Draft health policy likely to be devised within a week
PESHAWAR: The Khyber Pakhtunkhwa government is formulating a draft of health policy and devising a strategy for its implementation to improve healthcare along with strengthening regulations as part of the first 100-day agenda of the ruling PTI, according to officials.
Health Sector Reforms Unit in collaboration with DFID UK, USAID, WHO, UNFPA, Unicef, JICA, Aga Khan Health Services, Pakistan Population Welfare Council, Khyber Medical University and Khyber Medical College is busy in analysing the situation and hammering out a document that would be presented to the provincial cabinet for approval prior to assuming status of health policy.
October 2018 - While not all health improvements in the remote, rural areas of northern Pakistan can be ascribed to the AKDN alone, it is clear that the Network has had a significant impact in the region. In areas where it works, access to safe water rose from 5% of the population in 1986 to 72% in 2014. Likewise, infant mortality dropped from 158 per 1,000 live births in 1986 to 20 per 1,000 in 2014. The number of deliveries assisted by skilled attendants rose from 13% to 86%. Today, over 60 Aga Khan health centres are reaching more than 750,000 people in this area, responding to increasing concerns around high blood pressure, heart disease and cancer, and other non-communicable diseases.
Aga Khan Hospital Dar es Salaam has performed at least 102 plastic and reconstructive surgeries on women and children resulting from violence, burns and accidents.The hospital on November 27 will offer a free medical screening camp as it prepares to perform other 40 similar plastic surgeries on women and children.
AKUH Nairobi introduces region's most advanced cancer diagnostic technology
The Aga Khan University Hospital, Nairobi, announced that it has invested more than KES 600 million (​US $5.9 million) to become the first hospital in the region to introduce a state-of-the-art technology that will improve the diagnosis and treatment of cancer, heart disease and other diseases.
The Positron Emission Tomography–Computed Tomography (PET-CT) scanner and Cyclotron is the first such scanner in East and Central Africa. It enables physicians to study the body in extraordinary detail, allowing them to diagnose diseases early and plan the most effective course of treatment. No longer will patients have to leave the region to access this advanced technology.
First Lady of the Republic of Kenya, Her Excellency Margaret Kenyatta, was Chief Guest at a ceremony inaugurating the PET-CT scanner. Also in attendance were Dr Jackson Kioko, Director of Medical Services, Ministry of Health, and other dignitaries.
An innovative mobile health application, Nighedaasht, which has helped expand access to vital maternal and neonatal health services in remote areas of Pakistan, has won a prestigious award at the Commonwealth Digital Health Awards 2018 (CDHA).
Nighedaasht won the top prize in the Maternal and Neonatal Health category. Judges commended the application’s innovative use of SMS technology to synchronise data about healthcare services received by pregnant women and new mothers in rural areas of Gilgit-Baltistan and Chitral. Nighedaasht was up against eight other finalists from Asia, Africa and Europe in the category.
The annual CDHA awards recognise the best digital health innovations in the 53 Commonwealth countries, which are raising the standard of healthcare and wellbeing. The award means that Nighedaast will be showcased to health ministers from around the Commonwealth during meetings at next year’s World Health Assembly in Geneva where policymakers will review emerging healthcare challenges and discuss which innovations can be scaled up.
Learn more about Nighedaast in this video.
“Gaps in health service delivery for expecting mothers and newborns are especially concerning in hard-to-reach areas," said Saleem Sayani, Director of the Aga Khan Development Network (AKDN) Digital Health Resource Centre. "Applications like Nighedaasht play a key role in ensuring that pregnant women and new mothers receive antenatal and postnatal care whenever and wherever they need it.”
From January to September 2018, Nighedaasht has helped serve 513 mothers; supported community midwives (CMW) with 158 deliveries, 399 initial antenatal, and 162 follow up antenatal visits; and tracked 47 referrals.
The application is currently being used by 31 CMWs and eight physicians in eight health facilities in northern Pakistan. The application was developed by the AKDN Digital Health Resource Centre under the AQCESS Project, implemented by Aga Khan Health Services, Pakistan, and funded by the Aga Khan Foundation, Canada, and Global Affairs Canada.
Another award-winning mobile health application, Teeko, which was developed jointly by AKDN and Aga Khan University, has been adopted by the Sindh government after a successful pilot in the province in 2015.
The CDHA 2018 event was organised by the Commonwealth Centre for Digital Health in association with the British Medical Journal, in Sri Lanka.
Dar es Salaam — The Aga Khan Hospital and Muhimbili National Hospital (MNH) have partnered with religious leaders and non-governmental organisations to raise Sh268 million that will fund plastic and reconstructive surgery for 40 women and children who had suffered incidents that caused them to lose their original appearances.
The two facilities have been offering this kind of treatment and their initiative has now been supported by other organisations.
Women for Women - a non-governmental organisation - will provide doctors while Sadaka Network will coordinate the financial contributions from the public.
Dar es Salaam Regional Sheikh Alhad Mussa Salum said yesterday that the initiative deserved support from religious leaders.
"We are obliged to make vulnerable groups feel happy as part of our society. We can do this by putting our beliefs a side and unite to facilitate the achievement of one goal," he said as he asked people to contribute.
For his part, the Aga Khan Hospital Marketing and Communications manager Olayce Lotha said a total of 16 surgeons will be performed on November 27.
Ten will be from 'Women for Women' organisation, three from Aga Khan and three from MNH.
Aga Khan Hospital laboratory acquires global accreditation
NAIROBI, Kenya – The Aga Khan University Hospital Laboratory, Nairobi, Kenya has been awarded accreditation by the committee of the College of American Pathologists (CAP). The CAP accreditation is a global recognition for the excellence of the services provided by the Hospitals Laboratory.
Dr Zahir Moloo, the Chair Department of Pathology and Medical Director of Laboratory Services, was advised of this recognition and congratulated for the excellence of the services being provided.
“It has been a team effort since we began our journey towards CAP Accreditation three years ago. The faculty and the technical team in the department are proud to be the first Hospital-based Clinical Laboratory in Africa to achieve such a high standard of recognition. This Accreditation will be recertified every two years” said Dr Zahir Moloo.
