Editorial Advisers

Message

We are very happy to share many notable events through this Annual Report that have occurred at CRP in 2002-2003. The most successful event this past financial year was the official start of therapy services at CRP-Mirpur. This has been our goal. Previously CRP was only in rented premises in Dhaka City but today CRP has its own 13-storey complex in Mirpur! Among many other events, CRP’s Open Days were one of the most important. Held for the first time in 2003, we hope it will continue every year. This past year was also the first time our mouth painter, Lovely, had an opportunity to visit Germany to sell her cards and calendars and to gain knowledge that will be reflected through her artwork. Lovely’s trip was made possible by Carolyn Scott, President of the Friends of CRP-Germany and by Emirates Airlines. I am very grateful to our friends in the UK and Germany who helped make our fundraising tour this summer a success.

CRP emphasised awareness raising of disability issues during this past year by arranging a Geet and Gazal Evening, a sponsored walk, preparing and broadcasting TV messages, screening the Bihongo film at several venues and other activities that showed the importance of rehabilitating paralysed people. In 2004, CRP plans to observe its Silver Jubilee throughout the year, aiming to further raise awareness about our work and disability issues.

CRP cannot run without the support of our friends who care about disabled people and see them not as a burden but as valuable members of society. Please continue your support in whatever form it takes.

Thank you.

Valerie A. Taylor OBE

Coordinator

CRP

Message

The Centre for the Rehabilitation of the Paralysed (CRP) has completed nearly 24 years of service for disabled people in Bangladesh. We are happy to announce that CRP will observe its Silver Jubilee programme in 2004, focusing on its aim of creating equal opportunity for disabled people in Bangladesh. CRP has planned a year-round programme to make the Silver Jubilee a success.

CRP is working to implement disabled people’s rights in all areas of their lives. In 2003 CRP began forming self-help groups in its community-based rehabilitation (CBR) areas. CRP believes if disabled people organise and pressure the government for the creation of equal rights, then the differences between able and disabled people will be minimised. Disabled people will no longer be treated as burdens but instead they will contribute to their families and to society.

CRP’s activities are increasing every day and it is our hope that one day people living in every part of the country will have access to these services. In addition to the development of the CRP head office, another two sub-centres at CRP- Gonokbari, the independent living centre for disabled women, and the CRP guest house in Gobindapur, CRP began offering physiotherapy and occupational therapy services in April 2003 in its own Dhaka City complex at CRP-Mirpur. Now disabled people in Dhaka City will have easy access to our services.

CRP’s activities follow the guidelines established by the UN standard rules, since Bangladesh is a UN member state. CRP has found that rehabilitation is not possible unless the public becomes aware of the positive contributions made by disabled people. CRP places priority on raising awareness of these issues and the Silver Jubilee programme will draw attention to this area also.

We can only continue our work through the generous donations and support from our friends and well wishers. We are grateful for their encouragement, for the dedication of the staff members and for the support of the government in this endeavour.

AKM Momin

Director

CRP
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TREATMENT SERVICES

The Centre for the Rehabilitation of the Paralysed (CRP) has a 100-bed specialised hospital for patients with spinal cord injury. This is the only specialised hospital of its kind in Bangladesh where people can receive proper treatment and rehabilitation. CRP applies a multi-disciplinary team approach to ensure appropriate management of patients with spinal cord lesions. Consultants, medical officers, physiotherapists, occupational therapists, counsellor, social workers, nurses and ancillary staff are involved in the multidisciplinary team of CRP.

Generally, 70% of CRP’s patients come from the poorest level of society in Bangladesh. However, CRP treats and rehabilitates patients regardless of their economic means. The patients generally present as cases of paraplegia and tetraplegia, mainly resulting from spinal cord lesion (SCL).

Between July 2002 and June 2003 a total of 528 patients were treated as follows:

Men Women Boys Girls Total

SCL patients admitted before July 2002

continuing treatment: 78 17 0 0 95

SCL patients admitted in the reporting year: 264 40 34 16 354

Cause

Falls from height 101 10 14 2 127

Fall while carrying heavy load on head 59 3 7 3 72

Disease process 42 16 6 8 72

Road traffic accidents 41 6 3 1 51

Bull attack 4 0 0 0 4

Bullet injury 1 0 1 1 3

Diving accident 1 0 0 0 1

Various 15 5 3 1 24

Surgical admissions: (men previous 3+38) 41 21 8 9 79

Total 383 78 42 25 528

Nursing Services

Nursing care is an important part of the treatment of paralysed patients. CRP has a number of trained nurses and some foreign nurses volunteer their services to work with them. Presently, a nurse from Cameroon works at CRP. The nurses are engaged to look after the patients’ physical condition, this includes bladder and bowel management, prevention and management of pressure sores and management of complications in spinal cord lesion. Nine nurses, twelve ward assistants, twelve cleaners and eight ayahs are working under the supervision of an assistant matron.

Profile of an inpatient

Momtaz Uddin is 55 years old and became paralysed from the neck down due to a cervical injury. Now he is receiving treatment at CRP. Momtaz is an employee of the Bata Shoe Company where he has been working for 30 years as a machine operator.

He lives in a rented house near his company office in Gazipur. Three months ago, on his way home after work, he was hit by a truck while trying to cross the road. The accident site was very near his factory and some colleagues rushed him to Holy Family Hospital in Dhaka city. After receiving treatment for 13 days, the hospital referred him to CRP for specialised treatment. Since coming to CRP he has had a successful operation. He is receiving therapy and practises walking with a frame. The Bata Shoe Company is paying for Momtaz’s treatment and is maintaining close communication with CRP and monitoring his improvement. Momtaz is very grateful for the support of his employer. He feels that his improvement is rapid and his muscle power is increasing by the day. Momtaz has three sons and two daughters, including an adopted daughter. His wife is giving great support to Momtaz and staying beside him on the ward.

Physiotherapy services

Physiotherapy is essential for the rehabilitation of physically disabled people and this service is provided both for inpatients and outpatients. Inpatient services are provided for patients with spinal cord lesion, some orthopaedic surgical cases and for children with Cerebral Palsy. The following conditions are commonly treated in the outpatients department:

Orthopaedic conditions: Musculo-skeletal conditions, including low back pain, fractures, osteo-arthritis, spondylosis, neck pain, soft tissue injury and spinal problems.

Neurological conditions: Cerebro-vascular accidents, Gullain-Barre Syndrome, peripheral neuropathy, head injuries, spinal cord injuries, adult cerebral palsy, post-polio and myopathies.

Outpatient services are also offered at three of CRP’s sub-centres, clinics in Gulshan, Mohammadpur and CRP-Gobindapur as well as part time at the Upazilla Health Complex in Kulaura.

At CRP physiotherapy services are managed by therapists who are qualified through the Bangladesh Health Professions Institute (BHPI), the academic institute of CRP. At present, physiotherapy services are provided by five B.Sc honours graduates, four graduates with diplomas in physiotherapy and nine physiotherapy assistants. Post-graduate McKenzie courses are conducted for qualified therapists. Foreign therapists work as counterparts of local therapists and foreign physiotherapy advisers work to develop the skills of qualified therapists and in the training of students.

During the reporting period, a total of 416 inpatients received physiotherapy, 332 male patients and 84 female patients. A total of 6357 patients received outpatient services at the CRP main campus, 3851 male patients and 2506 female patients.

Physiotherapy seminar: The Centre for the Rehabilitation of the Paralysed (CRP), in collaboration with Bangladesh Physiotherapy Association (BPA) hosted the Second National Physiotherapy Seminar, entitled "Evidence-Based Practice in Physiotherapy," on October 31, 2002, at CRP-Savar. The honourable Health Minister of the People's Republic of Bangladesh, Dr. Khandaker Mosharraf Hossain, was present as the Chief Guest, while Special Guests were Dr. Dewan Md. Salahuddin, MP; Prof. ABM Ahasan Ullah, the Director General of Health Services; Dr. A. Z. M. Zahid Hossain, BMA Secretary General and the representative of the World Health Organisation, Dr. Suniti Acharya. Eminent neurosurgeon Prof. Rashiduddin Ahmad was present as a Guest of Honour. CRP's founder, Ms. Valerie A. Taylor, presided over the inaugural programme, which was followed by the scientific sessions and cultural programme.
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Occupational Therapy Services

Occupational therapy is vital for patients whose ability to function in daily living activities has been disrupted. Inpatients and outpatients receive services through purposeful activities, therapeutic exercise, special equipment, skills training and environmental modifications to maximise the person's ability to participate independently in everyday life.

