Postal address: Department of Humanities, Mid Sweden University, SE-871 70 Sundsvall
Visiting address: Metropol, Building C, Floor 6, Universitetsallén 32, Sundsvall
Web page: https://www.miun.se/en/university/organisation/departments/humanities-hum

        – Eco-Humanities Hub (ECOHUM) 
        – Religious Studies 

The Department of Humanities is located at Campus Sundsvall. The department conducts research and offers more than 70 different courses in History, Comparative Literature, English, Spanish, Swedish and Religious Studies.

Research at the department connected to South Asia

Eco-Humanities Hub (ECOHUM)

      Web page: www.miun.se/universitetet/organisation/avdelningar/hum/forskning/forskningsprojekt/ecohum
      Contact person: Associate professor Olavi Hemmilä

This unit was launched by the Department of Humanities in the spring of 2014. ECOHUM helps coordinate a new set of linked research projects and educational initiatives through which five subjects in Mid Sweden University’s Department of Humanities – English, History, Comparative Literature, Religion, and Spanish – engage Environmental Humanities study foci.
Dr. Olavi Hemmilä works at ECOHUM since April 2015. Previously, he has been working at in the field of Comparative Literature at the School of Education and Humanities at Dalarna University, Campus Falun, from 1998 till mid-February 2010. In 2010, he was also Visiting Fulbright Hildeman Professor at the University of Washington in Seattle, USA. There, he taught a course entitled ”Sustainability in Contemporary Scandinavian Society”.
While working at Dalarna University, Olavi completed his PhD dissertation work at the Dept of General and Comparative Literature, Stockholm University. He defended his thesis on ”En yogi kommer till stan: Intresset för indisk religion i svensk skönlitteratur med särskild tonvikt på Dan Anderssons författarskap” (A Yogi Comes to Town: Indian religious thinking as reflected in Swedish fiction with special focus on the works of Dan Andersson), on 14 september 2002. In his dissertation Hemmilä presents a basic survey of the interest in Indian religious thinking as it is manifested in Swedish fictional literature over the years, with special emphasis on an analysis of the works of Dan Andersson. It turns out that Andersson wqas strongly influenced by Rabindranath Tagore’s poetry. More information on his thesis and research at Dalarna University.

Dr. Hemmilä has contuinued to focus on Rabindranath Tagore. In 2005, he wrote a booklet on the Indian poet Rabindranath Tagore’s visits to Sweden in 1921 and 1926. It was published at a ceremony in the Rabindra Bhavan museum in Shantiniketan, West Bengal on 7 May 2005. This was in connection with reinstatement of the the Nobel literature prize medal awarded to Tagore in 1913. The original medal was stolen in March 2004, but the Swedish Nobel Foundation in an totally unprecedented manner decided to present the Indian government two replicas of the stolen medal (in gold and bronze). Olavi Hemmilä was himself present at the reinstatement ceremony. More information.

Religious Studies

        Web page: https://www.miun.se/utbildning/kurser/sprak-litteratur-historia-och-religion/religionsvetenskap
        Contact person: Associate Professor Anna-Pya Sjödin, phone: +46 (0)10 142 81 28

Anna-Pya Sjödin has joined Mid-Sweden University in 2015. Previously, she was working as a research fellow at School of Culture and Communication, Södertörns högskola (Södertörn University). 
She defended her PhD in Indology at Uppsala University in 2007, and is still connected to the Department of Linguistics and Philology, Uppsala University, as well. More information about her dissertation, her post-doc research project, and publication activities.
Sjödin’s research is centered in the understandings and conceptualizations of knowledge and cognition, especially intrasubjective cognition, within the commentarial tradition of Vaiśeṣika- sūtra. She has been involved in a research project entitled “The little girl who knew her brother would be coming home: knowledge and cognition in Nyāya-Vaiśeṣika”.She furthermore works on the position of Indian philosophy within European academic philosophy.
Anna-Pya Sjödin also teaches courses on Buddhism, Materialism and Hinduism. In 2009 and 2010, a 15 ECTS course in History of Indian Philosophy was running. It was the first of its kind in Sweden. It focused on the Buddhist, Hindu, Materialist, and Sceptical traditions that have existed in India for a long time, starting with Vedic metaphysical speculations 3,500 years ago, and ended up with today’s postcolonial theories. The course ws aimed at students within the humanities, mainly Philosophy, Science of Religion, and from History of Ideas. More information.

At Mid-Sweden University a 7.5 ECTS web based course entitled ”Den blå guden: Religion och kultur i Indien, was run during the summer 2015. More information.

Postal address: Enheten för Natur, miljö och samhälle, Lärarutbildningen, Malmö högskola, SE-205 06 Malmö, Sweden
Visiting address: Nordenskiöldsgatan 10 (Orkanen-huset)
Web page: http://www.mah.se/

Contact person: Lecturer Inge-Marie Svensson, +46 (0)40 665 8010. Personal web page.

Field studies in India

Since 1993 an optional 15 ECTS credits course, ”Möte med U-land” (Encounter a developing country), has been offered for  teachers training students at Malmö University. The course focuses on India and is open for all fifth semester students, whether they are specialising in teaching younger pupils, older pupils or in the fields of Science, Social Science or Language.
The students, normally 18 each year but only 9 last year (2011), spend three weeks in the south Indian states of Tamil Nadu and Kerala, where they do field studies according to individual choice. They are assisted by local interpreters. After the course, the students write reports.
For many years, Inge-Marie Svensson has been in charge of the course, in recent years in collaboration with Anette Zeidler at the same department. 
Due to the fact that the course is only 3 weeks and therefore does not fit inte the new university curriculum, the course planned for September 2012 may be the last one. Efforts are however made to save the programme in one or another form. More information on the course. 

Inge-Marie Svensson is also involved in another course entitled ”Teaching for Sustainability”, a course that usually attracts a number of Indian students. Kerstin Sonesson is responsible for this programme.
Besides, Kerstin Sonesson is also involved in the Regional Centre of Expertise on Education for Sustainable Development Skane, one of the approximately 100 centres worldwide that together constitute the United Nations University – Institute of Advanced Studies (UNU-IAS) network of research and training centres. UNU-IAS conducts research, postgraduate education and capacity development, both in-house and in cooperation with an interactive network of academic institutions and international organizations. More information. 
RCE Skane is focused on making Skåne a leading example in Sweden of the power of education for sustainable development, where people of all ages are given the knowledge and tools they need to assume responsibility for creating a better tomorrow and a sustainable future. The main partners in the RCE, which include representatives from Lund City, Lund University, Malmö City, Malmö University and the region of Skane, work closely with individual citizens, businesses, public institutions, education institutions and other organizations to encourage sustainable development in the region through education. More information on RCE Skane. 

Research projects connected to South Asia:

Professor Margareta Ekborg defended a doctoral dissertation called ”Naturvetenskaplig utbildning för hållbar utveckling?” in 2003, and is now involved in a Sida funded research project on the interaction between knowledge and values in the opinion moulding on gene technology, in particular genetic manipulation of crops. In August 2005 she was given SEK 55 000 as a SASNET grant for an educational programme entitled ”Development of Biotechnological Education Programs and Information Packages in Nepal” This project was carried out in collaboration with Professor Olof Olsson and Dr. Gokarna Gharti Chhetri at the Department of Cell and Molecular Biology, Göteborg University. The partners in Nepal were:
• Dr. Binayak Rajbhandary, Executive Chairperson of the Himalayan College of Agricultural Sciences & Technology (HICAST).
• Tilak Shrestha, Associate Professor, Khwopa College in Bhaktapur, affiliated to Tribhuvan University.
• Bhola Man Singh Basnet, Head Communication, Publication & Documentation Division, National Agricultural Research Institute (NARI), Lalitpur.
Project abstract: During a SIDA supported project to develop more stress tolerant and nutritious rice cultivars for Nepal the researchers had identified a need to develop education and information packages to train existing Nepalese collaborators in biotechnology, to recruit and educate new workers and to inform the public in Nepal about their activities. With this planning grant the aim was to gain insight in the educational infrastructure in Nepal and establish collaboration with appropriate responsible Nepalese university teachers and their students. The researchers also wanted to build up a direct collaboration with the NARI press centre and make personal contacts with chosen representatives from the media.

Previous South Asia oriented research at the department

Professor Emeritus Lars Henrik Ekstrand worked as a University Lecturer at the Malmö School of
Education 1966–1990 (at that time an administrative part of Lund University), and became full Professor in 1992, and acted as such until he retired in 1996 (two years before the School of Teacher Education became part of Malmö University, from 1 July 1998). He defended his PhD thesis in International Education at the University of Stockholm in 1978. A thesis on ”Bilingual and Bicultural Adaptation”.
Lars Henrik Ekstrand was introduced to India during the Cross-Cultural Psychology conference held in Bhubaneswar, Orissa, in January 1980 where he presented a couple of papers. After the conference, he and his then wife Gudrun Ekstrand were invited by the legendary Prof. Radanath Rath to stay on for some time. Having noted that children seem to be treated very differently in different cultures, a cooperative project was initiated. This lasted several years with repeated data collection in various parts of Sweden and Orissa, and also in New Delhi.
This project yielded a number of monographs and international journal articles, as well as a doctoral dissertation by Gudrun Ekstrand on differences between Sweden and Orissa on child rearing and attitudes. She defended the thesis, called ”Kulturens barn – kontrastiva analyser av kulturmönster avseende förhållandet till barn och ungdom i Sverige och Orissa, Indien”, in 1990. More information on the dissertation.

From 1989 onwards Lars Henrik Ekstrand has devoted more and more time to development projects. It started when Dr. Eugene Ries, Director of the Community Development Service at the Lutheran World Foundation in Geneva asked him to perform an informal evaluation of the organisation’s development projects in northern Orissa, the Burdwan area in West Bengal, and in Kolkata city. This made him admire participatory activities with villagers taking part in every step of the decision process.
Later on from 1990 to 1992 he worked full-time as Coordinator for the Sida-supported Social Forestry Project in Orissa, being stationed in Bhubaneswar. The project, led by Mr. M. F. Ahmed (later becoming Inspector General for Forests in India), conducted plantations in somewhere between 5,000 and 7,000 villages all over Orissa. SIDA later on interrupted this project prematurely.

In 1989 Lars Henrik Ekstrand initiated the formation of an Educational Development Association, EDA (U-landspedagogiska Föreningen) at the Malmo School of Education. For several years, this association conducted a large number of activities, including information, research exchange and cooperation with a number of NGOs in Orissa. It also sponsored support to destitute children. Furthermore groups of teachers and students from the Malmo School of Education started to travel to India on a yearly basis. Many students went for field work in Orissa with Minor Field Studies programme grants. Indian groups of students and teachers visited Sweden in a reciprocal way.
Over the years, EDA had intimate connections with the NGO Bana Basi Seva Samiti (Forest Dwellers’ Organisation), in Phulbani district in the interior of Orissa. It is an NGO operating over a wide area in a tribal belt (more than 60 p.c. tribals), badly hit by severe malnourishment, high IMR and MMR, malaria and other epidemic diseases, alarming school drop-out, and high adult illiteracy. It was founded in 1972 by freedom fighter and Gandhian Biswanath Patnaik. The Lutheran World Service, India, provided with geological and water-drilling expertise for this cooperative water resource project between EDA and BBSS, that to a large extent was funded by Sida. The project was implemented between 1994 and 1998.

After his retirement in 1996 Lars Henrik Ekstrand has spent considerable time in Orissa with his new wife Rita Ray, Professor of Sociology at Utkal University in Bhubaneshwar. Prof. Ray is doing socio-economic research on Resettlement and Rehabilitation for various development projects, to which L H Ekstrand also contributes. In 2001 they published a joint study on ”Chaos and Complexity Theory in Development” in the International Journal of Sustainable Development and World Ecology. Presently he is finalising a major world-wide quantitative study on corruption. In September 2005 Lars Henrik Ekstrand presented a paper called ”Socio-cultural factors affecting corruption and what to do. A study of psychological and other non-economic macro-variables affecting corruption” at the 5th regional anti-corruption conference, held in Beijing, People’s Republic of China (a conference under the auspices of ADB/OECD Anti-Corruption Initiative for Asia and the Pacific). Read the full paper (as a pdf-file).
In December 2005 SASNET’s Lars Eklund visited Lars henrik Ekstrand and Rita Ray in Bhubaneshwar. Read his report.