Dr Shawn Bolouki, Chief Executive upon learning of the laboratory’s accreditation, said: “We are very proud as an institution to be awarded this accreditation a testimony of our commitment to the provision of high-quality patient care equivalent to the best hospitals in the world. Quality diagnosis is critical to positive patient care outcomes, and this CAP accreditation is a validation of our laboratory’s capability which serves patients from across East Africa and Central. We appreciate and congratulate all our staff for their hard work towards this achievement. ”
During the CAP accreditation process, designed to ensure the highest standard of care for all laboratory patients, inspectors examine the laboratory’s records and quality control of procedures for the preceding two years. CAP inspectors also examine laboratory staff qualifications, equipment, facilities, safety program and record, and overall management.
CAP accreditation is one of many firsts for the Aga Khan University Hospital, Nairobi. In July 2003, AKUH became the first hospital in East Africa to be awarded the prestigious ISO 9001:2000 (now ISO 9001:2008) by the International Organization for Standardization, which is awarded to organisations that are found to conform fully to standards set for quality management systems.
In 2013 AKUH attained the coveted internationally recognised Joint Commission International accreditation that is recertified every three years, a first in East and Central Africa, affirming the hospital’s commitment to achieve is its vision as the leading teaching and tertiary healthcare institution in sub-Saharan Africa.
Aga Khan Health Services expands healthcare in Afghanistan’s Bamyan and Badakhshan provinces
Kabul, Afghanistan, 17 February 2019 – In a signing ceremony held at Afghanistan’s Ministry of Public Health, the Aga Khan Health Services (AKHS) took over management of health care facilities in the Bamyan and Badakhshan provinces on a pay-for-performance basis as part of the “Sehatmandi project”.
Through the Project, AKHS - with support from the Aga Khan Foundation (AKF) - will now manage over 1,015 health posts (within villages), 158 basic and primary health centres, 24 comprehensive health centres (around 10 beds each), five (5) district hospitals (30 beds each), and two (2) ISO-certified provincial hospitals in Faizabad and Bamyan until June 2021.
The project has the objective of increasing the utilisation and quality of health, nutrition and family planning services across 31 provinces. The expansion is based on earlier positive experience of the AKHS, which has managed the Bamyan and Faizabad provincial hospitals, on behalf of the government of Afghanistan since 2004.
“The agreement specifies the staff, equipment, diagnostic services and medications that should be provided by each primary health facilities in the Afghan health system,” said Dr. Massoud Mehrzad, CEO of AKHS Afghanistan. “It also sets the standards for hospitals in the system.”
Under the Sehatmandi project, the new health system will operate under a new pay-for-performance model. The Agency’s success will be measured on the number of antenatal and postnatal care visits, institutional deliveries, family planning, growth monitoring and nutrition counseling for children under the age of 24 months, health consultations for children under the age of five, the number of immunized infants, the number of women of reproductive age who are immunized against tetanus, the number of tuberculosis cases that are successfully treated, and the quantity, as well as quality, of caesarean sections and major surgeries.
“The idea that service providers will be compensated for their work if they meet pre-established benchmarks is a game changer for Afghanistan,” said Dr. Gijs Walraven, AKDN Director of Global Health. “And while these requirements may seem challenging, the Aga Khan Health Services and the Aga Khan Foundation are committed to meeting the targets set by the Sehatmandi project.”
The Sehatmandi project was launched in 2018 in recognition that while significant advances had been made to improve access and the quality of health care in Afghanistan since 2002, progress had been uneven. The World Bank - in partnership with the Afghanistan Ministry of Public Health (MoPH), United States Agency for International Development (USAID) and the European Union - launched the programme of performance-based contracts (also known as a pay-for-performance model). The Sehatmandi project holds service providers accountable for delivering improvements based on established targets.
About the Aga Khan Health Services
When Aga Khan Health Services (AKHS) - with the support of the governments of Afghanistan, Canada and France, and His Highness the Aga Khan through AKDN and AKF - first established itself in Afghanistan in 2003, the Agency’s core mandate was to enhance the quality of both primary and secondary health care services in the difficult to reach provinces of Bamyan, Badakhshan and Baghlan. AKHS also partnered with the Afghan government and its Ministry of Public Health (MoPH) by providing them with technical assistance to help improve health care delivery across the country.
AKHS has also trained community midwives to work in rural areas in Badakhshan, Bamyan and Baghlan where maternal and child health care provisions were most needed. The Agency established the first 24-month Community Midwifery Education Programme in 2004, and has since trained, as well as deployed, 459 midwives across the three provinces. In 2012, AKHS initiated the Community Nursing Education Programme, which has graduated 194 community health nurses who now work across the three provinces.
IN a bid to improve health services and curb Non-Communicable Diseases (NCDs) in the country, the Aga Khan Hospital is looking forward to launch its 192bn/- building soon.
The launching of the modern building is expected to provide relief to wananchi who suffer from non-communicable diseases. According to information released yesterday, Prime Minister Kassim Majaliwa is expected to be the guest of honour during the launch, which is scheduled for Saturday, this week.
Aga Khan Hospital is looking forward to using sophisticated equipment and technology in kidney and liver transplant, heart surgery and cancer treatment.
Aga Khan Health Service Tanzania Medical Director, Dr Ahmed Jusabani, said the expansion of the hospital aims at among other things, promoting "Reverse Medical Tourism"; in the country, which minimises the number of Tanzanians who seek treatment abroad, mostly to India, South Africa and Europe.
With the increasing population of Tanzanians exiting the country to seek medical treatment abroad and the huge impact on the nation's economy, it has become a matter of urgency to revamp the health sector to edge the ugly trend since 2013/14.
The concept of Medical Tourism has served to undermine confidence in our healthcare system as most providers in countries mentioned, portray foreign doctors and medical facilities as vastly superior to those within Tanzania; he said.
According to him, the hospital's models of care will double its reach by providing quality healthcare to over one million Tanzanians annually. The institution catered for 287 international patients mainly from Malawi, Zambia and the Comoro Islands in 2017.
Video: Opening ceremony of the Aga Khan Hospital, Dar es Salaam - Phase II
The Aga Khan Hospital, Dar es Salaam is managed by the Aga Khan Health Services (AKHS), which has been operating in Tanzania since the 1920s, and counts among the longest-serving healthcare institutions in East Africa. The Hospital and its associated healthcare centres follow an integrated approach based on a continuum of care for the local community.
