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FIELD PRACTICUM REPORT, Hospital Social Services Office, DMCH

Article · February 2024

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 FIELD PRACTICUM REPORT

Agency
Hospital Social Services Office
Dhaka Medical College Hospital
Dhaka-1000

Submitted to
Institute of Social Welfare and Research, University of Dhaka

Submitted by
Tareq Mohammad Shakil
Roll no. 120667
Reg no. 2017517304
Course: MSS-201 (Field Practicum)
nd
MSS 2 Semester Final Examination 2022 (Session: 2021-22)

January 2024

i
 Field Practicum Report

Agency
Hospital Social Services Office
Dhaka Medical College Hospital
Dhaka-1000

Duration of Field Work

13 November 2023 to 28 January 2024

In partial fulfillment of the requirements for the degree of Master of Social Science
(MSS) in Social Welfare, this report is presented to the Institute of Social Welfare &
Research, University of Dhaka.

Institute Supervisor Agency Supervisor

Dr. Fozle Khoda Dipika Rani Shaha

Professor Social Services Officer
Institute of Social Welfare and Department of Social Services
Research Dhaka Medical College & Hospital
University of Dhaka

Presented by
Tareq Mohammad Shakil
Session: 2021-22 (Examination Year:
2022)
Examination Roll no. 120667
Course no. MSS-201

ii
 Acknowledgement

First, I want to convey my gratitude to almighty Allah for keeping me mentally strong despite
being physically weak to complete this report. The theoretical knowledge that is gathered from
the educational institution is not sufficient to know the subject matter, rather practical knowledge
is a must. A social worker can use field practicum to practice their professional social work
knowledge in the field. I want to express my unwavering appreciation and gratitude to the
respected individuals who provide guidance, inspiration, and encouragement in a variety of ways.
I was sent to the Hospital Social Service Office, Dhaka Medical College and Hospital from
Institute of Social Welfare and Research as an apprentice of social work. My heartfelt thanks go
to Dr. Fozle Khoda, Professor, Institute of Social Welfare and Research. He provided me enough
time to explain how to put academic knowledge into practice in the field. He also provided me
with important guidance, and assistance in report writing. He was meticulous about my tasks
from beginning to end. He provided me mental strength by my side with valuable advice and
motivation during my sick days.
I would also like to impart gratefulness with respect to my agency supervisor, Dipika Rani Saha,
Hospital Social Service Officer, Dhaka Medical College and Hospital. Without her expert
knowledge, behavior, well thought & direction, it cannot be possible for me to write this report in
an excellent manner. I would like to express my heartiest gratitude to Shilpi Bhowmick, Syeda
Tanjida Hasan another social service officers and the staffs of different sectors of Hospital Social
Services Office, Dhaka Medical College Hospital who have helped me by providing different
information. Concededly, I would also like to thank all my colleagues of my field practicum
group for supporting me morally and mentally to complete this field practicum.

iii
 Preface

Social work as a profession is of very recent origin. Social work is socially constructed in three
areas of relationship among clients, workers and social agencies. As for professional services,
field workers are the most important part of social work education. It helps the students to be
skilled social workers. An internal supervisor and an external supervisor provide guidelines to the
students. In this dynamic society, the social worker has great scope to solve various induced
problems from positive and negative changes and to learn this with gaining theoretical
knowledge, the social work students must be trained about social consequences through field
practicum.
The purpose of the field education is to provide students with an opportunity to learn hands-on
through internship work experience. Field practicum provides the student with an opportunity to
gain first-hand knowledge of social service systems in urban and rural settings, apply theoretical
knowledge to urban and rural problems. In addition, students learn to communicate oral, written,
and technological information reflecting professional social work skills. Field Practicum provides
practice experiences in continuum of modalities and varying sizes of systems, including work
with individuals, families, small groups, and communities within an organizational and
community context. It is expected that students will experience a diversity of client populations
and intervention issues, relying upon a range of theoretical concepts and models to develop
breadth of learning and establish a broad base for practice.
As a student at the Institute of Social Welfare & Research, University of Dhaka, I have been sent
to the Hospital Social Service office, Dhaka Medical College Hospital for Field Work for 60
working days. I am very blessed to get a great chance for a field practicum at this place. I have
propounded my performed activities, experience, success, failure, and institute acquaintance by
this final report on field practicum. Though I am not gaining exhaustive success in fieldwork as
an apprentice, I have tried my best to accomplish assigned duties with purity and devotion.
Through this, I have gained new knowledge about society, and it will help me in every footpace
of proper activities in my life. Overall, it is an earthling to bring forth my different experiences
consequently during field education through the fieldwork practicum report.