Postal address: Akademin för ekonomi samhälle och teknik, Box 883, SE-721 23 Västerås, Sweden
Visiting addresses: Högskoleplan, Västerås
Web page: http://www.mdh.se/est?l=en_UK

Contact person: Dr. Fredrik Wallin, Senior Lecturer in Energy Engineering, and Head of Internationalisation at the School of Business, Society and Engineering, phone: +46 (0)21 10 31 90. 

Mälardalen University (MDH) has over 13,000 students studying one of our approximately 65 programmes and about 1,000 courses. The University participates in several national research schools and conducts graduate studies within the technological branch of scholarship. The School of Business, Society and Engineering hosts education and research within a wide range of fields: from business administration, economics and political science, to energy, building and environmental engineering. Within the school, there are two research specialisations, Industrial Economics and Organisation; and a Future Energy Center.

South Asia related activities

During the recent years, the MDH has participated in a Erasmus Mundus project including Indian Institute of Technology Bombay (IITB) as one of the partners. More information about the Erasmus Mundus programme established in 2008.
The collaboration includes several of the schools in the university and their education programmes and research fields.

As a result of this, the School of Business, Society and Engineering submitted an application for initial grants from the Swedish International Programme Office for Education and Training in its thirteenth round of Linnaeus Palme Exchange Programme grants.
The application was approved in March 2013 (project period 1 July 2013 – 30 June 2014, and initial grant of 80,000 SEK), and together with the Department of Energy Sciences and Engineering at IITB the work on establishing increased knowledge-base for an enhanced collaboration between the organisations could start. The goal is to establish good conditions for long-term exchange activities for both teachers and students. The work is in the first phase focused on the energy engineering area, but with the intention to include several other areas/subjects as well. The initial grant project will be finalised with an application of starting teacher and student exchange within the framework of Linnaeus-Palme. The Swedish coordinator for the initial grant project is Fredrik Wallin, and the contact person at IITB is Professor Rangan Banerjee.
The project has received continued funding for 2015-16 with SEK 227 0712. More information about South Asia related Linnaeus Palme programme grants for 2015-16. 

Besides the IITB initiative the school supports a university wide collaboration with Prin. L N Welingkar Institute of Mangement Development and Research(WeSchool), based in Mumbai and Bengaluru. The collaboration is hosted by the School of Innovation, Design and Engineering at MDH.

As a result of the recent activities in India the University co-hosted and supported an Inspirational Symposium on Energy Innovation (more information about the symposium), as well as an innovation platform Workshop on Innovations Accelerators together with WeSchool (more information about the workshop); the Swedish Energy Agency; Business Sweden; the Consulate General of Sweden; and the Confederation of Indian Industries (CII), among others. These initiatives have resulted in Indian students now assisting 11 Swedish clean tech companies in their ambition to enter the Indian market. Both events took place at WeSchool, Mumbai in April 2014.

Previous research:

Professor Emeritus Peter Söderbaum used to work on Ecological Economics. During the 1990s he was responsible for the establishment of an Ecological economics undergraduate programme. This was the first Ecological Economics programme in Sweden where a large part of the courses in economics, business and environment, ecology etc. were designed specifically for the programme. Later the programme was called ‘Economics for sustainable Development’. He also published a large number of books in his research fields. More information on his personal web page.
He collaborated with Rajeswari S. Raina from the National Institute of Science, Technology and Development Studies in New Delhi. During a period, Dr. Raina worked as a guest scholar at Mälardalen University.
Before joining MDH, Peter Söderbaum was employed at the Departments of Economics, Uppsala University and Swedish University of Agricultural Sciences (SLU), Uppsala. He stayed for 20 years at SLU before coming to Mälardalen University in 1994.

Postal address: Box 883, Mälardalen University, SE-72123 Västerås
Visiting address: Högskoleplan 1, Västerås
Web page: http://www.mdh.se/idt/

Contact person: Prof. Sasikumar Punnekkat, phone: +46 (0)21 107324.
In early 2015, Dr Sasikumar Punnekkat, who has been the professor of Dependable Software Engineering since 2007 was appointed as the Director of the prestigious Birla Insitute of Technology & Science in Goa, India. Earlier, he had acquired valuable research and development experience as a scientist at the Indian Space Research Organization (1984-2004). He takes charge from K E Raman who had over 37 years of experience at BITS Pilani in various capacities. Read more.

The School of Innovation, Design and Engineering covers a large research field covering theatre, innovation, entrepreneurship, information design as well as product- and process development, network technology, aeronautical engineering, computer science and electronics.

South Asia related activities at the department

Prof. Sasikumar Punnekkat does research in Software Engineering and Real-time systems. He has been involved in collaborations with Swedish companies such as Ericsson and ABB, and also IT companies in India such as Tata Consultancy Services. During the period 1984–2004 he worked as Scientist Engineer in the Indian Space Research Organisation.
In December 2008, he participated in the Workshop on ‘Sustainable City – Systems and Technologies for Sustainable Development‘ in Kochi, India, organised by INSTEC (Sweden) & CUSAT (India). More information about the conference.
Prof. Punnekkat and Dr. Abdulkadir Sajeev (based at University of New England, Australia, but during 2009 a visiting professor at MDH) presented a paper titled ”Virtual Cities and Sustainable Development”. 

A top-talent program in Software Engineering for Indian students with scholarships was introduced at the School of Innovation, Design and Engineering in the Fall 2008.
In 2008, Mälardalen University was also able to become the coordinator of one of the European Commission funded so-called Erasmus Mundus External Cooperation Window (EMECW) programmes, lot no 12. The project coordinator is Prof. Sasikumar Punnekat. EMECW lot 12 is a university consortium consisting of 16 universities, nine in Europe and seven in South Asia – out of which 4 are in India, and 1 each in Nepal, Pakistan and Sri Lanka. The programme has been given the name EURECA ( European Research and Collaboration Project with Asia), and it will have a mobility flow of 320 fully funded students, researchers and academic staff per year. Uppsala University is a second Swedish member of the consortium.
The lot managed to get a changed geographical focus compared to what was stated in the original announcement, excluding Afghanistan and Bhutan.
The South Asian universities within the consortium are Amrita Vishwa Vidyapeetham University in Coimbatore; Indian Institute of Information Technology and Management Kerala (IIITM-K) in Thiruvananthapuram; Indian Institute of Technology (IIT) in Kanpur; XLRI School of Business & Human Resources in Jamshedpur; Institute of Engineering at Tribhuvan University in Kathmandu, Nepal; Lahore University of Management Sciences (LUMS), Pakistan; and University of Colombo, Sri Lanka. More information about the EURECA project.
In June 2009, it was announced that the consortium led by Mälardalen University will not get continued funding for the coming period, but the mobility that has already started is in full swing.
More information about the EMECW programmes.

Linnaeus Palme collaboration programmes

The School of Innovation, Design and Engineering has a comprehensive collaboration with Welingkar Institute of Management Development and Research in Mumbai and Bangalore, India. The overall purpose is to broaden and deepen a common understanding and knowledge in Innovation, Design & Management in the Global Economy from a Swedish as well as from an Indian perspective.

Welingkar Institut is among the “Top 5” business schools (of 1800) in India, doing pioneering work as a frontrunner in the field of contemporary and futuristic management education on master level, with an integrated concept of design & innovation thinking. Mälardalen University (MDH) is a leading academy imparting education and research in the field of innovation, design and engineering. The School of Innovation, Design and Engineering has a unique multi-disciplinary approach to produce entrepreneurs, designers and engineers on undergraduate, graduate and doctoral level.
In 2007 an Agreement of Collaboration of academic exchange of students and faculty members between the two institutions was signed, in executive education and in development of a learning organization with focus on building an innovation culture. Cooperation has been frequent since November 2006. Welingkar Institute also runs a course on Masters level in Creativity & Innovation Management in cooperation with Mälardalen University and Munktell Science Park.

A Linnaeus-Palme International Exchange Programme was started in 2008. More information about the Linnaeus Palme programme, administered by the International Programme Office for Education and Training but financed by Sida. The collaboration with Welingkar and the Linnaeus Palme collaboration programme is administered by Dr. Sten Ekman and Dr. Annalill Ekman at the School of Innovation, Design and Engineering, and by Professor Anuja Agarwal at Welingkar Institute of Management Development and Research.
The Linnaeus Palme collaboration project with Wellingkar Institute of Management received continued funding for the period 2009-10, 2011-12, and for 2014-15 the project was granted SEK 696 232. 

In 2014, the department also received initial funding, SEK 80 000, for a new Linnaeus Palme project with the International Institute of Information Technology in Bangalore (IIITB), India. The contact person is Profesor Sassikumar Punnekat.  More information about the South Asia related Linnaeus Palme projects for 2014-15.

In March 2015, the department received SEK 80 000 as initial funding for a new Linnaeus Palme project with the Birla Insitute of Technology & Science in Pilani, India. More information about South Asia related Linnaeus Palme programme grants for 2015-16. 

International workshops

Postal address: Akademin för utbildning, kultur och kommunikation, Mälardalens Högskola, Box 883, SE-721 23 Västerås, Sweden
Visiting address: Högskoleplan 2, Gåsmyrevreten, Västerås
Web page: http://www.mdh.se/ukk

Research and other activities connected to South Asia:

Professor Emeritus Anders Törnvall retired from Mälardalen University in 2006 (and settled in Linköping). He was Professor of Intercultural Communication at Mälardalen University, but was also connected with the Dept of Management and Economics at Linköping University. He was engaged in research on Asia, mostly Japan and China. At Mälardalen University he was in charge of several courses on Asia and Asia related issues in the last years, and he was also involved with SWETECH, Swedish Technology in Foreign Countries, a supplementary postgraduate programme for MSc students interested in international marketing as well as for engineers actively working in Swedish International companies.
Prof. Törnvall was also busy networking, promoting the establishment of a Center for Asian European Studies and Research – CAESAR – a collaborative project between the Dept of Humanities at Mälardalen University, the Dept of Management and Economics at Linköping University, the Dept for International Business, School of Economics and Commercial Law, Göteborg University, and the Center for Pacific Asia Studies (CPAS) at Stockholm University.
South Asia was part of the perspective in Törnvall’s research on “Religions in Asia and its consequenses for human rights and the development of democracy in Asia”. He presented a paper on this subject at the International Conference of Asian Scholars in Berlin, Germany in August 2002, in which he compared the development in a number of different Asian countries; India, Thailand, Bangladesh, the Philippines, Taiwan, China and South Korea. Anders Törnvall also did research on Asian business culture, and women’s situation in Asia. In 2002 he organized a series of seminars at Mälardalen University in Västerås on Internationalization and business cultures in different countries of Asia.

Dr. Diane Pecorari worked as a Senior Lecturer and Coordinator of English at the School of Education, Culture and Communication. She has now (2012) left her position at Mälardalen University.
In August 2008, Diane Pecorari received a SASNET guest lecturer grant to invite Dr. Ashis Sengupta (photo to the right) from the University of North Bengal in India to give a number of guest lectures at Mälardalen University in March 2009. The invitation was extended to include guest lectures also at the Dept. of Humanities, Växjö University, and at the School of Arts and Languages, Högskolan Dalarna.
At Mälardalen University, he gave two guest lectures based on his research in Indian drama, both on Thursday 26 March. In the morning, from 10.15–11.45 he lectured about ”Contemporary Indian Drama”. In this talk he presented a view of Indian drama that is inextricably connected with various performing art forms practiced in India almost as a way of life down the ages. Venue: Milos hall.
In the second lecture, also on 26 March, 15.15–16.45, he lectured about ”Gender and Sexuality in Contemporary Indian English Drama”, where he discusses four plays under the headlines “Body Blows,” “Women and the Inquisition, ”Gender Trouble” and “Destabilizing Sexual Identity”. By using these concepts he wanted to show how contemporary Indian drama, written in/translated into English, addresses the issues of gender and sexuality from multiple perspectives. Venue: Room T3-065 (Västerås). More information.