CRP is the only place training Occupational Therapists and one of the very few places in Bangladesh where qualified occupational therapists are engaged in the provision of services.There have been seven foreign occupational therapists working alongside local therapists at different periods during the year.

Inpatient Services: A total of 414 inpatients (male 331 and female 83) with spinal cord injuries were treated last year. Six interns and two occupational therapy assistants provided services for these patients supervised by a qualified therapist. Occupational therapists were involved in treating individual patients through hand therapy programmes, patients’ sports, wheelchair skills training and group therapy.

Outpatient services: A total of 1546 outpatients’ (male 1058, female 488) were given treatment last year. Six interns and one assistant occupational therapist provided services for these patients under qualified supervision. Different types of neurological, orthopaedic and learning disabilities were treated.

Splints and adaptive equipment for outpatients, inpatients and for the children referred from the mother and child care unit are made in the occupational therapy department. A total of 197 splints and pieces of adaptive equipment were provided last year.

Supporting Areas: Besides maintaining inpatient and outpatient facilities, the occupational therapy department also provides services to the mother and child care unit, the CRP-Gobindapur centre, the CRP-Mirpur centre, the CBR programmes in Moulvibazar and Mymensingh, the Special Needs School, the special seating unit and some outreach programmes.

Halfway Hostel

The CRP halfway hostel prepares patients for reintegration into the community. Before being discharged from CRP, patients spend 10-15 days in the halfway hostel in order to become competent in an environment similar to their home environment. There are facilities for 20 patients at the hostel. Recently the hostel has been further developed with the inclusion of more equipment and facilities. A hostel supervisor is responsible for ensuring the patients care. One occupational therapy intern and one physiotherapy intern work collaboratively at the hostel. The occupational therapist helps the patients and carers to develop a better understanding of their condition and they also educate the patients and their carers about lifting techniques, wheelchair management, home modification, income generation, social interaction, transport, relationships and maintenance of improvements gained in rehabilitation. Barriers to integration, including physical and attitudinal barriers, are discussed in focus groups. The half way hostel has proved to be a very useful area for therapy students on placement.

Motivation, Counselling and Recreational Services

Patients admitted to CRP with spinal cord injuries can develop irrational thinking about the future and feel hopeless, lonely, fearful and shy. In some cases they develop major depression and anxiety. A professional counsellor and two disabled peer counsellors help patients to overcome these psychological barriers. Motivation and counselling helps patients to understand and accept themselves and encourages them to enter into active training for self-sufficiency. This is very important for the rehabilitation of a disabled person in the community.

Adult literacy and educational programmes for patients are arranged mornings and evenings at CRP. Every afternoon patients play wheelchair basketball and many other games arranged by therapists and volunteers.

Patients also watch television and participate in outings and cultural events. In April 2003 the Ghoroa program was started. In this program, patients interact with popular personalities of the country by asking them questions, listening to songs, acting and participating in other activities that provide mental recreation. Patients are also regularly supplied with newspapers, magazines and books.

Mobility aids and appliances

CRP produces many types of mobility aids and appliances for paralysed people through its metal workshop. All these are produced using locally available materials so they can be easily repaired. During this reporting period, a total of 249 mobility aids and a total of 613 aids and appliances were produced by CRPs' workshops.
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Outpatient Services

Saturdays, Mondays and Wednesdays (from 8:00 am to 1:00 pm) each week are outpatient days at CRP. On each of these days, approximately 100 people with orthopaedic and neurological conditions and children with cerebral palsy come to CRP from different parts of the country. The outpatients’ facility was improved during this reporting period. “Singer-Bangladesh” donated a 34-inch colour television for creating awareness among outpatients of CRP’s activities. The number of outpatients served increases daily. Four doctors work with outpatients and a consultant helps with complex cases. Of a total of 15,970 outpatients receiving treatment and/or consultation advice, 9,794 were male and 6,176 were female.

Pathology

One foreign full-time biochemist with one senior medical technologist, three technicians (two of whom received their training from CRP’s Bangladesh Health Professions Institute) and one part-time pathologist consultant work in this unit. One ex-patient works as an assistant.

8,689 pathological tests were carried out on inpatients and out patients, including 5,340 tests for male and 3,349 tests for female patients.

Radiography

One consultant Radiologist is working part-time in the Radiography department along with one senior radiographer and two medical technologists, who received their training from CRP’s Bangladesh Health Professions Institute. One person works as an attendent.1,332 x-rays were carried out on inpatients, including 980 x-rays for male and 352 x-rays for female patients. In addition, 8,127 x-rays were carried out on outpatients, including 4,476 for male and 3,651 for female patients.

Surgery

Last year a total of 205 surgical operations were performed at CRP, 149 on male patients and 56 on female patients. A consultant orthopaedic and spinal surgeon, an anaesthesiologist, a registrar and two theatre nurses complete CRP's surgical team. From time to time, consultants from home and abroad volunteer their help in complicated surgical cases.

A team from the Leeds Teaching Hospitals Trust in the UK came to CRP for two weeks in the middle of November 2002. They donated a full set of equipment for spinal fusion surgery. The team members were two very experienced neurosurgeons, Mr. Gerry Towns and Mr. Jake Timothy; Roger Woodhall, the operating theatre nurse and Sheila Leadbeater, the librarian, all of whom worked voluntarily at CRP during their stay. Mr. Towns and Mr. Timothy supervised a number of spinal operations with CRP's operating team and helped CRP staff members to develop more confidence and better skills in performing spinal surgery.

Surgical Seminar

A very successful half day seminar on the management of cervical spine disorders was held at a local hotel in Dhaka city on 28 November. Gerry Towns and Jake Timothy, the two neurosurgeons from Leeds Teaching Hospitals Trust conducted the seminar. A total of 46 neuro- and orthopaedic surgeons attended the seminar which was organised by CRP in collaboration with Overseas Partnering and Training Initiative (optin).

Telemedicine Services

The first telemedicine services in Bangladesh were established at CRP in 1999. The creator of the CRP telemedicine link, the Swinfen Charitable Trust in the UK, continues to coordinate the CRP telemedicine referrals. CRP sends patients’ medical histories and diagnostic reports along with necessary photos taken by digital camera to the appropriate consultant mainly in the UK. Their reply takes the form of a second opinion. Last year a total of 25 cases (16 male patients and 09 female patients) utilised the telemedicine service.

Besides providing second opinions, this service is helping CRP's medical staff to continually update their knowledge.

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PROGRAMME FOR DISABLED CHILDREN

Mother and Child Care Unit

Children, most suffering from Cerebral Palsy, along with their mothers attend two-week sessions of physiotherapy, occupational therapy and training in activities of daily living. Through the sessions the mothers of children with disabilities are able to learn how to give appropriate care to their children in the home environment. The present capacity is 20 children each month, which has resulted in long waiting lists. An appointment is made for both to return at a later date for reassessment of the child. Cerebral Palsy, a condition which is usually acquired at the time of birth, is caused by an insufficient supply of oxygen to the brain. This condition is more prevalent in low birth weight infants and premature babies.

On January 29 a cheque for †65,000 was given to CRP for the construction of a new mother and child care unit. Otto Versand and Wuensche Handelsgesellschaft, two large German trading companies, donated the funds. The cheque was presented to CRP’s Coordinator Valerie Taylor by Drs. Otto and Thomas Wuensche. Both companies have representation in Bangladesh through Euro Centra and its representative, Mr. Bernd Deutscher. Also present was Mr. Gert Rietz from Otto Versand and the German Ambassador to Bangladesh, Mr. Dietrich Andreas. CRP was chosen by Mr. Deutscher as a suitable organisation for receipt of these funds. All the visitors from Germany were particularly impressed by the range of services offered by CRP for disabled people in Bangladesh. The new purpose designed mother and child care unit will enable 40 children to receive inpatient treatment each month.

During the reporting period, CRP showed the film Bihongo to the mothers of the disabled children so they could spread the message that there are positive ways to deal with disabilities. CRP also arranged outings for the mothers and children during their stay. The families of 10 children reported to CRP that after receiving treatment from CRP, their disabled children are now able to go to the local school. One of these children was able to take the SSC (class ten) exam this year.

CRP Mother and Child Care Activities

Activity Boys Girls Total

Children completing

inpatient treatment 156 78 234

Children attended

for follow-up session 387 291 678

Children attended as

new outpatients 247 149 396

Special Needs School

The Special Needs School is for children with Cerebral Palsy who require more individual care than is available in mainstream schools. An important objective of CRP’s Special Needs School is to prepare children with special needs to integrate into their local schools. At the beginning of the school in 1993 there were only three students but gradually the number of the students has increased to its present number of 28.