iv
 Table of Content

Contents
Chapter One .................................................................................................................................... 1

Field Practicum in Social Work ...................................................................................................... 1

1.1 Introduction ........................................................................................................................... 1

1.2 Conceptual Analysis of Social Work .................................................................................... 2

1.3 Social Work Code of Ethics .................................................................................................. 4

1.4 Conceptual Analysis of Field Practicum in Social Work Education .................................... 5

1.5 Conceptual Orientation of Field Practicum .......................................................................... 6

1.6 Historical Background of Field Practicum in Bangladesh .................................................... 7

1.7 Goals and objective of field Practicum ................................................................................. 8

1.8 Values of Field Work ............................................................................................................ 9

1.9 Importance of Field Practicum............................................................................................ 11

1.10 Scopes of Field Practicum in Bangladesh ......................................................................... 13

1.11 Inter-relationship between Social Work Education and Field Practicum ......................... 14

1.12 Conclusion ........................................................................................................................ 14

Chapter Two.................................................................................................................................. 15

Hospital social service. Hospital social service in Bangladesh. Hospital social service office,
Dhaka medical college and hospital. ............................................................................................ 15

2.1 Introduction ......................................................................................................................... 15

2.2 Meaning of Hospital Social Service ................................................................................... 15

2.3 Hospital Social service in Bangladesh ................................................................................ 17

2.4 History................................................................................................................................. 17

2.5 Services provided by the department of hospital. Social services. ..................................... 18

2.6 Hospital social services office, Dhaka medical college and hospital. ................................ 19

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 Subsequence .............................................................................................................................. 19

2.7 Target Groups of the agency ............................................................................................... 21

2.8 Strategies of the Agency ..................................................................................................... 22

2.9 Organogram of Hospital Social Services of DMCH........................................................... 23

2.10 Aims and objectives .......................................................................................................... 24

2.11 Conclusion ........................................................................................................................ 26

CHAPTER THREE ...................................................................................................................... 27

Duties and Performances .............................................................................................................. 27

3.1 Introduction ......................................................................................................................... 27

3.2 Performing Duties and Responsibilities Assigned by Institute Supervisor ........................ 27

3.3 Performing Duties and Responsibilities Assigned by Agency Supervisor ......................... 28

3.4 Performed Duties and Responsibilities during in agency ................................................... 29

3.5 Conclusion .......................................................................................................................... 36

CHAPTER FOUR ......................................................................................................................... 37

Application of social work knowledge, methods, techniques and approaches ............................. 37

4.1 Introduction ......................................................................................................................... 37

4.2 Application of social work Knowledge & principles in field work .................................... 37

4.3 Application of Social Work Methods ................................................................................. 38

4.4 Application of Social work Techniques in performing field work ..................................... 44

4.5 Conclusion .......................................................................................................................... 47

CHAPTER FIVE .......................................................................................................................... 48

Presentation of Selected Case Studies .......................................................................................... 48

5.1 Introduction ......................................................................................................................... 48

5.2 Case Profile – 01 ................................................................................................................. 48

5.3 Case Profile - 02.................................................................................................................. 53

vi
 5.4 Case Profile - 03.................................................................................................................. 58

5.5 Case Profile - 04.................................................................................................................. 63

5.6 Case Profile - 05.................................................................................................................. 68

5.7 Conclusion .......................................................................................................................... 73

