The history of Orthopaedic Service Programme in Bangladesh runs somewhat concurrently with the development
of the Rehabilitation Institute and Hospital for the Disabled.
With the War of Liberation, the new nation of Bangladesh was left with a great number of war injured. Although a few of the Freedom Fighters from among the wounded were taken by foreign countries for treatment, the great bulk of the wounded including the civilians had to be taken care of by the new nation itself. The vast majority of these patients had orthopaedic problems, and at that time there was only one qualified Bangladesh Orthopaedist in the country and he left within a matter of months.
My offer to come and do what I could to help meet this need was accepted readily and cordially by the Ministry of Health. The Secretary, Ministry of Health, took me to the Sher-e-Bangla Nagar
Hospital out patient Building and asked me to start a 100-bedded Orthopaedic hospital and Limb Center, and to run it for one year. He gave the promise that the Government of Bangladesh would
take over the financial responsibility of the hospital at the end of the time. In early June 972, the admitted into the Orthopaedic Unit of the Sher-E-Bangla Nagar Hospital. The name Sher-e-Bangla
was soon to give way to Shaheed Suhrwardy Hospital of which the Orthopaedic Department remained a part being the in-patient Hospital in this Out-patient Building upto 1978. on 12th May, 78
the new Orthopaedic Hosptal Building with facilities for 400 patients started functioning.
In those days, we had to depend mostly on volunteer staff, and they came forward from all over the world. There were doctors, nurses, physiotherapists, occupational therapists limb-makers, brace
makers, secretaries, pharmacists and administrators. By July, 1973 the Government of Bangladesh proved true to the promise, and assumed the financial burden of the hospital, which by that time
had mushroomed to 250 beds. Government appointed staff gradually replaced the majority of the volunteers. It became apparent, however, that if the Orthopaedic programme was to continue, young doctors of Bangladesh would need to be trained as Orthopaedic Surgeon. Volunteer Orthopaedists had been coming form England and Canada, from the onset of the work, and in 1972 Mr.
J.N. Wilson had come under the auspices of the Overseas Development Ministry of England to study the need and decide the feasibility of entering into a joint venture of training doctors in
Bangladesh.
Mr. Geoffry Walker followed soon after Mr. Wilson who had recommended that the O.D.M. be
actively
involved in securing highly qualified Orthopaedists to work along with us in the
training programme.
With the help of Mr. Walker, formal requirements were drawn up.
Concurrently with this, the project Director of the Sher-e-Bangla Nagar Hospital and I
began the
work of drawing up the first P.C.I. scheme to bring into existence a 400 bedded
Rehabilitation
institute and Hospital for the Disabled, Within a few months, however, Project Director
become
Director of Health Services (MET&R) and new Project Director, ably took up the job of
assisting
in drawing up the Scheme. The scheme was approved by the National Economic Council on
April 28,
1974 by the recommendation of the President who added that approval was given on the
understanding
that a 75 bed casualty Unit would be opened in the Shahid Suhrawardy Hospital to be
administered
along with the Orthopaedic Department. By this, the in-patient Hospital grew to 325
beds.
This was the second scheme, presented to the N.E.C. by the Ministry of Health, to be
accepted and
approved. As will be seen later on, it was because of the foresight of project Director
that
this rather cumbersome name proved to be great benefit to us in development of the
Medical Education
Programme.
It was to Director of Health (MET & R) then, that formal plans for establishing the
course were presented.
These plans were favourably received by him and forwarded to the Faculty of Medicine of
the University
of Dhaka. Subsequent correspondence then began between the Ministry of Health, the
Faculty of
Medicine of the University of Dhaka and the Orthopaedic Hospital. The Dean of the
Faculty of
Medicine (now the Director-General of Health Services) was very sympathetic and helpful
for the
purpose of carrying on this training programme. Consultation was made with many surgeons
of the
country especially Dhaka Medical college, Barisa, Rajshahi and Sylhet Medical College.
These
surgeons expressed approval of the programme and offered to co-oparete.
On January 5th, 1973 the Faculty of Medicine of Dhaka University acted on suggestion and
appointed
a committee to inspect the Shahid Suhrawardy Hospital as an acceptable place for
establishing
the course, the committee consisted of Prof. of Surgery, Dhaka Medical College and
myself. When
our findings were presented to the Faculty of Medicine on 15-3-73 it was recommended
that the
Master of Surgery (Orthopaedics) be started at Shahid Suhrawardy Hospital. Subsequent
necessary
formal approvals and recommendation by the various bodies of the University came as
follows:
–
June, 1973: Faculty of Medicine, University of Dhaka, Approved S.S.H.
for initiating
the course for Master of Surgery.
September, 1973: Post Graduate Faculty of Medicine and Research
approved the programme
for granting the Diploma in Orthopaedic Surgery.
October, 1973: The Syndicate approved the programme and instructed that
the course should
be administered under the Faculty of Post Graduate Medicine and Research.
December, 1973: Faculty of post Graduate Medicine and Research approved
the syllabus
for the courses.
Thus it was that the full-fledged course for granting the Master of Surgery in
Orthopaedics and Diploma
in Orthopaedics come into being. The M.S. (Orthopaedics) course was the very first
Medical Post
Graduate Degree Course of its kind in Bangladesh.
In the meantime, six young man had been selected by the Admission Committee to become the
pineer
bathch. They had started their work on July, 1973. five of those selected, were deputed
by the
Ministry of Health. The sixth, was sent from the Army. Their training lasted the
required two
and one half years, and was greatly enhanced by the continued deputation of experts form
England,
Holland and Australia, and Volunteers from the U.S.A and Canada.
During the time, plans were being implemented to begin the building of the new 400 bedded
Rehabilitation
institute and Hospital for the Disabled. A choice site was allocated by the Ministry of
Health
and the Public works Department, and ground was broken in late, 1974. Building went
ahead rapidly
and the new R.I.H.D. was ready for occupancy in April, 1978.
The pioneer batch, by the time, had completed their work for their degree and diplomas.
Then it was
that we came up to an unexpected problem with the actual granting of the degrees. The
were duly
inspected by a committee consisting of the Dean of the Faculty of post Graduate Medicine
and
Research, the Dean of the Faculty of Medicine and the inspector of Colleges. It was
during this
anxious period that we come to fully appreciate the foresight of Project Director in
advicing
that we be called the Rehabilitation Institute and Hospital for the Disabled, for had we
been
called anything less we would not have been recognized as a teaching institution. The
Bangladesh
Medical Council had also sent a committee to inspect us, and had voted to recognize our
Degree
and Diploma. Also, it was agreed by the Council that the R.I.H.D. should be the granting
institution
for it was on that date that the university of Dhaka gave us recognition as a
constituient institute
of the University. Our work had thus been fully established. To date there have been
eight Master
of Surgery (Orth) and twelve Diplomas (Orth) conferred. Two new groups of doctors are in
training
at present.
On August 24, 1979, the men who had qualified as Orthopaedic Surgeons met and formed the
Bangladesh
Orthopaedic Society, and invited all qualified Orthopaedists of Bangladesh to join. One
of the
pioneer batch, professor Salek Talukder, was elected the first President.
By early 1980 it became possible to send locally trained Orthopaedic Surgeons to every
medical college
of Bangladesh. They are doing their best to organise the service. Other necessary posts
have
been created to send more senior doctors. Auxillary services are being organized and
necessary
personnel being trained and four of the medical colleges have started providing this
service.
In coming years other important district hospitals will be provided with the service.
Orthopaedics
in Bangladesh is on its way.
Ronald J. Garst. M.D.
Project Director
R.I H.D. Dacca.