Developing a newborn screening system to detect congenital hypothyroidism

Partner Institutes
Queen Mary, University of London	National Health Research Complex, Lahore

Project brief:

Wardah is six, yet starting school is not an option for her. Abnormally short for her age and with distinct facial features, she has the mental age of a one-year old. Instead her mother takes her to a centre for special children thrice a week, where she plays with other children who do not make her feel like an outsider. Wardah is one of the many children in Pakistan who suffer from a thyroid deficiency called congenital hypothyroidism.

The real tragedy is that her condition could have easily been prevented. Congenital hypothyroidism is among several metabolic disorders present at birth that can lead to growth failure and mental retardation. In the developed world, one in every 4000 babies are born with congenital hypothyroidism. But because treatment is so simple and inexpensive, all babies are screened at birth and are treated within one month, to prevent them for being mentally retarded.

In Pakistan, however, the incidence of congenital hypothyroidism is one case per 1000 newborns, which is about 4 times that of the west. More worryingly, there is no means to diagnose the condition at birth, meaning that those born with it have to live with it for the rest of their lives.

The collaboration between Queen Mary, University of London and the National Health Research Complex, Lahore under the INSPIRE banner aims to start and strengthen newborn screening programmes to avoid late diagnosis of congenital disorders that result in unnecessary health and economic burdens for the country and emotional trauma for the family.

Imported systems of screening are very expensive and local hospitals, with their already stretched budgets, do not place great importance on acquiring them. This project plans to develop testing kits locally to make the process of newborn screening inexpensive and accessible to all hospitals across Pakistan. A centralised screening lab has already been established, where blood spot samples are being screened from different hospitals.

National and international in-job technologists, researchers and post-graduate students are also using the facility of this lab, which has been equipped by the donation of the UK link coordinator, the late Dr. Raymond Edwards. 

A very important aspect of the collaboration is to create awareness amongst local communities about congenital disorders so that early screening and diagnosis can be made possible. The project team has carried out awareness campaigns that highlight how simple it is to treat the condition if it is revealed in time. A daily dose of the hormone thyroxin is all that is required to prevent more Wardahs from feeling like they don’t belong.

Lessons learnt: 

The collaboration of Pakistani researchers with labs in the UK has given them the opportunity to broaden their vision, and to learn modern techniques for transfer of technology. They have also learnt to develop reagents at affordable costs for diagnostic use.

Challenges faced:

• Convincing local hospital authorities to implement the screening programme.
• Difficulty in procuring one of the reagents (the detecting antibody).

The impacts/benefits of the project

• Locally developed reagents would be available for establishing a nationwide screening programme. 
• A screening programme for congenital hypothyroidism would be available at an affordable cost and save Pakistan valuable foreign exchange.      
• Newborns could be saved from being mentally handicapped.
• More screening tests could be developed using the same technology.             Further research could be carried out at an affordable cost.

Key contacts:

Prof David Perrett, Queen Mary, University of London 

d.perrett647@btinternet.com, www.qmul.ac.uk/

Farkhanda Ghafoor, National Health Research Complex

fghafoor99@hotmail.com, www.pmrc.org.pk/nhrc.htm

Treating anxiety among adolescents in Pakistan

Partner Institutes
University of Roehampton	Fatima Jinnah Women University

Project brief:

Being a teenager is a tough job – there is pressure to do well at school and get into a good college, the pressure to be socially accepted by peers who can be unquestionably cruel and there are the demands of unreasonable parents who seem to forget that they too were at this awkward stage once upon a time.

It is little wonder then that anxiety is one of the most common problems among adolescents in western countries, affecting up to 18% of people between the ages of 13 and 19. Various sociological and economic factors in Pakistan – escalating poverty, the lack of jobs, poor counselling services, to name just a few – have contributed to a significantly higher rate of anxiety disorders amongst its adolescents. However, no large-scale study has been conducted to date that aims to deal with this growing concern.

The partnership between the University of Roehampton and Fatima Jinnah Women University is seeking to change that by examining the prevalence of anxiety disorders among adolescents in Pakistan and finding ways to control them .

