Roshan, Cisco, Aga Khan University Hospital and the French Medical Institute for Children Team up to Expand Healthcare Access by Linking Afghan Hospitals to International Medical Institutions
Kabul · June 20th, 2007 /PRNewswire/ — Roshan, the leading telecom operator in Afghanistan, today launched a pioneering Telemedicine solution in Afghanistan to expand healthcare access and delivery across the country. Using broadband technology, wireless video consultation and digital image transfer, the Telemedicine project will provide hospitals in Afghanistan with real-time access to specialist diagnosis, treatment and training expertise from abroad.
Roshan has teamed with Cisco, Aga Khan University Hospital (AKUH), French Medical Institute for Children (FMIC) and other technology suppliers to launch the project. The first phase of the project has already linked FMIC in Kabul, Afghanistan to AKUH in Karachi Pakistan, enabling access to a broad array of radiology expertise provided by AKUH. Subsequent phases will link major Afghan regional hospitals to the FMIC, which is being developed as an Afghan center of medical excellence. Eventually, the links can be extended to medical institutions in Europe and North America. The Telemedicine project developed in Afghanistan is also seen as a model for addressing healthcare delivery shortcomings in other developing countries where access to medical diagnosis, treatment and training is limited.
“Access to healthcare, especially specialist diagnosis and treatment, remains a critical problem in Afghanistan,” said Karim Khoja, CEO of Roshan. “Telemedicine technology provides a solution that has the potential to dramatically expand access to quality medical care for Afghans whose only option previously was to seek specialist diagnosis or treatment overseas. Telemedicine not only immediately enhances access to medical diagnosis and treatment, but it also helps to build and sustain the nation’s healthcare capacity through sharing of expertise. Patients will now benefit from the international knowledge without the need to transport specialists to the country.”
“Our Government is striving to improve the quality of life of our people and providing quality healthcare is one of our top priorities. Telemedicine is the perfect marriage between the speed, convenience and cost-effectiveness of wireless and broadband technology. This innovative use of technology and telecommunications to enhance healthcare delivery will help underpin our efforts to meet the nation’s other development challenges,” said Amirzai Sangin, Minister of Communications and Information Technology, Islamic Republic of Afghanistan.
“At Cisco we believe that quality healthcare is one of our world’s most vital needs. That is why we have taken a leadership position to develop technologies, such as our medical grade network that enables collaboration and sharing of health information over a secure and intelligent infrastructure. We are proud to be a part of this collaborative effort to deliver a telemedicine solution to Afghanistan,” said Sam Alkharrat, Cisco Managing Director, Gulf & Pakistan. Cisco, together with other telecommunications suppliers, is providing digital image transfer systems and video consultation for the Telemedicine project.
Telemedicine involves the use of broadband technology that provides real-time high speed access for the transfer of medical imaging, video, data and voice. Applications include the ability to send real-time X-ray, ultrasound and CAT Scans (Computerized Axial Tomography) for evaluation. The technology also enables e-learning and training through video consultation.
The initial service provided will be teleradiology, the electronic transmission of radiological patient images. There will be an average of 60 to 80 transmissions and 10 to 15 teleconferences between hospitals per month, with the numbers increasing over time. Telemedicine capabilities will gradually be expanded to address different services and procedures including evaluation of tissue samples and the on-line performance of medical and surgical procedures.
“This project not only represents cooperation between the companies and institutions involved, but is also an important collaborative effort between Afghanistan and Pakistan to address regional healthcare needs,” said Firoz Rasul, President of Aga Khan University. “Telemedicine will dramatically expand the healthcare diagnostic and education of health professionals, who will be accessible to the people of Afghanistan and will allow hospitals across the nation to leverage AKUH’s world-class medical expertise.”
“FMIC is on the front lines of healthcare delivery in Afghanistan, serving per month an average of 4,000 patients in the out patients department, 3,000 patients in radiology and 14,000 lab tests. Telemedicine is already allowing us to expand the resources at our disposal and draw on the expertise of AKUH for specialist consultation, second opinions and treatment input, resulting in speedier diagnosis and treatment and better outcomes for patients,” said Kate Rowlands, General Director, FMIC. “As the project expands to Afghanistan’s regional hospitals, patients across the nation, regardless of their socio-economic status, will benefit from the combined expertise and resources of FMIC and AKUH.”
