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About NITOR

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.


Health Minister
Honorable Minister
Ministry of Health and Family Welfare



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