– Research projects related to South Asia
– South Asia related educational programmes
– Linnaeus Palme International Exchange programmes
– Hans Rosling/Gapminder
– SASNET conference on The role of South Asia in the internationalisation of higher education in Sweden
– Partner driven Swedish-Asian collaboration project on Evidence for policy and implementation 

Postal address: Karolinska Institutet, Department of Public Health Sciences, Division of Global Health (IHCAR),
SE-171 77 Stockholm, Sweden
Visiting address: Nobels väg 9, Solna Campus
Web page: http://ki.se/ki/jsp/polopoly.jsp?d=12350&l=en

Contact persons: Professor Vinod Diwan, phone: +46 (0)8 524 833 86
                            Professor Cecilia Stålsby Lundborg, phone: + 46 (0)8 524 83366

The history of 60 years of KI research
collaboration with Pakistan and India

Bo Lindblad report on collaboration between KI and Aga Khan University

The research at the Division of International Health focuses on health problems that are big in the world but small or non-existent in Sweden. Many know the division by its earlier acronym, IHCAR. It is part of the Department of Public Health Sciences. Since the start in 1984 it has developed extensive research in several fields within international health.
This multidisciplinary division pursues research and education in collaboration with researchers in Europe, North and South America, Asia and Africa. Through the experience of collaboration with global partners and stakeholders, the division aims at being a resource centre at the Karolinska Institutet, recognized for its comprehension of global health issues. Extensive collaboration exists within Karolinska Institutet and the division is an active stakeholder in the Karolinska International Research and Training (KIRT) Program and the Centre for Global Health (KICGH).
IHCAR has practiced the successful sandwich PhD system for many years, that has resulted in a large number of theses by PhD candidates from among other third world countries, India, Pakistan and Bangladesh.

A seven-member delegation from the international and private Aga Khan University’s (AKU) campuses in Karachi , Pakistan and Nairobi, Kenya visited Sweden on 9–11 June 2011. They came to visit Uppsala University’s Department of Women’s and Children’s Health, hosted by Prof. Lars-Åke Persson, on June 9th, and the Department of Public Health at the Global Health Unit, Karolinska Institutet in Stockholm, hosted by Prof. Bo Lindblad and Prof. Vinod Diwan (who is chairman of the Karolinska International Research and Research Training Committee, KIRT), on June 10th.
Photo of Vinod Diwan and Bo Lindblad.
The visits are part of planning for a new Centre of Excellence in Neonatal-Maternal-Child Health (NMCH) at AKU. The delegation wants to learn how KI and Uppsala University have organized the continuum of Reproductive Health and MCH programs from the academic point of view. They also like to discuss how current collaboration should proceed; initiatives are planned to be extended to both South Asia (Pakistan, Afghanistan, Tajikistan) and East Africa (Kenya).
Aga Khan University has had an official research and research training program with KI since 19 years (more information). Nine of the faculty at AKU Karachi currently have PhDs from KI, all have returned to Karachi and three of them hold interim chairs.
The Pakistani delegation was headed by Mr. Allaudin Merali, Vice President, Health and Operational Services, responsible for AKU’s operational functions across all locations, including: AKU Hospital in Karachi and affiliated health services in Pakistan and Afghanistan. Among the participants are also Prof. Zulfiqar A. Bhutta, Noordin Noormahomed Sheriff Professor and Founding Chair of the Division of Women and Child Health at AKU in Karachi. Prof Bhutta was a member of SASNET’s South Asian reference group till 2008.

The division has seven research groups addressing the major health and health system problems in low and middle income countries.

– Medicines and health system with focus on antibiotics
– Epidemiology and health systems research
– Health systems and policy research
– HIV/AIDS and Global Health (no South Asia related research)
– Injuries’ Social Aetiology and Consequences
– Sexual and Reproductive Health and Rights
– Adolescent Sexual and Reproductive Health

The focus is on public health, health system and policy, clinical and translational research. Main public health problems that are addressed are: HIV and AIDS, tuberculosis, malaria, diarrhoea, pneumonia, sexual and reproductive health, adolescents’ health and development, child health, use of pharmaceuticals, consequences and causes of intentional and unintentional injuries and the Know-Do-Gap.

Educational Programmes

The division has well developed education programmes in Global Health at undergraduate, magister and doctoral level. A research school in Global Health is organised together with Umeå University. More information below.
IHCAR currently plans to introduce a virtual Centre for Global Health at KI, involving reearchers from different departments.
In addition, the division collaborates closely with Gapminder foundation for developing evidence based information. More information below.

Research projects related to South Asia

Projects by Professor Emeritus Bo Lindblad

Prof. Bo Lindblad has extensive experiences from a long career in clinical paediatrics and international health. At present he is Professor Emeritus of International Child Health, IHCAR, Karolinska Institutet, and Professor Emeritus of Paediatrics at Aga Khan University, Karachi, Pakistan. Every year, he spends a few months teaching in Karachi.
He has also held professor positions in paediatrics at the King Saud University, Riyadh, at the United Emirates University, Al Ain and also been professor and chariman in paediatrics at the Aga Khan University, Karachi. His main research interest is the impact of prenatal micronutrient nutrition on the metabolism of sulphur containing amino acids and fetal growth and development. On-going projects are supported by SASNET and Sida/SAREC in collaboration with Health Service Academy, Islamabad and Aga Khan University, Karachi, Pakistan.
During the period 2001–2006, Bo Lindblad was a member of SASNET’s board.

Research projects during recent years:

• Research programme in the field of B-vitamin Supplementation to Women, with a completely new hypothesis.
The project has been carried out in collaboration between Campus Karolinska Institutet, Stockholm; Danderyd Hospital; Astrid Lindgren’s Children’s Hospital, Stockholm; Aga Khan University, Karachi; King Edward Medical College, Lahore; a genetic lab in Islamabad; and Trivandrum Medical College, Kerala, India.
The differences in women’s health in Sind, Punjab and Kerala are an important basis for broad village based socio-medical study of this kind. Bo Lindblad was given a SASNET Planning grant for this programme in August 2001.
In November 2002 the project called ”Evaluation of the relationship of folate and B12 deficiency during pregnancy on pregnancy outcomes, intrauterine growth retardation and newborn vascular reactivity in Pakistan” was granted 600 000 SEK from the Swedish Research Links (Asian–Swedish research partnership programme) for three years (2003-05) by Sida and the Swedish Research Council. The researcher Helena Martin is involved on the project along with Professor Zulfiqar Bhutta, Dept. of Paediatrics, Aga Khan University, Karachi, Pakistan.
Bo Lindblad is now involved in a similar project with Professor Shakila Zaman, Dept. of Preventive Paediatrics, Fatima Jinnah Women’s University in Lahore, and Dr V.K. Mahadik, RD Gardi Medical College, Ujjain, India.

Prof. Lindblad’s research on how folate/B12 deficiency among South Asian women may lead to vascular endothelial dysfunction has received wide international recognition with rising citation rates. In 2005 a research paper based on a study in Lahore supported by a SASNET planning grant was being published in the peer reviewed magazine Acta Obstetricia et Gynecologica Scandinavica (2005:84:1055-1061). It was based on research by Bo Lindblad (photo), Professor Emeritus of International Child Health, Division of Global Health (IHCAR), Karolinska Institutet (KI), Stockholm; Dr Shakila Zaman, Dept. of Social and Preventive Peaditrics, King Edward Medical College, Lahore, Pakistan; and a number of other KI researchers (Helena Martin, Anna Mia Ekström, Arne Holmgren and Mikael Norman). The paper, entitled ”Folate, vitamin B12, and homocysteine levels in South Asian women with growth retarded fetuses” shows how in intraurerine growth, retardation folate levels were half that in cord blood and mothers as compared to local controls.
Two years later, a second paper on the same issue, again written by Bo Lindblad, Helena Martin, and Mikael Norman, was published in Pediatrics (2007:119: 1152-58). In the paper, entitled ”Endothelial function in Newborn Infants”, the researchers for the first time convincingly show the correlation of folate levels to vascular endothelial dysfunction (still there at 9 years of age being a known condition leading to arteriosclerosis, hypertension and stroke).
Recently, Prof. Lindblad’s hypothesis of folate/B12 deficiency in the pathogenesis of preeclampsia has also been supported by four new papers focusing on folate supplementation to pregnant women in Canada and the USA. Obviously being at the research front, Prof. Lidblad and his colleagues are now discussing how to proceed with research for supplementation in India and Pakistan. There is a need for both basic science, biochemical and genetics, as well as controlled supplementation studies in developing regions with known folate and B12 deficiency.

• A project aiming at involving and supporting younger postgraduates in Sweden, Pakistan and India.The collaboration has been going on between IHCAR at KI (in the fields of obstetrics, pediatics and midwifery), the Stockholm University (Depts of Social anthropology and Economics) and the Nordic School of Public Health(Epidemiology) in Göteborg, AKU (Obstetrics, Pediatrics and Community health) in Pakistan, Christian Medical College and Hospital, Vellore in India (Obstetrics) and The Population Council, UN, New York (Community based studies in South Asia). The focus has been on Pregnancy Related Morbidity and Mortality, a major medical and economic problem in the region.

In August 2003 Bo Lindblad was awarded 90 000 SEK as a SASNET planning grant for a research programme on ”Pregnancy and Infancy in South Asia (PISA)”. See the full list of SASNET planning grants, August 2003.
In August 2006, Prof. Bo Lindblad received SEK 150 000 as another SASNET planning grant for organising an interdisciplinary workshop on ”Micronutrient Supplementation to Pregnant Women in South Asia, as part of the research programme.” See the full list of SASNET planning grants 2006.
A symposium was held in Bangalore, India, 7–8 September 2006, with participants from St John’s Research Institute (part of St. John’s National Academy of Health Sciences) in Bangalore, headed by Prof. Anura Kurpad; two community health researchers from Pune; Prof. Staffan Bergström, and Prof. Bo Lindblad from Karolinska Institutet; and Associate Professor Mikael Norman from the Department of Neonatology, Karolinska University Hospital, Huddinge. From a Swedish viewpoint, the seminar was successful. Besides discussions with representatives from the Indian research institutions, Bo Lindblad and Mikael Norman were given the opportunity to lecture for the Indian Neonatal Society, about their research on Micronutrient Supplementation to Pregnant Women. Prof. Bergström discussed the extremely high mortality rate for pregnant women in India, and an agreement was made about joint research efforts by St John’s Medical College (also part of St.John’s National Academy of Health Sciences) and Karolinska Institutet.
Later, Prof. Lindblad has established a close collaboration between IHCAR and St. Johns.

Research Group on Medicines and health system with focus on antibiotics

• Professor Cecilia Stålsby Lundborg (photo to the right) is Professor of International Health at Karolinska Institutet, visiting professor at R.D. Gardi Medical College, Ujjain India, and visiting faculty at Tata Institute of Social Science (TISS) in Mumbai, India. Her research interest includes all aspects of antibiotic use and ways to improve it and relations between antibiotic use and resistance.
Current projects include e.g. studies in India on antibiotic use and resistance in children and adults and environmental aspects of antibiotic use, studies in Vietnam on antibiotic use and resistance in children and intervention studies to improve antibiotic use in child infections and in reproductive tract infections in women and studies on farmers’ use of antibiotics Sudan. She is a member of the international secretariat of ReAct action on antibiotic resistance and the steering committee of Strama, the Swedish Strategic Programme for Rational use of Antibiotics and Surveillance of Resistance. Since January 2007, she is also deputy chairperson of SASNET, and the coordinator at KI of one of the Erasmus Mundus External Cooperation Window Lot 13 programmes for India, and scientific coordinator at KI for public health collaboration with India. Besides, she is a member of SASNET’s board during the period 2007– September 2010.
She is working on several South Asia related research projects.
In June 2006, she received SEK 1.4 million for a project titled ”HIV and STI infections among Female Sex Workers in Lahore, Pakistan – prevalence, resistance, knowledge and attitudes – a health systems perspective” from the the Sida programme Support to HIV/AIDS research. More information.
Project abstract: The aim is to establish a network between three institutions of Sweden and Pakistan, IHCAR, CONTECH International Health Consultants in Lahore, and Fatima Jinnah Medical College, also in Lahore, Pakistan. The latter is a medical school for women. A study will be done to assess the prevalence of sexually transmitted infections (STIs) among female sex workers of Lahore, Pakistan. Respondent Driven Sampling will be adopted to select female sex workers for interview. The study will help to assess the magnitude of sexually transmitted infection as well as to develop a health communication program for female sex workers. The study will serve as a basis for future studies like measuring the antibiotic resistance while using the syndromic management of STIs, assessing the knowledge, attitude and practices of health care providers and policy analysis of STIs. All of this together would result in a major policy dialogue. In the subsequent studies, another institution i.e. Örebro University Hospital, Department of Microbiology will also join the network.