Roshan has spearheaded development of the Telemedicine project from initial conceptualization through implementation as part of its ongoing commitment to serving as a catalyst for the reconstruction of Afghanistan.
Roshan (Telecom Development Company Afghanistan Ltd) is Afghanistan’s leading Telecom Operator, with a countrywide network of 180 cities and towns. Roshan is owned by an international consortium made up of the following shareholders: The Aga Khan Fund for Economic Development (AKFED) – 51%, Monaco Telecom International (MTI), a subsidiary of Cable & Wireless – 36.75%, MCT Corp – 12.25%. Roshan directly employs more than 900 people and provides indirect employment to more than 20,000 people. Roshan has invested over US$ 260 million in Afghanistan and is the country’s single largest investor and tax payer contributing approximately 6% of the Afghan Government’s overall domestic revenue. Roshan is deeply committed to Afghanistan’s reconstruction and socio-economic development.
The Aga Khan Development Network, which has been supporting humanitarian assistance and rehabilitation in Afghanistan since 1995, works for the common good of all citizens, regardless of their gender, origin or religion. In all its activities, AKDN is guided by Islam’s ethic of compassion for those less fortunate. At the same time, the Islamic ethic discourages a culture of dependency, lest it undermine a person’s dignity. AKDN’s ultimate aim, therefore, is to help the poor achieve a level of self-reliance whereby they are able to plan their own livelihoods and help those even more needy than themselves. Its programs in Afghanistan come under a comprehensive development agreement signed by His Highness the Aga Khan and President Hamid Karzai.
Aga Khan University Hospital in Karachi is committed to providing the diagnosis of disease and team management of patient care. These facilities are backed up by highly specialized doctors and nurses as well as quality support services. The Hospital’s multidisciplinary approach to diagnosis and care ensures a continuum of safe and high quality care for patients.
FMIC focuses on its missions of providing quality care, being accessible to all sections of society, upgrading the human capacity within Afghanis and providing a model for sustainability. FMIC has established itself as a reputable hospital delivering high quality care for children. Volumes have continued to soar; in 2006, FMIC served 1,280 inpatients and 23,000 outpatients in the clinics in one full year and already in the first five months of 2007, it has seen 987 inpatients and 13,365 outpatients in clinics, growths of 85% and 39% respectively. Pediatric cardiac surgery has been introduced for the first time in Afghanistan and over 170 cases done to date. Sophisticated orthopedic and general surgery cases are being performed regularly. Laboratory at FMIC is being monitored regularly for quality for its hematology/clinical chemistry testing and over 70 tests are being done on-site, with other tests being sent to Karachi. Radiology services include a CT Scan, general radiography and ultrasound.
Speech by His Highness the Aga Khan atGraduation Ceremony of the Masters of Public Affairs (MPA) Programme at the Institut d’Etudes Politiques de Paris (Sciences Po),
15 June 2007
Mr. Richard Descoings, Director of Sciences Po
It is a great honour to be with you today.
This is a memorable time for all of you who are graduating today – and for your friends and families. And it is also a special moment in the life of this School – the graduation of the first class to earn the new Master of Public Affairs degree.
The values which Sciences Po honors today are deeply rooted in its history – stretching back now over a century and a third a lot of people have been ahead of you. But the School’s hallmark is that it has always honored the past by embracing the future. The Master of Public Affairs programme -especially its emphasis on international partnerships – is an ideal example of new innovation in the service of old ideals.
Among those ideals has been the principle of educating for leadership, but leadership based not on social standing or material resources but on intellectual merit.
The founders of Sciences Po realized in their time that aristocracies of class must give way to aristocracies of talent – that is, to meritocracies. And the path to meritocracy in leadership is meritocracy in education.
