The Aga Khan University Hospital in Karachi and the Unity of Din and Dunyā
Résumé
In 1969, the Aga Khan IV, the forty-ninth hereditary Imam (spiritual and temporal leader) of the global Shiʻi Ismaili Muslim community, selected a “suitable team” to design and construct the Aga Khan University Hospital in Karachi, Pakistan. The buildings began going up in 1971, and the complex was completed in 1985. This article situates the design and planning of the University Hospital in the context of 20th-century hospital architecture to explore how it was designed and planned differently from Western models of the period. It shows that the University Hospital was designed to embody the Aga Khan IV’s theological quest for harmony between dīn (faith) and dunyā (world). Understanding and appreciating this theological quest helps going beyond merely adding the University Hospital to the historiography of hospital architecture in the 20th century to discern how it diversifies this historiography. Since the quest for harmony between dīn and dunyā raises the question of whether the Aga Khan IV supported ambitions for Pakistan as an Islamic state, the article also reflects, although briefly, on the place of the University Hospital in ambitions for Pakistan.
Entrées d’index
Index chronologique :
XXe sièclePersonnes citées :
Aga Khan IV (1936-2025)Plan
Haut de pageTexte intégral
- 1 Thomas M. Payette, “Designing the Aga Khan Medical Complex,” in Margaret Bentley-Seycenko (ed.), Th (...)
- 2 Ibid.
- 3 Shamash Nanji, “Guidance amid Great Changes,” Africa Ismaili, 11 July 1982, p. 48.
1In 1969, the Aga Khan IV, the forty-ninth hereditary Imam (spiritual and temporal leader) of the global Shiʻi Ismaili Muslim community, selected a “suitable team” to design and construct the Aga Khan University Hospital in Karachi, Pakistan (fig. 1). The team consisted of architects, landscape architects, contractors, health consultants, and “traditional” tilemakers. Thomas Payette, the principal of Payette Associates of Boston (USA), and Mozhan Khadem, an Iranian-American architect, were among the members of this team. Upon the Aga Khan IV’s instructions and Khadem’s recommendation, Payette and Khadem went on a study trip to Spain, North Africa, Turkey, Iran, and Pakistan to visit “several of the major historic sites.”1 Writing about the “process” by which the team arrived at the design, Payette noted in 1988: “[t]hat process of discovery was the soul of the design process. The results freed us from some of our Western assumptions about what a hospital ought to be.”2 This statement is intriguing, especially if it is considered alongside Shamash Nanji’s statement in 1982, that “one could almost say [the University Hospital was] designed to change meanings of hospital and health care in general.”3 Together, these remarks prompt us to reconsider the historiography of 20th-century hospital architecture as we know it, which is largely confined to the tropes of modernization discourse and connected to the rise of liberal international organizations. Payette and Nanji’s statements encourage us to investigate non-Western starting points, worldviews, priorities, and needs. With that in mind, I explore how the Aga Khan University Hospital was designed differently from Western models of the period.
- 4 URL: https://www.archnet.org/; https://the.ismaili/; https://www.architecturalrecord.com/articles/1 (...)
2In the following, I draw on published and unpublished articles and the Aga Khan IV’s speeches. These documents are held at the Institute of Ismaili Studies (ISI), London; the Royal Institute of British Architects (RIBA) Library, London; the University of Utrecht Library; and McGovern Historical Research Center, Houston Academy of Medicine-Texas Medical Center Library. I supplement these documents with online materials available on Archnet, the.ismaili, and Architectural Record Archive.4
- 5 Tom Avermaete and Cathelijne Nuijsink, “Architectural Contact Zones: Another Way to Write Global Hi (...)
- 6 Making a firm distinction between the Aga Khan IV’s private and public visions requires proper theo (...)
- 7 Daryoush Mohammad Poor, Authority Without Territory: The Aga Khan Development Network and the Ismai (...)
- 8 The question of how to conceptualize the role and agency of the design team members is part of my w (...)
- 9 Lynn M. Thomas, “Historicising Agency,” Gender and History, vol. 28, no. 2, 2016, p. 327. DOI: http (...)
- 10 Talal Asad, “Agency and Pain: An Exploration,” Culture and Religion: An Interdisciplinary Journal, (...)
- 11 Stephanie Olsen, Kristine Alexander, Susan Miller, Ville Vuolanto, Simon Sleight, Mischa Honeck, Sa (...)
3My goal is not to describe the vision of every design team member. To do so would require cross-referencing the above materials with those from every member of the design team, along with local sources (if necessary, incorporating oral history and “[digital] concept-mapping techniques”).5 That is outside the scope of this study. Rather, my focus is entirely on the Aga Khan IV’s (public) vision.6 Although various people were involved, his vision played a decisive part, not least because, instead of merely commissioning the facility, the Aga Khan, who had studied Islamic history at Harvard, was actively involved in the design development. In addition to considering the Aga Khan’s role in the context of his knowledge of Islamic history, we shall also view it in relation to his imāmate, which Daryoush Mohammad Poor has described as a “bifocal leadership.”7 The Aga Khan IV interpreted the faith, and on that basis, he provided guidance on this-worldly matters. In sum, although the design process of the University Hospital was collaborative in some ways, it was guided by a definite vision, which must be incorporated into future investigations into the work of the design team.8 This is not to strip other design team members of agency; rather it is to highlight the importance of moving away from the notion of agency as “the defining contribution” to consider the form, scale, and scope of other members’ activities.9 Since imāmate is viewed as a divinely guided leadership, it is only logical to consider how the team conceptualized their design through its agency. Although this might not mean that they were willingly powerless,10 it does mean that “reliance on modern, Western, enlightenment-based understandings of selfhood, action, autonomy, and rational choice” cannot explain their involvement and contribution.11
4First, I shall offer an overview of the historiography of hospital architecture in the 20th century to highlight the underlying fault lines that continue to undermine alternative ideas and practices. Next, I provide a brief account of the design and construction process of the University Hospital from 1963 to 1985. Since my aim is to discuss how the design of the University Hospital differed from Western models of the period, I make no attempt here to situate the University Hospital in the context of healthcare history in Pakistan. Rather, I simply show when the hospital was commissioned, who was involved in the design and construction process, and when the complex was completed and opened. Subsequently, I examine the architecture of the University Hospital. A cursory examination might place the University Hospital alongside such hospitals as Saigon University Hospital, South Vietnam, which was constructed in the 1970s. But I contend that the University Hospital is part of a story that began in the 19th century. This longer story helps us understand how the University Hospital was designed to embody the Aga Khan IV’s theological quest for harmony between dīn and dunyā, which is what makes the facility stand out in and diversify the historiography of 20th-century hospital architecture. The Aga Khan IV’s quest for harmony between dīn and dunyā raises the question of whether he supports ambitions for Pakistan as an Islamic state. Thus, the last part of the article briefly reflects on the place of the University Hospital in ambitions for Pakistan, without offering any specific position on the question.
Figure 1: Aerial view of the Aga Khan University Hospital in Karachi.

Source: Photo by Gary Otte. Archnet. Creative Commons Attribution Non-commercial 4.0 International (cc BY-NC 4.0).
Historiography of 20th-century hospital architecture
- 12 Fay Bound Alberti, Matters of the Heart: History, Medicine, and Emotion, Oxford: Oxford University (...)
- 13 Hilary Marland, “The Changing Role of the Hospital, 1800-1900,” in Deborah Brunton (ed.), Medicine (...)
- 14 Cynthia Imogen Hammond, “Reforming Architecture, Defending Empire: Florence Nightingale and the Pav (...)
5Hygiene, fresh air, sunlight, ordering and administrating life, and righting, protecting, and enhancing the body and the mind are among the concepts generally agreed to have driven hospital design since the mid-19th century. The story goes as follows: integral to the rise of these concepts were 19th-century medical and scientific separation of body, mind, and soul (known as “Cartesian dualism,”) that located mind in the brain and reduced the body to a mere reactive force in the production of emotion,12 and the modern state's reliance on health and wellbeing for its political power.13 These concepts were first embodied in the pavilion-plan hospital in 19th-century Europe. They were simultaneously adjusted, adapted (e.g. “tropicalized”), and circulated across European imperial territories. Influential in popularization and global circulation of the pavilion-plan was Florence Nightingale’s work during Crimean War (1853-56) and her subsequent book, Notes on Hospitals (1863). The pavilion plan was also spread by the British Army, the Paris-based Office International d’Hygiène Publique (OIHP), and inter-imperial flows of architectural exchange and expertise.14
- 15 Cynthia Imogen Hammond, “Reforming Architecture, Defending Empire,” op. cit. (note 14), p. 1; Jiat- (...)
6Advocates of the pavilion plan were concerned with the high mortality rate in hospitals, which they linked to bad air, or miasma, accumulated in dark and stagnant spaces, as well as lack of discipline and surveillance. To limit the spread of hospital infection, they aimed to allow air—and natural light—to permeate every part of the hospital, and to impose strict disciplinary regimes. Thus, medical-scientific, environmental, social, and political factors intertwined to shape and popularize the pavilion-plan hospital. If pavilion-plan hospitals were meant to control and discipline impoverished or female bodies in the metropole, they were also meant to create “healthy” armies and enhance the productivity of labor to successfully exploit economic resources, hence defending and cementing empires.15 These key principles dictated hospital planning long after discoveries in bacteriology rendered the concept of miasma obsolete.
- 16 Jonathan Hughes, “The ‘Matchbox on a Muffin’: The Design of Hospitals in the Early NHS,” Medical Hi (...)
- 17 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 243.
- 18 Ibid.; Jonathan Hughes, “The ‘Matchbox on a Muffin’,” op. cit. (note 16), p. 30-32.
- 19 Julie Willis, Philip Goad and Cameron Logan state that, “in many respects, the discourse that arose (...)
7There were some noticeable, although not widespread, changes in the second decade of the 20th century. Wards were subdivided into smaller sections, and bigger and more integrated, pavilions were constructed to improve efficiency.16 To be sure, from the 1920s onwards, pavilion-plan hospitals began to fell out of favor, judged to be unfit to support aseptic procedures and to accommodate rapidly changing technological advancements. They were slowly being replaced with high-rise, office-like structures. It is important to note that US-based hospital practitioners, who were (among) the first to advocate for high-rise hospitals, were not merely concerned with efficiency; they were also motivated by a desire to disentangle American hospital architecture from European standards.17 Only in the 1940s and the 1950s did securing fresh air become less of a concern. Hospitals were now being widely viewed as medical, technological, and health factories.18 Thanks to the establishment of the US-based International Hospital Association (IHA)—later renamed the International Hospital Federation (IHF)—in 1929, the British-based Nuffield Foundation in 1943, and efforts of architects such as Paul Nelson (1895-1979) and Richard Baron Llewelyn-Davies (1912-1981), high-rise hospitals were built in many parts of the world, in the following decades, until the 1980s.19
- 20 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 299.
