Thus MSR is not led by donor agenda or media stereotypes, but by real needs, carefully identified in consultation with the relevant Romanian stakeholders. At the outset it was decided that this UK initiative should be medically rather than emotionally directed.

We swiftly learned that effective change needed to involve Bucharest; that some laws that needed changing. In 1991 MSR conducted the first Medical Appreciation of a Romanian hospital by a UK charity. This led to the focus on the departments that served the whole hospital such as the diagnostic departments of Laboratory & X-ray, and other unglamorous areas, e.g. Stores, Laundry, Mortuary and the Sterile Services Project. 

Mr RN Villar FRCS, a Consultant Orthopaedic Surgeon in Cambridge, initiated a Medical Appreciation of Salaj District Hospital in 1991. 

1991-1993 

Medical Appreciation conducted by Richard Villar, FRCS. This was then followed up by visits of medical and laboratory specialists in subsequent years. In October 1993 Salaj Hospital’s Director asked MSR to assist the X-ray department which was about to “die.” 

1994

Salaj Hospital and Hinchingbrooke Hospital in Cambridgeshire agreed to twin. Twinning plaques unveiled in both hospitals in 1995, cementing a relationship that facilitates exchanges of staff and ongoing support. In May an expert team from Hinchingbrooke Hospital assessed the X-ray Department, condemning the Paediatric X-ray room which was permanently closed. (See Case Study) English tuition to hospital staff was established. 

1995

The British Council funded and arranged a visit to Bucharest by two MSR specialists to enable MSR’s findings “to be aired in a national context.” One of them, a radiographer, had spent five months that year at Salaj Hospital during which six X-ray units were installed.

1996

Immediately before MSR re-equipped the Accident & Emergency Department, it was completely refurbished by the hospital. Departmental refurbishment has subsequently been a hallmark of the hospital’s response to MSR’s equipment provision programme.

An Infection Control-led Infrastructure Project covering sterile services, laundry & waste disposal, was identified. At this point the Bucharest Institute of Public Health became involved and became the means whereby local piloting in Zalau could have national outcomes.

1997

The Transfer of Knowledge training programme between MSR & Addenbrooke’s, with the Hospital Hygiene Unit of the Bucharest Institute of Public Health, was initiated. Salaj Hospital goes on-line following the phased introduction of IT equipment, and begins to access medical and other resources on the Internet.

1998

In May, Salaj Hospital hosted the Romanian National Pathology Meeting - a result of the upgrading, refurbishment & training of the department since 1993. See Case Study. The Romanian Minister of Health visited the hospital during the laundry installation.

The hospital, with MSR input, moved its stores to an appropriate new location, following three earlier visits by a British stores manager, all of which were shadowed by a team from the Bucharest Institute of Public Health which expanded its remit to include stores.

1999

A Nursing Appreciation was done. Hospital theatres were assessed. Australian Occupational Therapist, Benita Powrie began her year in the paediatric department. Her visit marked the first collaboration between MSR and BESO. 4 British student electives were done at the hospital - 2 Physiotherapy, 1 Dental & 1 Midwifery. The hospital opened its own web-site.

2000:  Feasibility studies for theatre & sterile services upgrades. Assessments of Midwifery services by the head of Kent Midwifery Education, & Oncology services by Macmillan palliative care nurses & Consultant Oncologist. First-time funding from the UK Department of Health for visiting Romanian specialists. Ministerial ordinance on hospital laundry services approved and issued. Initiated by the Institute of Public Health, Bucharest, it acknowledged MSR’s input.

2001

In May, Princess Marina Sturdza opened the new Delivery Suite; a 10-strong paediatric surgical team from Addenbrooke’s made its mark. MSR drivers were invited to Bucharest to meet with Dr Daniela Bartos, the Minister of Health. At her request, a 3-strong team visited Bucharest in November to consult on matters concerning hospital sterile services.

2002

Salaj Hospital opened a new Paediatric Surgical Ward. A 5-strong Paediatric Surgical Team visited. The hospital hosted a physiotherapist for 3 months and 7 electives covering nursing, physio & medicine. The hospital opened a new Ophthalmology Operating Theatre.

2003

The year saw significant follow-up with training given in the areas of Occupational Therapy, Physiotherapy, Laboratory and Midwifery. Equipment delivery strategy was similar to the previous year. Four doctors and nurses from Salaj Hospital’s Urgenta Department came to Addenbrooke’s Hospital as medical observers. As a direct result of taking several staff to the Hospice Casa Sperantei in Brasov, a Beacon Project for the Balkans, Salaj Hospital hosted a 5-day Palliative Care Training course given by the team from Brasov. It was attended by 25 hospital staff and others from the ACASA Rehabilitation Centre in Zalau. The course was funded by the EU. ACASA, a Dutch-Romanian foundation, provided the £100 extra needed to cover the cost of the lunches for the whole course. Reports about the course were highly positive and more wished to attend it than could.