The school is divided into three different classes- Golap, Shapla, and Shimul- based on students’ cognitive abilities. The national curriculum is followed by the Shimul class so that eventually some of these students will be able to receive education in a mainstream school. Between 1998 and 2002, nine pupils were successfully integrated into mainstream schools and three pupils commenced vocational training. This reporting year one student was integrated in a local school. Four qualified teachers who are trained in the methods of needs based teaching for children with Cerebral Palsy are currently working in the school. BHPI arranged six days training for improving the quality of teaching in the Special Needs School. This training was based on actual staff needs in such areas as skills development and the philosophy of inclusion.

Each class has a specific work plan. The teachers follow these plans and each child’s Individual Education Programme (IEP) to give instruction that meets individual learning needs. Students of the Certificate in Education for Special Education, physiotherapy, occupational therapy and rehabilitation nursing courses participate in placements at the Special Needs School to gain knowledge about the inclusion of disabled children in the community.

Daily riding sessions and swimming classes take place, providing both enjoyment and therapeutic value. Teachers are actively involved with the students while riding and swimming. The school also runs recreational activities for the students which includes sports, outings and cultural programmes within CRP and outside. A group of young artists from Dhaka have continued to give recreational therapy in the form of singing, dancing and drama to the students once each week which they much enjoy. Since March Mr. Nazrul Islaam, Music Director, has volunteered his services to take singing classes.

The Special Needs School teachers, housemother and care givers train the students in activities of daily living (ADL) such as dressing and feeding. Students also receive training in computer literacy and gardening and develop vocational skills as they progress through the school.
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Profile of Riaz

Riaz was born in 1994 in Dhaka district. He has been attending the CRP Special Needs School for one year. Riaz has Cerebral Palsy and cannot feed himself or take care of himself. Because Riaz has severe motor problems and is unable to walk, he uses a wheelchair with assistance. Riaz also has a mild learning disability and his left hand is paralysed.

Riaz was born normally and his development was perfect. When he was six, however, he developed a high fever with convulsions. Riaz remained at home and received treatment from an unregistered village doctor but no improvement was found and his situation deteriorated to its present state. His father brought him to CRP after referral by a CRP staff member. Riaz was not admitted to the mother and child care unit but was placed directly in the CRP Special Needs School.

Riaz lives at the CRP hostel. His father lives in Dhaka and is a day labourer. Riaz’s mother died during the birth of another son. His father has only a small income and has two other sons and three daughters, so Riaz is attending the CRP Special Needs School free of cost.

Riaz is a happy boy who enjoys attention from his teachers and volunteers. Even though he has speech problems and cannot communicate verbally, he attends the Golap class and participates in all activities.

Special Seating Service

CRP established its special seating project in 1999 with the support of Motivation, a British charity. Motivation trained four therapists and two engineers at CRP through a year-long course. Then Motivation handed the project over to CRP, along with the necessary equipment and CRP continues to run the project independently. Each chair is made for the individual child's needs, to stabilise the child, improving their balance and enabling them to use their hands, encouraging communication and reducing further deformities.

CRP is a pioneer in this field in Bangladesh. There are three sizes of special seats.One size is for very young children. This chair has no wheels and children can sit independently as their mothers continue to work. The other two designs have wheels to encourage children to use their hands to push themselves around. All three chairs have trays so children can play and communication boards are also available for children who need them. A child is first assessed in the special seating unit and then the unit produces an appropriate special seat. All parents are given training in managing their children’s posture, techniques of fitting chairs, toileting, feeding and hygiene. The unit follows up children after one month and after six months. As the children grow, CRP provides larger chairs without further cost. CRP subsidizes the cost of chairs for poor children. For raising public awareness, CRP continues to show the television message on special seating on local TV channels.

Between July 2002 - June 2003 a total of 75 special seats were produced and distributed to disabled children, 50 to boys and 25 to girls. 38 per cent of children attended regular follow up sessions at CRP.

Rehabilitation Services

One of the major aims of the rehabilitation services is to ensure that disabled people are integrated successfully into their families as well as their communities. To achieve this goal, the units of social welfare, community-based rehabilitation, vocational training, micro-credit and special seating work together under the rehabilitation division of CRP.

Social Welfare Unit

The aims and objectives of CRP’s social welfare unit are to rehabilitate the disabled person in the community. The unit works in two main areas, in the institution and in after care.

In the institutional setting the social welfare unit arranges for patient admission and discharge, patient assessment, counselling and motivation, facilitates treatment by collecting blood for emergency patients, arranging funding for poor patients, supplies shoes and clothes, arranges weekly meetings with patients, prepares patients for work and for ultimate return home. Staff workers on this unit also prepare waiting lists for patients, coordinate treatment with patients’ guardians, help in patients’ vocational training and micro-credit programmes. The unit arranges for home visits to ex–patients as part of after care when social workers assess the success of patients rehabilitation in all its aspects and advise accordingly. Last year the unit sent on three occasions a total number of 9651 follow-up forms along with the Paralysis Newsletter to all ex-patients. The unit also arranges campaigns and wheelchair rallies for awareness raising and the prevention of disabilities. In this reporting period, the following activities were carried out by the social welfare unit:

Activity Male Female Boy Girl Total

No. of home visits 363 108 9 7 487

Provision of financial aid to poor in- and outpatients 300 129 74 60 563

Financial grants for income generating activities 18 8 - - 26

No. of units of blood collected 161 95 3 - 259

No. of inpatients returning to former jobs 115 37 4 - 156

No. of inpatients finding new jobs 109 7 0 1 117

No. of participants in 37 road safety campaigns 1,023 725 3,756 4,580 10,084

No. of participants in 7 wheelchair rallies 280 77 2 - 359

No of inpatients attending literacy classes at CRP 12 10 5 4 31

Vocational Training

When people become disabled, returning to their former work it is often very difficult. CRP tries very hard to restore disabled people to their previous jobs and otherwise help them to become independent. Vocational training is one way to help people become independent. Taking into consideration a person’s ability, desire and environment, CRP arranges training in computers, electronics repairs, tailoring, shop management, poultry raising, embroidery, laundry services, painting of pictures, paper bag and fishing net production. The table overleaf shows the achievements of this reporting period:

Training Disabled Relatives Poor Total

Computer operator 28 - - 28

Electronics repair 13 - - 13

Shop management 116 58 7 181

Tailoring 30 8 2 40

Poultry 3 - - 3

Barber 1 - - 1

Paper bags 4 - - 4

Fishing nets 4 - - 4

Embroidery 2 - - 2

Laundry 1 - - 1

Painting of pictures 2 - - 2

Total 204 66 9 279

Though the training programme was first introduced for ex-patients of CRP, at present all physically disabled people and in some cases their family members, can be included in the vocational training programme.

All training is free of charge and some of those receiving training also receive a stipend. Hostel stays and meals for the trainees are also arranged by CRP. Attendance at cultural and recreational programmes is encouraged.

Job Placement

Accessibility to employment continues to be a great problem for disabled people. However, CRP tries to arrange employment for patients who have received vocational training and hopes in the future to provide job placements for all trainees. A survey by mail taken in the reporting period of 70 graduates who attended the vocational training programme at the start found that 62.86% are self-employed, 18.57% are working for others, 07.14% are doing studies and 11.43% are unemployed.

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Case Study

Twelve-year-old Nazrul stood on the roof of his neighbour’s two-storey house trying to catch the string of a kite. When he touched a nearby power line, there was a big bang, and people saw Nazrul falling to the ground. His hand was severely burnt and there were multiple injuries to his head and legs.

The doctors at the local hospital could not stop the bleeding from his injuries, so he was transferred to Dhaka Medical College Hospital the same day. After three days he was transferred to CRP in Savar. There he was told that he had broken his back. His spinal cord was damaged and he would be paralysed from the waist down for life.

With CRP’s specialised nursing care, the injuries to his hand, head and legs soon healed. He also learned how to manage his bowels and bladder. After physiotherapy he was ready to consider how he could contribute to his family, which is very poor. He is the youngest in a family of five brothers and one sister and he lost his father when he was only three. At school Nazrul studied up to class iii.

Nazrul was trained in shopkeeping and now sells small items such as sweets to patients from a stall on the CRP campus. Soon he hopes to return home and open his own stall.

CRP’s Mobility Aids Fund granted him half the cost of his wheelchair and Nazrul was able to pay the remaining amount.