Aga Khan Health Services launches critical hospital expansion in mission to advance the delivery of care to 1,000,000 Tanzanians
Dar es Salaam, Tanzania, 9 March 2019 - Aga Khan Health Services (AKHS), today launched the completion of the second phase of a US$83.5 million (TZS 192 billion) expansion of the Aga Khan Hospital in Dar es Salaam, which will enable the institution to serve over one million patients each year.
The expansion, funded by a US$ 53.5M (TZS 134 billion) loan from the French Development Agency (Agence Française de Développement - AFD) and a US$ 26.3million (TZS 58 billion) contribution from the Aga Khan Development Network (AKDN), transforms the previous 74-bed facility to a leading 170-bed tertiary care, referral and teaching centre that will serve as an integrated health care medical facility for Tanzania and the rest of sub-Saharan Africa. The second phase development also marks a country-wide expansion of AKHS with 35 outreach health centres, 23 of which are already operational.
“I am pleased that the hospital today employs some of the most qualified and competent human resources, supplemented by world-class technical expertise, and will offer specialised programmes … which will also respond to the increasing burden of non-communicable diseases in Tanzania,” noted Princess Zahra Aga Khan, Member of the Board of Directors of the Aga Khan Development Network (AKDN), in a speech given on the occasion of the expansion’s opening. “I am delighted that this advanced facility will allow Tanzanians to receive world-class treatment at home thereby reversing medical tourism and also encouraging medical tourism from the region.”
Strong partnerships answer to government’s healthcare agenda
Tuesday March 12 2019
Tanzania, like most developing countries does not have an elaborate health financing system and the majority of its citizens pay for their own medical expenses.
By SISAWO KONTEH
Health systems in Tanzania have been improving over the past decade as the country aims to establish acceptable and universal health provisions for its citizens.
The country has made some progress in improving local health facilities through modernisation of its infrastructure, acquisition of leading-edge technologies, development of sound policies to support the healthcare system, as well as the growth and expertise of the human resources pool that supports the country’s health infrastructure. However, additional work is required to ensure consistency across the country.
Tanzania’s health system is a referral pyramid, which includes interventions at the village and ward level where there are community dispensaries; divisional level where there are rural health centres; district level where there are district or district designated hospitals; regional level where there are regional hospitals; zonal level where there are referral/consultant hospitals and the national level where there are national and specialised hospitals.
At the national level, the Ministry of Health administers and supervises national hospitals, consultant referral hospitals, special hospitals, training institutions, executive agencies and regulatory authorities.
At the regional level, provision of health services is vested to the Regional Administrative Secretary with technical guidance of the Regional Health Management Team.
At the district level, management and administration of health services has been devolved through the respective district’s Council Authorities, Health Service Boards, Facility Committees and Health Management Teams.
Understanding the tiers in Tanzania’s health system is key to understanding the scope and depth of the government’s measures to achieve universal health coverage (UHC). The government has worked closely with local and international players to ensure a vibrant system that not only provides curative but also preventive healthcare.
Tanzania dedicates 5.6 per cent of its GDP towards the growth and development of its health sector, which is higher than the amount invested by other countries in Africa. In addition, 35 per cent of government expenditure on health programmes comes from external sources. (Source: World Bank 2016).
Tanzania, like most developing countries does not have an elaborate health financing system and the majority of its citizens pay for own medical expenses, which, according to the World Bank, stands at 23 per cent compared with 34 per cent for the sub-Saharan region. (Source: World Bank 2016).
This has led to the government developing a mechanism to increase the number of people with health insurance coverage.
A bill developed through consultation with health system stakeholders and the National Health Insurance Fund (NHIF) will soon seek to consolidate existing schemes and change the manner in which people pay for health services. Health insurance through pooling of risk protects individuals and families from catastrophic health expenditure.
Meaningful partnerships are crucial in order for the government to achieve this ambitious agenda and collaboration with institutions such as Aga Khan Health Service, Tanzania (AKHS,T) are an example of how this vision is being realised.
As an agency of the global Aga Khan Development Network (AKDN), AKHS,T has been committed to providing quality healthcare in Tanzania for over nine decades. The vision is to create a truly integrated system that provides access to quality and affordable healthcare.
Today, its contributions align with the government's National Development Plan 2025, particularly as this relates to the following areas: Access to primary healthcare for all; gender equality and the empowerment of women in all socio-economic and political relations and cultures; access to quality reproductive health services; reduction in infant and maternal mortality; addressing the increasing burden of non-communicable diseases including mental health issues; effective treatment of injuries; and increased life expectancy.
The Aga Khan Hospital in Dar es Salaam sees over half a million patients through its outpatient care services, and conducts 1.3 million lab tests, 75,000 radiology investigations, and over 7,000 surgeries annually across its facilities.
Five primary medical centres, located in Dodoma, Iringa, Mbeya, Morogoro, and Mwanza, serve an additional population of approximately 10.9 million (source: Tanzania Bureau of Statistics population projection 2017).
Through its partnership with the Aga Khan University’s Institute for Education Development (AKU-IED), the Aga Khan Hospital is committed to being the premier teaching hospital in the country, offering health sciences education in both the medical and nursing fields an integral part of its vision.
Together with AKU, the Aga Khan Hospital offers postgraduate medical education in family medicine, internal medicine and surgery. Since 2004, AKU has graduated over 600 nurses and midwives in Tanzania and continues to expand its post graduate residency programmes to help train more qualified nursing professionals.
Over the past few years, 23 AKHS outreach health centers have opened throughout the country, making affordable and quality healthcare accessible to even more Tanzanians.
These expansion plans are part of a much larger integrated health network that AKDN is developing in East Africa, which uses a hub and spoke model that pairs the Aga Khan Hospital with a series of community health programmes, health centres, as well as local clinics and hospitals.
The Phase 2 expansion of the Aga Khan Hospital this week is yet another reminder of the importance of partnerships to achieve Tanzania’s critical healthcare goals. Together with Agence Française de Development (AFD), AKHS,T will expand its facilities to provide specialised care to fight non-communicable diseases in the areas of oncology, cardiology and neurosciences.
Drawing from the strength of its global network and lessons learnt from around the world, it will provide excellence in every sphere, in full commitment with the government’s development agenda.
Tanzania’s healthcare system is continuously evolving to fulfill its government’s vision of delivering an integrated, full service offering to its citizens. And while this commitment is noteworthy, there is recognition that no one stakeholder can go the distance alone.
At AKHS, we believe that everyone has the right to quality healthcare and the ability to pursue their dreams, to build their lives, their communities and their nation together. And we are proud to be a partner to the government of Tanzania in realising the full potential of this vision.
