On 17th June 2006 part of the Mission Croatia Team left their colleagues in Kraljevica and travelled to Stancic near Zagreb, to return to the Learning Disabilities Hospital where we have worked for two years previously.

At this point I must comment on the fantastic new road system in Croatia. Two and three lane highways now crisscross the country and a trip which once took five hours is now completed in three. However, the drawback is that the Croatian government decided that as they were building so many roads in such a short timeframe, they would stop printing any maps for ten years. So travel in Croatia can be a little bit of an adventure where you take the leap of faith that any particular stretch of highway will take you roughly where you want to go. This year we had a Sat Nav system which was supposed to help us on our way but served only to take us off road and into what we think was a farm.

After a very hot drive we arrived to a great welcome and ready to face the challenges ahead. Our accommodation was in two rooms above a client area used as a craft workshop, so it was all the girls in one room and all the boys in the other. We had mattresses on the floor and clean linen so we counted ourselves as well provided for. Such dormitory lifestyle is common in Mission Croatia events, and we find that you make friends very quickly in such circumstances.

The hospital had several jobs which they asked us to undertake but it was not the concentrated efforts we had experienced in other years when we decorated ward areas. It was heartening to see that the hospital had continued to improve the client areas and walls were freshly painted and old windows were being replaced.

One of the tasks we were asked to tackle was the repainting of a fire escape at the end of a ward block. It also serves as a frequently used access route to the first floor ward so carried a fair bit of traffic day to day. A team including Hayley and Esther set to the task with great enthusiasm, led by the indomitable Graham Whicker. Preparation is vital in such a job so Graham decided that we should remove the worst of the rust, and one way to do this would be to use a hammer. Soon the ringing of hammer on metal could be heard, and the staff and clients seemed unperturbed by our rendition of the Anvil Chorus from Il Travatore. Disaster is never far from our heels and holes appeared where only rust had previously existed, and Graham soon became known as ‘Woodpecker Whicker’. Clearly this staircase was in a parlous condition and discussions with the Estates team from the hospital soon resulted in a declaration that the fire escape was to be condemned… sometime in the next year. So we moved to the staircase at the other end of the building and started all over again! It was a bit frustrating to have lost a whole day's work on a project which had to be abandoned, and there were real concerns that we would not finish the second staircase. In true Mission Croatia style, the problem was overcome by every member of the team, after an eight hour day in searing heat, putting in an extra hour after supper. We were ready to paint in record time!

Other jobs we undertook were the decorating of the entrance and hallway area of one of the smaller villas in the grounds where clients are encouraged to be more self caring and self determining. The clients chose the colour scheme and the painting team provided endless entertainment for the clients who clearly preferred the antics of Dave and Tom to Croatian daytime TV. Cat and Jodi, assisted by Tina and Mandy were responsible for re-staining and painting some of the outdoor furniture and playground equipment. In temperatures of well over 90 degrees, this was not an easy option.

In the heat of the day they would retreat into the ward block and help Ivor and Bill who were repainting a patient sitting room. The choice of colour was a matter of great debate and having settled on yellow, we found that no amount of colour concentrate would change the paint to anything other than the palest cream. Bill was our ‘gopher’ and he became well known at the local hardware store which we christened ‘B and Q’.

Our stay at Stancic only spans 6 working days but we managed to complete all the jobs to the delight of our hosts. It was a close run thing in some areas and Graham was still ‘snagging’ the staircase as we were loading the vans to leave!

The refurbishment tasks are the main focus of the trip to Stancic but we have begun an arm of activity with which we hope to improve standards of care to the clients. Jan and Maggie worked early shifts every day they were at Stancic. A 6am start to the day in a dormitory setting is difficult and fellow travellers were usually woken by their early bird colleagues. Sometimes they gave in and made a welcome cup of tea, but most shifts started on an empty stomach, or sometimes a square of chocolate to give the blood sugar a boost. Standards of care were, as they have been in previous years, well below what would be acceptable in the UK but some improvements were noted. The ward had lost some of its institutional aroma, and toenails seemed to have been trimmed. Staffing levels are extremely low, with two nurses being expected to care for forty clients. Clients still started the day with a damp cloth (usually a tee-shirt) being wiped round their faces, and a clean nappy being applied, sometimes after a wash and sometimes not. Bathing is a weekly event, and still involves clients being exposed nude in the corridor before being showered down by staff in the same room as others were being dried and dressed. We arrived with dozens of facecloths, a number of which we placed on the linen trolley each day. The staff used them and we were delighted to see them returning from the laundry and being used again. We also took dozens of toothbrushes and were pleased to see that some clients already had a toothbrush and tooth mug bearing their name. Unfortunately, having a toothbrush was no guarantee that mouth care would be offered. So Jan and Maggie worked alongside the ward staff and tried to demonstrate how care might be given. Last year had been marked by a pattern of offering clients hand and foot massagesand it was heartbreaking and yet gratifying that some clients clearly remembered the experience and slid shoes off and extended their feet out to attract attention. Armed with bottles of foot lotion, the pattern soon re emerged, with massages being offered during the morning when the clients have no form of activity or interaction. Both Jan and Maggie were moved to see the how clients revelled in this limited human contact, and it was particularly poignant when a client who has spent most of her life in a straight jacket, and has a history of violence to herself and others, allowed Maggie to massage her feet. The following day that same client leaned against Maggie for a few seconds. This may have been that person’s only self instigated kindly touch for a very long time and shows her capacity for communication.

