This country is suffering from high morbidity and mortality in widespread infectious diseases as well as pregnancy and neonatal complications. Research and interventions require a close collaboration on the campus between clinical and basic sciences departments, and the Department of Community Health Sciences (CHS).
Such development requires training of additional supervisors in public health research - three of CHS faculty are therefore now pursuing their PhDs at Karolinska Institutet in order to take up their important responsibilities in a couple of years' time.
The recently expanded and unique outreach curative and research activity of AKU might give you graduates and fellows additional training towards much needed community health leadership. Coupled with epidemiological training, as provided by AKU's Masters programme in this field, this could result in sustainable community input. If you have an opportunity, stay with AKU!
Training in preventive community-oriented medicine in Pakistan has a long history . it started already in 1947 at KEMC (King Edward Medical College), Lahore, soon followed by JPMC (Jinnah Postgraduate Medical College), Karachi and PIMS (Pakistan Institute of Medical Sciences), Islamabad. An even higher level was created here at AKU's CHS and more recently at the government's Women and Child Health Division. The door to the community has been opened for you! Take the chance!
Please remember and adopt the motto of all famous Pakistani public health nestors - that is those who have returned to the homeland - of the past: and here I quote Confucius:
"Go in search of your people, love them, serve them. And the work completed, of the greatest leaders the people say: we made it ourselves."
I wish you graduates and the whole of AKU best of luck - we in Sweden's academic life are looking at your future development with great interest and sympathy, and hope for continued good collaboration in years to come!
Thank you