Sisawo Konteh is the chief operating officer, The Aga Khan Health Service, Tanzania.
12 March 2019
The Citizen (Dar es Salaam)
Tanzania: Aga Khan Development Network Plan to Improve 24 Public Health Centres in Mwanza
By Ngollo John
Mwanza — The Aga Khan Development Network (AKDN) has started its plan of improving 24 public health facilities in Mwanza Region. The plan includes putting up rooms for males to wait for their female partners in labour.
The planned works will target Reproductive Child Health (RCH) units, 4 maternity wings (with minor theaters), 2 postnatal wards, 13 delivery units and 4 operating theaters as per the requirements of the specific facilities.
Speaking to The Citizen during the celebration of the International Women's Day held at Bujora in Magu District, Dr Benardin Ngaila, said the improvement of the health centers will go in hand with establishing modern toilets and will take into consideration requirements of people with disabilities.
"Most health facilities have no waiting rooms for males when their partners go in labour rooms. Therefore, we have come with this plan," she said.
Apart from the improvement, the project has also provided training to 716 community health care providers in Mwanza who will assist in efforts to eliminate child mortality.
He further informed that, the community health care providers will each be with a bicycle worth Sh91 million, back packs and file folders to help them record their daily reports.
For her part, Health minister Ummy Mwalimu urged male parents to stop negative attitudes towards women and instead help them for their developments and the country at large.
During the event, Ms Ummy warned all employers who fire and/or demote pregnant workers from work saying stern measures will be taken against them.
Nestled at the base of the Pamir mountain range lies Gorno-Badakhshan (GBAO), a place of immense beauty within a harsh and rugged mountainous region — home of Nasir Khusraw. The population in Badakhshan is predominantly Ismaili and live in small villages along the slopes of the Pamirs or near the tributaries of the Pyanj River that divides Tajikistan from Afghanistan.
Isolated from much of Tajikistan, the Jamat here is served by a number of agencies of the Aga Khan Development Network. The Aga Khan Health Service (AKHS) in Tajikistan operates health clinics in the various mountainous districts, and has a network of nurses and voluntary community health promoters to provide basic health services for the Jamat.
In 2014, AKHS USA sent a team of physicians and nurses to Khorog to introduce breast cancer awareness to the Jamat, and train local family doctors and nurses in the early detection and treatment of breast cancer.
Primary care in Khorog is a relatively new concept. In the Russian health care model, most people see specialists for their medical concerns. The Tajikistan government has recently introduced the concept of primary care, and has provided training for specialists to become family medicine doctors. Since preventive health care was not practiced in GBAO during the Soviet era, cancer screening was not common and women with breast cancer would go to their doctors quite late in the process, with devastating consequences.
The overall goal of the collaboration between AKHB USA and AKHS Tajikistan was to bring awareness about breast cancer to the Jamat, train health care professionals in clinical breast exams, and initiate a systematic process of treating women with a breast mass.
Liquid Telecom makes telemedicine a reality for the Aga Khan Hospital Mombasa to deliver healthcare to remote communities
Liquid Telecom Kenya, part of the leading pan-African telecoms group Liquid Telecom, has made telemedicine a reality for thousands of patients at the Aga Khan Hospital, Mombasa. Using its high-speed fibre network, Liquid Telecom has connected the main hospital in Mombasa to seven of its outreach centres in the coastal region bringing healthcare closer to the community.
The roll-out of services started last August to improve access to medical services that would often not be consistently available in some of the more rural communities. This includes online consultations and diagnostic services.
“Travel costs were often prohibitive for patients. For example, patients coming from Voi to Mombasa spend around Sh700 on bus fares, which is a major cost at a time when most of the population struggle to buy even basic medication, and often cannot afford to visit the hospital for follow up appointments,” said Hemed Twahir, Medical Director at Aga Khan Hospital Mombasa.
The hospital’s initiative comes at a time when Kenya is facing a shortage of healthcare specialists especially in dermatology (skin diseases and complications) and Otolaryngology (Ear, Nose and Throat (ENT) diseases.
“As healthcare providers strive to make specialists more accessible to patients in an affordable way through telemedicine, Liquid Telecom Kenya has been able to offer both the high-speed internet connectivity and software to enable uninterrupted two-way audio-visual and data communication in a delivery that aligns exactly with our vision of driving digital transformation across Africa,” said Adil Youssefi, CEO of Liquid Telecom Kenya.
“When a patient at a clinic requires specialised attention, the clinicians logs a video request with the specialist and run a video conference with both specialist and patient. They also use our newly installed digital medical equipment to make a diagnosis, with everything about the patient recorded in the hospital records system”, said James Siku, Head of ICT at Aga Khan Hospital Mombasa.
Liquid Telecom’s high-speed Internet network has also enabled the hospital to run e-learning courses covering Continuous Medical Education (CME) and Continuous Nursing Education (CNE) between the main hospital and outreach clinics. It also includes public hospitals such as Rabai, Tsangansini and Mariakani, to exchange knowledge and discuss medical case management – in a collaborative process that drives best-practice treatment plans. The forums also help clinicians earn credits for their professional qualifications and credit transfers under Ministry of Health guidelines.
“We have installed digital stethoscopes and multi-purpose scope equipment for examining a patients’ vitals. With these, specialists will be able to see in real time, say, the condition of the skin, and other vital readings, then offer consultancy and diagnostics,” said Sultana Shermana, Interim CEO of Aga Khan Hospital Mombasa.
The hospital has invested in a state-of-the-art cardiac catheterisation laboratory that is first in the coast province for diagnosis of heart conditions and a 1.5 Tesla Magnetic Resonance Imaging (MRI) machine and runs a digital HMIS - managing inpatient and outpatient records, lab results and diagnosis – that is now accessible across all of its clinics and main hospitals.
The telemedicine services focus on family medicine, obstetrician-gynecologist, ear, nose and throat as well as dermatology for Ukunda, Kilifi and Voi clinics being given priority, benefitting a total of up to 200 patients a day. The other outreach clinics are Nyali, Changamwe, Mtwapa, and Bamburi Mwisho.