Two of the students joined Jan and Maggie on the ward, and although they did not get involved in meeting hygiene needs, they did help to feed the clients and then took several out for short periods. Many clients do not leave the ward for very long periods and the chance to see the dappled shade from trees and to feel the wind on their faces was a great treat. This was the first time that students new to Croatia had travelled to Stancic, and the first time that students had been actively involved with the clients. Tina and Mandy rose to the occasion and were wonderful ambassadors for the University. They did find it an emotional experience, as did Maggie and Jan, despite their many years of experience. Tears were shed, sometimes tempers were tested, and often frustration bubbled over, but there was always someone ready with a friendly arm and an understanding ear.

Mission Croatia sets out to be a working party and Stancic is always hard work. However, please don’t be under the impression that there is no fun or moments of wonderful laughter. The night the Reverend Moody got locked in the lavatory will provide many a pub or dinner party anecdote. Graham’s determination with a hammer resulted in him being left with just the shaft in his hand as the head flew off (fortunately no harm befell anyone within range), and the ongoing saga of whether Mandy’s bite cream was in Tina’s bag provided endless fun. The subject of bite cream leads neatly to the great enemy of the trip. The Croatian Mosquito is larger than the English with a bite which outstrips the infamous Scottish Midge. Night after night, precautions were taken. Deet based lotions were applied in large quantities and plug in devices were strategically placed. Just as sleep approached you would be jolted awake by someone shouting ‘Ouch!! The blasted (please feel free add any expletive of your choice) things are still biting!!!’ The number of bites per person became a competition and Hayley was the clear winner with over 15.

As our time at Stancic drew to a close we all felt that we had achieved a lot. The staff obviously agreed and have already worked out the tasks for next year. We will be back in client areas, decorating a ward and improving the client’s immediate environment. If past years provide a pattern, we will be asked to complete three rooms and we will actually do four or five.

Oh yes, as a post script….. The condemned fire escape is still in use as a main access route and frequently has the weight of twenty or thirty clients on its rusty rivets and its platforms which have more holes than Swiss cheese. Would anyone like to open a book on whether it has been changed by next summer? With the poor odds that you will get from anyone from Mission Croatia, you might as well donate the money to us and we will use it for paint, flannels, towels and maybe a new hammer for Graham.

And finally….. as promised earlier in the Kraljevica report, news of some exciting progress that was made this year…….

Institute of Health and Social Care Croatia Initiative

The involvement of staff from the once Health schools, now the Institute of Health and Social Care in Mission Croatia stretches back over 8 years. Jan Hancock and Helen Wilkins led the vanguard to Kraljavecia and found that clients in very poor conditions with standards of care which were completely unacceptable. Over the years, through Mission Croatia, other staff members from the Institute have taken up the banner with Jan. Client care has improved and the conditions in which they live are not recognisable as the dark and sordid places of 1998. The new venture at Stancic has offered new challenges.

The Institute of Health and Social Care has put forward a proposal to offer colleagues in Croatia the chance to undertake some Anglia Ruskin University modules. These modules are intended to be the first step in a process of education leading to Croatian nurses becoming enabled to work in equal partnership with other health care professionals. The South Essex Partnership Foundation Trust has also been involved in discussions and has offered the chance for job exchanges between key staff members, with Croatian colleagues visiting Essex, and Trust staff visiting Croatia. In addition it is hoped to hold a conference opportunity in Croatia during 2007. The theme would be ‘Nurse Led Care’ and the south Essex Partnership Foundation Trust has agreed to provide key speakers. This proposal has been supported by the University Directorate, in particular by Colin Day, Chair of Governors, as well as by Mike Cook, Dean of the Institute. Pam Donnelly (Associate Dean) and Jan Hancock have provided the business and operational arm of the project

In June 2006 Pam Donnelly and Colin Day travelled to Croatia and joined the Mission Croatia team. Jan, Ivor, Pam and Colin held meetings with Croatian care managers and members of the Regional Governments. At these meetings, the proposals were outlined and discussed. They were very positively received and a start made in forging an alliance between care services in Croatia, the Institute of Health and Social Care and the South Essex Partnership Foundation Trust.

Photo gallery of Stancic 2006