New Zealand Rehabilitation Association, Inc.

This month’s interview is with Julian Verkaaik, Manager of the Burwood Academy of Independent Living (BAIL). BAIL is an independent public trust, situated at the Burwood Hospital campus in Christchurch, and established in Feb 2006.

What is the purpose of the BAIL?

Our first purpose is to promote the concept of Independent Living both here at Burwood and in the broader NZ rehabilitation context.  We have a real interest in what recovering people bring to the rehab process – it’s a fairly neglected area of research and a real gold mine!

Our second purpose is to develop a dynamic research culture here at Burwood Hospital.  Burwood has great potential to contribute around its speciality areas, but the coordination of this has been very haphazard in the past.  Burwood is known for its spinal injury and brain injury rehabilitation, but it also offers specialist orthopaedic services plus there are also a number of other interesting things that happen here, such as the Champion Centre for children with spectrum disorders (e.g. autism, Down’s syndrome etc).  So there’s quite a diverse range of services here but there’s never been any coordinated research efforts – and internationally most rehab centres like Burwood would have a strong university presence; technological development happening on site etc. – and that’s what we’d like to see develop here over time.

So what was happening here prior to BAIL being established?

It was very much investigator driven – so every now and then you might get a clinician who was interested in research who would pull together a team or, very rarely, an HRC research grant – although I don’t think we had ever had anything really specialised based here.

Who first set up BAIL?

Professor Alan Clarke (1932-2007) instigated it.  It started initially as a project of the NZ Spinal Trust, and in fact it was Alan’s vision that the Spinal Trust would become a pan-disability Academy of Independent Living.  However after Alan left the Spinal Trust they decided that they wished to remain just with their focus on New Zealanders with spinal cord impairment, so we set up a separate trust and split BAIL out of that – but we all operate out of the Allan Bean Centre here at Burwood.

Where does the funding come for BAIL?

We were set up primarily with a one-off grant from the Lamar Trust of $250,000 – they had previously supported other services here at Burwood at a similar level.  So that’s our base funding and we are seeking funding through other organisations, like other community trusts.  However, primarily we’re looking at establishing collaborative projects – such as we have modelled with the Rehabilitation Teaching and Research Unit (University of Otago, Wellington) with our first significant project, which is the WHO ICF spinal cord core set project.  We’ve coordinated that project.  We’ve contributed some funds to it, Otago University, through the RTRU contributes, and the DHB also contributes a small amount in the support of the staff onsite here.

You’ve also mentioned that part of your work is about providing information to the community.

Being a charitable organisation, we have an interest in education.  We don’t want be just white paper driven only.  A big driver for us and a big part of the interest in the Independent Living Model is in having consumer organisations plugged right into us and completing the cycle if you like – they are able to work with us to establish priorities for what should be looking at in research.  We have a consumer leadership group in place, which represents a variety of stakeholders with impairments resulting from spinal cord injuries, brain injuries, arthritis, and aging – and they advise the board on priority areas within their representative groups.  We are looking to utilise those connections to put in place educational outcomes from any research work that we do. 

Some of the areas that we interested in looking at in some detail are the likes of the patient-clinician interface and associated relationships, and the different models that we could apply there.  One of the things that could come out of that might be a mini-workshop or education session for patients coming into hospital for rehabilitation to teach them about the role they should play as a patient – because at the moment nobody tells you that.  You’re left to figure it out by your own devices.  Some people are very good at this and they cotton on to how the institution runs and they make the most of their situation.  Other people never ever get it and their outcomes must surely be affected.

What activities is BAIL involved in at the moment?

Well, we’re involved in a number of initiatives to just try and spark research.  We are a member of the Rehabilitation Research Working Group with Otago University.  We’ve assisted the Christchurch City Council in developing an Accessible Cities Programme.  We’re working with Trade and Enterprise to develop a cluster of businesses who work in the field of assistive technologies in the local region here.  And most recently we’ve just helped to form a New Zealand Chapter of the Australasian Spinal Cord Injury Network (ASCIN).  ASCIN was established primarily to promote research into stem cell and alternative therapies (although its interests have since broadened.)  We are looking to developing a much more coordinated New Zealand response to spinal cord recovery – and that’s all aspects of recovery; it’s not just focused on cure.

How many people are employed by BAIL?

At this point in time, we have a manager (myself), the administration assistant, and we employ two researchers part-time who work for the DHB and we part-fund a lead researcher, Anne Sinnott, from RTRU.  In addition to that we have a collaborative project with Industrial Research Limited, and there are seven research engineers who work in partnership with the staff at BAIL and in the hospital.

What does the future hold for BAIL? What’s the next step?

Well, long term we want to build a research environment here at Burwood.  We want to have quite a dynamic multi-party environment.  We want to get sports bodies involved – the likes of ParaFeds and perhaps some of the elite wheelchair athlete programmes.  We want to establish a range of different research programmes that reflect Independent Living, and that includes quite a number of different areas for research: psychosocial areas, potentially economic areas as well as allied health, orthopaedics etc.  We have a vision for a nice mixed environment where we’ve got clinicians, researchers and consumers all working together in quite a community space on site – a cross-fertilization model if you will.

So what does BAIL offer that is not already under offer in NZ?

I think just the fact we’ve adopted the Independent Living Model gives us the opportunity to provide a fresh perspective on rehabilitation in New Zealand.  Also the fact that we are consumer led makes us quite unique.  There are plenty of models where researchers consult with people with disabilities, but the Independent Living Model is very much about having consumers in leadership roles.  I think that is one of our key points of difference and one which will provide us with a unique set of research objectives.

Soapbox time.  Do you have any soapbox issues you would like to contribute for the NZRA Newsletter?

Soapbox issues?… Big fish, small pond.  I think one of the most… trying to think of the right word for it… disappointing aspects of New Zealand health and rehab services is that there are very few practicing clinicians who have the opportunity to travel and be exposed to new thinking and new ideas.  Sure our senior consultants do.  People who rise to senior levels in the therapies may – although often this can still be very rare.  And I think our practice has suffered as a result, because our leading clinicians are not exposed to current, international innovations.  We only hear about them when they are presented in very cold, depersonalised publications.  There’s nothing like that one-on-one interface involved in travelling to rehabilitation centre in another country and seeing it in action. 

And the solution?

More funding for clinicians to travel.

Sounds good to me!  Thanks for your time.