- 21 Paul Emmons and Andreea Mihalache, “Architectural handbooks and the user experience,” in Kenny Cupp (...)
- 22 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 308-317; Joy Knoblauch, The Arc (...)
- 23 To read more about antibiotic resistance, see Claas Kirchhelle, Pyrrhic Progress: The History of An (...)
- 24 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 338-342; Annmarie Adams, “Decod (...)
8Flexibility and efficiency—the ability to adapt to and accommodate new scientific discoveries, technological advancements, and changing nursing requirements—replaced cross-ventilation as the catchword in the 1940s and the 1950s.20 The demand for flexibility and efficiency was also a response to the increasing standardization of building elements, promoted by the publication of the architecture manuals.21 Coupled with the fear of cross-infection and contamination, the perceived need for flexibility and efficiency ultimately changed hospital planning in a way that made the construction of high-rise structures unfeasible. Meanwhile, the making of flexibility and efficiency into top design priorities turned hospitals into medicalized machines or factories, which were deemed unattractive and unpleasant. Consequently, by the mid-20th century, the crucial question facing hospital designers had become how to combine architectural and psychological insights to design flexible, efficient, attractive, and pleasant hospitals.22 Nevertheless, post-war urgencies and urban transformations ensured the continuation of the high-rise hospital trend for much longer than some medical and architectural practitioners desired. The resurgence of nosocomial infection rates, due to antibiotic-resistant strains of bacteria,23 coupled with increasing demands for the normalization of healthcare environment, finally led to the emergence of new hospital planning principles in the 1970s and the 1980s.24
- 25 Annmarie Adams, “Canadian hospital architecture: How we got here,” CMAJ, vol. 188, no. 5, 2016, p. (...)
- 26 Cor Wagenaar, “Five Revolutions: A Short History of Hospital Architecture,” in Cor Wagenaar (ed.), (...)
- 27 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 308-317.
9The following picture emerges from this historiography: the hospital as a ventilation and disciplinary system, a medicalized machine, and finally a therapeutic, attractive, and efficient workplace.25 However, this outline holds true only if we consider modern hospital movement solely a product of the emergence of the modern state; the “victory of science, philosophy and technology”; the separation of body, mind, and soul; and the rise of liberal international discourse.26 The only diverging scenarios pointed out by Jeanne Kisacky are differences between North American and European hospitals during the modernist movement, and ongoing uncertainties about the value of a hospital as a ventilation system or a medicalized machine.27
- 28 Cristiana Bastos, “The Hut-Hospital as Project and as Practice: Mimeses, Alterities, and Colonial H (...)
- 29 Ayşe Zarakol prefers to speak of “world orders” instead of “international orders.” See Ayşe Zarakol(...)
- 30 Ana Antic, Johanna Conteri and Dora Vargha, “Conclusion: Beyond Liberal Internationalism,” Contempo (...)
10Yet studies by Cristiana Bastos, Cathy Keys, Simon de Nys-Ketels, and myself have highlighted, no matter how implicitly, that a sole focus on the British Army, the Office International d’Hygiène Publique, the International Hospital Federation, and the Nuffield Foundation exaggerates the importance and reach of these institutions.28 Such an approach assumes that there exists a pure or authentic form of international order (or world order).29 It fails to differentiate between cultural differences in the philosophy of science and technology. It also takes the separation of body, mind, and soul as tenable. As a result, it does not account for groups and projects that had fewer members or were short-lived,30 and neglects alternative practices and different beliefs about the body-mind-soul relationship.
- 31 These is increasing work on the socialist world in global health history. For example, see Dora Var (...)
- 32 “News from the International Catholic Confederation of Hospitals,” World Hospitals, vol. 3, 1967, p (...)
- 33 Annmarie Adams, “Canadian hospital architecture: How we got here,” op. cit. (note 25), p. 370-371.
11Clear is the need for an expanded and diversified historiography of hospital provision and design in the 20th century, in which socialist, Christian, and Muslim world orders, to name but a few, are considered on their own terms.31 The activities of organizations such as the International Catholic Confederation of Hospitals (ICCH), which was active in East Asia, East Africa, and the Middle East and co-operated with the IHF, are completely unknown,32 as are the activities of the Aga Khan IV and the Ismaili global community. Not only do we not know “how we got here,” to use Annmarie Adams’s phrasing,33 but we are also unclear on what “here” encompasses.
The design and construction process
- 34 “A Glorious Record,” Africa Ismaili, 11 July 1982, p. 8; High Highness Aga Khan IV, Speech at the d (...)
- 35 Neil Davidson, An Archive of the Aga Khan University Medical College, 1983-1990, 29 May 1990, p. 5. (...)
- 36 Ibid.; Also see Stuart W. Leslie, “New Universities for a New Nation: American Architects Redesign (...)
- 37 “600-bed Aga Khan Hospital and Medical College for Pakistan,” Africa Ismaili, vol. 4, nos. 3-4, 197 (...)
- 38 Mildred Schmertz, “Indigenous High-tech,” Architectural Record, vol. 175, May 1987, p. 136. URL: ht (...)
12On July 11, 1957, his Highness Prince Karim Al-Husayni Aga Khan succeeded his grandfather, Sir Sultan Mohammad Shah, the Aga Khan III, becoming the forty-ninth hereditary Imam of the Nizari Shiʻi Imami Ismaili Muslims. Although the topic of hospital construction was at the back of the Aga Khan IV’s mind from the beginning,34 it was not until 1963 that he met for the first time with the Central Health Board for Pakistan and its Chairman, Dr. Habib Patel, to discuss “the possibility of setting up an Aga Khan Hospital in Karachi.”35 He officially announced his decision to commission a hospital and medical college on December 20, 1964.36 Subsequently, it took three years to choose a suitable plot of land, a year and half to obtain the required tax exemption, and about another year to select a “suitable team.”37 The members of the team were based in or from the US, Canada, the UK, Iran, and Pakistan. The Aga Khan IV also played a role in “conceptualization and design development” along with his brother, Prince Amyn, who paid particular attention to “interior design and ornamentation.”38
- 39 “600-bed Aga Khan Hospital and Medical College for Pakistan,” op. cit. (note 37), p. 18. According (...)
- 40 Murray Fraser, “Davies, Richard Llewelyn, Baron Llewelyn Davies (1912-1981),” Oxford Dictionary of (...)
- 41 Richard Baron Llewelyn-Davies, Hugh Montagu, and Cameron Macaulay, Hospital Planning and Administra (...)
- 42 Neil Davidson, An Archive of the Aga Khan University Medical College, op. cit. (note 35), p. 10.
- 43 They published an article in Architectural Record in 1942. Frederick Markus and Paul Nocka, “Constr (...)
- 44 Mildred Schmertz, “Indigenous High-tech,” op. cit. (note 38), p. 135.
13According to Dr. Habib Patel, president of the Aga Khan Central Health Board for Pakistan (1955-1973), the Aga Khan IV selected a suitable team after meeting several “Hospital Planning Consultants in America, France and the UK in 1968.”39 He initially recruited Messrs. Llewelyn Davies of London and Arthur D. Little of Boston to prepare a feasibility report and assist in the designing of the University Hospital. Richard Baron Llewelyn-Davies was a prominent figure in post-war hospital research and design in Britain.40 Among other things, he is known for co-authoring a book for the World Health Organization (WHO) entitled Hospital Planning and Administration (1966).41 According to Neil Davidson, the Chairman of the Department of Physiology (1983-1990), the report Llewelyn Davies co-authored was rejected after a year for not considering “the specific requirements of Pakistan” and because it “did not come up to expectations.”42 The Aga Khan IV then recruited Thomas Payette of Markus and Nocka, a Boston firm that specialized in hospital design.43 Mozhan Khadem was taken on as a design consultant and Garr Campbell (1942-2011) of Sasaki Associates in Watertown, Massachusetts as the landscape architect.44
- 45 The Aga Khan IV graduated from Harvard in 1959.
- 46 Philip Jodidio, Under the Eaves of Architecture. The Aga Khan: Builder and Patron, Munich; Berlin: (...)
14Notwithstanding, some personal connections might have been involved. Payette, Khadem, and Campbell all earned degrees from the Harvard Graduate School of Design in the 1950s, when the Aga Khan IV was studying Islamic History at the same university.45 Payette did not recall knowing Khadem, but recalled being recruited under the condition that he would work with him. Similarly, Payette knew little about the Aga Khan IV aside from who he was. However, he did know Morgan Wheelock, the only North American on the hiring committee. “One morning at breakfast in Wheelock’s home,” Wheelock suggested to Payette that he should apply for the Karachi project.46 Meanwhile, Campbell had previously been involved in designing of the Aga Khan IV’s residence in Chantilly, France.
- 47 “Speech by His Highness the Aga Khan on Occasion of Hospital Foundation Stone Laying Ceremony,” 03 (...)
15Payette and Khadem began the planning after their one-month study trip to Spain, North Africa, Turkey, Iran, and Pakistan. The planning stage took almost two years between 1969 and 1971. After a feasibility study, a team from the Economist Intelligence Unit and International Professional Consortia prepared a report with the help of the Pakistan Medical Association.47 Subsequently, the foundation stone of the University Hospital was laid on February 3, 1971 by the President Yahya Khan of Pakistan. Construction of the buildings was officially commenced in 1972. The School of Nursing was opened in 1981 (fig. 2) followed by the Hospital in 1985 (fig. 3).
- 48 “The Aga Khan University Hospital, Karachi,” Mimar: Architecture in Development, vol. 14, 1984, p. (...)
- 49 Ibid., p. 33.
16The University Hospital was built on 84 acres of land, off Stadium Road to the east of Karachi. It comprises a 721-bed hospital, a community clinic, a medical school, a school of nursing, male and female student dormitories, and a mosque.48 Rather than being a free-standing high-rise structure, or an “object building,” the University Hospital consists of several interconnected, low-rise structures of no higher than three floors (see fig. 1). Only the private wing is a four-story building. Apart from the private wing, which provided accommodation for 127 patients, the rest of the University Hospital’s accommodation was designed as general five-bed wards and semi-private rooms (fig. 4).49
Figure 2: Mowlana Hazar Imam and President Zia cut the ribbon to open the School of Nursing in Karachi on February 16, 1981.

