January 1990 - Volume 5

Since the starting of "Mukti Bahini" ward in Dhaka Medical College Hospital the demand for trauma service in the country was quickly felt after liberation and was met by a very able and dedicated person without whose effort we will not be here today Dr. R. J. Garst started the Othopaedic Hospital in Shaheed Sarwardy Hospital Complex in 1972 and also started the post graduate orthopaedic training. New hospital building at the present site and started funtioning in 1976 with 400 orthopaedic and traumatic beds. From one orthopaedic surgeon in 1972 in the whole country to 65 working today and 10 working abroad are all produced from this institute (RIHD) situated in the some hospital.

Orthopaedics in Bangladesh has come a long way in a very short time. Now at this level we must think about Orthopaedic research. Orthopaedic research of today is really the Orthopaedic treatment of tomorrow. I think we can be proud of the fact that there has been more progress in Orthopaedic & traumatic surgery than in any other surgical discipline after the indifendence. But the problem is that the very success of the country has meant that treatment we can offer and which is now demanded by the public has increased our work much that we have little time for clinical research and academic work. But still that should not be the excuse and we should start clinical research atleast at any cost.

By Research, I dont mean that it has to use Laboratories or animal experiment finding out how club foot after operation has recurred would count as a very useful piece of research.

We must try to find out what factor is tending to limit or inlimit research work at this stage.

There are mam- factors inhibiting our research work. Above aH I wiH say the willingness to devote time, enthusiasm to continue and lack of recognition of the work in the society are the main factors. Money, lack

of fascillities are other problem. Considering all these of couse, a vital factor in research is time and lack of time is most important diement that discourage research.

In a pratical subject like Orthopaedic surgery, time for research is always in competition with the needs of clinical activity. We must increase the number of consultants at the institution to give more time in research. Consultant looking up 130 bed in indoor and both casualty & outdoor will not have time for research as it is now at RIHD.

Above all the most important ingradient in research is the right man. What sort of person is he or she? He must have an enquiring mind, and I hope that all of us have some element of that in our make up. He must be a person with ideas.

Having identified a problem, a true research man must have the energy and enthusiasm to pursue it until he finds some answer. It is often laborious and sometimes tedins but alway rewarding, even when answer does not turn out to be what was hoped for.

A will designed prospectus survey or trial is the keystone of clinical research once the problem of question has been identified, there is no doubt in my mind that the only way to proceed is to set up special clinics. We must try to set up Hand clinic. Polio clinic CP clinic clubfort time etc. at this stage in the institutions.

Good documentation is the next vital requivements. Photographs are another important tool of clinical research.

In spite of the difficulties that there may be, any one. any where with good clinical acumen, a suitable problem to solve, the capacity to organise perhaps against the odds and the determination and willingness to give some of his time, can add his contribution to clinical research - to that continuous and laborious search after truth may continue.