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THE BUDIMEX HOSPITAL BUCHAREST
This is a report by our long serving Director of Programmes, Julia Smyth, who retired a few years ago but recently kindly agreed to visit the projects in Romania - most of which she had set up - and report on their progress.
RFFR have funded several projects at the Marie Sklodowska-Curie Children’s Hospital (known as “The Budimex”- name of the building firm who repaired earthquake damage and had a hoarding up for years) since the early 1990’s including:
- The supply of orthopaedic surgical instruments
- Publication of Bailliere’s Nurses Dictionary – 2 editions *
- Standards of Nursing Care Project (focus on children from institutions)
- Play Workers and Play Rooms
- Nurse exchange visits to the UK to study Paediatric Intensive Care and Infection Control
- Management training for nurses
- Infection Control Project
- Nursing publications
This report is of an interview with Ozana only on Saturday 28th September. Dana Condrea, the Co-ordinator was in Hungary and not able to attend. It was not appropriate to go to the hospital as I had a heavy cold and cough.
Ozana Ilie is a paediatric psychologist specialising in counselling therapy for children and their families facing surgery and palliative care.
The hospital underwent a refurbishment in 2009 following a TV campaign. The Playrooms have all been taken over owing to pressure on bed numbers. Ozana therefore incorporates play, art, story tapes and music in her work with the children. She has received training and the National Diploma in Combined Arts Therapy from the FSC Impart team. She originally started work with RFFR as a Play Therapist and has developed the role since the Playrooms disappeared.
Ozana’s work consists mainly in looking after the patients of an eminent orthopaedic surgeon Professor Burnei (who I note has orthopaedic procedures in various Journals of Medicine online) on the 2nd floor and the oncology department on the 5th floor.
Professor Burnei has referrals from all over Romania for scoliosis requiring spinal rods, leg lengthening and osteo-sarcoma – a very aggressive bone cancer. He can see as many as 100 new children a month 5 of whom are referred for osteo-sarcoma treatment. Most children and families therefore are facing long hospital stays, aggressive treatment and surgery, amputations, leukaemia treatment and so on. There are many traumatic issues and Ozana says she supplies "lots and lots of support to distressed children and parents."
Professor Burnei himself was brought up in an orphanage and is a gentle and sensitive man who often operates until the early hours of the morning.
The work is very stressful and Ozana was sometimes close to tears when telling me the stories of various children she had cared for. She is often asked to help in other parts of the hospital but does not have the time. She is the only psychologist or support worker in the whole hospital. Ozana also raises donations for toys and books.
Other organisations/partners who help
- Divine Mercy Sisters: www.divinemercy.org A Belgian organisation who have a school downstairs and have 4 Romanian teachers who continue the children’s education, who help with Ozana’s young patients and see the long stay children every day.
- Hospice Casa Speranta: give advice, supply medicines and improve quality of life for terminally ill children
- Ich Acolo: an organisation who provide young volunteers for 2 hours every Friday and perform theatre, clowns etc.
- Dana Condrea: Project Co-ordinator visits 2 – 4 times a month
- There are other psychologists at The Fundeni and Gregore Alexandrescu Hospitals doing similar work but they are really too busy to give each other support. There are no national networks or organisations in this field
Constraints and problems
- Stress and isolation - though she loves her work and gets rewarding thanks from children and parents
- Difficult to manage on her salary most Romanians pay 50% tax
- Would like a proper volunteer programme
The legacy of past RFFR projects
- Standards of Care: Ozana says standards generally much better than ten years ago. Ioanna the very good nurse on Intensive Care who came on UK training visits continues to be an agent for change and high standards. Cristina Oprea who received considerable support and training from RF when she was Director of Nursing is now working in a private hospital.
- Infection Control: Ozana says supplies of antiseptic hand gel, paper towels , gloves and rubbish collection (collected correctly in different categories) all now very satisfactory.
- Generally: Ozana reports that the hospital now looks good with TV in all the rooms. Parents stay with their children in the same bed "What, even if it’s a 16 year old boy?" - "Yes". "What if people do not have their mother or any money?" - "O.K." but this was with an ambivalent and rueful look but when I questioned further she said that the Infirmieres really did care quite well for children with no parents. Children from institutions now come with a personal carer. They now have a good Hospital Manager who is not a doctor which she says is a vast improvement.
Conclusion and recommendations
I cannot make valid recommendations after one interview but my impressions were these:
- Given that all the Playrooms have been taken over for lack of beds this project with help from the teachers and volunteers seems a very good use of funds given the distressing problems of so many referrals with bone cancer, leukaemia etc. The service is better than I anticipated, I thought it may be too psychologically weighted but this is not the case. It is caring and pragmatic and I should imagine the need is very great.
- Ozana is isolated and badly in need of some support. The options for networking with others in the same field are not really there. She sees and pays for her own psychologist. Ozana is dedicated and sensitive and at least her “boss” Prof Burnei is kind and very grateful for her role.
- A good volunteer programme would be a great help but Ozana does not have the time or resources to set this up, set standards, train etc. A formal programme like FSC have incorporates training, standards, supervision etc. The Bacau programme is very impressive, several of the volunteers having won prizes. Volunteering can be sloppy and dangerous so within a hospital setting it would need to be pretty structured and would need permission from the hospital.
- Could/should the hospital be paying for this role and more like it? I did ask this question and the answer was "No". It seems that, as in other fields, the emphasis is more on pioneering surgery than providing good and adequate after care etc.
This work is not a project as such but funding of an important role for the children and families in the orthopaedic and oncology wards. I think that the reason the hospital does not fund such roles is not necessarily a lack of funds but a lack of precedent. The RFFR/FSC policy of demonstrating the need for high quality care not provided by the state, as in the Rural Home Carers for the sick and elderly, which progresses to state funding, has not worked here. There has been a lot of funding at the Budimex over recent
Years - the refurbishment of 2009 and in September of this year, the very week I was in Romania, Italian surgeons conducted heart operations on 6 children in a programme which included cardiac surgery equipment to the tune of 4.2million Euros of which 2.3million Euros came from the Romanian Ministry of Health. In 2012, 63,000 Euros were donated by the Japanese Government. (Source www.romania-insider.com a news clip site.)
Could Dana Condrea approach the Hospital Director with the Sisters of Divine Mercy and make a proposal for hospital funding and more support workers like Ozana? On the other hand, is independence an important factor in the role?
* Bailliere’s Nurses Dictionary
This was funded by the late Maria Bjornsen whose grandmother was the first Romanian woman to qualify as a Medical Doctor