Prof. Stålsby Lundborg’s research group is also engaged in a project titled ”Antibiotics as environment pollutants and resistance in waters in rural India – relation to antibiotic management”. It is carried out in collaboration with R.D. Gardi Medical College in India. The project was given SEK 1 425 000 as a three-years project grant (2007–09) from the the Swedish Research Council in November 2006. The project also received SEK 600 000 as an additional three-years grant as Swedish Research Links Programme in October 2006.
It deals with the fact that antibiotic resistance is an emerging global public health threat. Morbidity and mortality are substantial especially for poor women and children. Little research has been done in relation to the public health problem of antibiotics in waters and its implications for resistance. The overall purpose is to assess environmental aspects and public health consequences of antibiotic management in rural India. Long-term aim is to disseminate findings in collaboration with policymakers to improve antibiotic use and antibiotic waste management in order to contain resistance and maintain the possibility to treat infections in need of antibiotics. More information about the project.

On 21 October 2009, Prof. Stålsby Lundborg received SEK 2 250 000 as a three-years project grant (2010–10) from the Swedish Research Council, for a continuation of the above-mentioned project on antibiotics resistance. The project is now called ”Antibiotic pollutants in waters and resistance in rural India – Interventions to improve antibiotic resistance management”. More information.
In October 2010, she was then awarded a major grant from Sida/SAREC’s Developing Country Research Council, this time SEK 2.7 m for a comparative research project over three years (2011-13). The project is entitled ”Antibiotic resistance a global challenge – contextualized interventions to improve infection control and antibiotic management in Vietnam and India”. More information. 

• Mohsin Saeed Khan from Islamabad defended his doctoral dissertation entitled ”Poverty of Opportunity for Women Selling Sex in Lahore, Pakistan: Knowledge, Experiences and Magnitude of HIV and STIs” on Wednesday 15 June 2011. The faculty opponent was Prof. Eric Sandström, KI. The main aim with the thesis is to estimate the magnitude and severity of HIV / STIs among women selling sex along with their health seeking behaviour and the level of preparedness of the health system for management of HIV/STIs. He has been supervised by Cecilia Stålsby Lundborg.
Mr. Khan has 17 years of public health experience working for Government of Pakistan and multilateral, bilateral and international NGOs including World Bank, UNFPA, UNHCR, UNICEF, CIDA, DFID, GTZ, EC, British Council and National AIDS Control Program as a Health Systems Specialist.
Venue: Rockefeller, KI, Nobels väg 11, Solna.
More information, with link to full-text thesis.
Results from the studies were presented with a poster presentation at the conference on current Swedish development research, organised in Uppsala 27–29 May 2008. The conference, “Meeting Global Challenges in Research Cooperation”, was organised on behalf of the Swedish International Development Cooperation Agency (Sida) by the Centre for Sustainable Development in Uppsala.
During 2009, Mr. Saeed Khan was a member of SASNET’s South Asian Reference Group. More information.
As such, he participated in the SASNET funded conference on ”Women and Migration in South Asia – Health and Social Consequences”, held in Colombo, Sri Lanka in February 2009. More information.
On Tuesday 24 November 2009, while being in Sweden working on his doctoral thesis, Mr. Khan visited the SASNET root node office in Lund, along with another member in the South Asian Reference Group, Prof. Kumudu Wijewardena. The purpose was to have informal discussions with Anna Lindberg and Lars Eklund about the future direction of SASNET from 2010. More information.

• Dr. Farzeen Tanwir defended her doctoral dissertation, entitled ”Absence of toothache syndrome. Oral health and Treatment needs among urban Pakistanis”, at KI’s Department of Periodontology, Institute of Odontology in 2008. Her post doc research at IHCAR focuses on pattern of antibiotic prescribing for oral care. Further, she also analyses the perceptions and treatment seeking behavior regarding management of oral diseases in a poor area and investigate antibiotic prescribing practices of dentists. Dr. Tanwir is also Director of Post graduate Studies and Research, and Assistant Professor at the In-charge Department of Periodontology, Ziauddin University, Karachi, Pakistan.

• Dr. Megha Sharma is another post-doc researcher within the research group on Medicines and health system with focus on antibiotics. She has done Masters and PhD in Drugs and Pharmaceutical Chemistry from India. Megha is working on antibiotic use in hospitals. She is the research coordinator of a project ”Antibiotic pollutants in waters and resistance in rural India – implications of in- and outpatient antibiotic management”. Besides, she is working in R.D. Gardi Medical College, Ujjain, India as Pharmaceutical Chemist.

• Dr. Vishal Diwan (photo) is working on drugs in environment focusing antibiotics and antibiotic resistance in hospital associated waters. Vishal has masters and PhD in Limnology and Masters in International Health. For his PhD he worked on constructed wetland for wastewater treatment in India. He is Assistant Professor of Public Health & Environment in R.D. Gardi Medical College, Ujjain India. His other interests are hand hygiene, sanitation, waste management, Health Information Management System and GIS.

• PhD candidate Ashish Pathak is Assistant Professor in Department of Pediatrics at RD Gardi Medical College Ujjain, India where he teaches and serves as member of various scientific committees. Ashish has done his Diploma in Pediatrics from Mumbai University and Diplomate of National Board (Pediatrics). His topic of research isAntibiotic use and bacterial resistance, diagnosis prescribing and antimicrobial susceptibility surveillance-studies in rural Madhya Pradesh, India.

• PhD candidate Krushna Chandra Sahoo (photo) has done masters in Zoology from Utkal University, India and Masters in Environmental Sciences from Halmstad University, Sweden. His PhD research is on Association between environmental factors and antibacterial agent resistance in Orissa, India. 

A number of Visiting Researchers from India have been working at IHCAR recently, some of them within the framework of the Erasmus Mundus External Cooperation Window Lot 13 mobility programme, in which Karolinska Institutet is a member. They include:
– Dr. A.J. Tamhankar, who has also been supervisor for post-doc and PhD students at KI. He is the national coordinator of the Indian Initiative for Management of Antibiotic resistance (IIMAR), visiting professor of Environmental Medicine at R.D. Gardi Medical College, Ujjain India and professor emeritus at Acharya and Marathe College, Mumbai, India. He was previously head PSIT, BioMedical Group, Bhabha Atomic Research Centre, Mumbai, India. His research interest include the association between environmental factors and antibiotic resistance, antibiotic use in hospitals, antibiotic residues and resistant bacteria in aquatic environments with an emphasis of developing interventions and the impact of non-human use of antibiotics on resistance.
– Dr. Harshad P. Thakur, Associate Professor and Chairperson, Centre for Health Policy, Planning & Management, School of Health Systems Studies, Tata Institute of Social Sciences (TISS), Mumbai. He is also an MPH Programme Coordinator.
– PhD candidate Jennifer Kipgen from School of Social Work, Tata Institute of Social Sciences in Mumbai, India. Her PhD research focuses on ”Utilization pattern of health services by widows living with HIV/AIDS: A study in Manipur”.  She has also worked as an HIV/AIDS Coordinator at World Vision India, Pune.
– Dr. Sujith J Chandy, Professor of Clinical Pharmacology and Head, Pharmacy at the Christian Medical College, Vellore, India. He is also visiting faculty at Oman Medical College, Sohar. Besides teaching undergraduate and postgraduate students in Pharmacology, he has been actively involved in research in the area of medicine use with a focus on antibiotic use. He has collaborated with INCLEN and WHO on projects looking at community use of antibiotics and surveillance systems for antibiotic use. He is on a number of committees in the areas of Antimicrobial Policy, Hospital Infection Control and Drugs & Therapeutic Committee. He is now looking forward to collaborating with the Division of Global Health, KI in the area of antibiotic use and is a prospective PhD candidate.

Research Group on Epidemiology and Health systems research focusing on equity and gender

This multi disciplinary research group aims at contributing to improved health in low and middle income societies through research and research training. The group focuses on TB, HIV/AIDS, health financing and insurance systems, public/private mix in health care, training of health personnel, maternal health, childhood studies and human rights. The group has competence in caring sciences, medicine, epidemiology, bio-statistics and health economics. The group is a scientific partner to socio-economic and demographic surveillance sites: FilaBavi in northern Vietnam and Palwa Field Laboratory in Central India. Several research and research training projects are on-going in these sites. The group has collaborative projects in India, Vietnam, China, South Africa and Zambia. More information about the research group.

Professor Vinod Diwan (photo to the right) defended his doctoral thesis on ”Epidemiology in Context. Effectiveness of Health Care Interventions” at IHCAR in 1992, has also worked at the Nordic School of Public Health, NHV, in Göteborg, and he chairs KIRT, Karolinska Institutet Research and Training Committee.
Prof. Diwan leads the research group, that involves research on Gender and Tuberculosis, identifying gender inequalities in India, Pakistan, Bangladesh and Nepal. Part of the research has been located to the city of Ujjain in Madhya Pradesh state, India, where studies of a rural district, with a population of 60.000, has been carried out in collaboration with the RD Gardi Medical College. The project has included a socio-demographic surveillance system, where two persons from each village has been trained to collect data on births, deaths, migration and pregnancies. A 500 bed hospital serves as the teaching hospital.

Professor Diwan is involved in five large research projects, partly India related, funded by the European Commission. One project deals with IT and Access to Health services and has been given a research grant of SEK 150 m. It deals not only with India, but also China, Vietnam, Uganda, South Africa and a couple of other countries.

Another EC project deals with Distance Education and has been given a grabnt of SEK 40 m, dealing with 11 countries.

In November 2005 Prof. Diwan received SEK 600 000 as a three-years (2006-08) Swedish Research Links grant for a project titled ” Equity and gender in tubercolosis control in high burden countries – from research to policy”. The Asian partner in the project is Biao Xu. More information on the Swedish Research Links grants 2005.

Prof. Diwan is also engaged in a project titled ” Information technology in Health: A geographic health management information system in Madhya Pradesh, India”. The project is carried out in collaboration with Ram Mohan Singh, National Center for Human Settlements and Environment in India. The project was given SEK 600 000 as a one-year grant from the the Swedish Research Links Programme in October 2006. It deals with the use of information technology for better health management in the central Indian province Madhya Pradesh. More information about the project.

In August 2007, Prof. Diwan received a SASNET planning grant for a new research project on ”Improving maternal health outcomes in Madhya Pradesh, India – bridging the gap between research and practice.” See the full list of SASNET planning grants 2007.
The projects aims at developing the already established collaboration between the RD Gardi Medical College in Ujjain, Madhya Pradesh, and IHCAR at Karolinska Institutet, to study maternal mortality and morbidity from the perspective that these women’s deaths and suffering could to a large extent be prevented.
The other collaborating partners on the Swedish side in the project were Grethe Fochsen (more information below) and Ms. Linda Rydberg, currently working for the Women and Gender Equity Knowledge Network, which is part of the WHO’s Commission for Social Determinants of Health. Ms. Rydberg planned to start her PhD studies in Madhya Pradesh in 2008, and her role in the project is to contribute with the social and political sciences perspective. She was also supposed to coordinate the planning of a workshop to be held in the beginning of 2008.
The collaboration partners on the Indian side are Prof. V.K. Mahadik, medical director of the RD Gardi Medical College; and Dr. Kirti Deshpande, Assistant Professor in Community Medicine, RD Gardi Medical College.

In November 2007, Prof. Diwan was given SEK 1.5 million as a three-years grant (2008-10) from Sida’s Developing Country Research Council (U-landsforskningsrådet), for this same project, now titled ”The Know-Do gap: a case study of the implementation of reproductive and child health policies in Madhya Pradesh, India”. More information about the Sida grants 2007.
In November 2008, Prof. Diwan was given SEK 400 000 as a one-year grant (2009) from Sida’s Developing Country Research Council (U-landsforskningsrådet), for a project titled ”A randomized controlled trial: Improving adherence to Anti Retroviral Treatment in South India”. More information about the Sida grants 2008.