Mtanya Matuja: The partnership between AFD and the AKDN
In March 2019, Princess Zahra Aga Khan and the Prime Minister of Tanzania, Hon. Kassim Majaliwa launched the completion of the second phase of a US$ 79.8 million (TZS 183 billion) expansion of the Aga Khan Hospital in Dar es Salaam, which will enable the institution to serve over one million patients each year. The expansion was funded by a US$ 53.5 million (TZS 134 billion) loan from the French Development Agency (Agence Française de Développement - AFD) and a US$ 26.3 million (TZS 58 billion) contribution from the Aga Khan Development Network (AKDN). In this interview for the AKDN website, Mtanya Matuja, Programme Officer with AFD in Tanzania, explains why the AFD partners with AKDN and why they saw this hospital as such an important project for AFD to support.
Countess of Wessex visits AKDN Health project in India
In May 2019, Her Royal Highness The Countess of Wessex visited a health programme run by the Aga Khan Health Services at the Sir Elly Kadoorie School and Junior College in Mumbai, India. The Countess was on a five-day visit to India to see the work of the Queen Elizabeth Diamond Jubilee Trust.
The Aga Khan Development Network (AKDN) has made a significant contribution to the Swatch Bharat Abhiyaan (Clean India Mission) launched by the Indian Government in 2014. The nation-wide campaign aims to clean up the streets, roads, and infrastructure of India’s towns, cities, and rural areas.
In an effort to help realise this aspiration, AKDN agencies in India have improved sanitation facilities for tens of thousands of households in the states of Bihar, Gujarat, Uttar Pradesh, and Madhya Pradesh. AKDN institutions have also won awards including the Federation of Indian Chambers of Commerce and Industry (FICCI) India Sanitation Coalition Award for the Best Non-Profit Engagement in Sanitation in 2017, and the Dainik Bhaskar Award for improved health outcomes from sanitation in 2019.
A key component of Swatch Bharat Abhiyaan includes the improvement of Menstrual Hygiene Management (MHM) in schools all over India. This involves providing access to sanitary pads, access to safe disposal, and providing MHM education to adolescent girls in schools. The Aga Khan Health Service (AKHS) in India has made this a key focus area, in partnership with corporate donors such as Crisil, SONY, and the Times of India group.
Her Royal Highness was welcomed to the Sir Elly Kadoorie School by Amin Manekia, Chairman of AKHS, India; Deane Menezes, a Queen’s Young Leader, and founder of the NGO Red is the new Green; and the Principal of the school. Mr Manekia briefed the Countess on the various activities conducted by AKHS and the Prince Alykhan Hospital for the vulnerable population in Mumbai and India.
Dr Kranti Rayamane, Director of Community Health at AKHS India, explained the impact made by work to raise awareness of MHM, after a survey showed that a large percentage of young girls had little to no knowledge of menstruation, and that many faced restrictions from participation in school activities, or remained absent from school during menstruation.
The Countess interacted with the trained teachers, adolescent girls, and parents. She was also shown the sanitary pad vending machines and incinerators installed in the school premises as part of the programme.
The programme is currently being implemented in 21 schools in Mazgaon, Mumbai, benefitting over 7,400 girls, including two Aga Khan Education Services (AKES) schools in Mumbai. The intervention includes supply of sanitary vending machines, portable incinerators and providing MHM education. Over 200 school teachers have been trained in MHM, and an interpersonal tool for communication with girls and a teacher’s manual has been developed.
Her Royal Highness expressed appreciation for the courageous and important work done by AKDN institutions in the region, and was heartened to see the programme being implemented professionally and with sensitivity. She extended her best wishes for the success of teachers and children in Mumbai and India.
Her Royal Highness The Countess of Wessex is married to Prince Edward, The Earl of Wessex, the youngest son of Her Majesty the Queen, and Prince Philip, The Duke of Edinburgh.
The Swatch Bharat Abhiyaan campaign contributes to India reaching the UN’s Sustainable Development Goal number 6, which calls for sustainable clean water and sanitation for all. The campaign was launched to realise Mahatma Ghandi’s aspiration of a clean India, and counts various public figures as ambassadors, including Amitabh Bacchan, Priyanka Chopra, and Sachin Tendulkar.
The Aga Khan Hospital in Tanzania provides opportunities for in-service nurses to continue their medical education, thereby advancing their skills and credentials, while earning a living and supporting their families. Students and alumni report feeling more confident and able in their roles as nursing leaders.
Highlights of the opening of the Phase II expansion of the Aga Khan Hospital, Dar es Salaam
Google translation of the original article in Portuguese
AKHB (Portugal): Osteoporosis
Osteoporosis is one of the most widely spoken diseases today, namely in older people. But what is osteoporosis anyway?
This disease is characterized by a decrease in bone mass and a deterioration of bone architecture, leading to its weakening and a higher likelihood of fracture risk. This type of fracture most often affects two large population types: postmenopausal women and elderly women and men, thus representing a serious public health problem due to its high prevalence, the clinical consequences they cause, the diminished quality of life. and the economic and social costs they entail. In Portugal, it is estimated that osteoporosis affects about 500,000 people.
What are its causes?
As noted earlier, osteoporosis most often affects women after menopause, which occurs on average at 51, and men and women over 65.
There are numerous factors that are directly related to this disease, some of which may be linked to unhealthy lifestyle habits that may or may not be modified. The risk factors we can control include low-calcium diet, excessive alcohol consumption, smoking, sedentary lifestyle, hyperthyroidism, drug use (cortisone), early menopause and prolonged immobilization. On the other hand, uncontrollable risk factors include female gender, age over 65, Caucasian or Asian race, family history of fractures, short stature or excessive thinness.
What are the symptoms?
Osteoporosis is manifested by the occurrence of fractures with minor trauma, especially in the vertebrae, hip and wrist. Its symptoms only occur when the disease is in a very advanced state and therefore early diagnosis is essential to prevent its progression. The diagnosis is made through medical examinations, which should be performed soon after any suspicion of osteoporosis or vertebral fractures is suspected. Bone densitometry is the most important exam for the diagnosis of osteoporosis, since it allows measuring bone density, which is directly related to bone mass. This examination is painless and rapid, using radiation at a much lower dose than a chest X-ray and is very reliable. Densitometry is recommended for women after 65 and for men after 70 or for both sexes after 50 if there are risk factors. If osteoporosis is confirmed, a laboratory evaluation is important to identify the causes and a radiograph of the dorsal and lumbar spine to verify the existence of vertebral deformation.
