Item(s) for March, 2008

Mar 24,2008

U of A health researcher’s pilot project shows treatment on par with the best hospitals in east African nation.

Keith Gerein, The Edmonton Journal
Published: Sunday, January 13

When Arif Alibhai went to Uganda two years ago, he knew the job before him required both scholastic ability and a humanitarian touch.

The east African country had made substantial strides in combatting an AIDS epidemic, yet the progress was tragically uneven. Anti-retroviral drugs were available only at major urban hospitals, effectively denying treatment to patients in many rural areas.

The challenge offered to Alibhai, a University of Alberta health researcher, was to devise a system of dispensing medication in these remote districts.

The catch? Not only would any solution have to be low-cost and sustainable over the long term, it would also have to get around a critical shortage of doctors.

After tossing around a few ideas, Alibhai and his team came up with a plan: Instead of using health professionals to deliver drugs, the job could be done by unpaid community volunteers.

So far, the concept appears to be working.

Early results from a rural pilot project show treatment that is on par with the best Ugandan hospitals — a success story that could potentially serve as a model for drug programs in other AIDS-afflicted countries.

“The whole point was to look at the problem of how rural people access treatment,” said Alibhai, the senior project manager. “We asked ourselves, is it possible to move the treatment to where the people are?”

The site chosen for the pilot project was Kabarole, a predominately rural district on the western edge of Uganda where subsistence farming is the main activity.

A poor area, the prevalence of HIV among adults in Kabarole is 10 per cent, significantly higher than Uganda’s national rate of six per cent.

Such a disparity is a major concern, said Tom Rubaale, a member of the district health team. Since the disease kills people in their prime working years, it has a particularly devastating impact on poor families who depend on their strongest adults for income, he said.

That thin line between survival and starvation is one reason why rural AIDS patients in Kabarole often choose not to be treated. With anti-retroviral drugs offered only in the district capital, many people find it’s too far to go, said Joa Okech Ojony, a district health officer.

“It may take two days for people to make the trip, and they can’t afford that because it’s two days away from their livelihood,” he said. “Others are too frail to travel, and even if they weren’t, the costs of travel are prohibitive.”

The project team knew that bringing drugs into rural areas would solve only half the problem. The more critical conundrum was the lack of doctors. Without them, who would hand out the medication? Who would ensure patients took their pills twice a day on schedule? Who would keep watch for adverse effects?

In searching for answers, team members recalled a study done in Haiti on hard-to-reach patients and thought they could adapt the Caribbean program to sub-Saharan Africa.

“Anything we did had to be sustainable in the long term, meaning it had to be minimal cost,” said Alibhai, who joined Ojony and Rubaale in Edmonton recently at a global health conference. “We already knew that volunteerism is a big part of Ugandan culture, so calling on volunteers seemed to make sense.”

Working out of small rural health clinics — upgraded with funding from the Canadian Institutes of Health Research — community members were recruited and trained to take on many duties traditionally performed by health professionals.

The most important of these was to make weekly visits to patients to ensure they were taking their medication, and to check for any negative reactions.

After six months, the project has shown strong results. Ninety per cent of rural patients have had successful treatment outcomes, while the drug adherence rate has hovered near 99 per cent — achievements at least equal to the district hospital. Alibhai believes the program’s success is due, in part, to the personal touch patients receive from friends and neighbours assigned to check in on them. Volunteers can outperform doctors when it comes to offering social support, compassion and encouragement.

And success builds success. As people hear of positive results and see neighbours getting better, more patients sign up for the program. Women in particular are more likely to seek treatment when it is delivered in a community-based setting, said Walter Kipp, the U of A health scientist who supervised the project.

Researchers will continue to study the drug program over a two-year period. During that time, one of the biggest challenges will be to avoid complacency, both in keeping patients taking their drugs and keeping volunteers motivated to perform their duties, Kipp said.

Funding is another issue. More money is needed not only to keep the program going in Kabarole — where an estimated 16,000 people will need treatment in the next five years — but also to expand the project to other areas of Uganda and other countries afflicted with AIDS, Alibhai said.

“When you start working in global health,” he said, “you have to make a commitment to stay in it for the long term because the need is great.”


Mar 24,2008

Victoria, British Columbia—February 1, 2008 – This evening, at the Victoria Conference Centre, the Honourable Beverley J. Oda, Minister of International Cooperation joined Aga Khan Foundation Canada’s Chief Executive Officer Khalil Z. Shariff along with local dignitaries and other guests to officially launch Bridges that Unite, a new, interactive exhibition showcasing our national ability to bridge the developed and the developing world.

The traveling exhibition invites visitors to consider Canada’s role in the world through the lens of a remarkable 25-year partnership with the Aga Khan Development Network (AKDN) in some of the world’s most isolated and impoverished regions.

“Bridges that Unite is an opportunity to explore what we’ve learned, to build on our experience and to chart a way forward for Canada and the world,” said Khalil Z. Shariff, CEO of Aga Khan Foundation Canada, which is presenting the exhibition. “Canada at its best has had a real impact in a way that is sensitive, thoughtful and sustained,” he said. “The exhibition draws on our rich experience in the developing world to spark a conversation about what Canada and Canadians can contribute to ensure a more peaceful, prosperous and pluralist world.”

“Over the years, as Canada has contributed to the work of the Foundation, we have seen the solid results achieved by the Foundation, often in extremely challenging environments,” said Minister Oda. “In many diverse ways, the partnership between Aga Khan Foundation Canada and the Government of Canada has been a long and successful one.”

Twenty-five years ago, Canada invested in an innovative partnership with the AKDN in northern Pakistan – one of the world’s poorest, most isolated and volatile regions. Since then, this partnership has grown in scope and depth and created a wealth of knowledge and practical experience that has had a ripple effect across Asia and Africa. Visitors to the exhibition will discover that, from Afghanistan to Zanzibar, a ring of chairs, in which people meet to discuss and find solutions to their problems, has become a symbol of lasting, positive change.