• Dr. Grethe Fochsen is a researcher who was associated to the Research Group on Epidemiology and Health systems research focusing on equity and gender. Before that she worked on a research project at Department of Nursing regarding health care personnel’s work environment. Her research concerns tuberculosis control from a gender perspective in rural India.
On Friday 14 December 2007, she defended her PhD thesis titled ”Encounters with power: health care seeking and medical encounters in tuberculosis care: experiences from Ujjain District, India”. In the thesis, Grethe Fochsen examines health care seeking and medical encounters in the context of TB care in a rural district in Madhya Pradesh. More specifically, the study focuses on how relations of power between health care providers and patients are created, altered and maintained during medical encounters in a diversified health system. More information.
Dr. Fochsen now works at The National Board of Health and Welfare (Socialstyrelsen), a government agency in Sweden under the Ministry of Health and Social Affairs.

• Ayesha de Costa (photo to the right) is an MD who has trained and worked in India. She has worked as a resident at the All India Institute of Medical Sciences and with the Danish International Development Assisstance (basic health services programme) in Madhya Pradesh, India.She has worked with drug policy and geographic information systems for health in Central India. Her interests include health systems, access to essential medicines and ethics. Her research project focuses on the private health sector in India.
Ayesha defended her doctoral dissertation entitled ”Barriers of mistrust : Public and private health care providers in Madhya Pradesh, India” on 17 September 2008. The thesis highlights the heterogeneity and dominance of the private health sector, and the distribution of different provider groups in rural and urban areas/districts. Rather than an absolute shortage of manpower, maldistribution seems a problem here. Access to women providers is low, important in a setting where women would prefer seeing women providers. The possibility that scheduled castes might have lower access to health care providers than the rest of the population is presented, a finding with important political implications. The barriers to trust between the public and private health sectors in the setting are complex. Addressing these as a step to making real collaboration possible, calls for deeper more structural changes in the working of the health system, including a redressal of the regressive fee-for-service payment mechanism. The government must consider some form of health insurance for more vulnerable groups of people. More information, with link to full-text thesis. 

• Fazlul Karim from the Research and Evaluation Division (RED) at BRAC in Dhaka, Bangladesh, defended his doctoral dissertation entitled ”Gender matters: Understanding of access barriers to community-based tuberculosis care in Bangladesh” at IHCAR on 17 April 2009. The thesis concludes that sex differences exist at different clinical steps for TB control. Women compared with men, encountered longer delays at various clinical stages for TB treatment. The adverse effects of stigma both reflected and worsened gender inequalities. Gender disparities were evident in the patterns of distress, perceived causes, and help seeking behaviours, affecting more women, whilst TB-related financial distress affected more men. The estimated true period prevalence of smear-positive PTB was high in the community, and almost all socio-economic groups were at risk of TB. More information, with link to full-text thesis. 

• Syed Farid-ul-Hasnain defended his doctoral dissertation entitled ”Young Adults in Urban Pakistan; Barriers and Challenges for Improving Health Behaviors in the wake of the HIV/AIDS Epidemic” on Thursday 16 September 2010. The faculty opponent was Professor Urban Janlert, Dept. of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University. Read an abstract with a link to the full-text thesis.
Syed Farid-ul-Hasnain (photo) is a medical doctor previously holding a masters degree in Epidemiology from Aga Khan University Pakistan and has ECFMG certification (MD) from USA. He is a faculty in ‘Population and Reproductive Health’ Program at the Department of Community Health Sciences the Aga Khan University, with major involvement in undergraduate and graduate teaching. He is also involve in facilitating & directing short courses on ‘Reproductive Health Research’ and participating in ongoing research activities pertaining to Reproductive Health program. His main interest is in adolescent reproductive health and gender issues.
The thesis is grounded in the fact that HIV/AIDS is spreading globally more specifically among the younger generation. Pakistani young adults having inadequate knowledge and awareness are vulnerable to the global HIV/AIDS epidemic. Both young men and women are well motivated to acquire good education and employment; and seem to belief in gender equality. Transition to better education and gender equality will result in new health related challenges, which emphasize that these young people should be equipped with proper knowledge about STDs and health related behaviors. Religious and cultural barriers to discuss reproductive health issues further deteriorate the situation. Nevertheless, as the prevalence of HIV/AIDS is still comparatively low, the epidemic has not yet enforced a general discussion on the importance of a well-informed younger generation.
Dr. Syed did his PhD research under supervision by Professor Gunilla Krantz, Dept. of Community Medicine and Public Health, the Sahlgrenska Academy, University of Gothenburg.

• Tazeen Saeed Ali is another PhD candidate at IHCAR. She started this programme in October 2007. She has completed an MSc Epidemiology, has a Masters of Science in Epidemiology and Bachelors of Science in Nursing from Aga Khan University as well as a Diploma in Nursing from Aga Khan University, and Midwifery training, from Aga Khan Jan Bhai Maternity Homes, Karachi. Tazeen is an Assistant Professor at Aga Khan University School of Nursing (AKU-SON) and Department of Community Health Sciences (CHS). She is primarily an educator and researcher, and she has qualifications in nursing, midwifery and Epidemiology. More information.
Her doctoral research project is entitled ”Violence against women in the family – a normal part of Pakistani women’s lives or a serious transgression of women’s human rights?”. Tazeen is also supervised by Professor Gunilla Krantz in Gothenburg, and is expected to defend her thesis in the end of 2011. 

Research Group on Health Systems and Policy research

The multidisciplinary research group “Health Systems and Policy” (HSP) at IHCAR deals with individuals’ perceptions of health and health care, health seeking behaviour and at the macro level policymaking and how the system meets needs and demands of consumers of care. Action research with robust evaluations have been core activities in studies in Africa, Asia and Europe often conducted in consortia with other research teams. Method development includes multifaceted interventions in public and private sectors for improved quality of care evaluated in randomised control trials with health facilities as study units. The basis of any health system – the household-is being studied in relation to management of children with fever. Malaria case management is studied including the interface between consumers and providers as well as drugs and resistance. Several projects and courses (senior decision makers, PhD and MPH students) aim at more evidence based health policymaking.
More information on the Health Systems and Policy Research group.

The group is led by Göran Tomson, Professor in International Health System Research (photo to the right). It has an extensive international network especially in Africa and Asia. Swedish collaboration includes the Dept. of Political Science, Lund University and Stockholm School of Economics. European collaborative institutions include Institute of Tropical Medicine Antwerp, Department of Tropical Hygiene and Public Health of University of Heidelberg and London School of Hygiene and Tropical Medicine.

• Dr. Fauziah Rabbani, Associate Professor at the Dept. of Community Health Sciences at AKU (photo to the left) has been a member of the research group. During the period 2005–10, she carried out a sandwich PhD training at IHCAR, supervised by Prof. Tomson. On 24 March 2010, she defended her doctoral dissertation entitled ”Science and practice of balanced scorecard in a hospital in Pakistan: Feasibility, context, design and implementation”. The external examiner was Dr. Zoe Radnor, Associate Professor, Warwick Business School, United Kingdom.
Abstract: Millennium Goals emphasize good governance and health systems research. In Pakistan, hospitals provide the major bulk of both basic and advanced care. Challenges faced by the hospitals in Pakistan include: poor quality of care, weak management structures, inappropriate resource allocation and a lack of timely information system for decision making. Balanced Scorecard (BSC) is a strategic performance management tool that could offer an opportunity to improve performance measurement and management. The main aim of the study was to determine whether BSC application is feasible in the context of a low- income hospital setting, to identify organizational culture, as well as design the scorecard and describe the contextual barriers and strategic processes that hinder or facilitate its implementation. More information, with a link to the full-text thesis.

Dr. Rabbani’s special interest is health systems development and health care administration. She has served as WHO technical advisor and grant recipient of WHO UNISOL, which is a WHO network grant of ‘Universities in Solidarity for the health of the disadvantaged’. She is member of various national and international committees and networks, attended numerous international conferences and has many peer reviewed publications to credit. Together with Prof. Tomson she is trying to evolve a Swedish-South Asian Network on health administration and management training and research. A project to be realised through collaboration between IHCAR, the Medical Management Centre at Karolinska Institutet, and the School of Business at Stockholm University on the Swedish side, and with the departments of Community Health Sciences and Medicine at the Aga Khan University Hospital in Karachi on the South Asian (Pakistani) side.
In August 2005 Prof. Tomson and Dr. Rabbani received a SASNET planning grant for an educational project on ”Networking in research and training for better health administration and management (NHART)”. More information on the August 2005 SASNET grants.
Project abstract: In low income countries research and training in health systems and good governance has been identified as a major challenge in achieving millennium development goals. Medical universities and hospitals are an important but often neglected component of health system. Research and training is needed to develop balanced set of performance measures and in use of information systems to continually and simultaneously assess clinical outcomes, financial performance, patient satisfaction and provide this feedback to all parties. Balanced Scorecard (BSC) is one such performance management tool.
With AKU’s MSc in Health Policy and Management Program a formal networking for health systems development and management research training between Swedish partners and AKU will open new avenues for health administration and policy in South Asia. Moreover AKUH has elaborate computerized information technology and operational systems to improve quality of care for patients but there is a need to integrate these systems from a professional and managerial perspective. Therefore AKUH presents a good study site to test various performance measurement and management models in health care administration.

As part of the educational programme an International three day workshop on ”Health Administration: Strategic Planning and Performance Management” was held at Aga Khan University (AKU) in Karachi, Pakistan, 22–24 November 2006. It was organized by the Department of Community Health Sciences, Dept. of Medicine and Medical Director’s Office at Aga Khan University. The aims of the workshop were; to understand how to develop vision and mission statements, get familiar with methods for conducting organizational assessment and stakeholder analysis, learn to develop outlines of a strategic plan, appreciate some experiences of strategic planning in health care organizations through case studies and be informed about use and application of Balanced Scorecard as a strategic performance management tool in health care organizations. Participants came not only from Pakistan but also from Afghanistan and East Africa (on the photo above). Read a full report from the workshop (as a pdf-file)

PhD candidate Meena Daivadanam has a bachelors degree in Medicine and a bachelors degree in Surgery from Christian Medical College, Vellore and a Masters degree in Public Health from Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, India. She is currently doing her PhD, sandwich-model between SCTIMST and division of global Health (IHCAR) under the Erasmus Mundus scholarship program. Her research topic is Community-based Intervention to change dietary behaviour for prevention of chronic NCDs in rural Kerala. She will most probably defend her dissertation in 2013. 
The project aims to translate currently available scientific knowledge related to diet as a risk factor for chronic NCDs into a practical and sustainable intervention that is socially and culturally acceptable to the local population. She has mainly worked in the area of non-communicable disease epidemiology particularly risk factor surveillance, training of lay community volunteers for surveillance and estimation of catastrophic health expenditures and its consequences for households in relation to acute coronary syndrome.
She was also selected as an Emerging Voice from the Global South for 2010 through an essay competition organized by the Institute of Tropical Medicine, Antwerp, Belgium.

Research Group on Injuries’ Social Aetiology and Consequences (ISAC)

The ISAC group is concerned with the mechanisms underlying the social patterning of injuries between groups and geographic areas and also with the short and long term consequences of injury events. Emphasis is placed on injuries among the young and the elderly. Both intentional and unintentional injuries, in particular in the traffic environment, are considered. More information about the ISAC Research Group

• PhD Candidate Samina Mohsin Khan is working on a doctoral project entitled ”Pakistan – Disability and support mechanisms among older citizens. Studies among non-injured and injured in Islamabad”. The main aim of the research is to document the needs and living circumstances of older Pakistani men and women, in particular those who are disabled or suffer from injury. The study will be conducted in the tertiary hospital in Islamabad the capital city of Pakistan among the patients 60 years and above coming to hospital. Both quantitative and qualitative research methods will be employed. The former will measure the nature and levels of disability among both non-injured patients (cross-sectional assessment) and injured patients (longitudinal assessments) and will relate this to family support mechanisms available and health related quality of life. More information. 