Micro-credit

CRP established a micro-credit programme with the support of Aus-Aid in July 1999. Disabled people and their family members have the opportunity to use these facilities if they live in Savar or in the nearby upazilla. CRP started this programme to help disabled people become financially independent.

Tk 8,58,000.00 was disbursed in the form of loans from July 2002 to June 2003. A total of 120 people received micro credit. Of the recipients, 47 were male and 73 were female. 90% of loans have been recovered. Of the 120 micro-credit beneficiaries 53 were disabled, 57 were family members of disabled and 10 were extremely poor.

Each recipient may take a loan on three separate occasions from CRP in order to facilitate their ability to live independently.

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COMMUNITY BASED REHABILITATION (CBR)

CRP established its Community Based Rehabilitation (CBR) programme in 1994 in collaboration with the social services department of the government. The programme’s aim is to provide disabled people with access to community services throughout Bangladesh and to promote equal opportunities for disabled people in mainstream society. Currently, CRP covers 61 Upazillas under 8 districts in Bangladesh. Awareness raising and disability prevention campaigns, mobile clinics, referral services, vocational training, assistance in accessibility, CBR worker training and CBR management meetings are all included in the CBR programme. The CBR programme in each Upazilla is owned and managed by an Upazilla Action Group Implementation Committee (UAGIC), consisting of nine or eleven members including an Upazilla Nirbahi Officer and an Upazilla Social Services Officer (USSO) from the government, along with local political leaders, teachers, social workers, students, religious leaders and disabled members of society and their family members. All of them work voluntarily, with only one paid member of CRPs staff to coordinate all the workers in each district. Appropriate training is given to these members in accordance with their responsibilities within the programme, after which a UAGIC takes over the responsibilities of community management. The local action group coordinators who are CRP staff assist in the programme operation and act as facilitators in the development of UAGICs and the training of their members.

Self-Help Groups

CRP formed 61 self-help groups in all CRP's 61 CBR areas in the reporting period, with the title, the Upazilla Disabled People’s Development Council (UDPDC), to serve disabled people in the Upazilla setting. CRP's aim is that the problems of disabled people will be highlighted and pressure will be applied to achieve their rights with CRP supporting them behind the scenes. A total of 2075 disabled people are involved with this initiative. Working with the local government, CRP arranges office space for the groups and lobbies the Ministry of Social Welfare to obtain registration for each group to operate as an independent organisation.

Mobile Clinics

Mobile clinics are arranged at community locations with direct assistance from the local government administration at the upazilla level. The clinics offer medical advice and referral services to disabled people. They also provide guidance on assistive devices, vocational training and micro-credit schemes. Usually the mobile clinics are organised in a collaborative way so that the government, community and CRP participate equally. A multi-disciplinary team (including doctors, nurses, physiotherapists, occupational therapists and health workers) provide services in these clinics.

Collaboration Programmes

Besides working in collaboration with the Ministry of Social Welfare for the CBR programme, CRP works in collaboration with Proshika, a leading NGO in Bangladesh, since 1999. CRP and Proshika work in 18 upazillas under 6 districts which was only 2 upazillas in 1 district in the previous reporting period. CRP is also working in collaboration with 1 local NGO in Tangail district: the Village Organisation for Unity Research (VOUR).
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At a Glance: CRP’s CBR Activities

Programme Male Female Total

No. of UAGICs in operation - - 61

No. of self help group leaders who received 15 days training 24 3 27

CBR workers who received 7 days training in 12 Upazillas 342 177 519

NGO staff who received 1 month training 13 7 20

CBR workshops (day long) held in districts - - 8

No. of CBR workers who attended in 42 refresher courses 1,130 505 1,635

Total awareness raising campaigns in all CBR areas - - 591

Bihongo showings in two CBR districts - - 35

Approximate no. of viewers of Bihongo - - 60,000

Accident prevention campaigns in CBR areas - - 53

Home visits to ex-patients 1,021 191 1,212

No of mobile clinics - - 31

No. of people referred for services 13,796 7,670 21,466

Mobility aids supplied 39 30 69

No. of disabled people who found employment 47 30 77

CBR group leader meetings - - 282

Upazilla Action Group Implementation Committee Meetings - - 252

TRAINING

CRP has a strong commitment to training and believes that training plays a vital role if health care services in Bangladesh are to be strengthened and developed. At present, too few health professionals in Bangladesh are trained adequately to provide appropriate treatment and rehabilitation.

Aiming to provide highly trained staff to work in health care provision and rehabilitation countrywide, CRP established a training institute in 1992, the Bangladesh Health Professions Institute (BHPI).

BHPI is now one of the pioneer institutes for the training of health professionals in Bangladesh. BHPI provides 08 nationally recognised training courses. These courses are the Physiotherapy and Occupational Therapy diploma and honours degree courses, laboratory sciences and radiography diplomas, certificate in education for special education and a post-registration diploma in rehabilitation nursing. All these are recognised by their respective government departments.

The student enrollment of BHPI on 30.06.03:

Courses Male Female Total

BSc PT 54 45 99

BSc OT 34 13 47

Diploma PT 48 25 73

Diploma OT 20 8 28

Dip. Lab. Sciences 39 14 53

Dip. Radiography 24 3 27

Dip. Rehab. Nursing 1 yr 4 4 8

Cert-in-Ed Special Ed 1 yr 5 12 17

Of the 352 BHPI students, 228 are male and 124 are female.

Five institutes in Bangladesh currently run physiotherapy courses but BHPI is the only institute in the country offering occupational therapy courses. CRP promotes the recognition in Bangladesh of these professions by lobbying and networking with the government to create posts for physiotherapists and occupational therapists. However, one of the best ways for people to become aware of these professions is to see them in practice. Mrs. Anne Brau, a very experienced occupational therapy teacher, supervised a group of third year OT students on their two month psychiatric placement. They made a great impact on patients, staff and medical doctors alike at the National Institute of Mental Health, a new government hospital in Dhaka.

Physiotherapy Development

Philomena Commons, the physiotherapy adviser at CRP, flew to New Zealand in March to attend a three-day International McKenzie Institute workshop. Philomena also attended the International McKenzie Institute’s 21st birthday celebration, which was held in the home of Robin McKenzie (OBE).

The International McKenzie Institute has enthusiastically supported the development of the physiotherapy profession in Bangladesh and has already sponsored four McKenzie courses held at CRP since 2000. More courses are planned. Robin McKenzie is preparing a video message for the newly registered Bangladesh
Physiotherapy Association members, as he is unable to visit personally due to medical reasons.
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Speech and Language Therapy course

A team of professors from Jahangir Nagar University, including the Vice-Chancellor and senate members, visited CRP on May 21, 2003, to discuss CRP’s application to affiliate its planned speech and language therapy course with the university. Speech and Language Therapy is a new profession in Bangladesh.

Melanie Adams, a speech and language therapist from the UK, joined CRP in June. Melanie will be instrumental in establishing a speech and language therapy degree course in CRP’s training institute, the Bangladesh Health Professions Institute. Melanie has visited CRP several times before and is very experienced in her field, having worked for 18 months on a similar project in Sri Lanka. Melanie will also be undertaking some vital research during her planned two-year stay at CRP.

Collaboration with Leiden University

The first steps have been taken to form a collaborative relationship between the academic institute of CRP (Bangladesh Health Professions Institute) and Leiden University in the Netherlands. Two senior lecturers from Leiden University visited CRP for two weeks in November to hold workshops in management and administration and physiotherapy skills. Plans for a five-year partnership between Leiden University and BHPI have already been established. This will involve skill sharing, staff and student exchange programmes and curriculum and human resources development.

Huib Cornielje and Henk Lieffering conducted the workshops. Huib is senior lecturer in community health and an expert in community based rehabilitation, while Henk is senior lecturer in physiotherapy.

CRP SUB-CENTRES

CRP-Mirpur

The construction of the shell of the new CRP Dhaka City Treatment Centre in Mirpur is complete. The Centre has been built in a rapidly developing part of Dhaka on land given to CRP by the Bangladesh government in 1990. The Kadoorie Charitable Foundations have financed 50% of the construction of an impressive 13-storey building. CRP will occupy the first six floors, all of which will be accessible from street level by a wheelchair ramp – the only one of its kind in Bangladesh. Three lifts will be installed and gardens are being laid out at several levels. The upper seven floors will be rented out to NGOs or businesses preferably with a medical bias, the resulting income being used to defray running costs at CRP-Savar.