Another value which Sciences Po has emphasized from the start is that of pluralism – an outlook which rises above parochial preoccupations. That outlook is reflected today in your strong international commitments, including your new Master of Public Affairs degree.
I was impressed with this programme from the day I first learned that Sciences Po would join with Columbia University and the London School of Economics in its sponsorship. And my enthusiasm is reinforced as I look out at the global mix of your first graduating class. I wish I had the time to meet and talk to every one of you.
I had the opportunity to speak just a year and a month ago at the School of International and Public Affairs at Columbia University. I shared with that audience a definition I once heard of a good graduation speaker – they say it is someone who can talk in someone else’s sleep.
I hope that we can break that pattern today.
Toward that end, I thought it might be helpful if I took up a question which may well be on many of your minds: Just who is the Aga Khan, anyway? And why is he here?
In response, let me say first that I was born into a Muslim family, linked by heredity to Prophet Muhammad (May peace be upon him and his family). It was exactly fifty years ago that I became the 49th Imam of the Shia Imami Ismaili Muslims.
The ethics of Islam bridge the realms of faith on the one hand and practical life on the other – what we call Din and Dunya. Accordingly, my spiritual responsibilities for interpreting the faith are accompanied by a strong engagement in issues relating to the quality of life and well being. This latter commitment extends not only to the Ismaili community but also to those with whom they share their lives – locally, nationally and internationally.
One of the issues which has concerned me the most over these years has been the topic of education.
My forefathers, as far back as a thousand years ago and as recently as a century ago, founded some of the great universities of the Muslim world, and I have continued in that tradition through a program of Aga Khan Academies, a school system, and by establishing the Aga Khan University and the University of Central Asia.
Against this background, you can understand why the success of your new program is of such a great interest for me.
I should note that my own education has blended Islamic and western traditions. My secondary and university schooling, in fact, was in Europe and in America. But my perspective over these last fifty years has also been profoundly shaped by the developing world.
The Ismailis currently reside – as minorities – in more than 25 countries, mostly in the developing world. For five decades, that has been my world – my virtually permanent preoccupation. During that time we have built a wide-ranging series of programmes involving these societies – in fields such as health care, education and culture, economic infrastructure and social development, the environment, the arts, and the media – coordinated through the Aga Khan Development Network.
As the pace of history accelerates, developments that occurred over fifty years in my lifetime will happen in fifteen or even five years for your generation. This is why I believe that the most important thing you could have mastered in the course of your studies – as you were becoming “Masters” of Public Affairs – was not any specific body of knowledge, but rather the ability to go on learning.
There is nothing we can do to slow the pace of change, but we can hope to help steer its direction.
As we do so, there are three challenges in particular that I would like to highlight to you today. They are: first, the future of democracy, especially in the developing world; secondly, the central role which civil society can play in that development; and thirdly, the crisis in relations between the West and the Islamic world. These are all areas which are going to affect the world in which you live in the decades ahead.
The history of democracy, especially in areas of Asia and Africa which I know well, has been a long series of jolts and jars. Today, any thoughtful observer of those regions would have to conclude that democracy has been losing popular confidence as an effective form of government.
In many of these countries, governments, constitutions, parliaments, and political parties are little more than a dysfunctional assemblage of notional democratic vehicles. Elections are held, constitutions are validated, and international monitors issue their reports, but observing these forms of government is not the same thing as governing effectively.
A recent survey by UNDP of 18 South American countries confirmed that the majority of people were less interested in their forms of government than in their quality of life. In simple terms, most people would rather have a beneficent paternalistic dictator, provided he improved the quality of life, than a less effective, though duly elected, democratic leadership.
The question that must be asked, I believe, is not whether democracy is a good thing in the abstract, but rather how to help democracy perform better in practice. Do we really know what is going wrong? And why? Do we know what corrective steps should be taken? And by whom?
These are massive questions, and I do not claim to know the answers. But I do believe that significantly more thought must be given to these issues, by the intelligentsia of our world, yourselves included.
As we think about these questions, there are some hopeful signs. Generally speaking, the most successful developing countries are those which have engaged actively with the global knowledge society, those which have accepted and defended the value of pluralism, and those which have created an enabling environment for human enterprise, rather than indulging in asphyxiating policies which discourage human endeavour.