Research Group on Sexual and Reproductive Health and Rights

The group is led by Staffan Bergström, Specialist in Ob/Gyn, PhD, Professor of International Health (Chair). It gives priority to research related to maternal mortality and severe morbidity. Several projects are ongoing in HIV/AIDS related areas with focus on obstetric infections, postpartum haemorrhage and outcome for orphans after maternal death. Female genital mutilation and infertility belong to other areas of priority research.
The researchers have benn involved in a long-standing collaboration with the Christian Medical College and Hospital, Vellore, India, regarding studies on antenatal prediction of low birth weight and some factors that detarmine birthweight. A numvber of PhD sndwich programmes evolved from this collaboration.

• Dr Matthews Mathai, present chair of the Obstetrics and Gynaecology Unit in Vellore, defended his doctoral thesis at KI in 1999. It was entitled “Fetal growth in India: studies on antenatal prediction of low birthweight and some factors that determine birthweight” – see abstract.
Later Dr. Mathai has been involved in a collaborative study with IHCAR on Preganacy Related Morbidity and Mortality.

• Dr Elisabeth Matthai was involved in another sandwich PhD training at IHCAR on Pregancy related morbidity, supervised by Prof. Bergström. She defended her doctoral thesis, entitled ”Genital and Urinary Tract Infections in Pregnancy in Southern India. Diagnosis, managhement and impact on perinatal outcome” at KI on 15 December 2004. Read the abstract.

• Saima Hamid works as Assistant Professor at Health Services Academy (HSA), Islamabad, Pakistan. She defended her doctoral dissertation entitled ”Becoming a Woman in Silence: Studies on preparedness for reproductive life of young women in Pakistan” at IHCAR on 8 December 2010. The study explores the preparedness of young women for married life (communicating with spouse, initiation of sexual activity and child bearing) and ability to negotiate in marriage with spouse on number of children to have and on contraceptive use. In a culture of silence around sexuality, young women’s socialisation into submissiveness lays the foundation for the lack of control over their future reproductive health (I and II). The parents realised, though, that bringing up daughters for marriage requires not only obedience, but also building confidence and knowledge during their childhood (III). Women who had decision making freedom in their parental home carried this ability with them into marriage in their new home and were better able to negotiate about their fertility (IV). Knowledge about reproductive life could prepare young women better for the future life and give them more control of their fertility. Innovative interventions targeting women need to challenge current societal norms of womanhood to promote the upbringing of confident and knowledgeable young women.
The faculty opponent was Associate Professor Pia Olsson, Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University. More information, including link to full-text thesis. 

Research Group on Sexual and Reproductive Health with focus on Youth

All projects in this group are carried out in low-and middle-income countries. Several projects focus on issues related to young people and sexual and reproductive health, such as young people’s health seeking behaviour, coping strategies and quality of care for pregnant adolescents, the role of the nurse/midwife in meeting young people’s needs, sexually transmitted infections (STI) including HIV/AIDS prevention, the needs and role of young men/fathers, emergency contraception and other contraceptive methods, and sexual education in schools. More information about the Research Group

• Professor Emeritus Bengt Höjer, Head of IHCAR during the period 1995-2001, developed a research collaboration with the Thiruvananthapuram Medical College (TMC), and the Mangalapuram Primary Health Centre, both in Kerala, India. The collaboration partner on the Indian side was Dr K.T. Shenoy. The objective was to quantify the determinants for public health care seeking among pregnant women. It was designed to be a population based cross sectional and prospective study, involving a rural community with six health centres of six panchayats. The study included 1 345 pregant women at 24 weeks gestation.
Besides, Prof. Höjer has been the leader of a number of major research undertakings like ”Interdisciplinary research for HIV/AIDS prevention in southern Africa” (Zambia and Kenya) and ”Health systems research for development in Vietnam”.

South Asia related educational courses:

Erasmus Mundus External Cooperation Window Programme scholarship programme

A large number of Indian students, PhD candidates, post-docs and academic staff has come to Karolinska Institutet during the academic year 2009-10, as scholarship holders through the Erasmus Mundus External Cooperation Window mobility programme Lot 15, coordinated by Lund University. This programme was announced in 2008, and out of a total mobility of 320 persons, 20 Indian students, researchers and academic staff were selected to come specially to Karolinska Institutet. Out of them, 5 are Masters students, 7 PhD candidates, 4 post-docs, and 3 academic staff. Another five people have gone from Karolinska Institutet to Indian universities, out of them 2 Masters students and 3 academic staff. More information about the EMECW programme lot 15 (from 2009 renamed to be one out of four programmes under the mobility lot 13). Prof. Cecilia Stålsby Lundborg is the local coordinator fro the programme at Karolinska Institutet. 

Global Health courses and other programmes with relevance to South Asia

A 7.5 ECTS credits course in Global Health is arranged every semester for three weeks at KI, and then two weeks abroad – in East Africa, Cuba, Iran, India or Pakistan. The course is run in collaboration between IHCAR, the Dept. of Public Health Sciences, and the Department of Nursing at Karolinska Institutet. It is open to students at Karolinska Institutet in the Medical programme, Midwifery programme, Nursing programme, Dental programme, Biomedical laboratory programme, Physiotherapy programme, Occupational therapy programme, and the Biomedical programme. In South Asia, the students can choose to do the field work at Karolinska’s two main collaboration partner institutions: The Aga Khan University in Karachi, Pakistan; and Trivandrum Medical College (TMC) in Thiruvananthapuram, India. More information on the Global Health course.
Course coordinator: Dr. Birgitta Rubensson, phone: +46 (0)8 524 833 89.
The courses in Global Health has been running twice a year since 1996. The initiative originally came from Prof. Hans Rosling, at that time working at the Unit for International Child Health, Uppsala University but soon after changing over to the Division of International health (IHCAR), Department of Public Health Sciences at KI. Earlier, during the 1990s, Prof. Shenoy worked together with Prof. Hans Rosling in a project on Cassava Toxicity, funded by WHO and Sida/SAREC. The Global Health course was a side effect of their collaboration. More information on Prof. Rosling below.
As former Head of IHCAR, Prof. Bengt Höjer was also instrumental in realising the collaboration programme.
More than 500 medical students from KI have received training in Global Health only at TMC. The students coming to Kerala mostly has had a background in Medicine, Dentistry and Biomedicine, and they stay for two weeks. Prof. K.T. Shenoy, Dean, Faculty of Medicine, University of Kerala, has been the person in charge of the collaboration from the start on the Indian side. Read a SASNET report from TMC, November 2007.

Prof. Vinod Diwan at IHCAR organises Sida funded courses in Global Medicine for Junior Hospital Doctors (ST-läkare) on behalf of the Center for Public Health, CeFAM (a collaboration between Karolinska Institutet and the county council of Stockholm). The courses has dealt with diseases like malaria, TB and AIDS, and take place either in Ethiopia or in India (four months at R.D.Gardi Medical College, in Ujjain, Madhya Pradesh. More information on the training in Ujjain (in Swedish only)

Torkel Falkenberg is Professor of Pharmacology at the Center for Studies of Complementary Medicine (CAM).
Prof. Falkenberg is Head of the Research Group on ”Drug Utilisation and Complementary & Alternative Medicine”.
The Center is involved in research, development and education related to traditional medicine (TM), complementary and alternative medicine (CAM) and integrative medicine. Staff members at the center collaborate with a wide range of professions including professionals from conventional medicine and TM/CAM, health care planners and decision makers nationally and internationally. The mission is to promote the development of evidence based health care systems in which appropriate conventional medicine practices and TM/CAM practices are integrated on equal terms. Such integrative health care programes are sensitive to the patients’ freedom of choice and safety and acknowledges health and wellness of the whole person including biological, psychological, social and spiritual aspects, when relevant. More information on the International research.

European Master of Science International Health Degree Programme

IHCAR is one of eight European institutions awarding degrees in a new European Master of Science International Health Degree Programme. The programme is part of tropEd, a network of European institutions for higher education, in existence since 1996 and collaborating closely with institutions in Asia, Africa, and the Americas in providing postgraduate education and training opportunities.
The European Master of Science Programme in International Health is a one year, full-time study programme taught in English. The main objective of the programme is to raise awareness of current global health concerns. Students become qualified to identify and critically analyse key factors shaping the health and well-being of populations in low- and middle-income countries and to formulate effective and appropriate responses to complex health-related issues. Six possible study tracks are offered for this degree and reflect the strengths of the consortium institutions: Tropical Medicine and Disease Control; Health Systems, Health Policy and Management; Sexual and Reproductive Health; Child Health; Health Research Methods; and Health in Emergencies.
Each study track begins with a 3 month core course from September to December. Core courses provide a common basis of the main subject areas for all students. Students receive 20 European Credit Transfer System (ECTS) credit points upon successful completion of their core course. More information on the European Master of Science International Health Degree Programme.
Contact person: Anna-Lena Paulsson

Linnaeus palme International Exchange programmes

An exchange programme was introduced in the year 2000–01, through the Linnaeus-Palme Foundation International Students and Teachers Exchange Program, between Karolinska Institutet Medical University; Aga Khan University (AKU), Karachi, Pakistan (AKU); and Thiruvananthapuram Medical College (TMC), Kerala, India.
The programmes includes both undergraduates and teachers in the medical field, as well as students and teachers in the field of nursing and midwifery. Official exchange programs has been established for the Study programme in Medicine (“Läkarprogrammet”) and Nursing (“Sjuksköterskeprogrammet”) in Pakistan and in India for the study programmes in Medicine and in Midwifery, (“Barnmorskeprogrammet”). Exchange regularly takes place, even in times of political turmoil in the region.
The collaboration between KI and TMC was further stabilised after a meeting between representatives of KI and the Chief Minister of Kerala was held in November 2004. It was then proposed that KI doctors should be sent for clinical courses/workshops and carry out the clinical part of KI’s postgraduate courses in TMC. A new International Office in TMC coordinates these activities as a single window clearance system.
Coordinator for the undergraduate medical students and teachers: Professor Bo Lindblad (concerning Pakistan) and Associate Professor Sanjeevi Carani at the Center for Molecular Medicine (concerning India).
Coordinator for the undergraduate Midwifery students and teachers with India: Anna Hjelmstedt  
Coordinator for the undergraduate Nursing students and teachers: Helen Conte
Information about the Linnaeus Palme grants 2009, given by Swedish International Programme Office for Education and Training (Internationella programkontoret).

Gapminder

Hans Rosling, Professor of International Health at IHCAR, is one of the strongest personalities at IHCAR. He has 20 years of worldwide experience on global health concerning the character of the links between economy and health in Africa, Asia and Latin America. Furthermore, he has been advisor to WHO and UNICEF, co-funded Médecines sans Frontiers Sweden and has started new courses an published a textbook on Global Health.
Prof. Rosling was the driving force behind the creation of Gapminder, originally a non-profit venture based at Malmö that launched an animated computer programme using the so-called Trendalyzer software. – turning time series of development statistics into attractive moving graphics. A first project was the creation of a World Health Development Chart– in collaboration with WHO – showing the relation between the rates of child survival and GDP per capita during the last 50 years in all the countries of the World. Since 2003, Gapminder – now a registered foundation based in Stockholm – has developed through a collaboration with United Nations Division of Statistic and the UNDP, visualizing the fulfillment of the millennium development goals in the yearly Human Development Reports directly on the Internet. Since 2001, funding for the project has been given by Sida.
On 16 March 2007, Google acquired Gapminder’s Trendalyzer. Google intends to improve and scale up Trendalyzer, and make it freely available to those who seek access to statistics. The Stockholm-based Gapminder Foundation on the other hand will continue to spearhead the use of new technology for data animations. The goal is to promote a fact-based worldview by bringing statistical story-telling to new levels. In collaboration with producers of accurate statistics that are eager to give the public free access to databases, Gapminder hopes to recruit and inspire many users of public statistics. More information about Gapminder.

Today, Prof. Hans Rosling travels the world, virtually and in real life, to share insights about major global trends, and he confronts our prejudices about the world – as he himself has done with his own prejudices. Watch a 55-minute documentary on Prof. Rosling (with subtitles in English) 

In April 2010, Gapminder Desktop was released. This is the tool Hans Rosling uses to present global trends.
In a new video, Hans shows how you can use the tool from your own laptop and he gives 5 tips for a successful bubble-graph presentation. Go for the presentation.
– Watch the 3-minute how-to video and
– Download Gapminder Desktop

In a new TED video, Hans Rosling explains why ending poverty – over the coming decades – is crucial to stop population growth. Watch the TEDTalk

SASNET conference on The role of South Asia in the internationalisation of higher education in Sweden

In November 2006, Karolinska Institutet hosted a workshop on ”The role of South Asia in the internationalisation of higher education in Sweden” in collaboration with SASNET and the Swedish Institute. Prof. Bo Lindblad at IHCAR (also a member of SASNET’s board) was one of the main organisers of the workshop, that took place at Nobel Forum 28-29 November.
Full information about the workshop.