Embarking on a national tour following a two-week stop in Victoria, Bridges that Unite offers a vibrant, interactive space in which to explore some of the most pressing questions of the 21st century. Thought-provoking stories of initiatives spanning several continents are told through powerful images, evocative soundscapes and interactive, multimedia components.

This stimulating environment will also provide a compelling backdrop for lectures, workshops, and cultural events. Online discussions and exhibit highlights at will allow visitors to continue the conversation as Bridges that Unite travels across Canada.

For more information on the Bridges that Unite exhibition including venues, dates and program details, please consult our website at


Aga Khan Foundation Canada (AKFC) is a Canadian international development organization, and an agency of the Aga Khan Development Network, founded in 1980. Working primarily in Asia and Africa, AKFC works to address the root causes of poverty.

The Aga Khan Development Network (AKDN) is a group of non-denominational development agencies founded by His Highness the Aga Khan, with wide-ranging mandates covering social, economic and cultural development.


Jennifer Morrow,
Aga Khan Foundation Canada


Mar 24,2008

TORONTO – In the chilly confines of a warehouse, images, voices and words carried from the far reaches of the globe converge, radiating from still photos and video screens.For citizens from at least 40 countries including Afghanistan, Kenya and Pakistan, their common bond is Canada, which plays a crucial role in shaping their communities and lives.

Organizers of the Bridges that Unite exhibition, which had a preview stop in Toronto recently, say they hope these stories will soon be part of a national conversation as they hit the road with the interactive, travelling display designed to engage Canadians and help them explore the country’s role in the developing world.

Bridges that Unite marks a quarter-century partnership between Canada and the Aga Khan Development Network in the region. Aga Khan Foundation Canada (AKFC) is an agency of AKDN, an international group of non-denominational agencies with a humanitarian agenda encompassing social, economic and cultural development.

The network was founded by His Highness Prince Karim Aga Khan, the spiritual leader of about 15 million Ismaili Muslims in some 25 countries, including between 80,000 and 100,000 in Canada.

The Canadian International Development Agency and AKFC first collaborated 25 years ago in northern Pakistan employing principles around keeping the community in charge. They’ve seen “extraordinary results” in that part of the world, said Khalil Shariff, CEO of Aga Khan Foundation Canada.

Shariff said there have been improvements in almost all measures, including infant mortality and education for men and women.

“We thought this is an example of Canadian leadership, of thoughtful, sensitive, long-term visionary Canadian leadership, which is unheralded,” he said.

“At a time in the world where that kind of leadership is in real demand, we thought that showcasing it in a way that would make it accessible to lots of Canadians made sense: not only that experience in the northern areas of Pakistan but everything it has spawned across many other parts of the world.”

Just beyond the entrance of the sprawling 465 square metre exhibit sits a ring of chairs, symbolic of the approach allowing individuals to identify their own ideas and priorities for community development. Interactive audio elements allow visitors to listen to those working in the field, including program officers instructing on how to run a community meeting, take minutes and assign responsibilities.

“If we don’t understand, for instance, that the heart of most international development efforts is bringing the community together to discuss over time their problems, it’s gong to be very hard for us to appreciate why it’s complex, why it takes a long time,” Shariff said.

“If all we think (about is) distributing handouts, we’re going to be very poor decision-makers and very poor contributors.”

The Aga Khan University in Pakistan has also developed strong partnerships with Canadian institutions including the University of Alberta and the University of Toronto’s Ontario Institute for Studies in Education. Students can participate in exchanges or earn scholarships to study in Canada in hopes of taking their newfound knowledge back to their communities.

Hamilton’s McMaster University was involved in setting up a nursing school at Aga Khan University in Pakistan 25 years ago. In the past decade, the Aga Khan University went on to establish a growing presence in east Africa. In one of the featured short films, a Kenyan nursing grad speaks of her work at a local hospital while helping to raise her orphaned nephews and nieces.

“What we’re talking about here is investments in higher education so you create the leaders that you need to strengthen society and ensure all the parts are working together so you can have a vibrant, pluralistic, democratic society where people have choices,” said Jennifer Morrow, the foundation’s communications director.

The exhibition also spotlights Canadians who serve as “agents of change.”

Sarah Bandali followed two years of work with Aga Khan’s Geneva office with a two-year stint in Mozambique where she designed and facilitated HIV-AIDS prevention workshops.

She said it’s important to recognize the process of development is incremental, and the aim is to establish longer term changes and outcomes.

“I think working with communities, they have a lot of hope and inspiration and willingly and actively want to participate in enhancing their own development,” she said.

“I think they appreciate that you’re not only wanting to help them but you’re actually actively taking their concerns and voices into account by actively engaging them in the process itself.”

At the conclusion of the exhibition, visitors are welcome to share their thoughts on ways to help push Canada forward with “21 questions for the 21st century.” They can express what they believe to be among the most pressing global issues and how Canada can help address them. The answers will be compiled and posted on the exhibition website, along with details of future tour stops.

While initially greeted with walls of photos of a diverse array of faces, the journey concludes with visitors reflecting on their own image in a mirror and the Aga Khan’s parting words: “Successful experience with democracy, civil society and pluralism are the national genius of Canada of which much of the developing world is in dire need.”

“The significance of the mirror is that we see ourselves as the future, as Canadians who can make a difference, that we do have the capacity as individuals to have a voice of how we want Canada to play a role in the developing world,” Morrow said.

Bridges that Unite is slated to open Feb. 1 in Victoria at the Victoria Conference Centre, the first stop on a scheduled nationwide tour which will be open free to the public.