The Aga Khan Health Service, Tajikistan (AKHS, T) recently established the Aga Khan Medical Centre, Khorog (AKMC, K) as a private, not-for-profit hospital, offering high quality health care to the community. It began operations in December 2018, providing outpatient care, diagnostics and physiotherapy services. In April 2019, the hospital expanded its offerings to include inpatient, as well as emergency management services. The first phase of this expansion is supported with 48 beds and a provision for future growth, as needed. AKMC, K complements and supports the Government of Tajikistan's efforts to provide quality diagnostic and treatment services not currently available at the 450-bed Khorog Oblast General Hospital.

AKMC, K has benefitted enormously from collaboration with the Aga Khan Health Board USA (AKHB USA) and the Ismaili Health Professionals Association (IHPA). In 2014, Princess Zahra had visited the Aga Khan Hospital, Dar-es-Salaam (Tanzania). During her visit, she met with Dr. Mirza Kajani, then Chair of AKHB USA, who was one of the people involved in pulling together a team of volunteers who contributed to the Phase II expansion of the hospital in Tanzania. AKHS also requested AKHB USA to provide similar support for the AKMC, K project.

“Khorog is a distant, mountainous region with difficult terrain – the system of healthcare is very different, with much of it carried over from the Soviet Union days,” Dr. Kajani explains. “It’s a beautiful part of the world, and the majority of the population are Ismailis. There is a high level of literacy, great enthusiasm and an eagerness to acquire new knowledge. The plan took root in our hearts, and we set out to determine how we were going to approach this monumental undertaking.”

Mehrunnissa Taj was previously a member of AKHB USA and was recently appointed as the Honorary Secretary of AKHB USA. She describes the many challenges that had to be overcome. These included the significant language barrier, different educational standards and forming the right team to meet local needs. “We first evaluated the needs on the ground and assessed how we could supplement the local expertise,” Mehrunnissa said. “We determined that we had to focus on the basic, fundamental elements in four areas – nursing, pharmacy, laboratory and imaging. Beyond that, one of the major needs to enhance the standard of care was English language proficiency. In essence, we had to impart medical expertise and also teach English.”

Many international volunteers, including over 25 TKN volunteers, have played a critical role in the start-up and early operational phases of AKMC, K. They continue to contribute their professional skills and expertise and provide patient care. These volunteers also bring their positive attitudes, compassion and empathy, all of which are important soft skills for this type of assignment. The notable contributions made by some of these TKN volunteers at AKMC, K are summarized below.

  • Dr. Naushad Amin, a Family Practice Physician from Florida, is at AKMC for six months. He has played a key role in many areas and is helping new volunteers get accustomed to the facility. He also acts as a liaison between AKMC, K and AKHB USA.
  • Hafiza Ukani is a hospitalist and nurse practitioner from Atlanta. She came to AKMC, K as a Basic Life Support (BLS) Instructor and ensured that every clinician in the hospital was certified in BLS.
  • Almas Welji is a radiologist who taught local radiologists and technicians how to read X-rays and CAT scans, and how to write reports. She continues to provide support remotely, reviewing films and providing her impressions.
  • Dr. Zahir Moloo, Chief of Pathology at Aga Khan University Hospital (Nairobi), assisted with a needs assessment of laboratory medicine and continues to oversee implementation of best practices. 
  • Dr. Ryaz Chagpar, an Endocrinology Surgeon from Canada, was at AKMC, K for a month. During that time, he taught surgeons how to conduct procedures safely. He continues to work with local staff remotely and consults via WhatsApp.
  • Dr. Dilshad Hemani is a pediatrician from Maryland, D.C., who came to AKMC, K with her husband Alnoor, an internist. Dilshad has provided extensive support in setting up the pediatric clinic at the hospital on multiple trips to Tajikistan.
  • Zeenat Jiwani, ER nurse from Atlanta, brought stethoscopes from her hometown, taught nurses how to conduct various tests, and then presented each of the nurses with a stethoscope to wear in the hospital.
  • Samina Kajani is a NICU nurse practitioner from California. She started a Super User Program for nurses who are particularly interested in expanding their learning and being champions on the ground for others.
  • Shirin Nanjee is an English as a Second Language (ESL) certified teacher who has taught for more than 10 years. She went to AKMC, K for two months to conduct ESL training for all staff.

The team’s efforts are now shifting to how these programs can be sustained by Tajik professionals. They are developing a skills lab for clinicians to practice performing safe care for patients, with the help of an American instructor who will conduct training. In addition, an ESL teacher and nurse will be in Khorog for six months teaching medical terminology and English.

“Without the incredible commitment of our volunteers, our strong partnership with the dedicated local AKMC, K team, the structure we have in place and support from the TKN Office, it would have been impossible for us to implement this project in such a unified and diverse manner,” Dr. Kajani notes. “With Mawlana Hazar Imam’s vision for AKMC, K to become a major health care centre, this is just the beginning. The work we are doing in Tajikistan will continue and international Ismaili health professionals will stay engaged in this part of the world for a long time to come.”

AKHS, T and AKMC, K are immensely grateful to these volunteers for their exemplary dedication and remarkable contributions. The volunteers have also learned a great deal from their assignments with AKMC, K and AKHS, T. The learning process has been bidirectional and a great source of inspiration for TKN volunteers. One consistent outcome of such international efforts is that these experiences are deeply enriching for the volunteers – professionally, culturally and personally. These assignments are also an opportunity to acquire new knowledge about disease patterns and how to address them in partnership with local healthcare practitioners.