International cooperation with Islamabad Children's Hospital, Pakistan: The JICA project

The Japan International Cooperation Agency (JICA) provided the funds for the construction of the Pakistan Institute of Medical Sciences childrens hospital (ICH) in Islamabad. JICA worked with ICH between July 1986 and June 1993. Japan sent 67 specialists to ICH and Pakistan sent 34 counterparts to Japan for training. JICA also provided equipment. The high mineral content (e.g. calcium) of the local water damaged equipment. There is no competent Pakistani medical engineer to repair the equipment. The project has addressed the shortage of nurses. Feed back and horizontal discussions among physicians and nurses or paramedics are uncommon. Exposure to colleagues in Japan changed behavior of the Pakistani counterparts returning from Japan resulting in greater competence and in them behaving responsibly being loyal and adopting problem saving attitudes. Inadequate understanding of management by most counterparts except physicians or senior level professionals hurt the function and efficacy of ICH. ICH was governed by budget controls of the Pakistan Ministry of Health and of the Pakistan Institute of Medical Sciences which sometimes kept ICH from receiving essential operating costs. ICH had too many outpatients and limited space for the clinical laboratory. A filter-clinic set up in a new OPD building solved the space problem. A too bureaucratic policy initially hindered the project. Despite these obstacles ICH is a center of excellence in health care education and research. 82 physicians and 113 nurses work at ICH. ICH carries out much maternal and child health activity. ICH serves as a postgraduate teaching institution for pediatricians and for pediatric nurses. The Canadian International Development Agency evaluated the JICA ICH project and rated ICH as one of the most successful JICA medical projects.