Game Changer: The Story of Yasmin Amarsi and the Profession of Nursing in Pakistan
By Kamal Siddiqi
The Aga Khan University
ISBN: 978-969-8073-72-5
110pp.

Some people are born to succeed, no matter what life throws at them. And not only do they themselves move ahead, making the most of what comes their way while bringing about changes that have far-reaching effects, they leave footprints that allow others to follow their path.

One such person is Yasmin Amarsi, adviser and professor emeritus at the Aga Khan University (AKU). As a pioneering leader in healthcare, she laid the foundation of AKU’s School of Nursing and Midwifery (SONAM), shaping the future of nursing in Pakistan and East Africa, and spent more than four decades contributing to AKU-SONAM in these regions.

The book, Game Changer: The Story of Dr Yasmin Amarsi and the Profession of Nursing in Pakistan by Kamal Siddiqi, details her life and achievements, and comments on the state of the nursing profession in the country.

Dr Amarsi left her home country (Tanzania) and came to Karachi in 1968, to study and pursue a career in medicine. As luck would have it, she ended up joining the nursing profession and reaching great heights. Ironically, she had left Tanzania to escape the political disturbances there but found herself here amidst students’ protests, due to which city colleges remained closed for some time. Not wanting to waste time and on the suggestion of a distant relative, Noorali Amarsi (now her husband), she decided to pursue nursing and took admission in Jinnah Postgraduate Medical College’s (JPMC’s) School of Nursing.

A recent book details the story of a woman who, through her sheer dedication and pursuit of excellence, has shaped the future of nursing in Pakistan and beyond

Yasmin is a woman with aspirations. After completing her diploma in nursing in 1972, she was not content and wanted more. So she took the initiative to improve her qualifications and enrolled in a diploma in midwifery in 1975. This diploma was essential to get employment in the nursing profession, especially in the private sector. In 1977, she re-joined the JPMC College of Nursing for a diploma in ward management and then a diploma in teaching administration. These diplomas were considered the highest education in the nursing profession at that time in Pakistan.

In 1980, she joined the Aga Khan University, beginning “her 43-year journey at the hospital.” From here on, she did not look back and availed all the opportunities to improve her qualifications and capability. At the same time, recognising her talents and leadership potential, the institute offered her chances to study and train abroad.

She pursued the RN-BSN programme, which allowed registered nurses (RN) the chance to pursue a bachelor of sciences in nursing (BSN), and the Post-RN-BSN degree at McMaster University in Canada. She eventually became the first PhD nurse in the country when she completed her doctorate in nursing in 1998. During her career, she received many other honours, including the honorary doctorate of science degree by McMaster University, making her the first and only Pakistani to have received this honour.

In her pursuit of excellence, Yasmin faced many challenges. Yet she remained steadfast, even showing the courage to live thousands of miles away from her young children. In this, she had the unwavering support of her family. While doing her master’s, she wanted to give up after the demise of her mother-in-law, but her husband persuaded her to continue and himself took care of the children.

Yasmin’s story is not just about personal triumph but also about the impact one individual can have on an entire profession. And that, too, not only in her country of residence but wherever she was asked to assist. To make use of her expertise and dedication, the Aga Khan Development Network sent her to Afghanistan and Syria as well as to Egypt and East Africa, to help rebuild the healthcare systems there.

Her nursing career overlapped with the changes that the nursing profession in Pakistan experienced. From the time she decided to become a nurse to the time she retired, nursing had come a long way. When she joined JPMC, there was a shortage of qualified nurses in Pakistan, as nursing was considered an unattractive career choice. The nurse-to-patient ratio at the JPMC then was 1:60 (the ratio, according to the Pakistan Economic Survey 2020-2021, is 1:40). The first nursing school in Pakistan had been established in Lahore in 1948 at the Sir Ganga Ram Hospital, from where the first batch of nurses — seven in all — had graduated four years later in 1952. JPMC had started offering a diploma in nursing that same year.

An important change came in 2005 when, after a collective effort of more than 15 years, the Sindh government agreed to classify nursing graduates as officers in its service cadre. From then on, all nursing graduates were to join in grade 16, instead of grade 15, which is designated for non-officers. This was a historical moment for the nursing profession.

Following the initiative by the Sindh government, other provincial governments too began to recruit nursing graduates in grade 16. This move helped, gradually, in attracting more promising candidates. The most important element of this change was the way the public image of female nurses improved.

Even today, the medical profession in Pakistan has more doctors than nurses. It has one of the poorest ratios of doctors to nurses and midwives — there is only one nurse for every two doctors. In contrast, the global trend is for four nurses for every doctor. It is clear that Pakistan desperately needs more nurses entering the profession. Yet, what is seen is that the number of doctors continues to rise — the nursing profession is still not considered as attractive.

Yasmin believes that one of the reasons that the nursing profession is neglected is because, historically, there has been a lack of representation of nurses on committees at the government level. While in Syria, she had insisted that it was important to have nurses represented at the policy level, as they could have a real impact on the health sector. The Syrian government paid heed to her advice; one hopes that the Pakistan government also does so.

The book not only highlights Yasmin Amarsi’s dedication to improving healthcare, her innovative contributions to nursing and her unyielding spirit in the face of adversity, it also underscores the power of perseverance and the extraordinary achievement that can arise from unwavering dedication.

The reviewer is a freelance journalist. X: @naqviriz

Published in Dawn, Books & Authors, March 23rd, 2025