It was inaugurated by Professor Harriet Wallberg-Henriksson (photo to the right), President of Karolinska Institutet, and after that Associate Professor Elias Arnér (photo to the left), Dean of Post graduate education, gave a introductory presentattion about KI’s International activities. Read Dr. Arnér’s presentation at the workshop
(as a pdf-file)

Professor Cecilia Stålsby Lundborg and PhD Candidate Mohsin Saeed Khan gave a presentation about Karolinska Institutet’s experiences from the PhD sandwich programme with Pakistan, in the session titled ”Recruitment of South Asian students in hard sciences in Sweden”. Read Dr. Stålsby Lundborg’s presentation at the workshop (as a pdf-file)
Cecilia Stålsby Lundborg was also an invited speaker in the final panel discussion titled ”Best strategies for marketing Higher Swedish Education in South Asia, and for sending students to Higher Education in South Asia?”

Partner driven Swedish-Asian collaboration project on Evidence for policy and implementation

In July 2010, the Swedish International Development Cooperation Agency (Sida), through its program for Partner Driven Cooperation (Aktörssamverkan), announced a call for applications for grants to collaborative projects related to access to and use of research for the period 2010 – 2012. This program is not support to research but rather assisting partners in assessing and using research in policy formulation and innovation. Sida’s initiative for Partner Driven Cooperation is aiming to support sustainable cooperation relationships, and concerns only a few selected countries, namely China, India, Indonesia, Vietnam, South Africa, Botswana and Namibia. More information.
In December 2010, decisions were made. A total number of 32 projects were selected, out of which nine refers to Indo-Swedish collaboration projects. Information about all India related projects given grants.

Professor Vinod Diwan at Karolinska Institutet is the main applicant for one of these Asia related grants. He and his colleagues behind the application are given SEK 12 m for three years (2010-12) for a project entitled ”Evidence for policy and implementation – intensifying efforts to achieve health related MDGs in four Asian countries with developing economies (EPI-4) India, China, Vietnam, Indonesia”. At Karolinska Institutet, Dr. Rolf Wahlström from IHCAR’s research group on Health Systems and Policy Research, and Dr. Sarah Thomsen from IHCAR’s research group on Sexual and Reproductive Health with focus on Youth, are involved in the project implementation. Sarah is the Scientific Coordinator for EPI-4.
In Sweden, four universities participate in the project. Besides Karolinska Institutet, Gothenburg University, Umeå University and Uppsala University are partners.
In India, the partner institution is the Public Health Foundation in Ahmedabad, in the state of Gujarat. The EPI-4 India team will be led by Professor Dileep Mavalankar and include three Swedish senior researchers from participating universities. They will convene a small network (10-15 persons) of key policymakers, stakeholders and academicians to discuss emerging data on maternal health (MDG 5) and malaria and tuberculosis (MDG 6) in relation to disadvantaged populations and to make proposals for interventions to be prioritized by the Ministry of Health in their annual workplans. The data will be generated by analyses of existing national health surveys and from systematic reviews of the literature concerning disadvantaged populations and health.
The EPI-4 India network will produce policy briefs and other publications in an effort to assist the Government of Gujarat in applying evidence-based policy to improve the health of all its citizens. The project is currently funded for 2011 and 2012.

Contact person: Associate Professor Anders Gustafsson
Phone: +46 (0)8 524 883 31
Postal address: Odontologiska institutionen, Enhet 3 (Parodontologi), Karolinska institutet, Box 4064, SE-141 04 Huddinge, Sweden
Visiting address: Alfred Nobels Allé 8, Flemingsberg
Fax: + 46 (0)8 711 83 43
Web page: http://ki.se/en/dentmed/startpage

Research and Collaboration with South Asia:

The Institute of Odontology at Karolinska is involved in a collaboration project with Altamash Institute of Dental Medicine, AIDM, (photo to the right) a private dental institute affiliated with the University of Karachi, Pakistan, since October 2000. It includes educational and technical assistance, and since 2003 an exchange of students and teachers through the Linnaeus Palme International Exchange Programme. The funding for this exchange was further renewed during 2010-11. More information about the South Asia related Linnaeus Palme projects for 2010-11.

The Altamash Institute of Dental Medicine is a private dental institute with approximately 100 students founded by Dr. Mohammad Altamash, now AIDM President. Dr. Altamash has been instrumental in realizing the collaboration and has therefore visited Karolinska Institutet several times, where an agreement has been made with Folke Meijer from Karolinska Education AB.
Teachers from AIDM have come to Stockholm as guest lecturers, including Dr Farzeen Tanwir, Dr. Shah Salman Khan and Dr. Fawad Javed, and teachers from Stockholm (Assistant Professor Lars Frihiof, Professor Björn Klinge and Professor Jan Huggare) have gone to Karachi. The ambition has been to gradually extend the collaboration project by including also exchange of students from 2005.

Presently, during the Spring 2007 the first three exchange students from the Dentistry program at Karolinska Institutet are studying at AIDM for three months within the LP-program. Hopefully they will have many followers. Four students from AIDM spent their Spring semester 2006 at KI and four students were recently accepted for the Autumn semester 2007. The exchange program is quite popular at AIDM and the number of applicants by far exceeds available scholarships. Apart from the indisputable educational value for participants from both institutes the students acquire valuable understanding of the respective country, culture and education. Bonds between AIDM and KI are growing stronger each year thanks to the program.

Two of the AIDM teachers, Dr. Farzeen Tanwir and Dr. Fawad Javed were registered as PhD candidates at the department in Stockholm. They have had supervisors both at Karolinska and at AIDM.
Farzeen Tanvir (photo) worked on a project under supervision from Associate Professor Anders Gustafsson. The project consisted of an epidemiological survey on dental status and general health among underprivileged groups in Karachi. It received a SASNET Planning grant in February 2005. On Thursday 12 June 2008, Farzeen Tanwir defended her doctoral dissertation, titled ”Absence of toothache syndrome. Oral health and Treatment needs among urban Pakistanis”. Faculty opponent was Associate Professor Lars Gahnberg, County Council of Göteborg. More information.
Abstract: Dental caries and periodontal disease are among the most common diseases affecting mankind. Oral diseases have a negative impact on an individual’s quality of life and also represent a burden for health care systems worldwide. Populations in the developing nations are afflicted by a panorama of oral diseases similar to that of the developed nations: dental caries, periodontal diseases and oral mucosal diseases. In both developed and developing countries, the burden of oral disease is particularly high in underprivileged groups.
Pakistan, a developing nation, is excessively burdened by oral diseases, particularly dental caries and periodontal disease. The oral health status of adult Pakistanis is poorly documented.
The general aim of this thesis was to survey oral health and oral treatment needs among an adult population from a deprived area in Karachi, acquiring baseline data for future treatment strategies and research. The specific aims of the thesis were to describe perceived oral health and perceived treatment needs among adult Pakistanis; to survey oral health with special reference to habits, knowledge and attitudes; to investigate the influence of betel quid (pan) and betel nut (chalia) chewing on oral health; to relate objectively assessed dental treatment needs to perceived treatment needs; to relate objectively determined oral health status to risk factors such as betel nut habits; and finally, to determine whether – in this population with relatively poor oral health and poor oral hygiene – diabetes is associated with any specific oral problems.
In conclusion, the results of the studies on which this thesis is based show that among urban adult Pakistanis, oral health is not perceived as a major concern and has low priority. No association was found between poor oral health and educational levels or socio-economic status. In general, major restorative treatment is not required: the primary unmet treatment need is for minor restorative work or preventive measures such as scaling. Improving oral hygiene habits and dental health education could achieve major improvements in oral health. In this population with poor oral hygiene, diabetics have more missing teeth and a higher prevalence of peridontitis.

Dr. Farzeen Tanwir is now working as a post-doc researcher at the KI’s Division of Global health (IHCAR), within the research group on Medicines in the health system – focusing antibiotics. More information.

Fawad Javed’s project has been based on similar material and studies the relation between diabetes and periodontitis, including immunological and microbiological methods. It also has a clear clinical approach and aims at finding ways to improve oral health within vulnerable population groups.

A third Pakistani PhD candidate – Dr. Talat Qadri, is also working on a doctoral project at the department. Qadri is also coming from AIDM in Karachi, but is now a practicing dentist in Sweden.

The experiences from the dissertation projects have been very good so far, and both the institutions involved see benefits from the collaboration. The ambition from the Pakistani side is to increase the number of graduated teachers.

Postal address: Sektionen för sjukgymnastik, Institutionen för neurobiologi, vårdvetenskap och samhälle, Karolinska Institutet, SE-141 83 Huddinge, Sweden
Visiting address: Zanderska huset, Alfred Nobels allé 23
Web page: http://ki.se/en/nvs/division-of-physiotherapy

Contact person: Dr. Kristina Kindblom, Lecturer at KI,
        but also Guest Professor at Pravara Institute of Medical Sciences Deemed University (PIMS),
                                   Loni, Ahmednagar Dist, Maharashtra, India. Phone: +91(0)98 23825388

Academic collaboration with South Asia

Karolinska Institutet and Pravara Institute of Medical Science are both member universities of the ongoing Indo-European Erasmus Mundus External Cooperation Window programme Lot 15/13, that was decided upon by the European Commission in 2008. More information about the programme(coordinated by Lund University, running till 2013).

On recommendation by Professor Cecilia Stålsby Lundborg, Division of of Global Health (IHCAR) – Erasmus Mundus programme coordinator at Karolinska Institutet, Dr. Kristina Kindblom applied for and was selected for a scholarship to spend time as an academic staff at Pravara Institute in the fall 2009, at the College of Physiotherapy. Earlier the same year, Kristina had defended her doctoral dissertation entitled ”Movement awareness and communication in patient transfer – an educational intervention” at KI. Naturally, this became the theme also for her teaching work at Pravara, for its 2nd, 3rd, 4th year physiotherapy students, as well as for interns, teachers at the physiotherapy and nursing programmes, and medical staff at the hospital.
Commissioned by Professor K.V. Somasundaram, Director for the Center for Social Medicine at Pravara Institute of Medical Sciences Deemed University (PIMS), Kristina wrote a proposal on how physiotherapists could be involved in a slums project, focusing on elderly people’s health. They also discussed with the Physiotherapy College the possibility of setting up a collaboration programme between the physiotherapy training programmes in India and Sweden. 

The Erasmus Mundus scholarship developed into a position for Kristina Kindblom (photo) as Guest Professor at Pravara for three-four months every year since the academic year 2010-2011. Next, she will spend two months at Pravara in Octber-November 2013.
Her teaching initially focused on how to assist physical movements of patients with disabilities to move independently ”Friskförflyttning /Natural Mobility”. Physiotherapy students in II, III, IV year, interns and teachers received lectures and practical training. Nursing students II year, Nursing teacher and Nursing staff were also educated. Basic Body Awareness, Tai Chi and qualitative research method were other subjects for teaching and how to write a scientific paper.
Kristina’s teaching has now gradually developed with implementing knowledge into clinical practice both for students, providers and relatives. The students have taken some burden from relatives by giving patients more assistance to independent movements in bed and between bed and wheel chair. The understanding of qualitative research method has increased. KI may in the future use educational tools from India like Debate, Rangoli and Philosophy.

On behalf of Prof. Somasundaram at PIMS, Kristina has also been involved in writing a proposal on how physiotherapists could be involved in a Slum Project to promote health in aged people. Additionally, a discussion was held with the principals at the College of Physiotherapy PIMS, Dr. Rairikar/ Dr. Kahtri about starting an exchange programme between the Divisions of Physiotherapy in India and Sweden.