CRP-Mirpur will include Physiotherapy, Occupational Therapy, Pathology, Radiography and Operating theatres. A milestone was reached for CRP on April 10 when Physiotherapy and Occupational Therapy services were officially opened on the ground floor by Mr. Michael Kadoorie of the Kadoorie Charitable Foundations in Hong Kong. The Kadoorie Charitable Foundations funded approximately half of the £2.8 million construction costs for CRP-Mirpur. Mr. Kadoorie spoke of the obvious need for the facilities which CRP will provide at Mirpur. Christopher Lavender, Director of the Kadoorie Charitable Foundations, was also present. Dr. David Carter, the British High Commissioner in Bangladesh, also attended the ceremony.

The rented premises in Mohammadpur used by CRP for outpatient therapy were relinquished on completion of the new treament areas in CRP-Mirpur. During the year a total number of 428 male and 392 female patients received physiotherapy and 60 male and 24 female patients received occupational therapy at the CRP Dhaka city centres.

CRP- Gobindapur

The Gobindapur sub-centre provides therapy services catering particularly for people with paralysis caused by strokes, children with Cerebral Palsy and those who require therapy for spinal problems. During the year a total number of 84 boys, 54 girls, 738 male and 239 female patients received physiotherapy and 258 male and 105 female patients received occupational therapy at CRP-Gobindapur. Upazilla Action Group Implementation Committees (UAGIC) were formed in each of the six upazillas of the Moulvibazar district.

CRP staff members maintain contact with the many CRP ex-patients in the upazillas of Sylhet division who have received treatment at CRP during the last 20 years or more.

CRP-Gobindapur is situated in the scenic, tea-growing area of Sylhet division in the north of Bangladesh and is an ideal location for a short break. CRP-Gobindapur has three guest bungalows which are available for rental and this income from the bungalows helps to defray the cost of running the sub-centre and the outpatient and community based services.

To mark the completion of renovation work at CRP-Gobindapur, a ceremony was held at the premises in February. The renovations were financed by UNOCAL Bangladesh, a large oil and gas producing company. The ceremony was attended by Mr. Andrew L. Fawthrop, President and Managing Director of UNOCAL, who unveiled a commemorative plaque on the renovated outpatients hostel. A number of other distinguished guests were present, including local government officials and senior staff members of UNOCAL.

CRP-Gonokbari

The situation in Bangladesh for women with disabilities is especially difficult. They have to cope with the obstacles relating to their disability, along with the everyday obstacles in a male-dominated society.

It is not uncommon for the husbands of women who become disabled to take a new wife, leaving the disabled women destitute. There are still many stigmas relating to disability in Bangladesh. CRP has found that women who are successfully rehabilitated may be taken back by their husbands and become respected in the community, particularly if they can earn a living.

Women with different disabilities come to Gonokbari and the time required for training varies from one woman to another, depending on her disability. Also, most residents have not had any formal education. The main hostel at CRP-Gonokbari accommodates up to 28 women and girls, giving them the chance to learn the necessary skills to be able to cope with life and their disability when they return to their community. The residents are given vocational training opportunities such as training in embroidery, sewing or shop keeping. Further education is also provided, along with help in basic living skills.

The adjacent halfway hostel is run with minimal supervision as the last stage in the rehabilitation process before the women return to the community. Here the residents must cook, clean and work on their own. The hostel has been designed to replicate most of the conditions usually found in a typical Bangladeshi village. Cooking, for example, is done at ground level. It is to cope with such conditions that CRP favours use of a low trolley. This means the user is at the same level as the other members of the community who without possessing a chair, squat on their haunches whether cooking, washing or just chatting.

Recreation plays an important role in the women’s rehabilitation. The residents of Gonokbari enjoy singing, playing indoor games and going on occasional outings.

They have been involved in designing and making puppets for a puppet show to raise awareness of disability issues. This has been done with the help of Mejrema Reuter and a group of drama therapists.

During the last six months preparations have commenced to expand the nursery area at CRP-Gonokbari to include the production of medicinal plants and to improve the fish culture in the pond there. Expert voluntary help on these subjects has made this possible, while at the same time providing a valuable vocational training opportunity for disabled women.

Profile of a CRP-Gonokbari resident

Fatema Akter Popy started work in May as a new employee of the Social Welfare department at CRP. She contracted polio when she was only four years old. Initially she was treated at several distinguished hospitals in the country and finally she came to CRP as an outpatient in December 2001. Subsequently she was sent to the women’s project at CRP-Gonokbari for social and economic rehabilitation.

Popy was readmitted into the school near CRP-Gonokbari (previously she had dropped out of school after class IX due to lack of support from her parents) and she hopes to study further in future. At Gonokbari, Popy had a positive effect on the other women who stay there. She taught these disabled women sewing, block printing and hair styling, all skills she had learned from her family.

Popy’s family is not well off. She has four brothers and one sister. Her mother died when she was very young and Popy grew up with a stepmother.

Popy being a wheelchair user has much to offer other people she encounters at CRP. She says that CRP has changed her life completely and she is very grateful for the opportunities CRP has given her.

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DISABILITY PREVENTION

The Centre for the Rehabilitation of the Paralysed (CRP) found that 44% of patients admitted to CRP had work related injuries as a result of falling from heights, carrying heavy head loads, road traffic accidents etc. To attempt to change this situation, CRP undertook a project in September 2001 with the support of United States Department of Labour (USDOL). In this four-year project, CRP will undertake activities such as creating awareness, strengthening treatment and rehabilitation, research, advocacy and lobbying, community-based rehabilitation, work rehabilitation programmes and strengthening vocational training in order to develop CRP as a model Occupational Safety and Health (OSH) resource centre.

Under this project, five staff members of CRP received an eight-week-long training session. On October 9 a day-long Forum on improving occupational safety and health programmes in Bangladesh was held in Dhaka. The event was organised by Aurora Associates International who, like CRP, receive funding from the USDOL for OSH programmes. Nine CRP staff members were present, including five who received the OSH training. Valerie Taylor (CRP coordinator) introduced the subject "Prevention is Better Than Cure." then showed three television messages on OSH produced by CRP with funding from USDOL. The messages aim is to make the population of Bangladesh aware of dangerous work practices which can lead to disability.

Occupational Safety and Health Programme messages

CRP has produced three TV messages to raise awareness of the types of accidents that often lead to paralysis and disability. The themes of the messages are the dangers of carrying heavy head loads, falling from a height and the importance of road safety. These messages are shown at regular intervals on TV channels in Bangladesh and at different programmes both on the CRP campus and outside.

Occupational Safety and Health Research

CRP has successfully completed the first phase of a research project entitled “Improving Occupational Safety and Health in Bangladesh: An Exploration of Risks and Hazards on Worksites Involving Manual Handling Operations.” A draft literature review was presented on 20 March 2003 at a review meeting at CRP-Savar with occupational safety and health professionals and disability experts. A high-powered advisory panel has been established to supervise and ensure the quality of the research. The purpose of this research project is to improve occupational safety and health situations in workplaces utilising manual handling operations through participatory assessment of risks and hazards and to reduce work-related injuries by increasing awareness among workers, employers, union leaders, policy makers, government and non-government organisations and international labour agencies. The outcome of the research will be disseminated to the above mentioned target audiences.

CRP’s research and evaluation officer is involved as coordinator for this project and he and CRP's research associate are co-principal researchers.

Work Rehabilitation

Work rehabilitation and the Functional Independence Measure (FIM) research projects are being carried out in the occupational therapy department. Occupational therapy interns and staff are responsible for using the FIM to assess all inpatients on admission, during the rehabilitation phase and at discharge time. The interns record these assessment results for research purposes.

Road safety programmes

CRP public relations unit is coordinating the road safety activities of CRP with the social welfare department. CRP arranges regular meetings, seminars and rallies and is involved in networking on this topic. CRP arranged a national seminar in January on road safety initiatives. The Minister for Communication, Barrister Nazmul Huda, attended the seminar. Many other participants were present and heard Barrister Huda report that up to 70% of drivers in Bangladesh have illegal licences. He cited this as one of the major causes of road traffic accidents and promised his support to try to take effective measures to reduce the number and severity of accidents. The honourable communication minister Barrister Nazmul Huda declared that he would put stickers with the slogan of CRP's new road safety song “The road is for life, not for death” in all BRTC buses. CRP plans to develop a project to make Savar an accident-free zone, hoping that if the project succeeds it will become a model for other areas of the country. On 7 March 2003, Hong Kong and Shanghai Banking Corporation (HSBC) sponsored a day-long programme with CRP and made a colourful rally on the Dhaka-Aricha highway to promote the road safety activities of CRP.