Currently, there is one child psychiatrist in Pakistan for four million children and adolescents with mental health problems. Given the poor health infrastructure within the country, it is understandable that greater attention and resources are devoted to more pressing concerns – such as working with victims of natural disasters. Yet there is need to recognise anxiety as a serious problem that affects human potential, and if unchecked, can trigger other mental disorders such as depression, substance abuse and dependence.

The main objective of the research is to narrow down those unique environmental and cultural factors that cause anxiety in Pakistani teenagers and develop an anxiety-prevention programme to be implemented at the national level. The project also aims to train the end users (caretakers, teachers NGOs etc.) to deliver the programme effectively to a wide range of adolescents.

Lessons learnt:

This would be the first study of its kind which will enable the researchers to identify the prevalence as well as the plausible risk factors for anxiety among Pakistani children and adolescents between the ages of 13 to 19. This will allow the team to manipulate the risk factors that are involved in the development of and maintenance of anxiety.

Challenges faced:

There are many impediments to collecting epidemiologically sound data in developing countries. However, despite the limited resources, it is possible to carry out evidence-based research. This can be facilitated by collaborative efforts which can lead to effective strategies and guidelines to establish future assessments and interventions.

The impacts/benefits of the project:

The development of cost-effective programmes to prevent child and adolescent anxiety disorders will be beneficial not just for the child but also for the family and the society at large. It will increase productivity and enhance potential. 

Key contacts:

Professor Cecilia A. Essau, University of Roehampton

C.Essau@roehampton.ac.uk, www.roehampton.ac.uk

Dr. Farah Qadir, Fatima Jinnah Women University

drfarahqadir@yahoo.co.uk, www.fjwu.edu.pk/

Co-Combustion of Pakistani Coal and Biomass in Pilot Scale Combustors

Partner Institutes
University of Leeds	Pakistan Institute of Engineering and Applied Sciences, Mehran University, University of Punjab and Islamic International University

Project brief:

A steady increase in atmospheric carbon dioxide levels each year is contributing to global climate change. Hence, there is a push to develop low carbon combustion technologies. Pakistan’s huge coal reserves in Thar provide an ideal alternative for power generation and can help significantly reduce the gap between power supply and demand that is crippling the country.

The Pakistan Institute of Engineering and Applied Sciences has come together with multiple universities in Pakistan, namely Mehran University, University of Punjab and Islamic International University, as well as industrial giant Engro to come up with an alternative energy source. The University of Leeds is the UK partner under the INSPIRE brand umbrella.

The project will focus on technical developments to bring about the clean combustion of Thar coal at a pilot scale to gain information on how this coal will perform in a power plant. The results will be compared with those from a database of results of world coal combustion tests. The project has vast potential for commercialisation. National and international power companies and the government of Pakistan itself would be the main users of this technology. The impact will be enormous in terms of economical development and improvement in the quality of life in general by provision of cheap, clean and uninterrupted electricity to the nation’s individual consumers and industries.

The results of the research will be published on the 34^th International Symposium on Combustion, the European Conference on Coal Research and Its Applications as well as the World Congress of Chemical Engineering. It will also be published in international Journals of repute for wider audiences. The project will have a multidimensional effect in the region and will act as a catalyst for strong linkages with other national/international organisations.

An annual international workshop is being planned, which will help in developing better linkages regionally/internationally. This workshop would be telecast live to all participating institutes and will allow participating countries and higher education institutes to benefit from the research. As a result, there will be a flow of research projects from the Pakistani industry to local universities, increasing the levels of industrial funding and interaction.

Lessons learnt:

Partnerships among universities across the borders is a very conducive way to enhance research output.

Challenges faced:

The major challenge posed was the difficult working environment.

The impacts/benefits of the project:

The project will have a significant impact on national priorities and it has met with great success in transforming key organisational strategies on power generation in Pakistan.