Source: Ismaili Africa, 1982. Reprinted with the permission of the Institute of Ismaili Studies (IIS). The IIS owns and retains at all times the copyright on this item from its special collections. It may not be reproduced physically or digitally without prior written permission from the IIS.
Figure 3: Mowlana Hazar Imam performs the ground-breaking ceremony for the final phase of the Aga Khan Hospital and Medical College, Karachi.

Source: Ismaili Africa, 1982. Reprinted with the permission of the Institute of Ismaili Studies (IIS). The IIS owns and retains at all times the copyright on this item from its special collections. It may not be reproduced physically or digitally without prior written permission from the IIS.
Figure 4: Site plan of the Aga Khan University Hospital.

Source: Wolfgang Pehnt, “Im Namen Allahs: Das Klinikum der Aga Khan Universität in Karachi, Pakistan,” Bauwelt, vol. 26, 1986, p. 981. Available at the RIBA Library, London. Reprinted with permission.
The unity of din and dūnya
- 50 Mildred Schmertz, “Indigenous High-tech,” op. cit. (note 38), p. 136.
- 51 Wolfgang Pehnt, “Im Namen Allahs: Das Klinikum der Aga Khan Universität in Karachi, Pakistan,” Bauw (...)
- 52 Jason W. Frye, “A Healthier Look at Hospitals,” AIA Journal, January 1971, p. 28. URL: https://usmo (...)
- 53 H. Robert Douglass, “Health Education in Developing World: A Discussion of the Planning and Design (...)
17Despite Mildred F. Schmertz’s claim in an article for Architectural Record in 1987, the University Hospital was not different from conventional Western models for having a low-rise design. Schmertz wrote that “it was determined from the beginning that the complex should be an architecture of continuous interior spaces surrounding the observer rather than an ‘object building’ standing apart and aloof from him.”50 He further indicated that, while there had been other low-rise hospitals, the Aga Khan University Hospital was “the most notable” one. However, low-rise hospitals were not a product of the 1970s, as already shown. In an article about the University Hospital in 1986, Wolfgang Pehnt highlighted this point: “in 1972, when planning began, it was also an obvious decision in the West if one wanted to avoid multi-story buildings.”51 Markus Nocka Payette Associates’ design for the Leonard Morse Hospital in Natick, Massachusetts, which was opened in 1969, with its emphasis on color and the outdoors, also reflected this shift toward low-rise structures.52 Moreover, if we situate the design of the University Hospital within the mid-20th-century discussions concerning hospital provision and design in developing countries of the Third World, it becomes clear that it was not at all out of the ordinary to design a low-rise hospital. For example, the Houston-based firm Caudill Rowlett Scott (CRS), in association with Pope Evans and Robbins and a team of Vietnamese architects, designed a “low-lying building” with “open courtyards” for the 500-bed Saigon University Hospital, South Vietnam. The facility was featured in World Hospitals, the official journal of IHF, in 1973.53
- 54 Thomas M. Payette, “Designing the Aga Khan Medical Complex,” op. cit. (note 1), p. 164.
- 55 R. F. Bridgman, “Hospitals for the Developing Countries,” World Hospitals, no. 7, 1971, p. 197.
- 56 H. Robert Douglass, “Health Education in Developing World,” op. cit. (note 53).
- 57 A. Soumah, “Health centres to serve rural Africa,” World Hospitals, no. 4, 1968, p. 63-64.
- 58 “Israeli Group Designs Hospitals for Developing Countries,” World Hospitals, no. 4, 1968, p. 65.
18Payette wrote that “although a great deal of attention has been given to our ‘horizontal design,’ the issue we confronted was not whether this would be a vertical or horizontal solution, but how to design a health-care facility that expressed the concern about the people using the building.”54 However, the University Hospital was not distinctive for catering to the specific local requirements either. If we consider articles that were published in World Hospitals, we realize that drawing inspiration from “the history of the institutions of the economically advanced countries” was not recommended.55 Robert Douglass, author of the article about the Saigon University Hospital, stated that “the health problems of the developing countries […] are the reverse of our own.” He further noted that the “experience and background” of “western technicians” had hardly equipped them for addressing these problems.56 Likewise, in an article about “Health centres to serve rural Africa,” A. Soumah wrote that “account must always be taken of the wishes of those responsible for the health and services of the country.”57 Hospitals Design International, which was a subsidiary of the non-profit Institute for Planning and Development, supported by the Israeli government, was also of the opinion that “the type of hospital built in urban areas and in western nations cannot be transplanted into the developing nations of Africa, Asia and the Middle East.”58
- 59 Avigail Sachs, “Architects, Users, and the Social Sciences in Postwar America,” in Kenny Cuppers (e (...)
- 60 Samuel Isenstadt, “‘Faith in a Better Future’: Josep Lluís Sert’s American Embassy in Baghdad,” Jou (...)
- 61 Tom Avermaete and Maristella Casciato, Casablanca Chandigarh: A Report on Modernization, Zurich: Pa (...)
- 62 Samer Akkach, “Neo-Eurocentrism and Science: Implications for the Historiography of Islamic Art and (...)
- 63 His Highness the Aga Khan IV, “Islamic architecture: a revival,” 25 November 1979. URL: https://the (...)
19When hospital planners were arguing for the consideration of local circumstances, many (second) generations of modern movement architects were calling for a “more humanistic approach to design” and arguing for catering to everyday aspects.59 Among these architects was Josep Lluís Sert (1902-1983), who was the dean of Harvard Graduate School of Design during Payette’s and Khadem’s time there. As a young architect, Sert worked with Le Corbusier in Paris and was the organizer of a group of architects affiliated with the Congrès International d’Architecture Moderne (CIAM). After migrating to the US in 1939 and working with the firm Town Planning Associates in South America, he began to reconsider his CIAM tenets and temper them with a humanistic approach.60 Payette and Khadem, having been students while Sert was dean, were certainly aware of these preoccupations. Furthermore, the concept of their study trip is reminiscent of TEAM 10’s sociological and anthropological studies of “everyday reality” in the 1950s. When Le Corbusier was commissioned to design Chandigarh in 1950, he too embarked on a journey to Indian subcontinent.61 However, we do not find any direct reference to Chandigarh in relation to the University Hospital’s conceptualization, perhaps challenging the classic assumption that architectures in non-Western nations could not have an innovative basis of their own.62 Importantly, in a speech delivered at the Asia Society in New York in 1979, the Aga Khan IV recalled advising Payette against “succumb[ing], through nostalgia, to mimicry of the past.”63
- 64 William G. Clarence-Smith, “The Hadhrami Sada and the Evolution of an Islamic Religious Internation (...)
- 65 Shamash Nanji, “Guidance Amid Great Changes,” op. cit. (note 3), p. 47-48.
20To understand what was distinctive about the University Hospital design concept, we need to go beyond a preliminary reading of Schmertz, Pehnt, and Payette’s accounts. Taking their descriptions at face value comes at the cost of concealing the Aga Khan IV’s vision. Like some other Muslim intellectuals and reformers, such as the Hadhrami Sada in eastern Yemen,64 the Aga Khan IV views Islam (and tradition) as compatible with modernity and “modern science.” According to him, Islamic belief recognizes two parts to life, “neither of which must be forsaken”: din (faith, spiritual) and dunyā (world, material). The soul is “given a physical form”; hence, the fulfillment of an individual’s physical and material responsibilities, far from being the opposite of the spiritual, leads to “spiritual happiness.” The Aga Khan IV not only encourages his jama’at (followers) to follow his guidance in this regard, but also sees it as his own responsibility, “against the background of Christian religious tradition,” to cater to both the spiritual well-being and the material progress of his people.65 Rather than arguing that this “total progress” can be achieved by setting aside “the commendable scientific development of the Western nations,” he posits that:
- 66 Ibid., p. 50.
“Progress for the developing nations should come to mean something different from the one-sided material advancement of the West. The lives of the peoples in the developing nations can only be truly enriched if the commendable scientific development of the Western nations can be ‘married’ to the former’s unique traditions. The direction of this new progress must be such that it orients each individual to the search for spiritual fulfilment in his or her life, to that ultimate state of re-integration with Allah.”66
- 67 Jiat-Hwee Chang, “‘Natural’ Traditions: Constructing Tropical Architecture in Transnational Malaysi (...)
- 68 Vikramādiya Prakāsh, “Epilogue: Third World Modernism, or Just Modernism: Towards a cosmopolitan re (...)
21In order words, the Aga Khan IV does not impose a dichotomy between “modernity” and “tradition.” Nor does he turn away from “a future-oriented notion of progress.”67 Instead, he suggests an alternative concept of progress. His demand for the “marriage” of Western scientific development to the unique traditions of developing nations is not a postcolonial act; that is, “the work of inverting and reinscribing colonial ideologies in the service of the postcolonies rather than the metropolitan centers.”68
- 69 Samer Akkach, “Polarising ‘Ilm’: Science and Religion in Early Modern Islam,” in Samer Akkach (ed.) (...)
- 70 His presidential address to the Seerat Conference on 12 March 1976 explicitly stated this position. (...)
22To contextualize the Aga Khan’s vision, we need to consider the “conflict thesis” between science and religion. Two 19th-century philosopher-scientists, John William Draper (1811-82) and Andrew Dickson White (1832-1918), are widely recognized as its promoters. However, as Samer Akkach has demonstrated, the generalizations of Draper and White did not extend to Islam. Their grim picture of the history of the Catholic Church sat in sharp contrast with their delineation of “Islam’s rationalism, scientific-mindedness, inventiveness, and great scientific achievements, which made it not just compatible with science, but the religion of science par excellence.” The Arab and Ottoman intelligentsia of the early 19th century were aware of the conflict model. Different attitudes existed, but the view that “maintained an understanding of the harmony between science and religion” gradually became the dominant one, at the expense of the pre-19th-century general meaning of ‘ilm as “knowledge.” The publication of the books by Draper and White provided Muslim reformers with convenient evidence to argue for the “superiority of Islam over Christianity by virtue of Islam’s rationality, tolerance and support of scientific activity and philosophical thinking.” This position had endured “in the Muslim collective imagination”69 and is the one advocated by the Aga Khan IV.70
- 71 Faisal Devji, Muslim Zion: Pakistan as a Political Idea, Cambridge, MA: Harvard University Press, 2 (...)
- 72 Francis Robinson, “Other-Worldly and This-Worldly Islam and the Islamic Revival: A Memorial Lecture (...)
- 73 Aga Khan IV referred to the life of Prophet as a model in his presidential address at the Seerat Co (...)