But in too many places, democratic practice is deeply flawed. One problem is simple ignorance of the various forms of democracy. I attribute this in part to the absence of good education in comparative government. Holding a national referendum on a new constitution, is no guarantee that the provisions of the constitution have been understood, let alone validated, by popular consent.
In addition, the machinery of government – including the creation and funding of political parties, is often unguided and undisciplined, and widely open to manipulation and fraud. Nor is government performance monitored effectively – by internal processes or by the media.
Finally, the very concept of democracy must be adapted to a variety of national and cultural contexts. Effective democracy can not be imposed from the top or from the outside. Democracy’s value must be deeply felt in the daily lives of a country’s population, including the rural majority, if it is to be upheld and promoted.
Against this background, it would be wise, in my view, to prepare ourselves for a time of testing as far as democracy is concerned. We can expect a mix of successes, failures and disappointments, as well as a continuing array of governing arrangements: absolute monarchies, constitutional monarchies, single house or dual house parliaments, presidential and other systems, including numerous forms of federalism. In addition, regional groupings will increasingly play important roles.
But I have confidence that if we can ask the right questions about democracy, we will increasingly find the right answers.
As history demonstrates, so-called backward places can move forward over time. It is not unrealistic to plan for progress.
By civil society, I mean a set of institutions which are neither governmental nor commercial, organizations which are powered by private energies but designed to advance the public good. They work in fields such as education, health, science and research. They embrace professional, commercial, labour, ethnic and arts associations, and others devoted to religion, communication, and the environment. Many are targeted to fight poverty and social inequity.
Too often we have assumed that voluntary organizations are too limited to serve great public purposes. For some, the very notion of private organizations devoted to public goals seems to be an oxymoron.
But this skeptical attitude is changing. The power of civil society is becoming more apparent – in your coursework here at Sciences Po among other places. This is all to the good – civil society should have a prominent place in the new equation for social progress, complementing rather than competing with government. And the same thing is true of the private business sector – and the potential for public-private partnerships.
Civil and private institutions have unique capacities for spurring social progress – even when governments falter. For one thing, because they are intimately connected to the warp and woof of daily life, they can predict new patterns with particular sensitivity.
The development of civil society can also help meet the challenge of cultural diversity, giving diverse constituencies effective ways to express and preserve their distinct identities.
Private institutions also provide good laboratories for experimentation. Because they are multiple in nature, they can try a variety of approaches, sometimes failing and sometimes succeeding, but always learning from their experiences. And because these institutions need NOT make short term accommodations to conventional wisdom or current fashions, they have greater freedom to be controversial – and creative.
Let me move then to my third topic, the crisis in relations between the West and the Islamic world. I cannot remember a time when these relations have been so strained, or so wide-sweeping in their impact – both across generations and across the world.
I am deeply convinced that the fundamental roots of this crisis are infinitely more political than they are theological. And we can deal effectively with this crisis, I believe, only if we begin by addressing a complex set of political issues, rather than worrying so much about a conflict of religions.
If you reflect back to the origins of the present flash points, the historical legacy has been consistently political – and frequently explosive. The present Middle East situation was born at the end of World War I, growing out of the search for a homeland for the Jewish peoples of our world. The Kashmir conflict was born out of the decolonisation process when Britain withdrew from the then-united India. More recently, the Russian invasion of Afghanistan and the British and American invasion of Iraq have further contributed to the turmoil.
But disputes among the three Abrahamic faiths themselves have not been responsible for these conflicts. Yes, many of the problems have since taken on the colouring of interfaith conflict, but that development is the consequence, much more than the cause, of these tragedies.
Political conflict, of course, has sometimes intensified theological forces which were once less conflictual, particularly in the Islamic world. Separations within Islam have become more visible, more irascible, and more difficult to address. Some such divisions, such as relations between Arab Muslims and non-Arab Muslims, or between various interpretations of Islam, have historical roots which are centuries old, and have been revived and fanned by political developments. But other cleavages, between the secular states and the theocracies of the Muslim world, for example, or between the ultra rich and the ultra poor, are essentially the products of modern times – at least in their scope and scale.