Osteoporosis treatment involves the use of bone-mass-enhancing drugs, painkillers, and calcium and vitamin D supplements. Bone-mass-enhancing drugs, ie the amount of bone, are the most important in the treatment of osteoporosis, because will reduce the risk of fracture. Some of these medications delay bone loss and others increase bone formation. Calcium and vitamin D supplements are especially useful if the diet does not contain the amount of calcium needed and are used because bones have in their composition minerals, such as calcium and phosphorus, which make them dense and rigid. Vitamin D is necessary for absorption of these minerals and their incorporation into bones. These supplements can take many forms (tablets, chewable tablets, dissolving powder) and should be taken after a meal.
As the name implies, prevention has as its main objective the achievement of good bone mass levels and should be accomplished through the early identification of the previously exposed modifiable risk factors (eating habits and physical activity). Thus, it is essential to have a healthy diet with adequate levels of calcium and vitamin D, keep protein intake appropriate to the needs and avoid excessive consumption of caffeine, alcohol and tobacco. Vitamin D can also be synthesized in the skin by the action of sunlight, hence the importance of people (especially the elderly) being exposed to the sun. However, this exposure must be done outside the critical period of the highest heat due to the harmful effects that ultraviolet radiation can have on our body.
Physical activity should also be stimulated in the various age groups. In older people at higher risk of falling, individually tailored exercise programs that focus on gait, muscle strengthening, posture and balance should be designed.
Tanzania, partners sign 14.8 mln USD deal to improve cancer care
Source: Xinhua| 2019-12-16 23:50:59|Editor: yan
DAR ES SALAAM, Dec. 16 (Xinhua) --Tanzanian government and its two partners, the Aga Khan Health Services and the French Development Agency, on Monday signed a 13.3 million Euros (about 14.8 million U.S. dollars) grant agreement and Memorandum of Understanding (MoU) to improve cancer care in the east African nation.
The funding will be run by the Tanzania Comprehensive Cancer Project (TCCP), an innovative public-private project aimed at enhancing cancer care in Tanzania.
Under this funding, the French Development Agency will release a grant to the tune of 10 million Euros and 3.3 million Euros will be contributed by the Geneva-based Aga Khan Foundation, which is part of the Aga Khan Development Network (AKDN).
Speaking shortly after the signing of the agreement in the commercial capital Dar es Salaam, Tanzania's Deputy Minister for Health Faustine Ndugulile said with the rise in the prevalence of cancer in Tanzania, the project will serve to accelerate performance in cancer screening, prevention and early detection targeting low-income groups through mobile outreach campaigns.
Harrison Chuwa, a consultant oncologist at the Aga Khan Hospital in Dar es Salaam and director of TCCP, said the project was a four-year plan designed to reduce the burden of cancer mortality and morbidity in Dar es Salaam and Mwanza regions.
Chuwa said under the project, the implementing partners will create an integrated health care network at local and hospital levels to accelerate performance in cancer care in the country.
Julius Mwaiselage, the Executive Director of the Ocean Road Cancer Institute, the country's leading facility for treating cancer patients, said the facility was currently receiving 64,000 cancer patients annually, compared to 30,000 patients received in 2015.
Sh38 billion cancer project to enhance cancer care in Tanzania launched
Monday December 16 2019
With the rise in the prevalence of of cancer diseases in Tanzania, the proposed project will serve to accelerate performance in cancer screening, prevention and early detection targeting low-income groups through mobile outreach campaigns.
Burden of cancer morbidity and mortality in Tanzania to be reduced
Dar es Salaam, Tanzania, 16 December 2019 - To combat the rise in cancers and enhance comprehensive cancer care in Tanzania, the Government of Tanzania, the Aga Khan Health Services (AKHS), and the French Development Agency (AFD) today signed a grant agreement and memoranda of understanding related to an innovative Public Private Partnership project of 38 billion shillings (approximately €13.3 million).
With the global rise in the prevalence of non-communicable diseases, cancer is becoming an increasingly important public health issue. Tanzania and other developing countries are disproportionately affected by cancer, where a dramatic rise in cancer incidence and mortality is seen.
The rise in cancer places an enormous burden on the Dar es Salaam-based Ocean Road Cancer Institute (ORCI), which until 2014 was the only public cancer hospital responsible for serving the country’s 55 million inhabitants. Despite the addition of oncology services at Bugando Medical Center (BMC) in Mwanza, the number of cancer cases, usually presenting at late stages, continues to rise. Significant investments into each component of the cancer continuum from prevention, screening and early detection, continuing into diagnostics, treatment as well as palliative care and survivorship are needed to strengthen the quality of cancer care in Tanzania.
To address challenges facing cancer care in the country, Tanzania Comprehensive Cancer Project (TCCP) was aimed at strengthening and expanding the quality of access and the capacity of cancer care services through an innovative public private partnership (PPP) initiative.
Mr. Frederic Clavier, Ambassador of France, and Dr. Gijs Walvaren, Director of AKDN Health Services, are seen after signing the Grant Agreement for the Tanzania Comprehensive Cancer Project.
AKDN / Venance Nestory
This project, funded by a €10 mio grant from AFD and €3.3 mio contribution from Aga Khan Foundation Geneva, builds on the long history of successful cooperation between AFD and AKHS-T in the health sector in Tanzania, including the recent inauguration of the Aga Khan Hospital’s expansion in Dar es Salaam on 9 March 2019.
On behalf of Chief Guest Hon. Ummy Mwalimu, Minister of Health, Community Development, Gender, Elderly and Children, government of Tanzania, the Deputy Minister Dr. Faustine Ndugulile said, “This project will directly benefit approximately 1.7 million people. The project will build the capacity of health personnel and community social workers at all partner institutions and participating communities. Expanding the range of cancer services using outreach programmes is to result in increased demand for quality primary health care services and improved referral mechanisms to secondary and tertiary centres. The project is also intended to contribute to improved knowledge, practices, and health seeking behaviours of the target groups and their communities. The public private partnership will not only increase the probability to achieve better access to quality cancer services, but also result in knowledge sharing and identification of good practices through establishing Memoranda of Understanding and service agreements signed today”.
Hon. Dr. Faustine Ndugulile added “In the four years of this project, the government expects to have major impacts: at least 60% of the country population to be reached by awareness campaigns via blends of communications channels; and increased access to oncology services from prevention, screening, diagnosis, treatment to survivorship especially to the under-served rural population. Currently, only 10% of cancer patients in the country reach hospitals. We expect to increase this number to at least 20% by the end of the project, reducing the rate of advanced stage presentation. Today 75% of cancer patients present at late stage 3 and 4. This is expected to be less than 50% by the end of the project.
