No single organisation alone can accomplish the desired benefits for the patients. The Bone and Joint Decade (BJD) is a multidisciplinary initiative involving everyone concerned with the care of bone and joint disorder. But how did it come about? The initiative was taken by a group of healthcare professionals who felt that the significant impact from bone and joint disorders on society, the healthcare system and the individual, needed to be addressed on an international level, with particular focus on the use of resources.

The idea began following the success of the Decade of the Brain 1990-2000, which served to raise awareness of the impact of brain disorder and led to significant scientific advances. An inaugural consensus meeting was held in Sweden in April 1998, which culminated in a proposal for the Decade of Bone and Joint from 2000-2010 as well as the formation of the International Steering Group, consensus document and a plan of continued work.

Although four years have been passed, we could not implement any programme to achieve the aims and objectives. Indeed we had no specific plan of action to carry on the spirit of the theme if the decade. The diseases associated with bones and joint disorders are to be treated by multidisciplinary approach. They should not be encircled only in the field of Orthopaedics and Trauma-tology. They need the attention of Physio Therapy / Physical Medicine, General Surgery, Neurosurgery, Neuromedicine, Gynaecology, Rheumatology, Paediatrics, Oncology, Radiology and so on. We need integrated approach to get the best outcome about trauma and orthopaedic problems.

Professor T K Shanmuga-sundaram took the initiative to spread the aims and objectives of the BJD to promote it in Bangladesh. In this connection there was a scientific seminar on Musculoskeletal disorder and Promotion of Bone and Joint Decade 2000-2010 in Dhaka Medical College Hospital last week by the department of Orthopaedics and Traumat-ology of DMCH. Dr Md Amjad Hossain, head of the department of Orthopaedics and Traumatology of DMCH took a great initiative to arrange the CME seminar to spread the spirit of the convening decade in Bangladesh.

On that occasion two pioneer of Indian medical science, Professor T K Shanmugasundaram (Chennai) and Profssor N S Laud (Mumbai) came to attend the seminar. They expressed their views to The Daily Star at the seminar.

Professor Shanmuga-sundaram thinks poor nutrition, environment, lack of sound knowledge, poor infrastructural facilities, inadequate economic support are mainly responsible for the current picture and the disease burden of our country. Multidisciplinary approach is needed to combat the bone and joint disorders. He put emphasis on communication, coordination and exchange of views at national and international level by arranging different seminars, workshops and visit.

He mentioned the example of National Action Network of India to fight against the diseases. The health professionals must come forward to face and manage the problem. Dr Amjad mentioned that we should not wait for government procedure any longer. If we can establish a coordinated movement at different disciplinary level we can easily achieve our goal. And the process has been started already, he mentioned with hope.

Professor Laud emphasised first on the education and awareness of the population to prevent the disease burden. He also recommended very good emergency medical care. Our doctors and health professionals should have sound knowledge to manage the cases. They should set the priority of treatment and refer only in the situations where it is actually needed.

Our people should change their lifestyle and thinking regarding way of living. For example we should be inclined to health behaviors which have the compliance to better health. We should be more conscious about our health problems and we must fix a portion of our income to spend for the purpose of maintaining good health. In this context Prof Laud strongly recommended health insurance policy. By the implementation of health insurance we will be able to reach the target of positive health. We should set an effective plan to improve our health status. This should not be considered as the expenditure, rather he calls it investment.

Prof Laud strongly recommended innovations in the existing system and educational system reforming. He suggested that we should know where to spend our money. He emphasised on proper education, not only academic but also common sense and necessary knowledge to maintain healthy life. It comprises awareness also. At the same time our law and orders must change to a better approach. For example if any driver does not give chance to an ambulance to go ahead he must be punished. Our ambulances may have different colors to be identified categorically and people can recognise it quickly and they can take initiative as per the instruction.

Prof Laud laid emphasise on stimulation of learning instead of teaching.