Key contacts:

Dr. Bill Nimmo, University of Leeds

w.nimmo@leeds.ac.uk, www.leeds.ac.uk/

Dr. M. Tayyeb Javed, Pakistan Institute of Engineering and Applied Sciences

m.t.javed@pieas.edu.pk, www.pieas.edu.pk/

Increasing the efficiency of wind energy systems

Partner Institutes
Cambridge University	Air University

Project brief:

The Pakistan Electric Power Company (PEPCO) has admitted that the country is facing a massive electricity shortfall of 7200 MW, unparalleled in our history. With power plants shutting down across the country and the demand for power unmet by almost 40%, we need to turn to alternative energy sources to help us out of this crisis.

Wind energy is one such readily available option. Not only is it a renewable source of energy, it has a very low carbon footprint, an important consideration given the high levels of pollution in Pakistan. Globally, wind turbines generate about 2% of the entire electricity usage.

Air University, in collaboration with the University of Cambridge, is developing a micro-machined sensor that would enable wind turbines to function more effectively. Such a sensor would be the world’s first, and would be of significant research, industrial and commercial value.

A design for the sensor has already been conceived and patent protected by the team of researchers from Cambridge University and Air University. During the last phase of this project, on-turbine tests are planned on a 20kW wind turbine, which is owned by Cambridge Wind Technology and is located next to the Whittle Lab at the University of Cambridge. As a result, it provides an ideal location for quickly and efficiently testing the sensor.

Through this partnership, Air University will be able to develop long-term research links with Cambridge. The faculty at Air University will benefit from the experience of the world’s best academics and researchers at Cambridge University. This will improve the overall teaching and research standards at Air University and increase awareness of its cutting-edge research projects that aim to transform the way we live.

Lessons learnt:

It is both exciting and challenging for the Pakistani team to work on an international collaboration project with a top class university like Cambridge.

Challenges faced:

Keeping the desired pace of the research activities has proved to be challenging. This is partly due to a difficulty in finding a suitable PhD student for this project which needed a niche research/educational background.

The impacts/benefits of the project:

• The project aims to produce the world's first fast-response micro-machined entropy sensor which, if successful, will allow the direct measurement of the performance of both gas and wind turbines.
• The sensors proposed in this project are and will be IP protected. Therefore, contingent upon their good performance, they can become commercial products. If that happens, both UK and Pakistan governments will benefit.
• The project will also facilitate the introduction of world-class engineering courses (adopted from Cambridge) at a nascent Pakistani university.
• The faculty members at Air University will learn and benefit from some of the world's best academics and researchers at Cambridge University. This interaction will bring about new ideas for collaborative research, improve teaching standards and develop the interpersonal and teaching/research skills of Air University faculty. Numerous Pakistani students will benefit from the presence of a more educated, experienced and internationally-linked faculty at Air University.

Key contacts:

Prof. Florin Udrea, University of Cambridge

fu@eng.cam.ac.uk, www.cam.ac.uk/

Dr. Ibraheem Haneef, Air University

Ibraheem.haneef@mail.au.edu.pk, www.au.edu.pk/

Women empowerment and the crisis of good governance in South Punjab

Partner Institutes
Royal Holloway College, University of London	Bahauddin Zakariya University, Multan

Project brief:

17-year-old Shakorwan Bibi woke up feeling feverish on the morning of July 19^th, 2010. Having been unwell for the past few days, she decided to visit the local hospital in her hometown Dera Ghazi Khan for a check-up. Little did she know that this simple decision would cost her her life. On her return home, she was brutally stabbed to death by her father who thought his daughter had defamed the family’s honour by allowing a doctor to examine her.

Such outrageous cases of violence against women are, unfortunately, a common occurrence in Pakistan. According to the Human Rights Commission of Pakistan, 675 females were murdered for honour during the first nine months of 2011. Given their treatment as second class citizens in this male-dominated society, it is impossible for them to speak out and take action against such injustices.

Royal Holloway College, University of London and Bahauddin Zakariya University in Multan, Pakistan have collaborated to provide women a voice and make them active participants of the political process. The underlying belief of the researchers is that unless women are given due representation at the local level, they will remain incapable of protecting their rights.