CHAPTER SIX ............................................................................................................................. 74

A Short research on ‘Challenges and Opportunities of indoor patients under Hospital Social
Services Office: A study on Dhaka Medical College Hospital..................................................... 74

6.1 Introduction ......................................................................................................................... 74

6.2 Objectives of the study........................................................................................................ 74

6.3 Research Methodology ....................................................................................................... 75

6.4 Data collection techniques and tools................................................................................... 76

6.5 Data Analysis ...................................................................................................................... 76

6.6 Findings of the Study .......................................................................................................... 76

6.7 Opportunities of Indoor Patients ......................................................................................... 78

6.8 Challenges of Indoor Patients ............................................................................................. 81

6.9 Summary of the Findings .................................................................................................... 84

6.10 Limitations ........................................................................................................................ 85

6.11 Recommendations ............................................................................................................. 85

6.11 Conclusion ........................................................................................................................ 86

CHAPTER SEVEN ...................................................................................................................... 87

Inter Agency Visit to Hospital Social Services Office, BSMMU ................................................ 87

7.1 Introduction ......................................................................................................................... 87

Historical Background of the Agency....................................................................................... 87

7.2 Introduction of Bangabandhu Sheikh Mujib Medical University....................................... 87

7.3 Experience of Visiting the Agency ..................................................................................... 88

vii
 Objective of the Agency ........................................................................................................... 88

7.4 Organogram ........................................................................................................................ 89

Function of the Agency............................................................................................................. 90

7.5 Contribution of the Agency to the National Level.............................................................. 91

A Brief Comparison between the Department of Social Services of DMCH and BSMMU .... 91

7.6 Nature of Coordination between the Two Agencies ........................................................... 92

7.7 Conclusion .......................................................................................................................... 93

CHAPTER EIGHT ....................................................................................................................... 94

ACHIEVEMENT, LIMITATION AND RECOMMENDATION ............................................... 94

8.1 Introduction ......................................................................................................................... 94

8.2 Achievement of field practicum.......................................................................................... 94

8.3 Strengths and Weaknesses of Field Practicum Agency ...................................................... 96

8.4 Strengths of Field Practicum Agency ................................................................................. 96

8.5 Weaknesses of Field Practicum Agency ............................................................................. 96

8.6 Strengths and Weaknesses of institute of social welfare and research, University of Dhaka.
Strengths of institute of social welfare and research, university of Dhaka by the scope of Field
Practicum .................................................................................................................................. 97

8.7 Recommendations ............................................................................................................... 98

8.8 Conclusion .......................................................................................................................... 99

CONCLUDING REMARKS ...................................................................................................... 100

References ................................................................................................................................... 101

viii
 Chapter One
Field Practicum in Social Work
1.1 Introduction
Field work is an integral part of social work education. Historically the profession of social work
has considered fieldwork a primary means of providing students with the opportunity to acquire
knowledge, value and skills. Simply we can say field work refers the process or approach in
which social knowledge, value, principles and other social work-related discipline are exercised
in the arena of social service welfare and sustainable development The Social Work is a
professional course builds the students who are socially concerned and competent to meet the
social needs and development of human being. The post-graduation course tries to promote a
sense of social responsibility and commitment towards the needy, vulnerable and the
marginalized sections of society. Both theoretical knowledge and practical help students to
develop the skills required for professional social work practice Field work means to work in the
field work agency. In this process, we get the opportunity to apply theoretical knowledge and
techniques in the field work agency to meet social problems. Social work emphasizes field work
to practice or apply its knowledge. In the field of social work, Field Work is such a way through
which the apprentice social workers get the opportunity to apply their theoretical knowledge
acquired in the class. For this, an apprentice social worker must apply his knowledge and skills of
social work in real sphere under a supervisor. Field Work provides the students with the
opportunity to realize how social problems are influencing the individuals, group, family,
organization, and community. Moreover, Field Work enables a student to understand the roles
and functions of social policy, law, and social service-related organization, network and
community resources.
In total, practical training gives a chance to a student to observe the role of a social worker in the
problem-solving process. About this statement it is said that the objective of the fieldwork
program in social work education is to provide the student with actual experience in applying
social work methods and enable him or her to become familiar with real work of practice. That is
to relate academic theory to concrete reality as found in the agency setting. It also aims to allow
the student to test himself/herself to develop sense of professional discipline to gain self-
confidence and to feel him or herself a social worker with beginning competence, components of
the social work

profession and its varied roles. The ideal field placement offers students a focus on the methods
of direct practice, policy development and implementation, and other social work special projects
and research activities. Field placements are arranged only for the students of 8th semester of