On June 21 residents of CRP-Gonokbari (the residential vocational training centre for disabled women) joined Baby Naznin, one of the most popular singers in Bangladesh, to record CRP’s road safety song. The song was written by a wellknown media personality, Syed Ashique Mahmood. The recording, which will be broadcast on national radio, will be used to raise awareness of road safety issues.

Infection Control

CRP holds general staff meetings on a monthly basis. Each month a different department has the opportunity to present information of their activities to all staff members. In October Mark Tovey, a microbiologist working in the pathology department, gave a presentation on the dangers of cross-infection in hospitals, with special emphasis on M.R.S.A, Methicillin Resistant Staphylococcus Aureas.

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ADVOCACY AND NETWORKING

The issues addressed by CRP’s advocacy and networking department include health, education and training, accessibility, rehabilitation and employment, accident prevention and disability awareness. CRP feels it expedient and necessary to promote the rights and general welfare of disabled people and believes in the principle of shared responsibility. This task is accomplished through influencing and lobbying the government, NGOs, civil society, local government institutions, local intellectuals, donors, social and religious leaders and others through personal contacts, group interactions, meetings, seminars, workshops, television programmes, magazine and newspaper articles, rallies and campaigns.

To help change the situation of disabled people in this country, CRP works in collaboration with the following forums:

National Foundation for the Development of Disabled Persons: This is a government organisation run by a board of directors of which Valerie Taylor is a member. The main activity of this organisation is the granting of funds to organisations working in the field of disability.

National Forum of Organizations Working With the Disabled (NFOWD): NFOWD is a network of non-government organizations working for disabled people in Bangladesh. To achieve and protect the rights of disabled people, NFOWD is involved in regular lobbying with government and other concerned agencies. CRP’s Asstistant Director, Ms Mohua Paul, is a member of the present executive body of NFOWD.

Assistive Device Network (ADNet) : ADNet was formed in 1998 as a result of a discussion at a three day workshop on the development of assistive devices which was organised at CRP in Savar. The responsibility for the ADNet secretariat is also held by CRP, with Assistant Director Mr Ahsan Habib and Public Relations Officer Md. Kabir Hossain holding the respective posts of coordinator and assistant coordinator of ADNet. A special 2 day programme for ADNet's strategic planning was held in CRP-Gobindapur in February.

Disability Resource and Documentation Centre (DRDC): DRDC is a network of organisations that publishes and circulates disability related books, documents, journals and other resources. CRP is one of the founder members of DRDC and actively participates in its functioning. In this reporting period, DRDC participated in a month long book fair in Dhaka.

NGO Samonnoy Parisad (NGO Coordination Council) : CRP along with a number of NGOs in the Savar area are working with this local network. The network tries to protect the interests of the member NGOs in Savar.

Naripakho ("On behalf of women") : A Bangladeshi NGO working to protect women from oppression. CRP is a member of this forum and is concerned for the situation of disabled women. Disabled women from CRP participate regularly in the meetings of Naripakho.

Shishu Bikash Network: The Shishu Bikash Network is a group of organisations working with disabled children and CRP is represented by Hosneara Parveen, Manager of the Mother and Child Care unit as a member of its executive body. The main activities of this network are sharing information, protecting rights and improving the situations of disabled children.

International Spinal Cord Society (ISCoS) formerly IMSOP: CRP is a member of this international network. ISCoS enables information to be shared particularly through international workshops, seminars and publications.

International Society of Orthopaedic Surgery and Traumatology (SICOT): CRP’s consultant Dr. Md. Fazlul Hoque is the only representative from Bangladesh of this international forum. He receives SICOT's regular publications.

Asian Spinal Cord Network (ASCoN): This is a network for development of treatment and rehabilitation of spinal injuries in countries of the Asia region which commenced following CRP's first international conference in 2001. CRP’s Consultant Dr. Md. Fazlul Hoque is coordinator of this network.

STAFF DEVELOPMENT

CRP believes that staff development is necessary for improving patient services and by increasing knowledge greater job satisfaction is found. Each year CRP staff members attend workshops, seminars and conferences at home and abroad. CRP staff also receive short-term and long-term training from national and international organisations. Highlights of some of these training sessions are as follows:

Overseas Training

CRP’s consultant surgeon, Dr. Md. Fazlul Hoque, visited teaching hospitals in Leeds and the Midland Centre for Spinal Injuries in Oswestry, UK from 27th August to 12 September. During his visit, he worked with Consultant Neurosurgeon, Mr. Gerry Towns and Mr. Jake Timothy in Leeds General Infirmary and Mr. El Masry in the Midland Centre for Spinal Injuries. It was a great opportunity for him to learn the latest surgical procedures and management for spinal cord injury. The aim of his visits was to develop skills in spinal stabilisation and spinal deformity correction, to gain knowledge in acute management of cervical spinal injury and to be exposed to standard surgical facilities and pre- and post-operative management of spinal cord injury, also to become familiar with the rehabilitation aspects of SCI patients in other centres abroad.

Sandie Barker, a nurse in the paediatric accident and emergency unit at Leeds General Infirmary, England, raised £840 for CRP by running the Leeds Half-Marathon. The money was used to pay for Dr. Md. Fazlul Hoque's visit to Leeds. The exchange was organised by the Overseas Partnering and Training Initiative (OPTIN) of the Leeds Teaching Hospitals Trust.

In October 2002 Dr. Hoque attended a four day surgical international conference in Dubai on spinal cord injuries. Dr. Hoque gave a presentation on the management of these cases in Bangladesh. The conference was arranged by the AO Spine Group of Switzerland.

Seminar on Disability Models

CRP’s Research and Evaluation Officer participated in a one day seminar on “Social Models of Disability: From Theory to Action,” one of the six seminar series in 2002-2003, held at the Weedwood Hall, Leeds, U.K., on November 27, 2002.

ESCAP meeting in Japan

CRP's Assistant Director Mr. Ahsan Habib attended the UN-ESCAP (Economic and Social Commission for Asia and the Pacific) meeting in Osaka, Japan in October. The meeting marked the end of the Asian and Pacific Decade of Disabled Persons 1993-2002. While in Japan, Mr. Habib also attended a high-level inter-governmental meeting.

Physiotherapists Attend Congress in Spain

Two physiotherapists from CRP attended the 14th International World Confederation for Physical Therapy (WCPT) Congress in Barcelona, Spain from June 7th to 12th. Md. Sohrab Hossain and Md. Obaidul Haque were among over 3000 delegates at the conference. They are both founder members of the Bangladesh Physiotherapy Association (BPA). During the conference they met with Ms. Sandra Moore, President, WCPT and Brenda Myers, Secretary General, WCPT and discussed how the BPA can become affiliated with the WCPT.

Workshop on Strengthening Management

All senior staff members of CRP participated in a week-long workshop on “Strengthening Management at CRP” in April 2003 under the guidance of CRP's Director. The workshop evaluated and reviewed the operational management procedures of CRP.

Strategic Plan review

CRP held a number of workshops in August to review its five-year strategic plan 2002-2007. Mr. Stephen Muldoon and his wife, Maggie acted as the facilitators of these workshops.

Teacher Training

As part of ongoing professional development, teachers of the Bangladesh Health Professions Institute (BHPI) participated in two teacher training workshops in February. Since the teachers of BHPI have no formal teacher training, this was highlighted as an area for development. The workshops focused on four main areas: the role of the teacher, motivating students, teaching methodologies and lesson planning. Participants were awarded certificates at the monthly staff meeting. The workshops were facilitated by Janet Adam (BHPI advisory coordinator) and Stuart Millar (physiotherapy teacher). Further teacher training workshops are planned in the future.

International Spine and Spinal Injuries Conference

From 22-25 November 2002 an International Conference on the Spine and Spinal Injuries was held in New Delhi in India at the premises of the Indian Spinal Injuries Centre (ISIC). CRP's consultant Dr. Md. Fazlul Hoque; Divisional Head of Rehabiliation Services, Mr. Abdus Salam; Occupational Therapy Superintendent, Mr. Ehsunul Ambia and a senior Physiotherapist Ummey Kulsum attended the conference. Dr. Fazlul Hoque, Mr. Ehsunul Ambia and Ummey Kulsum presented papers at the conference.

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INCOME GENERATING ACTIVITIES (IGA)

Although CRP depends heavily on foreign donations to meet its daily operating costs, great emphasis is placed on future sustainability from local income. A major source of this income is expected to be the rent from NGOs or companies occupying the upper seven floors at CRP-Mirpur but there are many other income generating activities already in place at CRP-Savar. In addition to selling CRP’s products from Savar and the other sub-centres, the Centre runs stalls at a variety of sales throughout the year. Along with the regular staff, disabled people also participate in production of saleable items as part of the rehabilitation process.