- 74 Ibid.
- 75 Allen J. Frank, “Sufism in the Face of Twentieth-Century Reformist Critiques: Three Responses from (...)
23For this view to become dominant, however, Islam had to be reduced to a “proper name” for a this-worldly “system.” Islam was no longer seen as “a passive subjugation to some inflexible command;” rather, it was “conceived as a form of action or stiving.”71 As Francis Robinson notes, this shift transformed Islam. From “a faith of contemplation of God’s mysteries and of belief in His will to shape human life,” it became “a faith in which Muslims were increasingly aware that it was they, and only they, who could act to fashion an Islamic society on earth.”72 To be sure, throughout Islamic history, tensions had existed between this-worldly and other-worldly. Depending on period and context, the emphasis swung in favor of one or the other. Other-worldly piety prevailed among most Muslims between the 14th and 18th centuries. However, the emphasis shifted towards this-worldly from the 19th century. The prime cause of this shift was the spread of Western power, which resulted in self-questioning and self-reflection among Muslims. Such questions as whether Muslims had worked hard enough to change human circumstances resulted in a renewed turn to Quran, Hadith, and the life of Prophet for guidance.73 It was in the context of this turn that the argument for the unity of din and dunyā gained prominence.74 Advocates of this-worldly Islam were of course not the sole drivers of change and reform in the 20th century. Depending on the context, this-worldly Islam was expressed differently, while its boundaries with other-worldly remained blurred at times and in some places.75
- 76 “The Aga Khan University Hospital, Karachi,” op. cit. (note 48), p. 35.
- 77 Ibid.
- 78 Mildred F. Schmertz, “Setting a Standard for Architecture in Islam: The Aga Khan School of Nursing (...)
- 79 Mildred F. Schmertz, “Indigenous High-tech,” op. cit. (note 38), p. 141.
24Acknowledging and understanding this position allows us to scrutinize the design and planning of the University Hospital. Descriptions of the buildings highlight how they “are part of an organic whole” and “are oriented inward; in contrast to the exterior, the spaces within are courts to delight the senses. There is still, running, and splashing water on patterned pavements” (fig. 5).76 They also refer to the architects’ particular attention to “the size of, and transitions between, courts,” their use of “traditional, indigenous principles of environmental control,”77 “development of appropriate Muslim ornament for entire hospital facility”78 and the design, with great care, of “the entrance portals and gates” with marble and “calligraphic ornamentation comprising Koranic verses” (fig. 6).79
- 80 Jiat-Hwee Chang, “‘Natural’ Traditions,” op. cit. (note 67), p. 3. Also see Idem, “Tropical Variant (...)
- 81 Annmarie Adams, “Decoding Modern Hospitals: An Architectural History,” op. cit. (note 24), p. 21-23
- 82 Robert Ivy, “the Aga Khan,” Architectural Record, February 2002. URL: https://www.architecturalreco (...)
- 83 Katharine Bartsch and Peter Scriver, “The House of Stars: Astronomy and the Architecture of New Sci (...)
- 84 His Highness the Aga Khan IV, “Islamic architecture: a revival,” op. cit. (note 63).
- 85 Robert Ivy, “the Aga Khan,” op. cit. (note 82).
25Besides being taken as evidence of the Aga Khan IV’s turn towards everyday “user,” or his desire to “re-evaluate and revive traditional architecture,”80 these descriptions may be interpreted as an indication of his preoccupation with attractiveness and “wayfinding.”81 However, the Aga Khan IV prioritized a design that would reflect the “spirit of Islam,” by which he meant “the value system of Islam, in terms of the interrelationship” between “din and duina [sic].”82 In this context, the design of an organic whole and a sequence of spaces and the incorporation of water and calligraphic ornamentation were not seen as “natural” or “attractive” per se; nor were they meant to denounce “modernity.” Rather, they were intended to facilitate harmony between din and dunyā and to prevent a jarring shift from one to the other.83 In a speech delivered in Asia Society in New York in 1979, the Aga Khan IV echoed this view after referring to the University Hospital: “Since all that we see and do resonates on the faith, the aesthetics of the environment we build and the quality of the social interactions that take place within those environments reverberate on our spiritual life.”84 Put differently, since dunyā is always “imbued with the presence and manifestation of God,” and people are “trustee of God’s creation,” a building can only be a “better place” if it facilitates the integration of din and dunyā.85
Figure 5: Private wing courtyard, 1985. Photo by Paul Warchol.

Source: Courtesy of Paul Warchol. Reproduced with permission.
Figure 6: The design of one of the entrance portals with calligraphic ornamentation comprising Koranic verses.

Source: Wolfgang Pehnt, “Im Namen Allahs: Das Klinikum der Aga Khan Universität in Karachi, Pakistan,” Bauwelt, vol. 26, 1986, p. 981. Available at the RIBA Library, London. Reprinted with permission.
- 86 Seyyed Hossein Nasr, An Introduction to Islamic Cosmological Doctrine, Cambridge, MA: Harvard Unive (...)
- 87 Seyyd Hossein Nasr, “Ālam Khiāl va mafhūm-e Fazā dar Miniyātor-e Irani,” Faslnāme Honār, no. 26, 13 (...)
- 88 Nader Ardalan and Laleh Bakhtiar, The Sense of Unity: The Sufi Tradition in Persian Architecture, C (...)
26A sequence, or hierarchy, of spaces may reveal further nuances regarding the integration of din and dunyā. In decades preceding the construction of the University Hospital, “the hierarchy of being” in Islamic cosmological doctrines was being discussed by such philosophers as Seyd Hussein Nasr.86 In an article published in 1968, Nasr even criticized the Cartesian dualism of body-mind and discussed how fazā (loosely, space) in Iranian/Islamic art facilitates contemplative perception (or Idrāk bi-l-taʾammul), leading the human from the material world to the divine world (and ālam-e khiāl).87 Nader Ardalan, an Iranian architect, and Laleh Bakhtiar, an Iranian scholar of Islam, made a similar argument in their 1973 book The Sense of Unity. They talked about “hierarchy of spatial linkages,” noting that “[j]ust as the Spirit defines the universe in which the soul moves, so sedentary man creates shapes which enclose spaces within which man’s essential soul can breathe.”88
27I cannot go so far as to suggest that Nasr, Ardalan, and Bakhtiar shared a this-worldly vision, although they certainly knew one another, since Nasr wrote the foreword to the book by Ardalan and Bakhtiar. It also remains to be determined whether the Aga Khan IV drew on their works. However, the reference to a sequence of spaces suggests that there must have been at least some influence or cross pollination.
- 89 For Idrāk, see Samer Akkach, “Naẓar: The Seen, the Unseen and the Unseeable,” in Samer Akkach (ed.) (...)
- 90 Faisal Devji, Muslim Zion, op. cit. (note 71), p. 210.
28The concept of Idrāk bi-l-taʾammul is also worth pondering. In its pre-modern meaning, it implied divine awareness including both intellect and perception by contemplation, without restricting perception and comprehension to the realm of the senses.89 This meaning was being revived in the 20th century, although within a revised understanding of “spirit” as being part of the body rather than a mere essence (jawhar) of it.90 Thus, the reference to the sequence of spaces implies that the integration of din and dunyā also unified perception and cognition, the body/mind and the soul. This becomes particularly important in light of how the 19th-century separation of body, mind, and soul is assumed to be tenable in the historiography of hospital architecture. Thus, what the Aga Khan IV envisioned more specifically was the incorporation of Western medicine, without separating body, mind, and soul and restricting perception and comprehension to the senses.
- 91 As Jonathan Crary has emphasised as early as 2001, “the ways in which we intently listen to, look a (...)
- 92 Daniel Lord Smail, On Deep History and the Brain, Berkeley, CA: University of California Press, 200 (...)
- 93 I would like to thank Sarah Borree with whom I have been thinking about the importance of recoverin (...)
29Do patients and visitors experience the hospital the way the Aga Khan hoped? The question must remain unanswered for the time being. Without any proper understanding of the contingent and historical nature of forms of bodiliness in Pakistan, any attempt at recovering people’s experiences would be incomplete, if not erroneous.91 It runs the risk of either restating colonial ideologies, in which non-Western colonized countries lacked culture or history, or assuming that colonialism wiped out non-Western forms of bodiliness and “set the clock to zero.”92 Recovering the experience of people in Pakistan, and the Global South more generally, requires more than a mere examination of counter-archives. It is also necessary to think about different forms of being in the world, or what may be called “counter-bodies.”93
- 94 Khalil Andani, “Divine Diversity: The Aga Khan’s Vision of Pluralism,” Journal of Islamic and Musli (...)
- 95 “Aga Khan Speech at the Takht Nishini Ceremony in Karachi,” 23 January 1958. URL: http://heritage.i (...)
- 96 “Speech at Karachi, Pakistan,” 04 August 1957. URL: http://heritage.ismaili.net/node/27414. Accesse (...)
- 97 Saadia Toor, The State of Islam: Culture and Cold War Politics in Pakistan, London: Pluto Press, 20 (...)
- 98 Khalil Andani, “Divine Diversity,” op. cit. (note 94), p. 14.
- 99 Soumen Mukherjee, Ismailism and Islam in Modern South Asia: Community and Identity in the Age of Re (...)
30Khalil Andani poses the question of the “practical application” of the unity of din and dunyā in light of “secularizing forces.” According to Andani, the Aga Khan IV’s rejection of “total secularization” does not mean that he supports “the idea of a theocracy or an Islamic state.” He goes on to explain that the Aga Khan's solution calls for “the creation of a pluralistic civil society that is informed by the ethics of faith.”94 His contention in turn raises the question of what the link between the University Hospital and demands for Pakistan is, especially given the Aga Khan IV’s reference to his grandfather as the “founder of Pakistan,”95 in whose “footsteps,” he hoped “to do his best to follow.”96 To address this question, it is essential to recognize the “contingencies and contradictions” that led to the establishment of Pakistan as a separate nation-state and continue to determine its course ever since.97 They reveal that the word pluralism has “a specific genealogy in the Imam’s (Aga Khan IV) thought” going back to his grandfather.98 As the founder and the first president of the All-India Muslim League, which was founded in Dhaka in 1906, the Aga Khan III’s thoughts about the future of India constituted a plea for pluralism and the idea of the post-national.99 Taking into account this genealogy will help situate the University Hospital better in the context of ambitions for Pakistan.
Pluralism
- 100 Stuart W. Leslie, “New Universities for a New Nation,” op. cit. (note 36), p. 309-310.
- 101 Ibid., p. 322.
