Byline: Harry Nelson, Los Angeles Times
Credit: Los Angeles Times
SO THE SAN FRANCISCO CHRONICLE (SFC)
Origin: Karachi, Pakistan
LP Karachi, Pakistan
One of the world's richest men is creating what may be the most ambitious private program anywhere to correct the crippling inequities that deprive people in developing countries of housing, education, health care and social advancement. He is a 52-year-old Harvard-educated British citizen residing in * France, Prince Karim Aga Khan, the 49th hereditary spiritual leader of the Ismaili sect of Shiite Muslims, who number 15 million. * For 30 years, the Aga Khan (the title means ""great leader") has carefully expanded the programs of social and economic development begun early in this century by his grandfather, whom he succeeded as spiritual leader of the Ismailis in 1957. The list of social and economic development programs now includes 300 educational institutions, 200 health-care centers, diagnostic clinics, dispensaries, five general hospitals and scores of business enterprises self-initiated by poor people in such countries as Pakistan, Kenya, Tanzania, India and Bangladesh. All are are financed primarily by Ismaili religious tithings and are available to everyone.
MEDICAL COLLEGE * Last month, the Aga Khan came to Karachi, Pakistan's largest and most slum-ridden city, to attend the graduation of the first class of * 42 physicians from the Aga Khan University Medical College, a $300 million institution with an ultramodern 721-bed hospital that is by far the best in the nation. Pakistan spends less than 1 percent of its gross national product on health. The government system has no slots for public-health nurses. Rural health centers are either underutilized or overwhelmed with patients but seldom have active programs to teach preventive health. * The Aga Khan's stated goal is not to replace the government health system but to create programs as models that can be duplicated by other developing countries. The medical college, in an unusual program, immerses students in the living conditions of the poor, who are the bulk of Pakistan's 100 million residents. From virtually the first day of class, each student is assigned to spend 20 percent of his five school years among Karachi's poorest residents or in backward villages, designing and running health programs. It is there, say faculty members, where future doctors will learn the causes - mostly preventable - of infant and maternal mortality, malnutrition and infectious diseases that curb economic development and make life insufferable. The official infant mortality rate is 126 deaths in the first year for every 1,000 live births - more than 10 times the U.S. rate - and in many settlements the rate is far higher. From these communities, many future doctors, nurses and other students are expected to come. The theory is that such students are the most likely to return to the villages to work. COMMUNITY-HEALTH NURSES Mumtaz Mughan, a 1988 graduate of the university nursing school, was born in the Gilgit region of Northern Pakistan among the majestic snowcapped Karakoram Mountains not far from China. Today, she is the * community-health nurse in Singul, a village where Aga Khan Health Services has built a satellite health center that serves perhaps 10,000 people living in villages strung along the Gilgit River Valley. ""I could make more money if I stayed in Karachi, but I came back because I wanted to help," she said. Her sentiment echoed many faculty members who returned from greener pastures abroad to help build a better health system in their native land. Most of the full-time faculty of 140 are Pakistani doctors who have returned home after years of training and working in Britain, Canada or the United States.
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