Launch of the expansion of the Aga Khan Hospital

Mawlana Hazar Imam addressing the guests at the ground breaking ceremony of the Aga Khan Hospital extension. Zahur Ramji

President Mkapa,
Honoured Guests,
Ladies and Gentlemen,

Thank you very much for joining us today to celebrate the launch of the second phase of the expansion of the Aga Khan Hospital.

Yesterday, President Mkapa joined me for the groundbreaking of the new Aga Khan Academy School to be built here in Dar-es Salaam. The President spoke eloquently about the need to increase the capacity in Africa to educate and retain more indigenous professionals and to reduce the costly dependence upon expatriates.

Mr. President, you will be pleased to know that our vision for this hospital, and our wider health strategy for East Africa, are entirely consistent with those views.

This hospital already plays an important role in supporting medical education and health care delivery for the people of Dar es Salaam, and those referred to it from our up-country medical centers in Morogoro, Dodoma, Iringa, Mbeya, and Mwanza. The new facilities planned for this site will enhance that capacity further. It will also solidify the hospital’s wider role in education and health delivery for East Africa.

The goal is to invest in medical education, and health care facilities, to enable the delivery of patient care to international standards in a wider spectrum of medical specialities.

And we will continue to reach far beyond this facility and this community to help others strive for that level as well.

This regional approach will allow us to offer the best in training for medical specialists, nurses and medical technicians in East Africa. We will also have the facilities and the equipment to enable them to practice in their chosen fields of expertise.

I have every confidence we will be able to train and retain more specialists here in East Africa. I also have reason to hope that some medical specialists who have left to practice abroad may be persuaded to return.

Our approach is being driven by powerful trends that are rapidly changing health care practice and patient care demands throughout the world. Increased medical specialisation and advances in pharmacology, diagnosis and surgical techniques are making possible dramatic improvements in patient care. They are also changing the way health care is delivered, altering the mix between treatments that require hospitalization and most effective out-patient and community-based care.

We are also seeing here in Tanzania and East Africa generally, rising demands for cardiac, orthopedic and oncology treatment very similar to those in the industrialised world. And there is of course the added challenge of malaria and HIV/AIDS.

We expect these trends to accelerate here as they have internationally. And unless we make significant investments in education as well as new equipment and facilities, East Africa will fall further behind in health care delivery.

Let me say a few words first about education.

Through linkages between the Schools of Medicine and Nursing of the Faculty of Health Sciences of the Aga Khan University, and the Aga Khan teaching hospital in Nairobi, we are building here in Dar-es Salaam a regional hub of quality medical and nursing services. This hospital will be part of what amounts to a regional teaching hospital network.

Post Graduate Medical Education programmes are already in place between here and the Aga Khan teaching hospital in Nairobi. The family medicine post graduate programme has been placed at this hospital, in part because of the important links to our five up-country community health clinics. Other post-graduate medical programmes will be established here in future. These programmes will be opened to physicians from our own and other hospitals to gain greater regional synergies. The hospital already has a partnership with the Muhimbili College of Health Sciences at the University of Dar es Salaam. Rotations for specialising physicians help them gain valuable clinical experience.

The hospital has been able to bring experts from abroad to help train medical staff in new surgical techniques. In the last six months, for example, the volume of less-invasive procedures known as keyhole surgery has increased significantly.

This is thanks to the assistance of an international specialist who has overseen training on recently-acquired laparoscopic equipment. In Nairobi, currently there are post graduate programmes in surgery, internal medicine and radiology.

But it is also in nursing education that we have made important commitments:

Our regional nursing education programme trains nurses in Tanzania, Kenya and Uganda. However it is here in Tanzania that it is considered the most successful. The East African regional programme now has more than 400 graduates. From this hospital alone, 45 nurses are currently enrolled in diploma and degree programmes – half of all the hospital nursing staff.

In addition to enhancing the status of professional women, we believe that by creating better academic opportunity for nurses and a rewarding work environment, we help reduce the rapid and damaging outflow of these crucial resources to the developing world.

Of course, the best training can only be put into practice with the right facilities. The aim of the Aga Khan Hospital is to create a virtuous circle of excellent training combined with the best facilities to increase the range of medical specialties at the hospital. That in turn will increase the capacity to train others.

Phase One of the hospital expansion, which opened five years ago, included a new Emergency Room department, 18 out-patient consulting clinics, a laboratory and a pharmacy.

It also included 56 new pediatric and medical-surgical in-patient beds in an air conditioned environment.

Since then the hospital has built up a sophisticated radiology department. In addition to x-ray and ultrasound technology, the hospital has added mammography, specialist dental and CAT scanners. Most recently the hospital acquired the county’s first MRI scanner. The MRI means that more referrals, and patients, will be able to benefit from enhanced diagnostic accuracy, and patients will no longer need to travel abroad for these investigations.

The range of specialists available in the hospital supports the very busy out-patient clinics, which serve 100,000 patients a year. They also enable the hospital to provide specialist emergency treatment on a 24-hour basis, seven days a week.

Phase Two of the expansion, which we are launching today, will increase capacity further.

Five new operating theatres will be added. Maternity delivery rooms will increase to four from the current two. The intensive care unit will expand from four beds to 12.

There will also be further improvements in the radiology department to bring all these services together in one physical department and add new ultrasound capacity. There will be new physiotherapy facilities as well.

The new operating theatres will enable the hospital to do more advanced cardiac and orthopedic surgery. They will include modern air flow control technologies, to reduce significantly the risk of infection. This is particularly important for orthopedic surgery where the complications from infection can be extremely serious.

Tanzanians will thus no longer have to seek this kind of advanced treatment outside the country, at considerable cost and inconvenience.

Any hospital that expands its services, introduces new equipment, and harnesses new medical practioners must pay special attention to quality care. To address this issue the hospital has also created 20 departmental quality teams to review working practices and ensure they progress to international standards. And it receives 200 questionnaires a month from patients to measure their perceptions of our services. The hospital was proud to receive ISO 9001 certification in October of 2003.