2004

The narrow-focus, wide-impact strategy from previous years was maintained with delivery of supplies in May & October. Altogether 22 with specialist skills went to Zalau during the year. In May, after a week spent in Zalau by a 2-strong management team, four others followed up with Radiography, Ophthalmology, and Management briefs. Nursing was a central focus of the visiting medical party in October, which included a first visit by 2 senior nurses from the Calderdale & Huddersfield NHS Trust. In addition, Saba Hinrichs, a graduate electronics engineer from Warwick University, went to Zalau in October for two months to do an audit of all Salaj Hospital’s electrical & electronic equipment. She was given full co-operation by hospital staff and especially those from the FIRAM, the department responsible for medical equipment. Her findings were made available and provide information relevant to the provision of adequate resources to maintain hospital equipment.

2005

The year witnessed several major developments, all with long-term consequences. The year began with an invitation to co-host the Romania Think Tank conference on Health Care Reform in Romania. MSR agreed to assist and as specialist consultant to this June conference held in Bucharest, MSR initiated 3 of the 4 main themes and produced 5 speakers, including the Director of Salaj County Hospital. This visit to Bucharest also had the effect of stimulating the Sterile Services Project. Later in the year, following further visits to the Salaj hospital by Sterile Services experts, the Project Manager of a potential funder visited the hospital in November. The two from the Calderdale & Huddersfield NHS Trust who had come to Zalau in 2004, initiated a 2-week October visit by an 8-strong multi-disciplinary team to Zalau. This visit, which has had lasting repercussions, received financial support from a joint DH / BMA / RCN Humanitarian Fund Grant. The first 2 modules of a 4-module Infection Control training Course, designed by Addenbrooke’s Hospital, were also given during the year. 

2006

The year saw major developments in several fields:

Sterile Services Project: Rodney Wood, head of Addenbrooke’s Sterile Services, visited Zalau in February to advance the project. In July MSR received a grant of £350,000. During the year, £261,000 was spent, primarily with Matachana for Sterile Services equipment and Fulton Boilers for the gas-fired steam boilers in a prefabricated plant room.

Infection Control Course: In July, under the leadership of Dr. Tim Wreghitt, Regional Microbiologist for the East of England Health Protection Agency. The 3^rd module of the Infection Control training course was delivered. He was assisted by Neil Bentley, Deputy Laboratory Manager, HPA Cambridge, Addenbrooke's NHS Trust and Rachel Thaxter, Infection Control Nurse, Addenbrooke's NHS Trust. The team conducted a CPA-style audit of the microbiology laboratory and its equipment and also a wound infection audit. They were assisted by two Cambridge University medical students who followed up the course for a further three weeks, to develop the staff’s use of the wound infection monitoring tool developed by the Addenbrooke’s team.

Nursing: MSR’s involvement in nursing also took a step forward with 2 visits by Kathie Butcher, RGN, Dip N, who had not been back to Zalau for 5 years, and 2 visits by Pat Ashworth, M.Sc., R.G.N., R.M., FRCN, a senior nurse educator who had made numerous nursing visits to Romania over several years. On the recommendation of the Royal College of Nursing, she had been one of the 5 MSR speakers at the 2005 Health Care Reform conference in Bucharest. A greater understanding was gained about the nurse training situation in Romania and locally, where there are serious problems with doctors doing much of the teaching with new university nursing degrees being offered and questionable poor training.

2007

In February, Ioan F. Muresan, General Manager of Zalau Hospital, spent several days at Addenbrooke’s Hospital to study how a modern UK hospital worked & to learn about the hospital from where 75 staff had made 132 visits to his hospital since 1990.

In May the British Ambassador, visited Zalau hospital to inaugurate Zalau Hospital’s Sterilizare Department which was still being installed. In October the new Sterilizare opened for business.  Considerable Sterile Services support was given by Addenbrooke’s staff during the year with 2 visits by Rodney Wood, 1 visit by Alan Tooke, and another in October by Michael Binns, the Deputy Head of Addenbrooke’s Sterile Services, visited Zalau the same month to give further training.  More work was done on the Sterilizare project including expenditure of a further £93,700.

In May, MSR trustee, Dr. Wilf Kelsall, Consultant Paediatric Cardiologist & Neonatologist, Addenbrooke's NHS Trust accompanied by Paediatric Specialist Registrar, Dr Cristina Matei, not only visited Zalau but also spent 3 days in Cluj-Napoca teaching and attending ward rounds in their Cluj University’s Obstetric & Gynaecology Clinic No 1, Neonatology Clinic No 2, and Paediatric Clinic No 2. This visit opened the way for new links between the Cluj University hospitals and Cambridge.