“The government is also expecting increase Human Papilloma Virus (HPV) vaccination uptake and establishment of the first molecular and digital pathology laboratory in the country that will serve the whole country to better characterise tumours and offer personalised treatment, roll out the 1st ever mobile cancer screening unit that expects to direct serve at least 1.7m clients, at least 100 community health facilities will be trained and capacitated to offer basic oncology care including screening, diagnosis, early referral, palliative care and survivorship and 330 healthcare workers from tertiary up to dispensary level will be trained by the project hence reduction of treatment costs by establishing cancer consortium in collaboration with MSD that will be able to do group purchases, hence leverage better prices/deals for anticancer drugs, pathology reagents and other consumables including collaborative research and statistics for cancer together with National Institute for Medical Research (NIMR)”.
Dr. Harrison Chuwa, Consultant Oncologist at The Aga Khan Hospital and Director for TCCP said “The Comprehensive Cancer Project is a four-year plan and is a high-quality, evidence-based initiative designed to reduce the burden of cancer morbidity and mortality in two target regions of Dar es Salaam and Mwanza in Tanzania. This will be achieved through a strategy that focuses on the enhanced performance and expanded outreach of the Tanzanian-based implementing partners, including Aga Khan Health Service, Tanzania (AKHS-T), Ocean Road Cancer Institute (ORCI), Muhimbili National Hospital (MNH), Bugando Medical Centre (BMC), Dar es Salaam and Mwanza regional secretariats under the President office regional and local government (PO-RALG), and Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) with technical support from Institut Curie in France in delivering the full range of cancer services in the two-targeted regions in Tanzania”.
Dr. Chuwa added that “TCCP will adapt a health system strengthening approach focusing on addressing leadership and governance, health information systems, essential medical products and technologies, human resources, health financing, service delivery and partnerships to ensure the comprehensiveness of the project. The development of a partnership between government and private institutions is to contribute to the creation of a strong, integrated cancer care network in targeted regions. The partner institutions have a long presence in Dar es Salaam and Mwanza with a strong understanding of the cancer landscape in the local communities, including functioning and requirements of local health systems. AKHS-T and partners are well equipped to enhance the quality cancer care provision and to address the large health challenges of cancer in Tanzania. The approach will create an integrated health care network at local and hospital levels to accelerate performance in cancer care and expand to underserved areas and low-income target groups.”
Addressing the objectives of this project Ms. Stéphanie Mouen, the Country Director of French Development Agency in Tanzania said “TCCP is an innovative initiative of 38 billion and is aimed at enhancing comprehensive cancer care in Tanzania“. She added that this project would have very strong social and financial commitments that have been agreed with the implementing agencies on creating greater access for the vulnerable population. Social contributions through care subsidisation will lead to needy cancer patients and those holding the National Health Insurance from NHIF receiving support in different medical programmes of oncology, at both primary to tertiary level care.
The financial contribution from the Aga Khan Foundation is intended for the supervision and management of the project and to build the capacity of staff, at all institutions, in the full spectrum of cancer care (in collaboration with various French and international referral training institutions such as Institut Curie). She further stressed, “these commitments have been decisive in AFD’s decision to indeed participate in the financing of the project. They are aligned with the objectives pursued by AFD to ensure such projects, which are intended to maximise the desired impact for target populations”.
On 15th February the Health Board for Angola held its inceptive First Aid Seminar
How important you think is to be ready, prepared or even conscious of basic First Aid actions in your daily life?
This pivotal seminar was headed by certified members of the European Medical Centre (EMC) and Medline addressed the key recognized principles for Cardio pulmonary resuscitation (CPR), Safety side position (SSP), and Air obstruction by an unknown object (AOUO).
Emphasis was put on precautionary measures imperative when approaching a victim taking into consideration road-traffic conditions, exposed electrical wiring and rain, presence of belligerent pets, and the calling for emergency services for assistance.
The presentation used visual as well as on hands involvement by participants offering a comprehensive program on all levels.
In synergy with this initiative, some recommendations on general safety precautions outlining good practices when dealing with bank withdrawals, traversing streets and entering dwellings, importance of a low profile demeanor, communications on cell phones and general guidelines were shared by a Safety and Security professional and member of our Angolan Jamat.
All participants are to receive a certificate of participation to be issued by the EMC.
From community health volunteers to hospital CEOs (and the nurses, midwives, and doctors in between), women are breaking down gender barriers to health and ensuring quality care for women and children across Africa and Asia.
In a Heartbeat explores the stories of four women working on the front lines of the healthcare system in Africa and Asia. They share what motivated them to take on their roles, and why they are inspired to continue their lifesaving work.
Director Biography - Benj Binks
Benj Binks is a seasoned filmmaker with a passion for telling people-driven stories. His films not only entertain but also inspire audiences to think, feel, and respond. He’s made dozens of documentaries, including films about the hip hop scene in Mongolia, women being trafficked in the aftermath of Typhoon Haiyan, and a boxing gym in the slums of Nairobi that works with young girls to keep them safe on the city’s streets. When his mum has her way he lives in Australia. She doesn’t have her way very often.
An Aga Khan Foundation film in collaboration with The Compulsive
In early February, the Ismaili India met up with the staff of the Cancer Rehab Centre at Prince Aly Khan Hospital. Now in its 25th year, the Centre leverages the strength and expertise of other survivors and volunteers to help cancer patients deal with the physical and emotional challenges of recovery. For patients and their care-givers, the Centre is a pillar of support and a testament to the fact, that where there is life, there is hope. Dr. Simran Rajabally met up with the Centre’s Founder, Ms. Anaita Vesuvala and her team, to talk about their inspiring work.
1. The work you and your team do is very impressive. What is it that inspired you to work for the rehabilitation of cancer patients?