Gonokbari Products

The attractive collection of products for sale includes tablecloths, cushion covers, bedsheets and salwar kameez. Several of the residents have become experts in the skills of weaving and embroidery and there is a steady demand for their products.

Metal Workshop

CRP’s metal workshop produces many different types of mobility aids and appliances for paralysed people, including made-to-measure wheelchairs, braces, and walking aids.

Wood Workshop

The wood workshop is another source of funds. It produces educational toys and puzzles for children and also furniture particularly for local schools. Last year the IGA Department received an order for shoe storage racks from the Bata Shoe Company, which provided work for both the wood and metal workshops. CRP supplied shoe racks to 13 different Bata stores in the country.

Fish and Plant Nursery

CRP has two ponds where fish are cultivated and sold to the public. There is also a sizeable nursery, which grows and sells trees, shrubs and a variety of pot plants. Once a week roses and other flowers are delivered to regular customers in Dhaka and fruit is also sold in season. CRP again participated in the annual national tree fair in June and was awarded the 4th prize for contents of the display out of approximately 100 other entries.

Cards and Calendars

Lovely who was paralysed from the neck down after falling from a roof at the age of 12, has developed into a talented mouth painter. For several years now her watercolour paintings have been featured on CRP greetings cards and the annual calendar, which are sold widely in shops and offices throughout Bangladesh. They are popular in other countries and are sold at many FCRP fundraising events. CRP also produces a book of postcards incorporating a set of pictures of the Centre.

CRP-Aware

CRP has opened a new showroom and resource centre in House 8, Road 72, Gulshan, Dhaka. The showroom, called “CRP-Aware,” was officially opened in April by the famous singer, Ms. Ferdousi Rahman and Ms. Suraiya Islam, the owner. CRP-Aware sells all products produced by CRP-Savar and CRP-Gonokbari. Information on CRP is also available there.

NOTABLE EVENTS

Epic Beetle drive to CRP

On July 14, five Volkswagen Beetles rolled into CRP. This is itself a very unusual sight in Bangladesh but considering that one Beetle had been driven all the way from Kathmandu, Nepal, it was indeed a special occasion.

Kanak Dixit is the Editor of Himal, a Nepalese current affairs magazine. Two years ago he miraculously survived a 150-foot fall while walking in the Himalayas. He was only rescued by his brother after lying unconscious for three days. Kanak suffered serious spinal injuries and although he has now fully recovered, the experience made him aware of the lack of specialist care for spinal injuries in Nepal.

Kanak was instrumental in the establishment of the Spinal Injury Rehabilitation Centre in Kathmandu. The centre was officially opened in April by Sir Edmund Hillary. The 12 hundred Km Beetle drive was a fundraising venture for the centre and CRP was the obvious finishing point for the Kathmandu-to-Dhaka drive. From CRP, Kanak drove to the Dhaka Press Club before starting the long drive home. Kanak was met by members of the Dhaka Volkswagen Beetle Club, who escorted him from the Indian border to CRP in a "Beetle convoy."

Kanak is also keen to establish links with CRP and to learn from CRP's development over the past 22 years. The next plan is for Kanak to drive from Kathmandu to Lahore, Pakistan, on a similar fundraising campaign.

Lovely and Shamoli visit Germany

Their visit to Germany was the first time that either Lovely or Shyamoli had been outside Bangladesh or had flown in an aircraft. Lovely, who is paralysed from the neck down following a fall from a roof as a young girl, attended a sale of greetings cards and calendars that feature her paintings in a Munich department store. Shyamoli went as her caregiver. The trip was a great success and the girls saw their first Christmas trees, first snowfall and first mountains. Special thanks go to Mrs. Carolyn Scott, President of FCRP-Germany, who arranged everything for Lovely’s visit and also to Emirates Airlines for supplying the return air tickets from Dhaka to Munich free of charge.

On her 7th visit to CRP in January Carolyn Scott was accompanied by her friend, Mrs. Elfrieda Orda. Mrs Orda kindly gave a digital camera to CRP and also made a donation for the purchase of a clothes drier.

CRP Celebrates 23rd Birthday

CRP celebrated its 23rd birthday on December 11. A discussion programme was held to mark the occasion, which was attended by many guests, patients, students and staff. Principal guests at the meeting were Major General (Ret’d) Dr. Md Nurul Haq, Muhammad Saidur Rahman, Mrs. Leena Alam and Mr. David Newell. Every speaker highlighted notable events relating to CRP. David Newell, who was OXFAM Director in Bangladesh in the early 1980s and played a crucial role in ensuring CRP’s survival, said he was amazed to see the development of CRP since he left Bangladesh 18 years ago.

Following the discussion meeting, a colourful cultural event was held, which included wheelchair dancing, songs from students of CRP’s Special Needs School, a drama relating to disability and performed by disabled women from CRP-Gonokbari, dances by children of CRP’s staff members and a performance by Nashid Kamal, a famous Bangladeshi singer.

Commonwealth Parliamentary Association (UK) Visit CRP

Five members of the Commonwealth Parliamentary Association (UK) visited CRP on October 12, 2002. Mr. Tom Cox MP (Tooting) led the team. Other members were Dr. Roger Berry, MP (Kingswood), Mr. Ben Chapman, MP (Wirral South), Dr. David Drew, MP (Stroud) and Mr. Gareth Thomas, MP (Clwyd West). They were welcomed by paralysed patients and given flowers. Later they talked with patients, staff members, volunteers, students of the BHPI and disabled children of CRP's Special Needs School. They were pleased to see the activities of CRP and assured us that they will highlight CRP's activities in future Commonwealth Parliamentary Association meetings.

Naval Chief Visits CRP

Chief of staff of the Bangladesh Navy, Rear Admiral Shah Iqbal Mujtaba, NDC, PSC, BN, visited CRP on April 23. He came to see a naval medical technologist who is receiving treatment at CRP. CRP’s Director, A. K. M. Momin, took the rear admiral on a tour of the CRP campus where he talked with patients, staff members, students and volunteers about the activities run by CRP. He assured CRP that he would take the initiative to instigate new opportunities for disabled children of naval personnel.

Patients' Picnic at Mymensingh

The annual patients' picnic at Mymensingh took place on February 7. Once more, CRP's patients and staff members were the guests of the Taize Community in Mymensingh, which is situated approximately 100 km. north of Dhaka. Sports, a cultural programme along with a delicious lunch and a boat ride on the Brahmaputra combined to make the perfect day out.

Sports for the disabled

On March 2, after several weeks of hard training and practice, a team of eleven athletes and several CRP staff members with disabilities joined many others from around Bangladesh to compete in the inaugural National Disabled Sports Championships in Dhaka. Athletes with various disabilities participated in the games. They competed in a variety of events, including wheelchair racing, sprint racing, softball throw, shot put and long jump. It was a fantastic spring day in Dhaka and all present had a great time. CRP athletes were particularly successful, winning a total of 23 prizes. Australian Physiotherapist Stuart Millar, was part of the team. Stuart helped to develop sports for the disabled during his 12-month stay at CRP.

Visit to Fantasy Kingdom

There was a special treat on May 29th for students of CRP's Special Needs School. A day out was arranged at the new theme park called Fantasy Kingdom. The management of Fantasy Kingdom, which is located only 15 km from CRP, invited the children to visit free of charge.

Fantasy Kingdom was opened two years ago and features train rides, bumper cars and a water slide amongst its many attractions.

Lovely receives Anannya Award

Fortnightly magazine Anannya awarded CRP-Gonokbari resident, Lovely, a prize as one of the “Top Ten Successful Women of 2002.” The prize recognises contributions in different areas of society. Lovely, a mouth painter, was awarded her prize in recognition of her skills as an artist in Bangladesh. Lovely has had many art exhibitions and regular readers will be familiar with her work.

BEPZA Executive Chairman visits CRP

Brigadier General (Retd.) M. Mofizur Rahman psc, P Eng., Executive Chairman of Bangladesh Export Processing Zones Authority (BEPZA) visited CRP in May. He expressed his satisfication of CRP's activities saying how well planned everything was from beginning to end. M. Kamal Aktar, General Manager of BEPZA accompanied him.

FUNDRAISING

CRP remains dependent on the donations of national and international organisations and individuals. However, we expect that the new CRP-Mirpur complex will generate about 50% of CRP-Savar’s running costs. CRP's fundraising section works closely with the public relations and income generation units.