Three observations are critical here. First, there really is no one single Islamic world, but a variety of individual situations which need individual analysis. Second, the faith of Islam, in the vast majority of its interpretations, is not in conflict with the other great Abrahamic traditions. Third, each crisis we encounter stems from its own specific political context.
Too often, there is also a tendency to run away from unpleasant truths. But we will not ameliorate these conflicts unless we address the underlying conditions – especially when economic despair leads to radicalization. It has taken 50 years, and the publication of the Sachar Committee Report, to acknowledge that the Muslims of India are second class citizens. But is the same thing not also true of the Muslims of Mindanao? It is perhaps understandable that any religious grouping which has been marginalized economically will see itself as being victimised. But our priority should not be to sharpen religious distinctions but to address human suffering.
Let me also comment on the sharpening of cultural conflict within western societies.
The past few years have been a dispiriting time in Europe – in part because of what many describe as a clash of civilizations in Europe’s midst, triggered by the rapid growth of minority populations. Perhaps, under a revitalized leadership, Europe can lead the world in meeting that challenge. But it will not be easy.
Cultural conflict in the past was often mitigated by the fact that sharp cultural distinctions were muffled by geographic distance.
But geography as a cushion between cultures has been diminishing in recent years. The communications revolution has meant “the death of distance”. More than that, cultures are now mixing physically to an extent that would once have seemed impossible.
Economic globalization contributes to the trend. Some 45 million young people enter the job market in the developing world each year – but there are not enough jobs at home for many of them. Immigrants now account for two thirds of the population growth in the 30 member countries of the OECD. Some 150 million legal immigrants now live outside their native countries, joined by uncounted millions of illegal immigrants. Remittances sent home by immigrants total some $145 billion a year – and generate twice that amount in economic activity.
The economic forces that propel immigration are far more powerful and relentless, I believe, than most people understand. They will not readily or easily be reversed or impeded.
As once homogenous societies become distinctly multi-cultural, the rhythms, colours and flavours of host communities change, inspiring some, but frightening others. More than half of the respondents in recent European opinion polls have expressed a negative view of immigration.
The frequent result of all these factors has been marginalization – socially and economically – for many minorities. And we need not look very far to see the evidence. To be sure, the victims of marginalization in our world can be found on the floodplains of Bangladesh, the village streets of Uganda, and the teeming neighbourhoods of Cairo. But they can also be found in the banlieu of Paris.
The “Clash of Civilizations” is both a local and a global problem.
The world is becoming more pluralist in fact – but not in spirit. “Cosmopolitan” social patterns have not yet been matched by what I would call “a cosmopolitan ethic”.
One of the great stumbling blocks to the advance of pluralism, in my view, is simple human arrogance. All of the world’s great religions warn against self righteousness – yet too many are still tempted to play God themselves – rather than recognising their humility before the Divine.
A central element in a truly religious outlook, it seems to me, is a recognition that we all have a great deal to learn from one another.
The Holy Quran speaks of how mankind has been created by a single Creator “from a single soul…” – a profound affirmation of the unity of humanity.
This Islamic ideal, of course, is shared by other great religions. Despite the long history of religious conflict, there is also a long counter-history of religious tolerance.
Instead of shouting at one another, our faiths ask us to listen – and learn from one another. As we do, one of our first lessons might well center on those powerful but often neglected chapters in history when Islamic and European cultures interacted cooperatively and creatively to realize some of civilization’s peak achievements.
The spirit of pluralism is not a pallid religious compromise. It is a sacred religious imperative. In this light, our differences can become sources of enrichment, so that we see “the other” as an opportunity and a blessing – whether “the other” lives across the street – or across the world.
Having looked then at the challenges of democracy, the opportunities for civil society, and the nature of our cultural divides, let me return to a point I made earlier – the acceleration of history, the danger of further drift, and the need to master change.
