Dr Fazila Lalani, a full-time emergency physician with the Aga Khan Health Services, Tanzania, is working in her ideal job, and it started as a TKN assignment.

After completing her medical residency four years ago, Dr Lalani taught medical school and emergency medicine residents as an assistant professor in Northwell Hospital’s Emergency Medicine Residency Program, in her hometown of Long Island, New York. She had a passion for international medicine since she was in medical school and worked in Northern Pakistan, Haiti, and Nepal after earthquakes struck in these regions. She also regularly taught in an emergency medicine residency program in a small town near Kolkata, India. In addition, she was actively involved with the USA Aga Khan Health Board throughout her residency, and dreamed of contributing her skills to improve practices in one of the Aga Khan Hospitals.

As emergency medicine continued to grow around the world, Dr Lalani was offered an opportunity to serve on a Time and Knowledge Nazrana (TKN) assignment with the Aga Khan Health Services, Tanzania (AKHS,T) hospital in Dar es Salaam in June 2017. Two months into the assignment, she knew she would stay longer than intended.

“The only way to make real, sustainable change is slowly over time,” Dr Lalani said.

The Aga Khan Hospital obtained her license and residence permit to work in Tanzania and she has now been working full-time for the past six months.

“My paternal and maternal grandparents were active volunteers, so this just felt like the path I was meant to take. There’s nothing more enjoyable and satisfying for me than knowing I’m having a positive impact on others,” Dr Lalani explained. “Moreover, after I did a semester abroad in Kenya while in college, I always knew I’d be back.”

Working with a team of emergency specialists, Dr Lalani has implemented a number of clinical and administrative processes, developed training programmes to support doctors and nurses, and established consistent standards of care to ensure that patients are getting the best possible care. For her, being able to make significant positive changes and introduce new processes is extremely rewarding.

Dr. Lalani said, "Aiming to achieve international standards, we are the only private hospital in Tanzania which has an emergency medicine specialist in house, seeing every patient with medical officers and interns, 24/7, year-round. We’ve added more classroom and on-the-job learning. Whenever we deliver emergency care, we also conduct bedside teaching. We’re using a residency-type model to treat every case as a learning opportunity and to enhance the skills of our medical team.”

In addition, Dr Lalani has helped to establish the Aga Khan Hospital as an American Heart Association Basic Life Support Training Center, which will expand to teach advanced and pediatric life support and eventually apply to be an international training centre. She also assisted in establishing the hospital as a primary trauma care training centre. Dr Lalani and her team have trained most clinicians in the hospital, and are now inviting doctors and nurses from local clinics, hospitals, and even from nearby Zanzibar, to participate in these courses and improve their skills. By focusing on continuous learning, the hospital has become a teaching centre for the wider health care community.

Dr Lalani credits the nine-month TKN assignment for giving her the full time opportunity that would have been unlikely otherwise.

“Many people want to volunteer, but it’s hard to find a hospital that is willing to engage you for a few months, and where friends from the community and coworkers become family instantly, everywhere you go,” she said.

Aga Khan Health Services,East Africa CEO, Sulaiman Shahabuddin, has high praise for Dr Lalani’s contribution: “She has brought world class emergency medicine practices to our hospital in Dar es Salaam. The emergency medicine training programmes she has implemented have benefitted both our staff and also health professionals from other public and private sector hospitals. This has enabled us to position our hospital as an emergency medicine leader in Tanzania. We are very pleased to have Dr Lalani on our team.”