- 102 “Speech by His Highness the Aga Khan on Occasion of Hospital Foundation Stone Laying Ceremony,” 03 (...)
- 103 “600-bed Aga Khan Hospital and Medical College for Pakistan,” op. cit. (note 37), p. 6.
- 104 Hamza Alavi, “Misreading Partition Road Signs,” Economic and Political Weekly, vol. 37, no. 44-45, (...)
31In his examination of the contribution of American architects to the redesign of education for a modern Pakistan, Stuart W. Leslie situates the University Hospital—along with the University of Islamabad and the East Pakistan Agricultural University—in the context of the Partition of India in 1947 and Pakistan siding with the US in the global Cold War. According to Leslie, “Pakistan was left without an educational infrastructure sufficient to transform itself into a modern nation.” To train “a new generation of Pakistan’s own scientists, engineers and physicians,” President Mohammad Ayub Khan drew on American, instead of British, universities as “appropriate models.”100 In particular, Pakistan was left with only one medical college, the King Edward Medical College in Lahore. Although new schools were established after partition, they were not enough. The Aga Khan IV took account of this “unfortunate circumstance” when he decided to “found and fund a new medical college and hospital” in Karachi.101 The Aga Khan IV’s reference to the University Hospital as an “important addition to the sum total of the national effort to preserve good health and fight disease” at the foundation stone ceremony supports Leslie’s observation.102 In another speech, he stated that “the complex […] will be a significant step forward towards solving the medical needs of Pakistan.”103 But Leslie’s analysis disregards the idea of a “Muslim India within India,” the absence of a strong separatist sentiment until the late 1930s, the Muslim League’s lack of interest in the inclusion of religion in politics, and the Aga Khan III’s demand for pluralism and his idea of the post-national.104 The place of the University Hospital in ambitions for Pakistan becomes ambiguous if these factors are considered. Here, I briefly consider the ideas of pluralism and the post-national.
- 105 Soumen Mukherjee, Ismailism and Islam in Modern South Asia, op. cit. (note 99), p. 79.
- 106 Ibid., p. 89-91. It remains to be examined whether he also drew on India’s pre-colonial connection (...)
- 107 This has particularly been acknowledged in relation to the Aga Khan III’s educational campaigns. Se (...)
- 108 Christophe Jaffrelot, “‘South Asian Muslims’ interactions with Arabian Islam until the 1990s. Pan-I (...)
- 109 Ibid., p. 71-79.
32Like the idea of a Muslim India within India, the Aga Khan III’s leadership aimed to transform the status of the Muslim minority in India. However, it also advocated for a distinct and “complex grammar of subjectivity.” This grammar favored the formation of a “collective polity” but not one that led to a strict form of political pan-Islamism or resulted in a “totalising or homogenising metanarrative of territoriality.”105 In putting forward this grammar, the Aga Khan III reworked “the very conceptual framework of pan-Islamism” and its “Arab-centrism” by overlapping “Pan-Asianism with Indic/Brahmanical and Islamic consciousness,” while also drawing on the colonial dispensation and India’s pre-colonial and historical connection with Africa.106 This grammar was the “guiding force” of his educational and medical campaigns, consolidated under the Aga Khan IV’s leadership.107 Thus, it would be a mistake to assume that the instrumentalization of Islam in the 1970s, which saw Islam become “the State religion of Pakistan” for the first time, sat comfortably with the Aga Khan IV.108 Whether he favored the idea of Pakistan as a “New Medina” or “sovereign Islamic state,” where the renewal and redemption of Islam in the modern world could take place, should also be considered critically. The Muslim League saw Pakistan only as a “homeland for Muslims” that could act as a “role model” or a “laboratory” for the Islamic World.109
- 110 Khalil Andani, “Divine Diversity,” op. cit. (note 94), p. 13-21.
- 111 Robert Ivy, “The Aga Khan,” op. cit. (note 82); Also see, Philippa Baker, Architecture and Polyphon (...)
- 112 His Highness the Aga Khan, “Opening Remarks,” in Reneta Holod (ed.), Toward an Architecture in the (...)
- 113 According to Andani, rather than viewing pluralism as a product, the Aga Khan IV described it as a (...)
33Since 1957, the Aga Khan IV has stressed pluralistic values in various contexts, ranging from intra-faith pluralism among Muslim communities to global pluralism for peace and progress.110 It is beyond the scope of this article to consider these different contexts. However, it is of note that the construction of the University Hospital led to the foundation of the Aga Khan Award for Architecture (AKAA), one of the purposes of which has been to influence the notion of pluralism. As the Aga Khan IV noted in an interview with Rober Ivy, the editor-in-chief of Architectural Record, in 2001, “by premiating [sic] different types of projects, and different environments and different countries, with different architectural traditions and languages, the Award has enhanced the notion that pluralism is an asset.”111 Thus, the University Hospital can be considered as the first step toward enhancing pluralism through architecture. This point is legible in the Aga Khan IV’s opening remarks at the Seminar One in the series Architectural Transformations in the Islamic World. After explaining how “during the design process” of the University Hospital a dialogue started that eventually led to the foundation of AKAA, he presented the University Hospital as “only one possible attempt” at solving the problem, not the solution.112 This is not to say that the design of the University Hospital embodies pluralism, but to point out that its very construction worked towards promoting pluralism as a malleable process.113
- 114 Cathelijne Nuijsink and Annamaria Bonzanigo, “Humanitarian Aid as Global Governance: The Architectu (...)
- 115 Sahir Dewji, “Beyond Muslim Xenophobia and Contemporary Parochialism: Aga Khan IV, the Ismā’īlī, an (...)
- 116 Khalil Andani, “Divine Diversity,” op. cit. (note 94), p. 15.
- 117 His Highness the Aga Khan IV, “The role of private initiative in developing countries,” Swiss Ameri (...)
34One may still wonder about the Aga Khan IV’s decision to employ Payette, Khadem, and Campbell—three Harvard-educated professionals. Highlighting the Aga Khan’s pluralistic vision is not meant to disqualify Leslie’s observation regarding Pakistan siding with the US in the global Cold War. Rather, it is to emphasize the multiplicity of factors at work. Although they were all Harvard graduates, their background and experiences were different. The Aga Khan IV’s decision to employ them, alongside architects and health consultants from Pakistan, the US, and the UK, may be compared with “non-governmental” “decentralized” logic of NGOs.114 This is especially likely, given that the University Hospital is now operating by the Aga Khan Health Services (AKHS), one of the agencies of the Aga Khan Development Network (AKDN).115 But such a comparison should not disregard the discourse of pluralism. Despite what Andani states, pluralism for the Aga Khan IV is more than just “a way to draw upon diverse human resources.”116 Instead, he sees drawing on diverse human resources as way to promote pluralism. As the Aga Khan IV explained in a speech at the Swiss American Chamber of Commerce in Zurich in 1976, “bringing together what private initiates have to offer of the best from various countries,” or “genuine international effort,” had many “attractive aspects to developing countries,” including enhanced “political acceptability.”117
Conclusions
35The historiography of hospital architecture is still largely West-centric: Western Europe (specifically Britian and France) and North America are often assumed to be the centers of innovation and invention. According to this historiography, medico-scientific shifts coupled with the emergence of modern state brought a new emphasis on hospital architecture from the mid-19th century. As a result, hygiene, fresh air, sunlight, ordering, and managing life, and righting, protecting, and enhancing the body and the mind emerged as key concepts dictating hospital design and planning. Alongside a few other studies that have highlighted counter-models to provide a broader picture of the history of hospital architecture in the 20th century, this article also explored how the Aga Khan University Hospital was designed differently from Western models of the period. It argued that the Aga Khan IV’s theological quest for harmony between din and dunyā dictated its design and planning. That said, the unity of din and dunyā should not be considered as just another concept—alongside the key concepts like hygiene and fresh air enumerated above. The very semantic complexity of the unity of din and dunyā encompasses all these concepts. However, instead of merely holding material importance, they are invested with a spiritual one as well. Moreover, the University Hospital was designed to change the meaning of hospital architecture because the unity of din and dunyā did not separate perception from cognition and the body from the mind and the soul. It also did not restrict perception and comprehension to the senses.
Acknowledgements
Research for this article was funded by an Alexander von Humboldt Fellowship for Postdocs (2022-24). I would like to thank Naureen Ali, the Cataloguer and Adlib Officer in the Ismaili Special Collections Unit (ISCU), the Institute of Ismaili Studies, London, for her assistance and support. I would also like to thank the two anonymous reviewers for their helpful feedback.
Notes
1 Thomas M. Payette, “Designing the Aga Khan Medical Complex,” in Margaret Bentley-Seycenko (ed.), Theories and Principles of Design in the Architecture of Islamic Societies, Cambridge, MA: Aga Khan Program for Islamic Architecture, 1988, p. 162. URL: https://www.archnet.org/publications/3101. Accessed 20 December 2024.
2 Ibid.
3 Shamash Nanji, “Guidance amid Great Changes,” Africa Ismaili, 11 July 1982, p. 48.
4 URL: https://www.archnet.org/; https://the.ismaili/; https://www.architecturalrecord.com/articles/13598-architectural-record-archives. Accessed 20 December 2024.
5 Tom Avermaete and Cathelijne Nuijsink, “Architectural Contact Zones: Another Way to Write Global Histories of the Post-War Period?” Architectural Theory Review, vol. 25, no. 3, 2021, p. 350-361. DOI: https://doi.org/10.1080/13264826.2021.1939745.
6 Making a firm distinction between the Aga Khan IV’s private and public visions requires proper theorization in relation to Islamic theology.
7 Daryoush Mohammad Poor, Authority Without Territory: The Aga Khan Development Network and the Ismaili Imamate, Basingstoke: Palgrave Macmillan, 2014 (Literatures and Cultures in the Islamic World), p. 226.
8 The question of how to conceptualize the role and agency of the design team members is part of my wider project. A conceptual article based on this question is forthcoming.
9 Lynn M. Thomas, “Historicising Agency,” Gender and History, vol. 28, no. 2, 2016, p. 327. DOI: https://doi.org/10.1111/1468-0424.12210.
10 Talal Asad, “Agency and Pain: An Exploration,” Culture and Religion: An Interdisciplinary Journal, vol. 1, no. 1, 2000, p. 29-60. DOI: https://doi.org/10.1080/01438300008567139.
