Singal, Pakistan


May 14, 1983

Your Excellency, Dr. Tajuddin Manji, Members of the Central Health Board, Distinguished Guests, Ladies and Gentlemen,

Thank you all for your welcome and your kind remarks. It was a great disappointment for the Begum and I not to be here in March, owing to the uncertainty of the weather. But that makes us all the more happy to be here now to inaugurate a Silver Jubilee project of which I think we can all be proud. Dr. Manji has given us the facts about this new Medical Centre and I would like to add My deep appreciation of the contributions made by those members of the Jamat who donated the land on which it is built and of the generosity of Alijah Ghulam Hussein Bhatia and his family for their substantial financial donation.

The Medical Centre is a valuable addition to the network of the Aga Khan Health Services in Pakistan. The Housing Board has done an excellent job in constructing it and I am sure it will become known and admired as one of the most modern health care facilities in the area.

You have heard about some of the refinements in its construction, such as the incorporation of solar heating panels. We did not incorporate high technology like this without first giving careful consideration to whether it would prove cost effective. We were not only bringing it into Pakistan for the first time, we were bringing it into one of the most climatically difficult parts of the country.

I mention this not as a fact to wonder at, but because I would like to emphasise that this Medical Centre was built in this form, and with these refinements, as a result of extensive demographic surveys of the health needs of the population. Common sense dictates that to commit capital expenditure without first considering the development needs not just of this region, but of the whole Northern Areas would be foolish. Nonetheless countless international aid projects have been launched without the kind of careful research we made.

Our surveys also showed us that what was broadly true of the needs of our own community, was also true of the population generally. Thus diseases affecting children did not only strike our community, if they were prevalent, they struck everyone. In consequence it was logical to design our new facilities for use by all communities, which is what we intend here in Singal.

You have heard that the Medical Centre has a maternity wing and a child care centre, with a doctor and excellent staff. Children need to be cared for from the time they are conceived until they reach maturity and I strongly advise expectant mothers to come here regularly.

Furthermore, we encourage the expectant mother to come here for the birth, that is, what the maternity beds are for. After the birth, mothers should continue making visits to the Child Care Centre. At the Centre their children can be immunised against disease and have their health properly checked.

Making use of these services will involve a small cost. Remember we have to pay for the salaries of the staff and the upkeep of the Centre. So it is right that those who receive treatment should make some financial contribution, although we would never turn away anyone who genuinely cannot afford to make a contribution, and the sums we shall be paid are unlikely to cover the full running costs.

I have mentioned the value of medical treatment in preventing disease. There has recently been an excellent illustration of how this can work. The Aga Khan Health Services have a programme for distributing iodised salt in the Northern Areas this Markhor brand salt helps to prevent small children being afflicted by goitre.

I am sure you all know about this iodised salt. What you may not know is that here in Gilgit district using the salt has reduced the proportion of children with goitre to only one in twenty-five. By contrast in other areas, where the distribution of iodised salt is only just beginning, one child in four is suffering of goitre. This is an enormous difference and it explains very clearly why people should use the salt. In particular if pregnant women use it, that will prevent their babies being born with goitre.

We are also helping pregnant women and young children by distributing three kinds of food. These are wheat, dried skim milk powder and butter oil. These foods contain high quality protein, which is valuable both for unborn babies and for growing children. The foods are provided by the World Food Programme of the United Nations, while our Aga Khan Foundation subsidises its transport and our Central Health Board arranges its distribution.

It is important to remember that this food is specifically intended for mothers to be, mothers with babies and young children and not for anyone else. I urge everybody to respect this fact. Your children represent the future of the Northern Areas and the food is for them.

In order to know how successfully such programmes are working it is essential that the officials and administrators concerned should keep statistics. We will need to have accurate figures of how many people use this Medical Centre, what treatment they are given and what the result is. Equally, visits made to mothers at home must be carefully recorded. Without the record of what is being achieved, we cannot decide what is needed for the future.

In this connection, I would like to mention that we shall soon be embarking on a further five year plan in the Northern Areas. In the past, the collaboration of individuals with our survey researchers has been of very great value. I sincerely hope that when new surveys are made, the cooperation we need will be forthcoming from everyone.

Finally, I would like to thank all those who have been concerned with the building of this Medical Centre for their generosity including UNICEF which has donated equipment. Dr. Manji has already expressed our grateful thanks to the international organisations who assist our work. I am very happy that both Governmental and International organisations have recognised the philosophy underpinning our development efforts. Not just in the Norther Areas, but in Pakistan generally and in other parts of the Third World. We look forward to extending our collaboration with these organisations wherever there are appropriate problems to be addressed, nor must we forget the lady health visitors, the midwives and all the volunteer workers who enable the Aga Khan Health Services to function so well. The heart and lifeblood of our network is the voluntary worker : the boards, the committees and the volunteers, young and old, who contribute their time and effort. Without them there could be no Medical Centre here at Singal. Equally they can be certain that now the Centre is established it will support their activities.

Thank you.