May I first thank you, Mr. President, for the very great honour you have paid to the Ismaili community, to my wife and to myself in joining us here today to lay the Foundation Stone of the Aga Khan Hospital and Medical College. I am most grateful for the generosity of your tributes and for your personal kindness and hospitality.

We are very conscious that the present period is an excessively busy and arduous one for you. We know the great burden of responsibility which you shoulder during this delicate transitional period in the political history of Pakistan.

It hardly seems possible that almost a year has passed since my wife and I were last in Karachi renewing old friendships and enjoying the warmth of its traditional welcome. In fact, it was February 9th last year that I spoke at a Reception given by the Municipal Board of Karachi and described some of the complexities of planning and constructing a modern hospital.

We have advanced another large step forward during the past twelve months. Mr. President, the planning stages of this institution are now complete. The feasibility study was prepared by a team from the Economic Intelligence Unit headed by Mr. Michael West, and from International Professional Consortia headed by Mr. Johnson Jones. In a succession of long meetings during the year, we have discussed their planning at length.

The preparation of this report, as its authors are the first to acknowledge, owed a great deal to the advice and assistance readily offered by members of the Pakistan Medical Association and eminent hospital administrators in both government and private institutions. We are sincerely grateful to them all.

What precisely is the contribution that this hospital can make to the future of Pakistan? Assembled here today is a high proportion of Pakistan's elite: leaders of Government, the Armed Forces, the Diplomatic Service, leaders of industry, men of law, of education, and medicine and many other walks of life. Their interest in this hospital could be a purely personal one.

In other words, this institution will be a small, but I hope, important addition to the sum total of the national effort to preserve good health and fight disease.

In that context, our hospital, once completed, will provide at least 6,000 patients every year with completely free hospitalisation. It is also planned to offer heavily subsidised treatment for another 14,000 in-patients annually. More than 35,000 low cost out-patients treatments will be given and there will also be a private wing for those patients who can afford to pay the full cost of their stay.

I hope, however, that the benefit of this hospital will spread far beyond the patients who enter its doors. It is, after all, to be a training institution, not only for doctors but also for nurses. In Pakistan, where there is just one doctor to every 7,000

inhabitants, an addition of even 100 doctors every year to the national total must quite soon have a major impact on national health standards.

The Nursing School will not be so large, but it too will be producing 75 trained staff nurses every year-and I can assure you that they will be very good nurses indeed. This is a profession which often has to struggle for its rightful status. If the official statistics are accurate, there are only 4,000 women in the nursing profession throughout the country and as a result, a great deal of nursing work is performed by males.

Now, especially, with my wife on the same platform, I would not dream of suggesting whom I should prefer to soothe my brow. If I were to simply content myself with a diplomatic observation of fact, there are some jobs for which the feminine temperament is better suited than others.

In many parts of the world nursing, by tradition, is one of them. Therefore I believe that nurses deserve the quality of training, the excellence of working conditions and the appropriate material rewards for such sensitive and important work. That, at any rate, will be our policy at this hospital and if it is followed elsewhere in the country, I shall be very happy.

The training of doctors presents a different kind of problem. There might be no obvious shortage of doctors in Pakistan if everyone who had completed their medical training overseas had returned here to work. There are of course many reasons for a large number of trained Pakistani doctors remaining abroad, often in very eminent posts, but I hope that with new medical institutions such as this, there will be much greater incentives for qualified men and women to return. This institution alone will create a number of senior and junior teaching posts.

I also intend that it should set a standard of quality which will automatically attract professional staff who might otherwise have been tempted to remain abroad. To perform their best work and to continue developing their professional abilities, the medical profession needs suitably conceived premises, research facilities and an appropriate professional environment. This is where, once again, a new institution such as the one we are about to build can make a major contribution. After all we should not forget that the first heart transplant was carried out on the African continent. The lesson is clear: provide the right men and the right surrounding and there are few limits to what can be achieved.

One of the greatest concerns of health authorities, not only in Pakistan but all over the world, is the escalation of costs. Whatever the reasons, this is likely to remain a major problem to countries with limited financial resources.

In the Ismaili community, both here and elsewhere in the world, we have concentrated first on the simplest and therefore the cheapest form of medical care. All over Pakistan, there are small Ismaili health centres, dispensaries, maternity and child welfare clinics which have been created to teach and administer the basic principles of preventive medicine. Independent witnesses from overseas have paid warm tribute to the work performed by these centres which are administered by voluntary workers under the able direction of Dr. Habib Patel. We are not alone in work of this kind of course and many other communities are making a similar contribution to Pakistan's national health services. The Aga Khan Hospital in Karachi will naturally become the hub and focal point of the Ismaili health institutions. We plan to train not only doctors and nurses but health visitors for our own clinics throughout Pakistan.

They will only be a small proportion of the total output of trained staff. But they will certainly help to raise medical standards for our community and everyone else who makes use of these clinics in the rural areas.

Finally, Mr President, if in the planning, construction or administration of this institution, we obtain information which could be of interest or use to Pakistan's Ministry of Health, we will most willingly pass it on. The techniques of hospital administration are constantly developing, and we plan to benefit from the most up-to-date systems available.

If, at a later date, we enter the field of medical research, the objectives of that research will be specifically directed to the needs of this country.

I will finish, ladies and gentlemen, by once again extending my thanks to His Excellency the President, members of the Foundation Committee, and all those other well-wishers who have helped to make this ceremony possible today.

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