The aim of this project is to address the marginalisation of women in Pakistani society, something which was seemingly addressed by the state in 2001 in terms of providing them with substantial representation (33%) in political institutions operating at the level of union council, tehsil (sub-division) and district. Within this political framework, women were to be realised as an agent of change through the acquisition of political power, which was to be functional through the devolution of power structures. This study will evaluate the performance of local government institutions and parallel power structures to see how far the status of women has been bolstered and whether their lot has improved.

The researchers will work with non-governmental agencies operating in the area so that the academic output can be translated into practical results. Training and capacity building is a major output and five optional courses will be developed by faculty from Bradford University.

Bahauddin Zakariya University plans to implement gender research at the post graduate level and train its faculty members in gender-related issues through exchange programmes with the Royal Holloway College. This will create a team of researchers and academics who have the sensitivity and the expertise to tackle local customs that perpetuate violence against women while providing counselling to victims who often have no one to turn to.

Lessons learnt:

• The Pakistani team has been provided the opportunity to interact with esteemed UK social scientists and historians. This experience with political figures (male & female) active within UK local councils brought to the knowledge of the visiting team that assertiveness of women for their rights could come through their self-awareness and as well by the complementary role of power structures through which services are dispensed.
• The UK team, meanwhile, has gained a better understanding of the various challenges and constraints that relate to the empowerment of women in south Punjab and how local researchers need to organise their teams in order to carry out projects in relation to this issue.

Challenges faced:

• The main challenge relates to Pakistan’s current political circumstances that mean that people from the UK may feel worried about travelling to Pakistan. However, the December 2011 visit of the UK team went smoothly.
• The aspect of field research is proving laborious due to the non-cooperative attitude of some of the staff members and local councillors involved in some of the union councils.

The impact/benefits of the project:

• The empirical study and research being conduced by students and faculty has brought local stakeholders within the framework of informal discourse to discuss, share knowledge and learn about the effects of the operational barriers and cultural constraints that have hindered women from becoming active agents of social change.
• This project will eventually produce a much clearer idea of the kinds of pressures operating at the level of local representative councils to inhibit or encourage female participation. The data collected will help identify the kinds of initiatives required to enhance female participation at this level.

Key contacts:

Dr.Sarah Ansari, Royal Holloway College, University of London

s.ansari@rhul.ac.uk, www.rhul.ac.uk/

Dr. Azra Asghar Ali, Bahauddin Zakariya University

azraasg@yahoo.co.uk, www.bzu.edu.pk/

Lancashire to Lahore: Exchanges to develop cultural understanding

Partner Institutes
University of Central Lancashire and School of Visual Arts	Beaconhouse National University

Project brief:

Visual arts embed in itself the cultural heritage of Pakistan, whether it is in the form of photography, calligraphy, landscape painting, printmaking or even filmmaking. The arts community in Pakistan has a vibrant and diverse repertoire of work that represent the real face of the country.

The Beaconhouse National University has initiated a strategic partnership with the University of Central Lancashire to develop a communications link that will document the contemporary culture of Pakistan. This INSPIRE partnership will provide a platform for local communities in the two countries to engage and explore the personal perceptions of the institutions within UK and Pakistan. This will lead to a dialogue between the communities and a fuller understanding of cultural differences.

The program involves a small-scale postcard exchange which was successfully piloted in 2010. Through visual communication; powerful political, personal and creative viewpoints were also exchanged. There are also opportunities to chat informally in designated forums about global issues and discuss and develop future symposia topics and plan group exhibitions together. A highly interactive website is due to be launched soon where discussions would be carried out and an online facility with live video conferencing would be available, both by recording and presenting information onscreen.

Staff exchanges between the two institutes are one of the key aims of the venture and the delivery of training will enable the development of new skills to support this project and instil this participatory learning into the curriculum. The learning and training set in place will provide a cornerstone in the policymaking of the institute. 

The main aim of the linkage is to grow and develop the idea of ‘international exchange through art’ into the curriculum, maximise knowledge, skill and social interaction. Also, a significant outcome of the partnership is to have accredited modules and extracurricular activities for the students of Beaconhouse National University.