Funding consortia

CRP's Business Consortium, a group of supporters from the local business community, meets quarterly at CRP-Mirpur. Its purpose is to generate financial support for the Centre amongst the Bangladeshi business community. There is also a Donor Consortium which meets annually and includes representatives of major donor organisations.

Important fundraising activities during this reporting period are highlighted below:

Open Days

On January 31 and February 1, Open Days were held at CRP-Savar for the first time. On both days many visitors came to CRP’s Savar headquarters from Dhaka and other areas of Bangladesh. Several stalls were set up selling handicrafts and other items produced at CRP and refreshment sales and stalls displaying services offered by CRP were also doing brisk business. Residents from CRP-Gonokbari (the residential vocational training centre for women with disabilities) had a beauty parlour and hand painting stall. A “taka mile” was arranged where visitors lined up coins to raise funds.

The cultural programme on the first open day involved performances by children and proved to be very popular with the patients, visitors, students and staff members who packed the sports hall to capacity. The second day, a normal working day at CRP, similar programmes were held, as well as a raffle with a variety of prizes. The Open Days raised direct donations of over Tk.100,000 (approx. $1,700). The main aim of the Open Days was to raise awareness of CRP and its activities, especially among the local community and residents of Dhaka. With extensive national press coverage and so many visitors, the Open Days were judged a great success.

Exhibition of Lovely’s Paintings

CRP-Gonokbari resident, Lovely, had a successful exhibition of her paintings, organised by HSBC bank in their Gulshan branch in Dhaka in August 2002. Present at the opening of the exhibition were the Chief Executive Officer of the bank, David J. H. Griffiths and CRP's coordinator, Valerie Taylor. The week-long exhibition attracted many visitors and much public attention. Most of the fifty paintings on display were sold.

Donation from school

Students from the Sunnydale School in Dhaka donated TK.166,000 ($2,900) to CRP. A cheque was handed over to CRP's coordinator, Valerie Taylor, when the students visited CRP in July 2002. This is the most generous amount ever received from school children in Bangladesh.

Monipuri Dance

A friend of CRP, renowned singer Ms. Shahnaz Rumana, arranged a cultural evening in October at CRP-Savar, where she presented a group of Indian artists from Visva-Bharati University, Santinikatan. Many distinguished guests were present and enjoyed the programme.

Concert

A Geet and Gazal concert was arranged at the National Museum Auditorium in Dhaka in March 2003. Eminent Gazal vocalist, Adil Asif, played to a sizeable audience. The event was organised by a dedicated team of Bangladeshi volunteers who arranged for the venue, artist, printing and publicity. Before the concert, a short presentation on CRP was given by Rubana Ahmed, one of CRP’s loyal supporters. CRP much appreciates the great help of those involved in making this event possible.

Donations in kind

Mampower Limited, the distributors for Makita Power Tools, donated a range of tools to CRP in September. Among the many items were drilling machines, saws, angle grinders and planers. The items will be used in the metal and wood workshops at CRP where many products are made, both for sale and for use at CRP.

CRP also received valuable donations from other sources during the year, including paediatric equipment for the mother and child care unit from Valerie Bryce, a supporter in Canada and splinting material from the Queen Victoria Hospital in East Grinstead, England.

Golf Tournament Benefits CRP

CRP benefited by over †1000 from a golf tournament which was held in April 2003 at Golf Club Bad Liebenzell, Germany. More than 100 players participated in the event, which was the annual golf professionals’ tournament for club members. The professionals at the club, under the leadership of head professional Michael Westall, decided that CRP should also benefit from the tournament. After the golf was completed, various items were auctioned, including three bottles of fine wine and a painting. Following this, a competition was organised where participants played golf shots from the patio of the clubhouse - over a pond - to the last hole of the course. To win a prize (a free golf lesson) players had to hit their ball closer to the hole than the professional. Amidst much hilarity and many golf balls lost in the pond, no accurate account was taken on who had won or lost.

Another golf event has been organised by golf professional Iain Gold of Golf Club Brunntal near Munich, Germany. Members of this club can participate in a season-long “hole-in-one” competition. If a player achieves a hole in one during a competition, he or she can win a new golf set from Mizuno (a sports equipment manufacturer). All proceeds from the tournament will be donated to CRP.

Birthday Party Raises †6000

Prof. Dr. Albert Rädler, vice president of FCRP-Germany, recently celebrated his 70th birthday. Guests at his birthday party were encouraged not to bring gifts but rather to make donations to CRP. As a result of this party more than †6000 was raised for CRP.

The staff at CRP in Bangladesh convey their thanks to Prof. Dr. Rädler for all his work as vice president of FCRP-Germany and his generosity on his birthday.

Party for CRP in Australia

Friends and supporters of CRP gathered in Melbourne, Australia, on November 16 to hold a fundraising party. A total of Aus$1000 was raised for the purchase of physiotherapy and occupational therapy equipment for CRP’s new Mirpur centre. The event was organised by Annie Trewhella, who had spent six months working as an Occupational Therapist at CRP.

Rojonee programme

This new fundraising initiative named ‘Rojonee’ was introduced in 2002 in the UK with the aim of raising awareness about CRP’s work and its urgent need for more income following the withdrawal of international donors who are unable to continue funding running costs. This initiative involves Bangladeshi restauranteurs across the country holding a lunch or dinner on their premises in aid of CRP. The campaign has already produced excellent results.

Members of the Bangladeshi British catering community held a reception on May 18, 2003 to mark Valerie Taylor's UK fund raising visit at the Croydon Hilton Hotel. Over 300 people attended the reception and the evening raised £10,500 for CRP. Mr. Mahmadur Rashid, chairman of the Valerie Taylor London Reception committee, presided over the event. Distinguished guests included Baroness Flather, Mr. Peter Fowler CMG (former British High Commissioner to Bangladesh), Minister Consul M. A. Salam from the Bangladesh High Commission and Brigadier Tony Kendall, the Chairman of Friends of CRP, the UK registered charity that exists to raise funds for CRP.

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ACKNOWLEDGEMENT

The following international donors contributed financially to CRP this year:

Name of donor Amount (Tk.)

i. The Royal Norwegian Embassy 25,334,529.19

ii. The Royal Danish Embassy 15,000,000.00

iii. FCRP-UK 8,266,259.31

iv. FCRP-Germany 5,083,969.00

v. Global Ministries Uniting Protestant Churches, Netherlands 994,785.00

vi. Caring & Sharing, UK 472,205.20

vii. Liliane Foundation, Netherlands 997,598.43

viii. US Department of Labour 12,088,719.70

ix. Kadoorie Charitable Foundations 64,124,807.65

Total 132,362,873.48

We gratefully acknowledge the above mentioned international donations as well as the many contributions from local organisations. Individuals, too many to list, from around the world, support CRP’s work in cash and kind. For all this assistance, we remain extremely thankful.

Receipts & Payments Accounts

Period: 1st July 2002 to 30th June 2003

Receipts Payments

Particulars Amount (Tk.) Particulars Amount (Tk.)

Opening Balance: Operating Cost:

Cash & Bank 31,589,452.71 Administration 8,648,830.70

Foreign Donations 132,362,873.48 Medical Services 7,434,101.29

Local Donations & IGA 19,871,692.54 Salaries 19,945,897.07

FCRP Bangladesh 26,160.00 Training 3,155,671.00

Human Development Foundation 138,000.00 Maintenance & Repairs 1,531,182.00

Interest on fixed Deposit & SB Accounts 1,314,203.07 Seminar/Conference/Workshop 721,579.00

Recovery of revolving loan 1,157,459.00 Contingencies 223,535.76

Recovery of student loan 23,010.00 Capital Cost:

Recovery of advanced fund 8,994.00 Civil Construction

a. Construction 77,718,987.07

Refundable: b. Land & Land development 2,656,797.00

Security deposit against staff 172,415.00 Equipment 6,155,906.25

Caution money 65,800.00 Vehicles 3,558,000.00

Encashment of FDR 31,500,000.00 Endowment fund 2,500,000.00

Revolving loan 908,000.00

Student loans 130,500.00

Short term deposits 77,289,396.00

Refund of Security deposits 150,005.00

Refund of Caution money 26,900.00

Advance 19,461.00

Closing Balance:

Cash & Bank 5,455,310.66

Total 218,230,059.80 Total 218,230,059.80

Auditor: M.S. Patwary & Co.

Chartered Accountant, Dhaka
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