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A WALK DOWN MEMORY LANE
A forty-year sojourn in Bangladesh
Valerie Taylor
Joining the anniversary celebration of the Holiday, this country’s outstanding newspaper, founded by an outspoken journalist, the late Enayetullah Khan, is a great privilege and honour. We offer our heartiest congratulations on its momentous stepping into the 46th year of publication.
While applauding our long-time friend and supporter A U M Fakhruddin on this newspaper’s 45th founding anniversary, and wishing the Holiday a long triumphant onward journey —- it is on this occasion that I was requested to write something about the past forty years that I have spent in Bangladesh.
It all began in the autumn of 1969 when as a physiotherapist with Voluntary Service Overseas (VSO), I was sent to work in the Christian Hospital at Chandraghona in the Chittagong Hill Tracts of erstwhile East Pakistan. My job description included commencing physiotherapy in the general hospital also in the nearby Leprosy Hospital and to train an assistant to take over the work in future.
A witness to Bangladesh’s birth
My assistant was a young man called Subilash Chandra Chakma. Later he was to join the ranks of freedom fighters in the War of Independence in 1971. I was evacuated along with the other VSO volunteers at the time of the civil disobedience movement in March but was able to return again in the autumn and thus was a witness to the glorious birth of Bangladesh on 16th December 1971 — the Bijoy Dibosh (Victory Day). Certainly that day no patient was at all interested to do his or her physiotherapy exercises as the air resonated with the slogan “Joi Bangla!” At that time Subilash and many others re-emerged and joined their previous work.
The three years that I spent working in the hospital at Chandraghona I considered to be the happiest of my life. A more beautiful place would be hard to imagine. The foreign staff lived in a bamboo bungalow at the top of one of the hills overlooking the hospital. The hospital was situated on the banks of the Karnaphuli River, with the hills across the river fading into the distance.
Mists and fireflies
A special winter memory for me was the magical scene on descending the steps on the hillside to hear the creek of the sampan oars and then out of the mist the sampan appearing as if suspended in midair above the river. Other natural scenes that I recall with fondness during the three years I spent at Chandraghona are the fireflies over the rice fields at evening time, the very loud croaking of the frogs and the constant companion in my room, a 15-inch long gecko.
The beauty of the place combined with the beauty of the people and the interest of the work made life exhilarating. I had previously not treated patients with leprosy before and found such fascination in the tendon transplant surgery performed at the time. This allowed leprosy patients who could not close their eyes, use their deformed hands or lift their foot while walking before the surgery to be able to do so afterwards. The surgery produced amazing results and the physiotherapy was needed in order to train the patients in the correct use of the transferred tendon.
On my arrival I received just two months of a basic language course in Barisal as I had signed on for a 15 months term only with VSO in London before embarking on my adventure. I quickly decided that if my “Banglish” did not enable me to communicate at least it provided a lot of laughter among the patients at my expense. I became known for the famous mistake, when asked what I was doing in the physiotherapy unit one day while giving a patient some ultraviolet light treatment; I responded quite confidently that I was giving the patient “a potato”. I had of course cleverly confused the word in Bengali for “light” with the word for “a potato”. I mixed up aloo (potato) with aal (light).
Contrasting situations
In the general hospital ward three different spinally injured patients were admitted during the first half of my stay. Having grown up living close to the National Spinal Injuries Centre at Stoke Mandeville in England, I witnessed the contrasting situations. In the UK spinally injured patients were not only routinely provided with a wheelchair but also with a small car operated by hand controls. At Chandraghona at that time there was no wheelchair, no adequate vocational training and thus for many paralysed people little or no hope in life. One day as I sat beside the bed of one of the paraplegic patients in the ward I resolved to try and do something to improve their situation.
Like gypsies
In 1973 I returned to England to attempt to raise funds to establish a rehabilitation centre for paralysed people in Bangladesh. I stayed in England for two years before returning in 1975. It took another four years before the Centre for the Rehabilitation of the Paralysed (CRP) was able to start work, permission from the Bangladesh Government and sufficient foreign funding needed to be acquired first. During this time, the four-member team who created CRP worked in the Shaheed Suhrawardy Hospital in Dhaka and it was in the grounds of this hospital that CRP had its first premises, two cement storerooms which were converted to treat the first spinally injured patients. Rather like gypsies, having moved to three locations during the first eleven years, CRP then found a permanent home and moved to Savar in mid-1990 where the head office is situated.
In the intervening years CRP has become: (1) an institution for the treatment and rehabilitation of spinally injured in-patients as well as treating children with cerebral palsy by training their mothers. Out-patients with neurological and orthopaedic conditions have physiotherapy, occupational therapy and speech and language therapy available to them.
(2) a training centre, the Bangladesh Health Professions Institute, running 11 different courses
(3) a place that encourages community based rehabilitation through self help groups of people with disabilities, currently in 8 districts in Bangladesh.
Future of CRP’s work
CRP has reached an important landmark - its 30th year of operation. We are now looking back and taking stock and then looking forward to the next 30 years. Having acquired experience and expertise in the field of rehabilitation, CRP plans to disseminate this knowledge to other areas of Bangladesh.
CRP will never be able to accommodate all of the spinal injuries that require treatment and rehabilitation across Bangladesh in one centre with 100 beds. It is our hope that if we can be successful in implementing the idea of small, satellite spinal injury units in Government medical college hospitals, that this idea could gradually spread. If initial acute care can be given in hospital near the patient’s home then at a later date the paralysed person could be transferred for vocational training to a hopeful new and enlarged training centre at CRP-Manikganj.
Therapy projects in six Upazilas
A community therapy project has recently commenced in six Upazila health complexes in the Moulvi Bazar district. It is clear that poor, disabled people cannot attend the CRP-Gobindapur site which is not easily accessible and instead the services need to be taken to them. Through the assistance of two therapists this plan is being realised.
Disabled people who are poor cannot afford to travel long distances to the capital city for treatment. CRP’s long term plan is to gradually commence a therapy centre in each of the six divisional towns. A team providing physiotherapy, occupational therapy, speech and language therapy, orthotics and prosthetics would enable disabled people to receive services much closer to home.
Local Kobiraj can be trained
There are many targets to reach, many barriers, challenges and obstacles to bring down. How good it will be if in the next decade traditional healers, the local “kobiraj”, can receive training at CRP as community rehabilitation technicians to enable them to be more useful to people in their local area.
How wonderful it will be if in the next decade we can see an end to disabled people being bound to crawl on their hands and knees in order to move around through lack of a mobility aid.
Working together for the disabled
Great changes in attitude of the general public towards disabled people are required to ensure equal opportunities in life and no one can effect these changes better than those with a disability. Already the employment rate for disabled people is gradually improving and helping to set the scene for the future.
“Working together” would seem to be the motto for CRP in the next 30 years whether as a patient, a staff member, a donor or a supporter to achieve a fairer, more equitable situation for everyone. We all have a part to play. Please come forward and join us.
Valerie Taylor is founder co-ordinator of the Centre for the Rehabilitation of the Paralysed (CRP), Savar.
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