“ I have long felt the enhancement of the nursing profession to be absolutely critical to the improvement of healthcare in the developing world, and the Islamic world. The way forward was to professionalize, to institutionalize, and to dignify this great profession.” -Mawlana Hazar Imam, Archon Award Ceremony of Sigma Theta Tau International, Copenhagen, Denmark,  June 7, 2001

Having learned the best practices of their vocation and passion, several nurses have found the inspiration to travel to other parts of the world to share their expertise. Many of these nurses fulfill this desire through the Ismaili Nursing Alliance (INA), the nursing body of the Ismaili Health Professionals Association (IHPA) part of the Aga Khan Health Board of the United States of America. INA members focus on the nursing skills necessary to realize one of IHPA’s missions: providing a resource base for health-related humanitarian activities.

One initiative that has blossomed is the collaboration between Aga Khan Health Services, East Africa (AKHS, EA) and INA, devised "to create a long-term partnership and a sustainable structure for knowledge-exchange” says Mehrunnissa Taj, Nurse Practitioner and INA lead. To achieve this, INA launched several programs, in collaboration with nurses from Canada, to strengthen local infrastructure through best practices, bridging knowledge gaps, and fostering personal and professional development of nurses. Following are snapshots of each program and the impact on host institutions.

Basic Lifesaving Skills (2016)
No formal organizations exist in Afghanistan to train health care staff on various certifications and basic life support skills. Kabul's French Medical Institute for Women and Children (FMIC) has had to send staff to the Aga Khan University in Karachi, for such training. As a result of the INA collaboration, FMIC is now able to certify and train its own staff, in addition to supporting and training staff at local government hospitals. About her experience, Atlanta nurse practitioner Hafiza Ukani, said this was a “this was a once-in-a-lifetime experience where we are able to visit and help a country in the worst political turmoil, but we are glad we went and achieved a huge success.”

Healthier Children for a Stronger Future (2018)
“I wanted to share my knowledge and experience with other nurses to help improve their knowledge and experience,” remarked Najma Ali of Houston. She and six other nurses and nurse practitioners led the Pediatric and Neonatal Intensive Care program at Aga Khan Health Services (AKHS), in Dar es Salaam. The program focused on sharpening and improving the skills of nurses. For example, the team developed a well-baby package, initiated sickle cell screenings and hearing screenings for newborns, among programs for both nurses and physicians.

Dr. Mariam Noorani, head of the pediatric department at AKHS, Dar es Salaam remarked: “The presence of the volunteers provided the much-needed expertise required to set up the state-of-the-art, evidence-based technology used in pediatric services," and  “Their impact will continue for a long time after their departure.”

Critical Foundation (2016, 2018)
The goal of assisting the intensive and critical care unit program at AKHS was to improve nursing care and improve overall patient outcomes. Led by Dr. Fozia Ferozali of Los Angeles, and using an e-health platform, skills of nurses who may not have had critical care experience were developed. Nurses and physicians participated eagerly, with Dr Ferozali highlighting the “enormous need to collaborate and share our experiences globally.”

In 2018, nurse Mona Dossani, from Atlanta, spent five months in Dar es Salaam educating and mentoring Emergency Room and ICU nurses. In addition to sharpening skills in a classroom setting, she worked with the local nursing team to improve their proficiency, thereby optimizing the delivery of care to patients and designing skills checklists.

Leaders of Tomorrow 
Using an e-health platform, this project's aim was to develop skills on human resource utilization, change management, budgeting etc. It was gratifying for nurse Shyroz Tejani, when nurses approached her individually to ask about strategies on how to improve their management skills.

Comments from hospital staff at Aga Khan University Hospital (AKUH), Nairobi, was that the training has helped them with “providing recognition for a job well done, exploring possibilities rather than repeating the same stories about why things are not happening, enhancing the working relationship amongst staff by being more empathetic, and improving conflict resolution skills.”

Caring with Compassion: Oncology and Palliative Care (2018-2019)
The Oncology (Cancer Care) program, was the first of its kind at AKHS, EA, with the objective of improving Oncology nursing skills and help implement best practices. David Echesa, a nurse manager from AKUH, Nairobi, reflected on the program, saying, “There have been improvements in safety standards of patient care, and the team is more inclined to advocate for evidence-based policies and procedures for the Oncology department." Another nurse remarked, “What was once thought of as a scary field to work in now seemed intriguing.”

Palliative care is care-focused on pain and symptom management, aimed at promoting dignity and reducing suffering in advanced illness, and at the end of life. The program was also the first of its kind at AKHS Dar es Salaam. Six nurses from the hospital were approached to be leaders, but more than 20 nurses participated in this program. All six who attended were identified as champions for palliative care in their respective units. A hospice facility was also initiated in Jubilee Towers, an existing long-term care facility where some of our Jamat resides.

These programs are but a snapshot of the desire that many of our nurses possess in the context knowledge-sharing, and what their efforts can achieve in improving healthcare outcomes and in-patient quality of life.