Linnaeus Palme exchange programme

On behalf of KI’s Division of Physotherapy, Kristina Kindblom-Rising and Associate Professor Lena Nilsson-Wikmar  wrote an application for a Linnaeus Palme exchange collaboration programme in 2010, to secure funding for them to make a planning tour to Pravara along with International Coordinator, Kristina Jesinkey.
The application was approved by the Swedish International Programme Office for Education and Training in March 2011 for the academic year 2011-12. Kristina Kindblom is the programme coordinator. 
The Linnaeus Palme exchange programme started with a visit to Karolinska Institutet by two teachers from Pravara College of Physiotherapy,  Dr. Deepak Anap and Dr. Atharuddin Kazi(photo to the right), followed by an India visit by Lena Nilsson-Wikmar and Kristina Jesinkey from Division of Physiotherapy in 2012.
No LP funding was received for the academic year 2012/2013. Despite this, a restricted exchange programme was initiated with other financing. Two students from KI took part in the collaboration at PIMS during four weeks in October /November 2012. They participated in a Certificate Course in Social Health and Development and took part in the Physiotherapy programme practically and theoretically. Two teachers from PIMS visited KI during three weeks in May 2013. They will taught and was involved in the international CHBR course, 7,5 ECTS credits by contributing in discussions.
The Swedish International Programme Office for Education and Training continues to fund the Linnaeus Palme exchange programme for the period 2015-16 with SEK 433 404. More information about South Asia related Linnaeus Palme programme grants for 2015-16. 

Dr. Carina Ursing from the KI’s Department of Clinical Science and Education at Södersjukhuset also applied for and received an Erasmus Mundus scholarship to visit Pravara Institute of Medical Science, and she has been there a number of times for shorter periods. She is involved in a research project on diabetes in collaboration with PIMS. initiated the development of a Diabetes Clinic at PIMS. An ethical application for a research project was approved.  This made it possible for a student at Global Heath (IHCAR) KI to collect data for her Master thesis at PIMS ”Diabetes and Physical activity” March 2013. Read more about Carina Ursing’s research.

Postal address: Box 280, SE-171 77 Stockholm, Sweden
Visiting address: Nobels Väg 16, Solna
Web page: http://ki.se/en/mtc/startpage

Contact person: Professor Ute Römling, Leader of the research group on Multicellular behavior in Enterobacteriaceae, phone: +46 (0)8 5248 7319. Web page about Prof Römling and her research group.
Prof. Römling is also Deputy Head of the Dept. of Microbiology, Tumor and Cell Biology, and co-ordinator of a European Commission funded project at MTC, called IMO-Train. This project makes it possible for 10 young bright researchers from other countries to do their PhD training in Sweden. IMO stands for ”Infection models beyond cell culture”.

Research connected to South Asia

In November 2005, Professor Ute Römling and her research group received SEK 1 million as a two-years grant (2006-07) project coordinator) from Sida’s Developing Country Research Council for a project titled ”Role of Biofilm on the Survival and Spread of Toxigenic Vibrio cholerae and Salmonella enterica in the Natural Aquatic Environment of the Bay of Bengal. More information about the Sida grants 2005.
Project abstract: Vibrio cholerae and Salmonella Typhi are major world-wide pathogens causing diseases due to inefficient hygienic standards. For both pathogens, it is hypothesized that biofilm formation in aquatic environments is a mode of transmission and persistence. Thus to understand disease outbreaks better we want to investigate the role of biofilm formation in the persistence and ecological niche occupation of the water-born pathogens, Vibrio cholerae and Salmonella Typhi in natural aquatic habitats.

The project was carried out by the then PhD candidate Mohammad Abdul Kader (photo to the right). Dr. Abdul Kader later founded the company Viola Vitalis, and is now its CEO. Viola Vitalis was established in 2005 with the aim of providing innovative and high quality nutraceuticals for the marginalized population, focusin largely on Bangladesh. The healthcare solution brought by the effort of Dr. Kader and the team of Viola Vitalis has been highly acknowledged in different documentaries in national and international television. He has received the ‘Change Maker’ award from Tällberg foundation in 2010 at Rework the world summit. More information about Viola Vitalis.
Since 2000, Dr. Kader has been involved with several research groups and worked as health coordinator and scientist in Wenner Gren Centre, Strategic Centre for Organic Electronics, Swedish Medical Nanoscience Center and Karolinska Institutet. Dr. Kader was the principal investigator in various studies including Feasibility of Human Milk Banking in South America, Feasibility of Biosensors detecting Arsenic with Helmholtz Centre for Environmental Research (UFZ, Leipzig, Germany). He also worked in the establishment of satellite clinic integrated with Human Milk Bank in Chile in 2010 together with Miris AB in Uppsala, Sweden. He was involved in teaching and has supervised many students from different institutions.

In November 2015, Prof. Ute Römling received SEK 1.2 m as a three-year (2016-18) Swedish Research Links grant, provided by the Swedish Research Council, for a Pakistan related project entitled ”Development of Antibiofilm and Antimicrobial Strategies in Pathogens relevant for Developing Countries”. The project has a Pakistani collaboration parter, Dr Iqbal Choudhari.
Project abstract: In developing countries, infectious diseases are still a major cause of morbidity or mortality. and in industrialized countries, they contribute to life quality. Biofilm formation is a significant virulence factor in 60-80% of the human microbial infections. Biofilm formation also is a cause of treatment failure, as biofilm forming cells are tolerant to antibiotics and the actions of the immune system. As established antibiotics score mostly insufficient, treatment strategies for biofilm forming bacteria are urgently required. In this project, biofilm formation of relevant pathogens will be analyzed by molecular and system biology methods, a screen for anti-microbial compounds will be performed and the mode of action of anti-microbial compounds will be analyzed on biofilm forming and multdrug resistant bacteria.
The study will be extended to clinical isolates to demonstrate generality of the findings. Pakistani and Swedish scientists’ experts will perform mutually beneficial collaborative research projects, visit to establish novel collaborations on both sides and to exchange ideas and knowledge to educate young researchers to work on basic scientific discoveries of infectious diseases that eventually translated into new therapies. With the support of Swedish research links, reciprocal educational workshops and seminars and hands-on trainings on techniques in infectious diseases will also be organized to establish a long-term research-oriented collaborative network. More information on the Swedish Research Links grants 2015.

Professor Roland Möllby is also working in the Dept. of Microbiology, Tumor and Cell Biology (MTC), heading a research group within the Biomedical Ecology field. He has run scientific projects in Bangladesh for many years and later in Mozambique, Nicaragua and in Iran. He has performed research on pathogenic mechanisms in Staphylococcus aureus infections, Urinary tract infections, Diarrhoeal diseases and on complex floras, like the human normal flora. He is one of the founders of the PhPlate Microplate Technologies AB, which developed the PhP biochemical fingerprinting system and has patented the MARA system for testing of environmental toxicity using bacteria. More information about the research group.

Professor Martin Rottenberg is heading a research group (along with Prof. Hans Wigzell) within the Immunology research node field. His research focuses on dissection of cellular immune responses to mycobacterial infections in mice, reconstituted de novo with human myeloid and lymphoid cellular lineages.
In November 2008, Prof. Rottenberg received SEK 720 000 as a three-years research grant from the Swedish Research Links programme (funded by Sida and the Swedish Research Council) for a Pakistani related project titled ”Regulation and role of “Suppressor of Cytokine Signalling” proteins in the outcome of infection with Mycobacterium tuberculosis”. The collaboration partner on the Pakistani side is Dr Zahra Hassan from Aga Khan University in Karachi. A PhD candidate, Kiran Iqbal, was also involved in the project. More information on the Swedish Research Links grants 2008.
Project abstract: Tuberculosis is a severe infectious disease caused respectively by the intracellular bacteria Mycobacterium tuberculosis. One third of the population worldwide is infected with M. tuberculosis and new infections occur at a rate of one per second. However, only about one in ten of the M. tuberculosis-infected individuals will develop disease TB. TB most commonly attacks the lungs (as pulmonary TB) but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, bones, joints and even the skin. In the rest of the infected individuals, bacteria are not completely eliminated and the infection will persist in an asymptomatic form. The project will investigate if SOCS-1 and a close “relative” SOCS-3, can be involved in an impaired clearance of the infecting bacteria and thereby in development of latency but will also benefit the host by inhibiting severe inflammation. The Pakistani partner will compare the levels of SOCS1 and a close “relative” SOCS-3 in blood cells from patients with latent TB, or with pulmonary and extra-pulmonary active TB, to determine if these molecules are related to their susceptibility to disease. The outcome of this project will be a novel, clinical and experimental in depth assessment of the role of SOCS molecules during mycobacterial infections. It will contribute to the improvement of the design of specific vaccines, to the prevention of severe TB and to a better understanding of the relationships between the invading bacteria and the host immune system. More information.

Vinnova/DBT programe on Treatment of Tuvberculosis

In June 2009, Sweden and India decided to jointly support research in tuberculosis. The Swedish Governmental Agency for Innovation Systems (VINNOVA) and the Department of Biotechnology (DBT), Ministry of Science and Technology, India, agreed to support top level research co-operation between Indian and Swedish scientists in the field of ”Biology, diagnosis and treatment of Tuberculosis”. The programme is one of the first bilateral co-operations, based on joint funding, between the two countries. Under this scheme, VINNOVA funds the Swedish research teams and DBT the Indian side. VINNOVA is committing around SEK 16 million to this program. More information on the Indo-Swedish collaboration project.
Four Indo-Swedish projects, out of a total of 15 proposals, were selected by DBT and VINNOVA and will receive funding for the period 2009–12. More information.
Dr. Markus Maeurer at MTC, was selected for a project entitled ”Biology of gene-deleted M. tuberculosis strains – immunological marker profiling”. The main collaboration partner on the Indian side was Dr. Nagaraja Valakunja, Department of Microbiology and Cell Biology, Indian Institute of Science (IISc) in Bangalore.

Postal address: Institutionen för laboratoriemedicin, KI, Karolinska University Hospital Huddinge F79, SE-141 86 Stockholm, Sweden
Visiting adress: Alfred Nobels Allé 8, plan 7, Huddinge (in the ”Odontology” building)
Web address: http://ki.se/ki/jsp/polopoly.jsp?d=6203&l=en
Contact person: Professor Lennart Hammarström, Head of Division, phone: +46 (0)8 5248 3586

The Department of Laboratory Medicine was formed in 2003 by a fusion of two departments: the Department of Medical Laboratory Sciences and Technology and the Department of Microbiology, Pathology and Immunology. Today, the Department of Laboratory Medicine consists of 9 divisions and it is representative for the laboratory medicine in the full sense of the word. 350 persons work at this department, half of them are PhD students.
In the graduate and post graduate education, there is a great demand of the competence field of this department, i.e. cell biology, laboratory medicine, physiology and technology. The department is one of the largest departments of education at Karolinska Institutet and it is involved in 12 of the 19 study programs including 500 full-time equivalent students. Furthermore, the department offers a great number of single subject courses and contract education courses. The department works closely together with the program of natural sciences at the Södertörns Högskola and the Royal Institute of Technology (KTH).

South Asia related research at the Division:

Prof. Lennart Hammarström leads a research group in Clinical Immunology (more information). The research deals with the role of different cell types in the defense against pathogens, understanding the ”language” used for communication between cells (cytokines/receptors), molecular basis of primary immunodeficiency diseases, the role of the immune system in transplantations (autologous, allogeneic, xeno), mechanisms involved in autoimmunity, and factors underlying the development of allergy Immunotherapy (cytokines, antibodies, immunosuppressive drugs, BMT/stem cell transplantation).
During the 1990s, Prof Hammarström worked on a project in Bangladesh, titled ”Oral immunoglobulin as prophylaxis and treatment of gastrointestinal infection”. The last research grant was given in 1995.

Dr. Shafiqul Sarker from ICDDR,B (Centre for Health and Population Research) in Dhaka, Bangladesh, defended his doctoral dissertation at KI on 12 December 2006. The thesis was titled ”Passive immunotherapy and probiotic agents in enteric infections in children” and dealt with diarrhoeal disease, one of the leading causes of global childhood morbidity and mortality throughout the World. Rotavirus and pathogenic Escherichia coli are the most common causes of acute diarrheal illness in children. The thesis presented results how the rotavirus diarrhoea in children can be effectively treated. Dr. Sarker had been involved in a sandwich PhD programme with the Division of of Clinical Immunology since 2001. He was supervised by Prof. Lennart Hammarström. Read the abstact of the thesis.