11 Stephanie Olsen, Kristine Alexander, Susan Miller, Ville Vuolanto, Simon Sleight, Mischa Honeck, Sarah Emily Duff and Karen Vallgårda, “A Critical Conversation on Agency,” The Journal of the History of Childhood and Youth, vol. 17, no. 2, 2024, p. 171. URL: https://muse.jhu.edu/pub/1/article/926862/pdf. Accessed 20 December 2024. DOI: 10.1353/hcy.2024.a926862; Olsen et. al. draw on Thomas and Asad’s argument. See also Rob Boddice and Mark Smith, Emotion, Sense, Experience, Cambridge: Cambridge University Press, 2020 (Cambridge Elements), p. 50-52.
12 Fay Bound Alberti, Matters of the Heart: History, Medicine, and Emotion, Oxford: Oxford University Press, 2019; Idem, This Mortal Coil: The Human Body in History and Culture, Oxford: Oxford University Press, 2016. The historiography of hospital design has been written with this separation in mind. I am undertaking further research to explore these changes vis-à-vis transformations in hospital design. Also read, Joy Knoblauch, The Architecture of Good Behaviour: Psychology and Modern Institutional Design in Postwar America, Pittsburgh, PA: University of Pittsburgh Press, 2020, p. 21-56. Although Knoblauch does not consider this topic explicitly, her examination clearly shows the reduction of body to a mere reactive force.
13 Hilary Marland, “The Changing Role of the Hospital, 1800-1900,” in Deborah Brunton (ed.), Medicine Transformed: Health, Disease and Society in Europe, 1800-1930, Manchester: Manchester University Press, 2004, p. 32.
14 Cynthia Imogen Hammond, “Reforming Architecture, Defending Empire: Florence Nightingale and the Pavilion Hospital,” in Aran S. Mackinnon and Jonathan D. Ablard, (un) Healthy Interiors: Contestations at the Intersection of Public Health and Private Space, Carrollton, GA : University of West Georgia, 2005, p. 2-3; According to Jeanne Kisacky, “it [Notes on Hospitals] became the international bible of late nineteenth-century hospital design.” See Jeanne Kisacky, Rise of the Modern Hospital: An Architectural History of Health and Healing, 1870-1940, Pittsburgh, PA: University of Pittsburgh Press, 2016, p. 23; For British Army, see Jiat-Hwee Chang, A Genealogy of Tropical Architecture: Colonial Networks, Nature and Technoscience, London: Routledge, 2016 (Architext Series), p. 94-128. For inter-imperial flow of architectural exchange and expertise, see Simon De Nys-Kettels, “A Hospital Typology Translated: Transnational Flows of Architectural Expertise in the Clinique Reine Elisabeth of Coquilhatville, in the Belgian Congo,” ABE Journal, no. 19, 2021. DOI: https://doi.org/10.4000/abe.12715.
15 Cynthia Imogen Hammond, “Reforming Architecture, Defending Empire,” op. cit. (note 14), p. 1; Jiat-Hwee Chang, A Genealogy of Tropical Architecture, op. cit. (note 14).
16 Jonathan Hughes, “The ‘Matchbox on a Muffin’: The Design of Hospitals in the Early NHS,” Medical History, vol. 44, no. 1, 2000, p. 26. DOI: https://doi.org/10.1017/S0025727300066060; Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 236-237.
17 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 243.
18 Ibid.; Jonathan Hughes, “The ‘Matchbox on a Muffin’,” op. cit. (note 16), p. 30-32.
19 Julie Willis, Philip Goad and Cameron Logan state that, “in many respects, the discourse that arose around the modern hospital in the 1920s and 1930s grew from the establishment of the IHA in 1929.” See, Julie Willis, Philip Goad and Cameron Logan, Architecture and the Modern Hospital: Nosolomeion to Hygeia, London; New York, NY: Routledge, 2019 (Routledge Research in Architecture), p. 19; Jonathan Hughes, “The ‘Matchbox on a Muffin’,” op. cit. (note 16).
20 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 299.
21 Paul Emmons and Andreea Mihalache, “Architectural handbooks and the user experience,” in Kenny Cuppers (ed.), Use Matters: An Alternative History of Architecture, London; New York, NY: Routledge, 2013, p. 35-50.
22 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 308-317; Joy Knoblauch, The Architecture of Good Behaviour, op. cit. (note 12), p. 21-56.
23 To read more about antibiotic resistance, see Claas Kirchhelle, Pyrrhic Progress: The History of Antibiotics in Anglo-American Food Production, New Brunswick: Rutgers University Press, 2020; Scott H. Podolsky, The Antibiotic Era: Reform, Resistance, and the Pursuit of a Rational Therapeutics, Baltimore, MA: John Hopkins University Press, 2015. DOI: https://doi.org/10.1093/cid/civ422.
24 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 338-342; Annmarie Adams, “Decoding Modern Hospitals: An Architectural History,” Architectural Design, vol. 87, no. 2, 2017, p. 16-23. DOI: https://doi.org/10.1002/ad.2148.
25 Annmarie Adams, “Canadian hospital architecture: How we got here,” CMAJ, vol. 188, no. 5, 2016, p. 370-71. DOI: https://doi.org/10.1503/cmaj.151233; Idem, “Decoding Modern Hospitals,” op. cit. (note 24), p. 16-23.
26 Cor Wagenaar, “Five Revolutions: A Short History of Hospital Architecture,” in Cor Wagenaar (ed.), The Architecture of Hospitals, Rotterdam: Nai, 2006, p. 26; Alistair Fair, “‘Modernization of our Hospital System’: The National Health Service, the Hospital Plan, and the ‘Harness’ Programme, 1962-77,” Twentieth Century British History, vol. 29, no. 4, 2018, p. 547-75. DOI: https://doi.org/10.1093/tcbh/hwy008.
27 Jeanne Kisacky, Rise of the Modern Hospital, op. cit. (note 14), p. 308-317.
28 Cristiana Bastos, “The Hut-Hospital as Project and as Practice: Mimeses, Alterities, and Colonial Hierarchies,” Social Analysis: The International Journal of Anthropology
, vol. 62, no. 2, 2018, p. 76-97. DOI: https://doi.org/10.3167/sa.2018.620204; Cathy Keys, “Designing Hospitals for Australian Conditions: The Australian Mission’s Cottage Hospital, Adelaide House, 1926,” Journal of Architecture, vol. 21, no. 1, 2016, p. 68-89. DOI: https://doi.org/10.1080/13602365.2016.1141790; Simon De Nys-Ketels, Johan Lagae, Kristien Geenen, Luce Beeckmans and Trésor Lumfuankenda Bungiena, “Spatial governmentality and everyday hospital life in colonial and postcolonial DR Congo,” in Daniel E. Coslett (ed.), Neoliberalism and Built Heritage: Echoes of Empire in Africa, Asia, and Europe, London: Routledge, 2019, p. 147-167. DOI: https://doi.org/10.4324/9780429429286; Sara Hornarmand Ebrahimi, Emotion, Mission, Architecture: Building Hospitals in Persia and British India, 1865-1914, Edinburgh: Edinburgh University Press, 2022. URL: https://www.jstor.org/stable/10.3366/j.ctv32vqmgq. Accessed 20 December 2024.29 Ayşe Zarakol prefers to speak of “world orders” instead of “international orders.” See Ayşe Zarakol, Before the West: The Rise and Fall of Eastern World Orders, Cambridge: Cambridge University Press, 2022 (LSE International Studies).
30 Ana Antic, Johanna Conteri and Dora Vargha, “Conclusion: Beyond Liberal Internationalism,” Contemporary European History, vol. 25, no. 2, 2016, p. 360. DOI: https://doi.org/10.1017/S0960777316000114.
31 These is increasing work on the socialist world in global health history. For example, see Dora Vargha, “Missing pieces: Integrating the socialist world in global health history,” History Compass, vol. 21, no. 7, 2023, e12779. DOI: https://doi.org/10.1111/hic3.12779; Johanna Conterio is writing a book on Therapeutic Natures: Environment and Health in the Soviet Sanatorium, 1917-1991. For works on Christian internationalism, see Pamela Slotte, “‘Blessed are peacemakers’: Christian internationalism, ecumenical voices and the quest for human rights,” in Pamela Slotte and Miia Halme-Tuomisaari (eds.), Revisiting the Origins of Human Rights, Cambridge; New York, NY: Cambridge University Press, 2015, p. 293-329; Michael G. Thompson, For God and Globe: Christian Internationalism in the United States between the Great War and the Cold War, Ithaca, NY: Cornell University Press, 2015 (The United States in the World). Also see, Guanghui Ding and Charlie Qiuli Xue, “Displaying Socialist Cosmopolitanism: China’s Architectural Aid in the Global South, 1960s-70s,” Architectural Theory Review, vol. 26, no. 3, 2022, p. 547-77. DOI: https://doi.org/10.1080/13264826.2023.2194662.
32 “News from the International Catholic Confederation of Hospitals,” World Hospitals, vol. 3, 1967, p. 112-3. Available at Utrecht University Library.
33 Annmarie Adams, “Canadian hospital architecture: How we got here,” op. cit. (note 25), p. 370-371.
34 “A Glorious Record,” Africa Ismaili, 11 July 1982, p. 8; High Highness Aga Khan IV, Speech at the dinner hosted by the Federation of Chambers of Commerce and Industry, 28 January 1958. URL: https://ismaili.net/speech/s580128.html. Accessed 20 December 2024.
35 Neil Davidson, An Archive of the Aga Khan University Medical College, 1983-1990, 29 May 1990, p. 5. Houston (United States), John P. McGovern Historical Research Center, Houston Academy of Medicine-Texas Medical Center Library, MS 176 Smythe box 5 folder 17.
36 Ibid.; Also see Stuart W. Leslie, “New Universities for a New Nation: American Architects Redesign Higher Education for a Modern Pakistan,” International Journal of Islamic Architecture, vol. 12, no. 2, 2023, p. 322. DOI: https://doi.org/10.1386/ijia_00115_1. Iqbal Paroo, the director of commissioning of the initial phase of the Medical Complex, also noted that “it started with a dream […] in 1964.” See Mozhan Khadem, Iqbal Paroo and Thomas M. Payette, “The Aga Khan University and Medical Centre,” in Sara O. Marberry (ed.), Innovations in Healthcare Design: Selected Presentations from the First Five Symposia on Healthcare Design, New York, NY: Van Nostrand Reinhold, 1995, p. 232.
37 “600-bed Aga Khan Hospital and Medical College for Pakistan,” Africa Ismaili, vol. 4, nos. 3-4, 1971, p. 18.
38 Mildred Schmertz, “Indigenous High-tech,” Architectural Record, vol. 175, May 1987, p. 136. URL: https://www.architecturalrecord.com/ext/resources/archives/backissues/1997-05.pdf?862459200. Accessed 20 December 2024.
