Monday 16th January
Met Fahmida at CRP
Met Val and introduced to the Executive Director, Shafiq-ul Islam
Lunch with the Heads of Departments
Afternoon visit to Gonakbati with Fahmida
Observed:-
• ‘Marks and Start Programme’ which is supported by Marks and Spencer
• Mushroom growing project
• Gardening and plant sales
• Work on delineating the boundary of the CRP property
• Possible fish farming project
• Recycled Paper Project
• Site for new building – possibly to house the metal & wood workshops currently sited in Savar
• Site for shops development
Shafiq later provided me with a copy of the proposed master plan for Gonakbari to share with VTT trustees.
Evening discussion with a surgical team from Leeds Teaching Hospital. They were at CRP for the week. A short report on their work is included later.
Tuesday 17th January
Meeting with the Executive Director
We discussed the management structure of CRP so that I would have a clear picture of how the organisation operates before visiting all the departments. I was provided with a diagram of the structure with the names of the Department Heads.
The ED described his plans for a career development structure within CRP and the drawbacks currently faced with staff retention, some staff unrest and ensuring the efficient delivery of services. A consulting firm is due to look at the procedures within CRP with the objective of providing advice on how to move forward on Operational Guidelines such as :-
• Recruitment Policy
• HR Manuals
• Staff Retention
• Job Descriptions
• Time management
Historically there are many very good practices at CRP but because CRP has grown so much there is a need to ensure that all staff continue to implement these good practices. There is very little in terms of written policies. Until clear guidelines are in place it is difficult to monitor performance and require staff to follow agreed policies and for CRP to operate at greater capacity and efficiency.
There will be extensive staff consultation and the consulting firm will be given the task of coming up with recommendations that are ‘deliverable’ and producing policies that can be realistically implemented.
Building Development
A new Admin and IT centre is under construction on the first floor. These departments will be moved from their current position on the ground floor. The ground floor rooms will be converted to patient accommodation.
Two apartments are to be rented to a Canadian Aid/Research organisation for two years. They will completely renovate the apartments putting in air conditioning, hot water , completely redecorating and furnishing. After two years the apartments will revert to CRP
Patient Management
A project worth 5 Lakh taka is about to be put in place to set up a database of all patients. This will improve efficiency and ensure that when a patient is treated in more than one department their records will be readily accessible.
Visiting Departments
Taking time to visit all the departments gave a good all round feel for the work of CRP. All staff members were keen to tell me about their work. The importance of VTT to the staff was very evident. The enthusiasm they demonstrated was heart warming. In every department I tried to speak to patients as well as staff. Being able to converse in Bengali was very useful. In the course of moving around CRP I had some very moving encounters with patients and their families. I will tell their stories separately.
Wheelchair Basketball
The sports and recreational staff invited me to watch a basketball match in which some of the able bodied staff joined in with the patients. It was great fun to watch and very competitive. The staff asked me to present the participants with Tshirts. It was an enjoyable end to a really good day.
Wednesday 18th January
A very early start with Val and the surgical team from Leeds Teaching Hospital. The surgeons were giving a lecture at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR). A large audience of doctors and surgeons were present and obviously keenly interested in the techniques being described. CRP staff were keen to share the expertise of the visiting team with other medical professionals and the team performed operations in both institutions. Staff from NITOR also came to CRP to treat patients. Evidence of the good relations being developed between CRP and other medical institutions.
Val, Shafiq and I left the lecture early to go to a meeting with the Chairman of TRP Mr Saidur Rahman.
Meeting with TRP Chairman
Val and the ED meet regularly with the Chairman so that there is full and open communication on matters that do not require a meeting of all Trustees.
I was privileged to be invited to attend the meeting where a wide range of matters were discussed including:-
• Building work at Savar
• Recycled Paper Project
• Developments at Gonakbari
• Changes to the floor plan at Mirpur
• The Gobindapur property
• Bank bonds
• Policy and conditions for private work by professionals at Mirpur
• Manikganj land dispute
• Annual Purchase Plans for woodwork & metalwork departments
• Scholarships for PT and OT students
• Patient database
Being present at this meeting gave me a real feel for the very positive way CRP is moving forward.
Visit to Mirpur
Val and Shafiq had other appointments so the Head of the Mirpur Centre showed me around.
It has a very different feel to Savar . The building is modern and the vast majority of the patients are paying clients. The staff offer Multidisciplinary Treatment Plans to both in patients and out patients.
Six floors of this building are rented out.
• Three floors are rented to the Advanced Welfare Foundation. They offer many different courses to students and have links to many other educational institutions in Bangladesh.
• One floor is rented to the Services Training and Educational Programme for Reproductive Health
• Two floors are rented to Bangla Link, a mobile phone company.
Thursday 19th January
Visiting the Inclusive School
This was of special interest to me because of my professional background. It was delightful spending time with the children and particularly observing the children with mobility problems being integrated into the mainstream. Thursday is half day so I wasn’t able to spend as much time as I would have liked in the school. Perhaps this should be a priority for my next trip.
Patients’ Meeting
Every week there is a patients’ meeting and each week a different department makes a presentation to the patients to help them to understand the nature of their injuries and explain the reasons for the various treatments.
I observed the OT department making their presentation. It was very interesting to watch two interns making a Powerpoint presentation explaining what happens when a person gets a Spinal Cord Injury (SCI). The OT in charge used a good explanation by describing the loss of connection to the brain with SCI as like an electric wire. If the wire is cut then the electricity can no longer travel along it.
Patients are encouraged to make responses and ask questions. Staff discuss with patients the history of their injury, explain what has happened and what their treatment will be.
Pictures of modifications to equipment to enable SCI patients to resume every day activities were used to show what can be achieved.
Patients who have completed their treatment are asked to tell their story to all the other patients. I heard a young man called Anu tell his story. I will relate it separately along with other ‘encounters’ during my time at CRP.
Observing a Spinal Operation
The team from Leeds were keen that I should observe an operation so I dressed in the appropriate gear and went in. Thankfully a very small part of the patient was visible. The operation was very complicated and required that the patient be first operated on whilst on his back, be turned over and operated on from the front of the neck, have some bone removed from his hip with which to form a clip for the spine, have the clip inserted at the front, finally, be turned over again and have the clip secured from both sides. Needless to say I only stayed for a short time. The patient was sitting up the very next morning. My description may not be terribly accurate but the work done by the team was incredible.
Friday 20th January
As Friday is a holiday I spent most of the day with Val and Poppy talking about CRP.
Saturday 21st January
This was my last day and the car was coming from Dhaka to take me back to my family. My sister in law and brother in law were coming to take me back but also to visit CRP.
Because I was so involved in talking to people I had not taken as many photographs as I had intended. This was my last opportunity. As I was walking around I met a man carrying a bucket of water. This was another of my special ‘encounters’ at CRP. Story to follow.
Margaret Hakim
January 2012