Lessons learnt: 

The project has been a great learning experience for both institutions. The first visit (BNU to UCLan) occurred in December 2011 and the trip was extremely well organised by Mr. William Titley and his team. The BNU team were given a tour of the facilities the university has, which gave them ideas for developing similar facilities at BNU. The BNU team not only attended workshops but also gave talks to UK students on art practices in Pakistan. Views on art, culture and social perspectives have been exchanged through this initiative. 

Challenges faced:

It has been smooth so far.

The impacts/benefits of the project:

The impact will be far-reaching in terms of the knowledge exchange that has and is going to take place.

Key contacts:

William Titley, University of Central Lancashire

WDTitley@uclan.ac.uk, www.uclan.ac.uk/

Salima Hashmi, Beaconhouse National University

hashmisalima@hotmail.com, www.bnu.edu.pk/

Wastewater reclamation using advanced treatment technology

Partner Institutes
University of Oxford	The Institute of Environmental Science and Engineering, NUST

Project brief:
Pakistan is an agricultural country with a population of approximately 180 million and a current growth rate of 1.8%. The rapid increase in population, coupled with growing urbanisation and industrialisation, has resulted in a shortage of fresh water supplies across the country, particularly in the major cities. Moreover, the few sources of fresh water still left are heavily contaminated because of untreated waste disposal. 

The INSPIRE partnership between NUST, Pakistan and the University of Oxford poses a novel way to clean water and make it useable for the general public. The project will utilise a new technology known as a membrane bioreactor (MBR), an efficient and cost-effective system of treating sewage that is being introduced worldwide. 

The facilities at Oxford and NUST will be used for evaluating the treatment technology, as well as training faculty and graduate students in the field of environmental engineering. This partnership will also open up new avenues for research collaboration between Pakistan and other European countries, particularly the Netherlands, Germany and France, as the research findings will be regularly presented in specialised conferences on membrane technology, wastewater reclamation and reuse, and biological processes etc. 

The project will involve setting up a laboratory-scale MBR at the Institute of Environmental Science and Engineering, NUST. This will allow students and faculty to interact with cutting edge technology on a first-hand basis and come up with innovative ways to overcome the country’s current water woes.

Lessons learnt: 
Teams from both universities have learned that there is considerable knowledge and expertise that can be shared between them and on that basis, further improvement in MBR technology can be investigated and developed. In this regard, the draw solutions for forward osmosis MBR (FO-MBR) are being developed and optimised at the University of Oxford and the MBR design, setup and operation of variable configurations is being investigated at the Institute of Environmental Sciences and Engineering (IESE), NUST. The combined efforts of both teams led to a successful international workshop, “Technological advances and challenges in water reclamation and reuse” on 8-9 December 2011 at the NUST campus in Islamabad in which 75 professionals and 200 graduate and post-graduate students participated.

Challenges faced: 

• The main issue being faced is the lack of funds to purchase permanent equipment for establishing and executing bench-scale MBRs at NUST.

The impacts/benefits of the project:

• The establishment of an MBR demonstration facility at bench-scale for water reclamation and reuse at NUST as well as University of Oxford. Such a facility will contribute to the advancement of MBR technology worldwide, in general and in Pakistan and the UK, in particular. Students and faculty from both institutions will benefit immensely from this facility.
• International workshops jointly conducted by NUST and the University of Oxford at the NUST campus in Islamabad have been pivotal in providing information to professionals, faculty, researchers and students on membrane science technology and applications keeping in view the local perspective of water reclamation and reuse.
• Exchange of PhD students between the institutions, particularly the short-term, four-month visits of PhD students from NUST to the University of Oxford, will help in achieving the research objectives and also add to their personal and professional development. 

Key contacts:
Dr Nick Hankins, University of Oxford
nick.hankins@eng.ox.ac.uk, www.ox.ac.uk

Dr. Sher Jamal Khan, Institute of Environmental Science and Engineering, NUST
s.jamal@iese.nust.edu.pk, www.nust.edu.pk