As you graduate, you have my warmest congratulations on all you have accomplished so far, and my prayer that God may be with you, inspiring you and empowering you, in all the good things you will be doing in the days ahead.
Marcus Gee. The Globe and Mail. Toronto, Ont.
Jun 8, 2007. pg. A.25
The cellphone craze has helped seed the hard soil of Afghanistan’s economy
This struggling city is crawling with do-gooders of all kinds, from the United Nations to the Red Cross to Germany’s Goethe Institute. But it’s a fair bet that a single outfit has given more real aid to Afghans than all the humanitarian groups and foreign governments combined. It’s a sharp little cellphone company called Roshan and it’s doing wonders for Afghanistan.
Starting from nothing four years ago, Roshan has built itself into the biggest private business in the country, employing 900 people at good wages. It has invested $300-million in Afghanistan and plans to spend another $75-million a year. The taxes it pays supply 6 per cent of the government’s revenue.
It refuses to pay bribes, setting an example of ethical practice in a society that runs on graft. It is preparing to roll out a staff medical plan that will be the first in the country. It spends $1,500 a person on employee training, sending promising employees to courses in France, Malaysia and the Philippines.
It encourages women to work, still a rare thing in a country where they are often expected to stay covered and at home. Twenty per cent of its staff are women, and each of them gets a lift to and from work by company car to make sure they don’t get attacked or hassled by disapproving men.
Roshan gives back to the community, too, building playgrounds, funding a soup kitchen for homeless children and sponsoring events such as an annual kite festival.
“We’re more than a telephone company,” says Altaf Ladak, Roshan’s Tanzanian-born, British-raised, American-educated chief operating officer. “We’re helping to rebuild the country.”
Coming from another firm, that might seem like mere corporate puffery. But Roshan is something different. It’s half-owned by the Aga Khan Fund for Economic Development, which makes a practice of investing in places where nervous money won’t go.
Afghanistan is certainly one of those places. With a war going on in the south, occasional suicide bombs in Kabul, few working roads, spotty electrical power and a capital without a sewage system, Afghanistan is no treat for investors. The Aga Khan went in regardless, determined to help the country get back on its feet after 30 years of civil war. The leader of the world’s famously charitable Ismaili Muslims, he built a five-star hotel in Kabul and helped start up Roshan (which means “light” or “hope”) in 2003.
The bet is paying off big.
After years of paltry phone service – there were only 20,000 telephone lines in the whole country before the mobile age – Afghans have gone mad for cheap mobile telephony.
Roshan’s first business plan predicted 12,000 subscribers in the first six months. It reached that in three days. Thousands of people waving application forms besieged its offices. Roshan now has 1.3 million subscribers and is adding another 60,000 every month.
Because the mail service barely works and almost no one has a credit card, customers buy phone cards at special shops and kiosks that are sprouting up around the country. Average cost for phone and activation card: $50. For those who can’t afford that, Roshan has 1,500 public call offices, little hole-in-the-
Along with making money for Roshan, the cellphone craze has helped seed the hard soil of the Afghan economy. As in many developing countries, the cellphone is a great enabler, helping people jump over the limitations of an economically backward society and into the future. When a trader wants to know when his shipment of bananas from Peshawar is getting in, he calls the driver. When a carpet-seller needs a loan to expand his business, he calls his brother-in-law in Dubai. Roshan is even rolling out a system that will allow Afghans to use their cellphones as a virtual wallet, with money text-messaged from their accounts.
Interactions like that make the wheels of commerce turn and the process of economic development begin – something all the billions in aid that have flowed into Afghanistan have failed to do.
Roshan is almost single-handedly creating a new, entrepreneurial middle class in Afghanistan. With an average age of just 22, its people are forward-looking, ambitious and ready to learn.
Hamasa Zaki is typical. She grew up in a refugee camp in Pakistan. At Roshan, she worked herself up from customer-care agent in a call centre to administrative assistant to sales officer. Now she runs the Roshan network of women phone agents and earns seven times the salary of her policeman father. Hamasa is all of 18.
People like her are Afghanistan’s future. Roshan has given them a place to thrive, and done its country an invaluable service.