"True happiness lies in the welfare of the community" - Dr Rozina Karmaliani

Dr Rozina Karmaliani is a public health researcher, educator, and practitioner. She has extensive experience in the field of maternal and child health, family planning, and health promotion. She also served as the Dean of AKU School of Nursing and Midwifery.

Dr Karmaliani obtained her Bachelor’s degree in Nursing from Aga Khan University, Pakistan, and her Master’s and Doctoral degrees in Nursing from the University of Minnesota, Canada. Her research focuses on improving maternal and child health outcomes in low - and middle-income countries, with a particular emphasis on South Asia.

Throughout her career, Dr Karmaliani has published numerous articles in peer-reviewed journals and has presented her research at several national and international conferences. She has also been involved in several research projects funded by prestigious organisations such as the Bill and Melinda Gates Foundation and Golden Affairs canada.

In addition to her research work, Dr Karmaliani is actively involved in teaching and mentoring students at AKU-SONAM.

She has developed and implemented various educational programmes to improve the quality of nursing and midwifery education in Pakistan and other countries in the region.

Dr Karmaliani is also a member of several professional organisations, including the Pakistan Nursing Council, the Canadian Nurses Association, and the International Confederation of Midwives. She has received several awards and honours for her contributions in the field of nursing and public health, including WHO's Global 100 Nurse and Midwife Leaders Award.

She is the first Pakistani nurse to be inducted as a Fellow of the American Academy of Nursing, FAAN. In an exclusive interview with You!, Dr Karmaliani shares her amazing journey in the field of research, medicine and nursing with our readers. Read on...

You! What motivated you to join the medical field?

Dr Rozina Karmaliani: Growing up I was extremely inspired by my uncle, who was a pharmacist. He was the one who invented the medicine Brufen. Hence, I was motivated by the idea of inventing miracle medicines and implementing solution-focused approaches to serve the community.

You! What is your role as the Associate Director, South Central Asia, and Implementation Scientist at Brain & Mind Institute, AKU? How do you maintain operational efficiency in this role?

DRK: This is a new and emerging role that I am excited to take on. I work in the areas of adolescent mental health and suicide prevention as well as sexual reproductive health. Moreover, my expertise also lies in the prevention of violence against women and girls and women’s economic empowerment. The Brain and Mind Institute at AKU is in its developmental stage. We are working towards strategic planning, building multidisciplinary teams with specialised skill sets, setting up policy and practice guidelines, and working on governance structures to optimise operational efficiency.

You! What motivates you at work?

DRK: Meaningful work that brings change and transformation in quality of life, especially for women and children in marginalised communities, who have limited access to basic health care. Family and community development are my primary areas of focus.

You! How do you set your goals as a professor in Community Health Sciences?

DRK: My primary goal is capacity building, to create future leaders in public health and health policy through quality education and mentorship. In addition, giving opportunities to emerging students to acquire skills for engaging and mobilising the community and building insight regarding social determinants of health.

You! How would you describe the state of Community Health Sciences in Pakistan?

DRK: Community Health Science (CHS) at large, takes the prevention and promotion role for community health and development. The need and scope to work in this area is huge, however, the demand needs to be created because the culture is more toward emergency response. A career in CHS is not well defined and appreciated as a promotive ladder of work. There is limited scope and subsidised compensation. However, gradually working with organisations such as WHO especially during the time of Covid, the need was identified thus, enhancing the scope of CHS.

You! You have also served as the Dean of AKU School of Nursing and Midwifery. What do you think are the most important areas of nursing education and nursing as a profession that Pakistan needs to work on?

DRK: There are some important areas such as quality of delivery of curriculum. We have a Higher Education Commission approved delivery of curriculum. However, faculty improvement is an area that could be worked upon. The Covid pandemic created pressure to work around simulation and virtual learning platforms. Another area is working on the regulation of schools of Nursing since there is a mushrooming of nursing schools which are not on a required standard level, hence the need for a regulatory mechanism. Pakistan Nursing Council and Pakistan Nursing Federation are the highest level of nursing structures that need to be strengthened. Moreover, nurses should be given autonomy and leadership roles in their capacities.

You! What has been the most career-defining moment that you are proud of?

DRK: To achieve a PhD in nursing is one of my most career-defining moments. In addition, as an alumna of AKU, being appointed as the Dean of the School of Nursing and Midwifery. Another proud moment was powering through the difficult times of Covid, where we sustained the quality of education amongst our graduates as well as saving precious human lives through Covid preparedness and response.