39 “600-bed Aga Khan Hospital and Medical College for Pakistan,” op. cit. (note 37), p. 18. According to Neil Davidson, he met with more than twenty architects and hospital planners. Neil Davidson, An Archive of the Aga Khan University Medical College, op. cit. (note 35), p. 9.
40 Murray Fraser, “Davies, Richard Llewelyn, Baron Llewelyn Davies (1912-1981),” Oxford Dictionary of National Biography, 2004. DOI: https://doi.org/10.1093/ref:odnb/31369.
41 Richard Baron Llewelyn-Davies, Hugh Montagu, and Cameron Macaulay, Hospital Planning and Administration, World Health Organization, 1966.
42 Neil Davidson, An Archive of the Aga Khan University Medical College, op. cit. (note 35), p. 10.
43 They published an article in Architectural Record in 1942. Frederick Markus and Paul Nocka, “Construction Simplified in the ‘Parallel Service Plan’,” Architectural Record, vol. 92. no. 2, 1942, p. 56-58. The firm was renamed Payette Associates in 1974.
44 Mildred Schmertz, “Indigenous High-tech,” op. cit. (note 38), p. 135.
45 The Aga Khan IV graduated from Harvard in 1959.
46 Philip Jodidio, Under the Eaves of Architecture. The Aga Khan: Builder and Patron, Munich; Berlin: Prestel, 2008, p. 16-17. URL: https://www.archnet.org/publications/5228. Accessed 20 December 2024.
47 “Speech by His Highness the Aga Khan on Occasion of Hospital Foundation Stone Laying Ceremony,” 03 February 1971. URL: http://heritage.ismaili.net/node/27440. Accessed 20 December 2024.
48 “The Aga Khan University Hospital, Karachi,” Mimar: Architecture in Development, vol. 14, 1984, p. 33. URL: https://www.archnet.org/publications/2873. Accessed 23 December 2024.
49 Ibid., p. 33.
50 Mildred Schmertz, “Indigenous High-tech,” op. cit. (note 38), p. 136.
51 Wolfgang Pehnt, “Im Namen Allahs: Das Klinikum der Aga Khan Universität in Karachi, Pakistan,” Bauwelt, no. 26, 1986, p. 981.
52 Jason W. Frye, “A Healthier Look at Hospitals,” AIA Journal, January 1971, p. 28. URL: https://usmodernist.org/AJ/AJ-1971-01.pdf. Accessed 23 December 2024.
53 H. Robert Douglass, “Health Education in Developing World: A Discussion of the Planning and Design of a Teaching Hospital in Saigon, South Vietnam,” World Hospitals, vol. 9, 1973, p. 20-27.
54 Thomas M. Payette, “Designing the Aga Khan Medical Complex,” op. cit. (note 1), p. 164.
55 R. F. Bridgman, “Hospitals for the Developing Countries,” World Hospitals, no. 7, 1971, p. 197.
56 H. Robert Douglass, “Health Education in Developing World,” op. cit. (note 53).
57 A. Soumah, “Health centres to serve rural Africa,” World Hospitals, no. 4, 1968, p. 63-64.
58 “Israeli Group Designs Hospitals for Developing Countries,” World Hospitals, no. 4, 1968, p. 65.
59 Avigail Sachs, “Architects, Users, and the Social Sciences in Postwar America,” in Kenny Cuppers (ed.), Use Matters: An Alternative History of Architecture, London: Routledge, 2013, p. 70-84; Sheila Crane, “The Shantytown in Algiers and the Colonization of Everyday Life,” in Kenny Cuppers (ed.), Use Matters: An Alternative History of Architecture, London: Routledge, 2013, p. 103-120; Tom Avermaete, “The Discovery of the Everyday: Team 10’s Re-Visiting of C.I.A.M.’s Modern Project,” in Pia Sarpaneva and Scott Poole (eds.), Contribution and Confusion: Architecture and the Influence of Other Fields of Inquiry, Helsinki: ACSA, 2003, p. 2-8; Zeynep Çelik, “The ordinary and the third world at CIAM IX,” in Max Risselada and Dirk ven den Heuvel (eds.), Team Ten: 1953-1981, in Search of a Utopia of the Present, Rotterdam: NAi, 2005, p. 276-279.
60 Samuel Isenstadt, “‘Faith in a Better Future’: Josep Lluís Sert’s American Embassy in Baghdad,” Journal of Architectural Education, vol. 50, no. 3, 1997, p. 172-188. DOI: https://doi.org/10.1080/10464883.1997.10734720. Accessed 23 December 2024. Christiane Crasemann Collins, Review of “Josep Lluís Sert The Architect of Urban Design, 1953-1969,” Journal of the Society of Architectural Historians, vol. 63, no. 4, 2004, p. 545. DOI: https://doi.org/10.2307/4128019.
61 Tom Avermaete and Maristella Casciato, Casablanca Chandigarh: A Report on Modernization, Zurich: Park Books; Montreal: Canadian Center for Architecture, 2014, p. 74-87.
62 Samer Akkach, “Neo-Eurocentrism and Science: Implications for the Historiography of Islamic Art and Architecture,” in Mohammad Gharipour and Daniel. E. Coslett (eds.), Islamic Architecture Today and Tomorrow: (Re)Defining the Field, Bristol: Intellect, 2022, p. 128-132; Florian Zemmin, Modernity in Islamic Tradition: The Concept of “Society” in the Journal Al-Manar (Cairo, 1989-1940), Berlin: De Gruyter, 2018.
63 His Highness the Aga Khan IV, “Islamic architecture: a revival,” 25 November 1979. URL: https://the.akdn/en/resources-media/resources/speeches/asia-society-islamic-architecture-revival-his-highness-the-aga-khan. Accessed 23 December 2024.
64 William G. Clarence-Smith, “The Hadhrami Sada and the Evolution of an Islamic Religious International, c. 1750s to 1930,” in Abigail Green and Vincent Viaene (eds.), Religious Internationals in the Modern World: Globalization and Faith Communities since 1750, Basingstoke: Palgrave Macmillan, 2012 (Palgrave Macmillan Transnational History Series), p. 233-251.
65 Shamash Nanji, “Guidance Amid Great Changes,” op. cit. (note 3), p. 47-48.
66 Ibid., p. 50.
67 Jiat-Hwee Chang, “‘Natural’ Traditions: Constructing Tropical Architecture in Transnational Malaysia and Singapore,” Explorations, vol. 7, no. 1, 2007, p. 4. URL: http://hdl.handle.net/10125/2250. Accessed 23 December 2024.
68 Vikramādiya Prakāsh, “Epilogue: Third World Modernism, or Just Modernism: Towards a cosmopolitan reading of modernism,” in Duanfang Lu (ed.), Third World Modernism: Architecture, Development and Identity, London: Routledge, 2010, p. 255-256.
69 Samer Akkach, “Polarising ‘Ilm’: Science and Religion in Early Modern Islam,” in Samer Akkach (ed.), ‘Ilm: Science, Religion and Art in Islam, Adelaide: University of Adelaide Press, 2019, p. 3-18.
70 His presidential address to the Seerat Conference on 12 March 1976 explicitly stated this position. See “Presidential Address by His Highness the Aga Khan at the International Seerat Conference,” 12 March 1976. URL: https://the.ismaili/speeches/presidential-address-his-highness-aga-khan-international-seerat-conference. Accessed 23 December 2024. He again championed the union of science and religion during a 1986 interview conducted in Egypt. See Riad Nagib El-Rais, “The Critical Time–interview to Al-Mostakbul newspaper of Cairo, Egypt,” 20 December 1986. URL: http://heritage.ismaili.net/node/36398. Accessed 23 December 2024.
71 Faisal Devji, Muslim Zion: Pakistan as a Political Idea, Cambridge, MA: Harvard University Press, 2013, p. 202.
72 Francis Robinson, “Other-Worldly and This-Worldly Islam and the Islamic Revival: A Memorial Lecture for Wilfred Cantwell Smith,” Journal of the Royal Asiatic Society, vol. 14, no. 1, 2004, p. 47. URL: https://www.jstor.org/stable/25188432. Accessed 23 December 2024.
73 Aga Khan IV referred to the life of Prophet as a model in his presidential address at the Seerat Conference. See “Presidential Address by His Highness the Aga Khan,” op. cit. (note 70).
74 Ibid.
75 Allen J. Frank, “Sufism in the Face of Twentieth-Century Reformist Critiques: Three Responses from Sufi Imām in the Volga-Ural Region,” in Devin Deweese and Jo-Ann Gross (eds.), Sufism in Central Asia: New Perspectives on Sufi Traditions, 15th-21st Centuries, Leiden: Brill, 2018 (Handbuch der Orientalistik, 25), p. 238-255.
76 “The Aga Khan University Hospital, Karachi,” op. cit. (note 48), p. 35.
77 Ibid.
78 Mildred F. Schmertz, “Setting a Standard for Architecture in Islam: The Aga Khan School of Nursing in Karachi, designed by Payette Associates and Mozhan Khadem,” Architectural Record, October 1981, p. 89.
79 Mildred F. Schmertz, “Indigenous High-tech,” op. cit. (note 38), p. 141.
80 Jiat-Hwee Chang, “‘Natural’ Traditions,” op. cit. (note 67), p. 3. Also see Idem, “Tropical Variants of Sustainable Architecture: A Postcolonial Perspective,” in C. Greig Crysler, Stephen Cairns and Hilde Heynen (eds.), The SAGE Handbook of Architectural Theory, London: SAGE Publications, 2012, p. 602-617.
81 Annmarie Adams, “Decoding Modern Hospitals: An Architectural History,” op. cit. (note 24), p. 21-23.
82 Robert Ivy, “the Aga Khan,” Architectural Record, February 2002. URL: https://www.architecturalrecord.com/articles/12623-the-aga-khan. Accessed 23 December 2024.
83 Katharine Bartsch and Peter Scriver, “The House of Stars: Astronomy and the Architecture of New Science in Early Modern Lucknow (1831-49),” in Samer Akkach (ed.), ‘Ilm: Science, Religion and Art in Islam, Adelaide: The University of Adelaide Press, 2019, p. 59-77.
84 His Highness the Aga Khan IV, “Islamic architecture: a revival,” op. cit. (note 63).
85 Robert Ivy, “the Aga Khan,” op. cit. (note 82).
86 Seyyed Hossein Nasr, An Introduction to Islamic Cosmological Doctrine, Cambridge, MA: Harvard University Press, 1964; Idem, Man and Nature: The Spiritual Crisis of Modern Man, London: George Allen & Unwin, 1968.
