Remembrance

Dr. R. J Garst

A surgeon, missionary and Visionary

Dr Garst, a pioneer spine surgeon.

DR MS Talukder

As we approached the arrival lounge at Nashville International airport, I spotted him sitting in a corner with his wife and grandson on each side. He looked a lot older than I remembered him. Our eyes met and with a huge smile on his face, he got up and rushed to welcome us. I quickened my pace and maneovered my way through the crowded airport towards him. I was overcome with emotion in the presence of a man whose vision, dedication and passion for improving orthopedics has changed the landscape of the field in Bangladesh forever.

The man I speak of is the legendary missionary, Dr. R. J Garst. His tireless dedication and hard work helped build orthopedics in Bangladesh into what it is today. Born in Cordell, Oklahoma in 1926, Dr.Ronald Joseph Garst developed a love for building and fixing things and the outdoors at an early age. He helped his family out in their farm whenever he could. In his teenage years, he spent his summer as a boy scout-I think these experiences helped develop his mental toughness and ability to work very hard. After graduating from high school at age 16, he started working at the Grand Coolee Dam on Columbia River, where he starting as helper and later went on to be part of the crew that tests pipes in the dam. From there, he moved to East Tennessee to work on the Norris Dam. At this point, his father encouraged him to go to college and he decided to attend a tuition free school. It was here that he met his first wife Barbara. They had two children- Kenneth and Steven. He worked as house builder and painter in his spare time while in school. His marriage with Barbara ended after a few years and he decided to go to medical school in Oklahoma. It is here that he met Ann, his second wife. They adopted two children, Linda and David.

After medical school, he chose orthopedics as his specialty and moved to western Kansas to start his practice. The United Methodist Church in Kansas offered him support when he applied for service abroad. He decided to join The Christian Medical College in Ludhiana, India. Before departing for India, Dr. Garst decided to go on a road trip with Ann and his two children around Eastern Tennessee to get acquainted with other church members. They were involved in a terrible accident on the road and his wife Ann passed away.

As a man deeply devoted to his faith, he kept his faith in God and decided to still go to India with his two children. There he worked on a project that became his lifelong focus- organising orthopedic services and training in third world countries. In India, he met a fellow missionary Marie Matthew whom he married in 1955.

Dr. Garst worked in Ludhiana for 15 years organising training and other sub-specialties, like physiotherapy, occupational therapy, Orthotics. In 1971, as his India mission was coming to an end, a call for help came from a country not too far away. Bangladesh had just gained independence. He heard about the situation in Bangladesh and miseries of our valiant freedom fighters and decided his mission was not over yet. He offered to help organise an orthopedic hospital for the wounded freedom fighters. His initial intent had been for the hospital to be for freedom fighters, but he persuaded the authorites to open it up for general public as well. The institution came into being in the Shaheed Suhrawardy Hospital Complex.

Dr Garst in an interactive academic session in the then RIHD.

With a motto, "attempt great things for God, expect great things from God,” he strived to create an institution that had seemed an impossible dream not too long ago. With a mere salary of $2 per month (which he received irregularly because of tax deductions), Dr. Garst worked tirelessly to bring his dream into fruition. Luckily, at the time, Bangladesh had caught the attention of the world. Dr. Garst happened to be at the right place at the right time and with the help of funding and training resources from around the world, he was able to organise the biggest orthopaedic hospital in the region at the time.

I met him in 1973 at a clinical seminar in P.G Hospital (now Bangabandhu Medical University and Hospital. He proved to be one of the best clinicians (bedside diagnostician) I had ever crossed paths with. I was inspired by his dedication to his work and his knowledge of the field. A few months after we had become acquainted, I had just finished my fellowship and was contemplating my next move. One evening, I was pleasantly surprised to find Mrs. Garst at doorstep. She had come to personally ask me to join RIHD (Rehabilitation Institute and Hospital for Disabled) now known as NITOR. I did not hesitate for a moment- I started the next day. The next couple of years turned out to be an unparalled experience not only in terms of valuable experience working alongside world famous doctors, but also being able to witness an amazing transformation of orthopedic practice in Bangladesh.

Under his direction, the outpatient building at Shaheed Suhrawardy was converting into a hospital. While evaluating the training programme for doctors in the country, he realised it needed improvement and co-ordinated the establishment of an M.S. and Diploma in Orthopedics through Dhaka University. He received help from different sources in hospital and training programme from India, U.K, U.S.A, Canada, Germany, Australia, Singapore and Hong Kong. His work attracted famous surgeons from all over the world who came to Bangladesh to assist with the development of orthopedics in the country - Mr J.N. Wilson, Sir Pulvertaft, Mr Tricky, Mr Powell., Mr Eyre Brook, Mr Gibson and Mr Walker from U.K, Mr Ditmanson, Mr Conner, Mr Jack Both, Mr Poul Spray from U.S.A., Mr Hubert, Mr Hasan, Mr Sharif from Canada, Mr.Walsh from Australia, Mr Bazliel and Mr Sood from India. The only orthopedic surgeon from Bangladesh at the time- Dr.K.S. Alam also played a significant role in asissting with the training of future orthopedic surgeons.

Under his watch, a separate orthopedic wing was built along with the Shishu Hospital. It came with different branches of orthopedic service like, physiotherapy occupational therapy, limb and brace, paraplegic, plastic and burn unit. The teaching programme was hugely popular because of the involvement of world famous doctors and teachers who all took special interest in the project. In the late 1970s, when the training programme was in full swing and the local orthopedic surgeons were becoming more experienced, Dr. Garst’s health started to fail. He was suffering from cardiac ailment and decided it was time to go back home to pursue his other dream- to build his own house. He left Bangladesh in 1981 but we were never far from his thoughts. Every year, he returned to bring back equipment and training materials for RIHD. Many of these materials were created in the workshop in his own house. In the earlier part of this decade, he received honorary citizenship of Bangladesh for his dedication to improve orthopedic service in Bangladesh.

In 2006, I had the chance to visit this dream house that he had always spoken of. It was the first and last time I ever had a chance to visit him in Tennessee.He proudly showed me his workshop at the side of his house where he had taken up carpentry as a hobby. He had made me a condiment stand for my table which I have sitting on my dining table to this day.

Dr. Garst died on September 15, 2009 a couple of months after his wife Marie passed away. Upon hearing of the news of his passing, my thoughts flashed back to the years we had worked together. I will cherish my time spent with a man who dedicated his life to improve orthopedics in countries so far away from his home. In the halls of NITOR that was his dream, the classrooms and clinics that benefited from his work, to the countless doctors who had the privilege of working with him, we all feel a deep sense of loss. He kept us close to his heart until the day he died. I hope Bangladesh as a nation does the same and in appreciation, we name one of the streets outside the hospital in Agargoan in his name.

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