1
BSS and the students of 2nd semester of MSS program. The students are supervised by two
professional (Institute and agency) supervisors. They are required to work for a minimum period
of three months (480 hours) spread over 60 working days beyond final report writing. Where they
are given the opportunities to apply theoretical knowledge, skills, techniques, values, methods,
theories and principles within an organizational, community and agency-based matrix to meet
social problems. The main objective of this paper is to observe and facilitate the pavements,
squatters and slum dwellers to provide various opportunities so that they can improve their
livelihood and ensure a better life.

1.2 Conceptual Analysis of Social Work

Social work is a helping profession which fundamentally and radically aims to assist the
individuals, groups and community to cope with their complex socio-economic and
psychological problems through enabling themselves so that they can solve their problem by
helping themselves. It is a professional and academic discipline that seeks to improve the quality
of life and subjective well-being of individuals, families, couples, groups, and communities
through research, policy, community organizing, direct practice, crisis intervention, and teaching
for the benefit of those affected by social disadvantages such as poverty, mental and physical
illness or disability, and social injustice, including violations of their civil liberties and human
rights. The profession is dedicated to the pursuit of social justice and the well-being of oppressed
and marginalized individuals and communities. A person who practices social work is called a
social worker. The most recognized definition of social work has been presented by the National
Association of Social Worker (NASW) in its “board of directors” in1970. It defined it as “Social
Work is the professional activity of helping individuals, groups, or communities enhance or
restore their capacity for social functioning and creating societal conditions favorable to this
goal”.
Social work developed as a 20th century profession out of its voluntary philanthropy and social
reform roots. These roots are deeply linked to ancient values and concepts of charity, equality
and compassion toward others in times of need. The profession's contemporary roots are
particularly connected to social welfare developments in the 19th century. These developments
included reform movements to change negative societal attitudes toward people in need; charity
organization
societies to help individuals and families; settlement houses to improve living conditions at the
neighborhood level; and rising feminist advocacy for human rights, social justice and gender
equality(Sarker, 2009).
It is a scientific discipline but still requires a creative and artful approach to work with
individuals, families, groups, and communities that are struggling with problems. This definition

2
of social work is known as the dictionary definition of social work. Social Work practice consists
of the professional application of Social Work values, principles, and techniques to one or more
of the following ends: to enhance the problem-solving, coping and developmental capacities
people; to promote the effective and humane operation of the systems that provide people with
resources and services; to link people with systems that provide them with resources, services,
and opportunities.

The following definition was approved by the International Federation of Social Workers
(IFSW) in July 2014, “Social work is a practice-based profession and an academic discipline that
promotes social change and development, social cohesion, and the empowerment and liberation
of people. Principles of social justice, human rights, collective responsibility and respect for
diversities are central to social work. Underpinned by theories of social work, social sciences,
humanities and indigenous knowledge, social work engages people and structures to address life
challenges and enhance wellbeing”.

The International federation of social worker has defined social work as such: The social work
profession promotes social change, problem solving in human relationships and the
empowerment and liberation of people to enhance well-being. Utilizing theories of human
behavior and social systems, social work intervenes at the points where people interact with their
environments. Principles of human rights and social justice are fundamental to social work.

According to National Association of Social Worker, “Social Work is the professional activity
of helping individuals, groups, or communities enhance or restore their capacity for social
functioning and creating societal conditions favorable to this goal. Social Work practice consists
of the professional application of Social Work values, principles, and techniques to one or more
of the following ends: helping people obtain tangible services; counseling and psychotherapy
with individuals, families, and groups; helping communities or groups provide or improve
processes.