87 Seyyd Hossein Nasr, “Ālam Khiāl va mafhūm-e Fazā dar Miniyātor-e Irani,” Faslnāme Honār, no. 26, 1373/1994, p. 79-86. URL: www.noormags.ir. Accessed on 23 December 2024. Originally published in Bāstān Shenāi va Honar-e Iran, no. 1, 1347/1968, p. 43-54.
88 Nader Ardalan and Laleh Bakhtiar, The Sense of Unity: The Sufi Tradition in Persian Architecture, Chicago, IL: The University of Chicago Press, 1973, p. 17.
89 For Idrāk, see Samer Akkach, “Naẓar: The Seen, the Unseen and the Unseeable,” in Samer Akkach (ed.), Naẓar: Vision, Belief, and Perception in Islamic Cultures, Leiden: Brill, 2019, p. 12-32.
90 Faisal Devji, Muslim Zion, op. cit. (note 71), p. 210.
91 As Jonathan Crary has emphasised as early as 2001, “the ways in which we intently listen to, look at, or concentrate on anything have a deeply historical character.” Jonathan Crary, Suspensions of Perception: Attention, Spectacle, and Modern Culture, Cambridge, MA: MIT Press, 2001, p. 1. Also see Bettina Varwig, “Heartfelt Musicking: The Physiology of a Bach Cantata,” Representations, no. 143. 2018, p. 36-62. URL: https://www.jstor.org/stable/26504450. Accessed 23 December 2024.While Varwig’s focus is on music, her examination can tell us much about how to recover historical forms of bodiliness.
92 Daniel Lord Smail, On Deep History and the Brain, Berkeley, CA: University of California Press, 2008 (Neurhistoire).
93 I would like to thank Sarah Borree with whom I have been thinking about the importance of recovering counter-bodies.
94 Khalil Andani, “Divine Diversity: The Aga Khan’s Vision of Pluralism,” Journal of Islamic and Muslim Studies, vol. 4, no. 1, 2019, p. 12-13. DOI: https://doi.org/10.2979/jims.4.1.01. Also see Sahir Dewji, “The Aga Khan’s Discourse of Applied Pluralism: Converging the ‘Religious’ and the ‘secular’,” Studies in Religion/Sciences Religieuses, vol. 47, no. 1, 2018, p. 78-106. DOI: https://doi.org/10.1177/0008429817713738
95 “Aga Khan Speech at the Takht Nishini Ceremony in Karachi,” 23 January 1958. URL: http://heritage.ismaili.net/node/27473. Accessed 23 December 2024.
96 “Speech at Karachi, Pakistan,” 04 August 1957. URL: http://heritage.ismaili.net/node/27414. Accessed 23 December 2024; also see “Speech at the All Nations Club of Calcutta (India) Dinner,” 22 September 1962. URL: http://heritage.ismaili.net/node/34570. Accessed 23 December 2024.
97 Saadia Toor, The State of Islam: Culture and Cold War Politics in Pakistan, London: Pluto Press, 2011.
98 Khalil Andani, “Divine Diversity,” op. cit. (note 94), p. 14.
99 Soumen Mukherjee, Ismailism and Islam in Modern South Asia: Community and Identity in the Age of Religious Internationals, Cambridge: Cambridge University Press, 2017, p. 77-113. DOI: https://doi.org/10.1017/9781316650479; Teena Purohit, “Muhammad Iqbal on Muslim Orthodoxy and Transgression: A Response to Nehru,” ReOrient, vol. 1, no. 1, 2015, p. 84. DOI: https://doi.org/10.13169/reorient.1.1.0078.
100 Stuart W. Leslie, “New Universities for a New Nation,” op. cit. (note 36), p. 309-310.
101 Ibid., p. 322.
102 “Speech by His Highness the Aga Khan on Occasion of Hospital Foundation Stone Laying Ceremony,” 03 February 1971. URL: http://heritage.ismaili.net/node/27440. Accessed 23 December 2024.
103 “600-bed Aga Khan Hospital and Medical College for Pakistan,” op. cit. (note 37), p. 6.
104 Hamza Alavi, “Misreading Partition Road Signs,” Economic and Political Weekly, vol. 37, no. 44-45, 2002, p. 4515-4523. URL: https://www.jstor.org/stable/4412807. Accessed 23 December 2024.
105 Soumen Mukherjee, Ismailism and Islam in Modern South Asia, op. cit. (note 99), p. 79.
106 Ibid., p. 89-91. It remains to be examined whether he also drew on India’s pre-colonial connection with Iran. See Mana Kia, Persianate Selves: Memories of Place and Origin Before Nationalism, Stanford, Ca: Stanford University Press, 2020.
107 This has particularly been acknowledged in relation to the Aga Khan III’s educational campaigns. See Soumen Mukherjee, “Being ‘Ismaili’ and ‘Muslim’: Some Observations on the Politico-Religious Career of Aga Khan III,” South Asia: Journal of South Asian Studies, vol. 24, no. 2, 2011, p. 204-207. DOI: https://doi.org/10.1080/00856401.2011.587507; Gail Minsult and David Lelyveld, “The Campaign for a Muslim University, 1898-1920,” Modern Asian Studies, vol. 8, no. 2, 1974, p. 145-189. URL: https://www.jstor.org/stable/311636. Accessed 23 December 2024.
108 Christophe Jaffrelot, “‘South Asian Muslims’ interactions with Arabian Islam until the 1990s. Pan-Islamism before and after Pakistan,” in Christophe Jaffrelot and Laurence Louër (eds.), Pan-Islamic Connections: Transnational Networks between South Asia and the Gulf, Oxford: Oxford University Press, 2017, p. 81.
109 Ibid., p. 71-79.
110 Khalil Andani, “Divine Diversity,” op. cit. (note 94), p. 13-21.
111 Robert Ivy, “The Aga Khan,” op. cit. (note 82); Also see, Philippa Baker, Architecture and Polyphony: Building in the Islamic World Today, London: Thames & Hudson, 2004, p. 5. URL: https://www.archnet.org/publications/5059. Accessed 23 December 2024.
112 His Highness the Aga Khan, “Opening Remarks,” in Reneta Holod (ed.), Toward an Architecture in the Spirit of Islam, Philadelphia, PA: Smith-Edwards-Dunlap, 1978, p. viii. URL: https://www.archnet.org/publications/3495. Accessed 23 December 2024.
113 According to Andani, rather than viewing pluralism as a product, the Aga Khan IV described it as a malleable process. See Khalil Andani, “Divine Diversity,” op. cit. (note 94), p. 19.
114 Cathelijne Nuijsink and Annamaria Bonzanigo, “Humanitarian Aid as Global Governance: The Architecture of the Red Cross’s Relief Operations after the 1976 Guatemala Earthquake,” Architectural Theory Review, vol. 27, no. 1, 2023, p. 84-102. DOI: https://doi.org/10.1080/13264826.2023.2228940.
115 Sahir Dewji, “Beyond Muslim Xenophobia and Contemporary Parochialism: Aga Khan IV, the Ismā’īlī, and the making of a cosmopolitan Ethic,” PhD diss., Wilfrid Laurier University, Waterloo (Canada), 2018.
116 Khalil Andani, “Divine Diversity,” op. cit. (note 94), p. 15.
117 His Highness the Aga Khan IV, “The role of private initiative in developing countries,” Swiss American Chamber of Commerce in Zurich, 14 January 1976. URL: https://the.akdn/en/resources-media/resources/speeches/swiss-american-chamber-commerce-zurich-his-highness-the-aga-khan. Accessed 23 December 2024.
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Titre | Figure 1: Aerial view of the Aga Khan University Hospital in Karachi. |
Crédits | Source: Photo by Gary Otte. Archnet. Creative Commons Attribution Non-commercial 4.0 International (cc BY-NC 4.0). |
URL | http://journals.openedition.org/abe/docannexe/image/16699/img-1.jpg |
Fichier | image/jpeg, 578k |
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Titre | Figure 2: Mowlana Hazar Imam and President Zia cut the ribbon to open the School of Nursing in Karachi on February 16, 1981. |
Crédits | Source: Ismaili Africa, 1982. Reprinted with the permission of the Institute of Ismaili Studies (IIS). The IIS owns and retains at all times the copyright on this item from its special collections. It may not be reproduced physically or digitally without prior written permission from the IIS. |
URL | http://journals.openedition.org/abe/docannexe/image/16699/img-2.jpg |
Fichier | image/jpeg, 429k |
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Titre | Figure 3: Mowlana Hazar Imam performs the ground-breaking ceremony for the final phase of the Aga Khan Hospital and Medical College, Karachi. |
Crédits | Source: Ismaili Africa, 1982. Reprinted with the permission of the Institute of Ismaili Studies (IIS). The IIS owns and retains at all times the copyright on this item from its special collections. It may not be reproduced physically or digitally without prior written permission from the IIS. |
URL | http://journals.openedition.org/abe/docannexe/image/16699/img-3.jpg |
Fichier | image/jpeg, 509k |
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Titre | Figure 4: Site plan of the Aga Khan University Hospital. |
Crédits | Source: Wolfgang Pehnt, “Im Namen Allahs: Das Klinikum der Aga Khan Universität in Karachi, Pakistan,” Bauwelt, vol. 26, 1986, p. 981. Available at the RIBA Library, London. Reprinted with permission. |
URL | http://journals.openedition.org/abe/docannexe/image/16699/img-4.jpg |
Fichier | image/jpeg, 600k |
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Titre | Figure 5: Private wing courtyard, 1985. Photo by Paul Warchol. |
Crédits | Source: Courtesy of Paul Warchol. Reproduced with permission. |
URL | http://journals.openedition.org/abe/docannexe/image/16699/img-5.jpg |
Fichier | image/jpeg, 272k |
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Titre | Figure 6: The design of one of the entrance portals with calligraphic ornamentation comprising Koranic verses. |
Crédits | Source: Wolfgang Pehnt, “Im Namen Allahs: Das Klinikum der Aga Khan Universität in Karachi, Pakistan,” Bauwelt, vol. 26, 1986, p. 981. Available at the RIBA Library, London. Reprinted with permission. |
URL | http://journals.openedition.org/abe/docannexe/image/16699/img-6.jpg |
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Sara Honarmand Ebrahimi, « The Aga Khan University Hospital in Karachi and the Unity of Din and Dunyā », ABE Journal [En ligne], 24 | 2024, mis en ligne le 31 décembre 2024, consulté le 28 mars 2025. URL : http://journals.openedition.org/abe/16699 ; DOI : https://doi.org/10.4000/13939
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