Anaita Vesuvala: 25 years ago, when I was diagnosed with cancer, like most patients I was completely devastated. I questioned myself constantly about why this happened to me. Gradually, I learned to accept it. I was treated at Prince Aly Khan Hospital (PAKH), by Dr. Sultan Pradhan who is not only an excellent doctor but also a wonderful human being. After the surgery, when I returned home, I wondered how things would go back to normal after the illness. That’s when I met a survivor who gave me the hope and confidence I needed. This made a huge difference and I told myself: “When I become well, this is what I am going to do.” I received a lot of support from Dr. Pradhan who encouraged me, saying that “if you could fight and come out of this illness, I would like you to give similar hope to my other patients.” What started as a centre to help breast cancer patients like me, later transformed into one where we offer support and training to patients who have undergone laryngectomy and even ostomy. I must mention here the immense contribution and effort that our very senior survivor and volunteer Mr Lahiri has made. His efforts helped us establish the laryngectomy support group. Dr Pradhan has been our guiding and motivating force in this entire journey, and we all view him not just as our doctor but as our mentor, our inspiration and our force.
2. What do we mean by rehabilitation? The Cancer Rehabilitation Centre at PAKH concentrates on the rehab of patients who have undergone mastectomy, laryngectomy and ostomy. Can you tell us more of what these particular rehabs comprise of?
Anaita Vesuvala: Rehabilitation is the process of helping a person who has suffered an illness or injury, and this is exactly what we do. We provide mental, emotional support to the patient and the family, caregiver. In addition, we also provide tools (like breast prosthesis, special mastectomy bras, laryngectomy and ostomy kits) which can enable the patient live a normal routine life. Though we try to help all cancer patients, we primarily support those who have undergone mastectomy (the removal of the breast ), laryngectomy (the removal of the larynx) and ostomy (which includes Colostomy and Urostomy).
Anaita’s team adds: As volunteers with the CRC team, we have worked with several patients who are recovering from breast cancer. For each of these patients we provide a prosthesis of the breast that fits into a special bra that is created with a pocket. These are available in a range of options so that women feel comfortable and they can go back to looking normal even after the surgery. Each of the patients who are operated are also given a pink bag to carry the drain bottle after the surgery and a pillow for under – arm comfort. Our aim is to ensure that they no longer feel like a patient and that they have the confidence to return to their everyday life.
3. Like all diseases, battling cancer is a physical and an emotional process. What role does counselling/therapy play, in ensuing that patients remain positive through their recovery?
Anaita Vesuvala: When a patient comes to us for rehab, they feel vulnerable and scared. This is where cancer survivors can play an important role. The patient initially feels hopeless, but when they interact with our volunteers, who are either survivors themselves or have a close family member who has battled the disease, they build a rapport and create hope in the patient that they too will be able to overcome this. When a laryngectomy patient who has lost his voice and believes that he will never be able to speak again, hears one of our volunteers who was earlier a patient, talk, he is left spellbound. It instils hope in him that one day he too will be able to speak. We also focus on counselling the family members, who are also traumatised by the illness of their loved ones. At the CRC, we make every patient feel like part of our extended family.
4. Your team has been doing a wonderful job. Tell us more about your team and its members. We know the Jamati volunteers play an important role - how have they supported the centre’s work?
Anaita Vesuvala: The centre’s work is built on the strength of an extraordinary team of dedicated volunteers who contribute their time week after week, caring for our patients. My team comprises wonderful people who take the time and effort to motivate, encourage and inspire recovery. The team undergoes frequent training sessions and updates by trained faculty and doctors. But, of course it’s all not just work… we also incorporate fun and belonging within our team, be it going for picnics or celebrating birthdays. Everything is a collaborative effort. We are truly indebted to Prince Aly Khan Hospital’s management, and especially to our senior Medical Oncologist Dr.Saikia and the entire oncology department, for supporting our work and providing us with valuable resources.
5. Cancer can impact both the patient and their care-givers. Does the centre provide support to family members as well?
Anaita Vesuvala: Counselling is a very integral part of the rehab process. We often call the family for counselling along with the patient. For example, after a mastectomy the woman can often feel very depressed. In such a case we counsel the husband (and other male family members) on how to respect these feelings but at the same time support and love the patient. Counselling changes the entire outlook of the family towards the disease. We try and ensure that when a patient goes home, they know that there is someone at home as well who is there for them and who understands them. We also make the family aware about the need for self-examination and regular check-ups.
6. You go home every day knowing that you have changed lives for the better. What inspires the energy for this kind of work?
Anaita Vesuvala: Seeing the relief and the smile that comes on a patient’s face, makes our time worthwhile. We know what we are doing, is like a drop in the ocean, but every drop counts. Seeing a patient feel confident makes us feel that we have made a change. And of course, our major motivation is Dr. Pradhan. If it wasn’t for him, we wouldn’t be here celebrating 25 years. He has truly been a driving force for all of us. I think it’s important for patients to know that they can live a full and enriching life after cancer. Early detection is the best cure. But even for those who are diagnosed with cancer, I would like them to know that they can learn to face it.
7. What are your aspirations for the CRC?
Anaita Vesuvala: Our wish is to be a beacon of hope for patients and to be able to help many more in their journey towards wellness. We would like to dispel this mis-conception that cancer is a death-knell…. It isn’t and it can be treated if detected early. I would also emphasize the importance of routine checks and self-examination even amongst healthy people. So, I would say that building awareness and confidence are the two most important goals that we would like our CRC to focus on.
Zanzibar: Nurses and midwives transforming the landscape of health
Zanzibaris are served by more than 200 health facilities providing primary, primary-plus, secondary and tertiary health care. Located in northern Unguja, Mnazi Mmoja Referral Hospital is the only tertiary-level institution that provides full referral facilities and comprehensive surgical care. Nursing resources are governed by the Zanzibar Nurses and Midwives Council, an independent body dedicated to the welfare of the members of the profession and to advancing nursing and midwifery as essential and professional services on the islands.
While strongly-networked, the health system still endeavours to provide tertiary-level care. Less than 10% of facilities currently offer emergency obstetric and neonatal care. Against this backdrop, the role that each individual plays in the delivery of healthcare becomes even more critical.
At the forefront of those delivering care are nurses and midwives. These are the individuals who engage with patients by their bedsides, provide a first port of call in the community, and advocate for changes to health standards and regulations in response to the needs they see each day.
For over 15 years the Aga Khan University School of Nursing and Midwifery has been working with these individuals, helping build the necessary skills for the nurses and midwives of Zanzibar to transform the landscape of health. These are their stories
This session is brought to you by the Aga Khan Health Board for India featuring Dr. Malik Merchant, Psychiatrist, Prince Aly Khan Hospital. Dr. Malik talks about how common mental health issues are and how we can successfully control them and take care of it.
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