You! You were inducted as a Fellow of the American Academy of Nursing in 2022 and you were the first Pakistani to receive this honour. How would you describe your experience?

DRK: The experience was extremely distinguished yet humbling. I was not only the first Pakistani, but also the first from the region to receive this honour. It made Pakistan and our national flag prominent amongst the American Academy of Nursing. I did not consider this my personal achievement, but overall success was the recognition and visibility of nursing in Pakistan through AKU.

You! What advice would you share with young nursing students and professionals to cope with the stress of nursing?

DRK: I would like to emphasise peer support and seeking mentorship and assistance from experienced nursing fellows to cultivate an environment of growth. A community of learning and growing together is pivotal in order to flourish in their fields as professionals. Nursing is a science as well as an art. In addition to learning and building through the curriculum, it is imperative to cultivate care and compassion which is central to the nursing profession.

You! What do you find most difficult about managing multiple and diverse professional responsibilities?

DRK: While indulging in multiple diverse professional roles; it is important to identify, sustain and retain competent human resource. That’s what I found to be a constant work at hand, to retain substantial human talent due to brain drain and turnover. Over the years, I have learned to prioritise and manage time, which is not easy. Co-dependency, collaboration, and partnerships are imperative, to build a sustainable model. Setting priorities and working in teams are the best way to go.

You! Being a part of the medical academia, is there anything that you wish to change about the teaching standards in the country?

DRK: Faculty development in health sciences, especially in times of digital enhancement, requires significant development and attention in simulation, technology advancement, and artificial intelligence (AI) in the nursing care profession. Each faculty member should be up to date with the current advancements through continued education and credit requirement.

You! You have worked towards the promotion of education in East Africa, Syria, Afghanistan, and Egypt. What were the highs and lows of your experience in these countries?

You! I would say the important aspect was bringing the advanced education curriculum and national standardisation of the same amongst low-middle-income countries. Furthermore, faculty development was the key to success in nursing curriculum delivery. Additionally, identifying and shaping young talent through structured leadership development programmes in the field so they can take ownership of their professional association in institutions - was an empowering experience. On the contrary, I would signify political instability and conflict situation as a collective low in most of these countries. However, the need for investment in the nursing profession and the recognition of the development of nursing as a part of the health system was emerging.

You! Your position has turned you into a prominent role model for many women. What is the most important advice you would give to women?

DRK: What has helped me is three Ps: persistence, patience, and partnerships. I strongly advise against self-pity. I am a huge advocate of recognising women as extremely resilient. The key is to be confident in all aspects and not shy away from hard work.

You! Do you think the mind-set of our society is changing towards women in the medical, nursing, or healthcare fields?

DRK: Yes, in the past five years, there has been a rapid pace of growth. The reason being the shift from the apprenticeship model to higher education in nursing. This shift has created more educated and competent nurses who have the mobility to work anywhere in the world. Moreover, due to Covid, the economic market and value of nurses has increased immensely - visibility and recognition in society to acknowledge this profession.

You! What does a typical day at work look like for you?

DRK: My typical workday includes teaching, supporting students, providing mentorship to young faculty, research project management, and grant writing. All of this entails intricate technicalities such as networking, working with and managing diverse teams from various global institutions with unique skill sets.

You! How would you describe your philosophy of life?

DRK: My philosophy of life is working with people to transform lives. True happiness lies in the welfare of the community and enhancing the collective quality of life of people around you. I appreciate these blessings in life, the accumulation of small wins!

You! What is your biggest indulgence at home?

DRK: Me time! I certainly appreciate giving due importance to oneself. Moreover, family and friends are my happiest indulgence.

You! What is your most treasured possession?

DRK: My children, my 24-year-old daughter, Maheen and 22-year-old son, Shayan.

You! Where do you see yourself in five years?

DRK: As a public health scientist, we would be able to work with a community cohort where we are engaging families working with us toward prevention of violence and promotion of mental health. I want to see a decline in violence against women and girls as well as adolescent suicides. Moreover, I would like to see feasible community care models for the elderly population. In the next five years, I see the development of the Brain and Mind Institute, not only in Pakistan but also in the region as playing a significant role in defining and sharing evidence-based practice models of mental health care for the populations we serve.