The practice of Social Work requires knowledge of human development and behavior; of social,
economic, and cultural institutions; and of the interactions of all these factors. Social Work is
concerned and involved with the interactions between people and the institutions of society that
affect the ability of people to accomplish life tasks, realize aspirations and values, and alleviate
distress. These interactions between people and social institutions occur within the context of the
larger societal good.

3
Therefore, three major purposes of social work may be defined:

 To enhance the problem-solving, coping and developmental capacities of people.

 To promote the effective and humane operation of the systems that provide people with
resources and services.
 To link people with systems that provide them with resources, services, and opportunities.
However, the underlying assumptions of social work are:

 Social work, like all other professions, has problem-solving functions.

 Social work practice is an art with a scientific and value foundation.
 Social work as a profession came into being and continues to develop because it meets
human needs and aspirations recognized by society.
 Social work practice takes its values from those held by the society of which it is a part.
However, its values are not necessarily or altogether those universally or predominantly
held or practiced in society.
The scientific base of social work consists of three types of knowledge:
 Tested knowledge
 Hypothetical knowledge that requires transformation into tested knowledge
 Assumptive knowledge (or “practice wisdom”) that requires transformation into
hypothetical and thence into tested knowledge.

1.3 Social Work Code of Ethics

The National Association of Social Workers Delegate Assembly created the first version
External link of the Code of Ethics in October 1960. It has since been revised several times
External link, but it maintains many of the original principles.

The code serves six purposes:

1. To establish the core values upon which the social work profession is based.
2. To create specific ethical standards that should guide social work practice and reflect the
core values.
3. To help social workers navigate professional considerations and obligations when ethical
uncertainties arise.
4. To provide ethical standards to which the social work profession can be held accountable.
5. To initiate new social workers to the profession’s mission, values, and ethical principles
and standards.

4
 6. To create standards by which the social work profession can assess if a social worker has
engaged in unethical conduct. Social workers who pledge to abide by this code must
cooperate with its implementation and disciplinary rulings based upon it

Based on this code of ethics social worker will perform tasks and activities aimed at achieving
the following:

 Enhancing the problem solving and coping capacities of people

 Restoring and maintaining the social functioning of people
 Linking people with resources that can provide needed support and services
 Planning developing and administering social agencies and social programs
 Protecting the most vulnerable members of society from destructive social influences
 Restoring and maintaining the social functioning of people
 Conducting research, developing and disseminating knowledge relevant to the practice of
social work.

1.4 Conceptual Analysis of Field Practicum in Social Work Education

Field work is considered an integral part of social work education. Historically the profession of
social work has considered fieldwork a primary means of providing students with the opportunity
to acquire knowledge, skills and values (KSV) in an agency setting. Simply, we can say, field
work refers to the process or approach in which social work knowledge, value, principles and
other social discipline are exercised in the arena of social service welfare and sustainable
development. Field work means to work in a field work agency. In this process, we get
opportunity to apply

theoretical knowledge and techniques in the field work agency to meet social problems. Social
work emphasizes field work to practice or apply its knowledge. It is a peer supervises of learning
process a qualitative or quantitative study that synthesizes and integrates knowledge that we have
learned in the classroom. It is a dynamic course that challenges students of social work to apply
social knowledge, skills, values, techniques, methods and principles within an organizational,
community and agency-based context. It is a vital dimension for undergraduate and graduate
students of social work education.

5
1.5 Conceptual Orientation of Field Practicum
Social work is an international profession and similarly social work education internationally has
always embraced both academic and practical components. Field work is an integral part of
social work education. Historically the profession of social work has considered fieldwork a
primary means of providing students with the opportunity to acquire knowledge value and skills.
Simply we can say field work refers to the process or approach in which social knowledge, value,
principles and other social work-related discipline are exercised in the arena of social service
welfare and sustainable development. Fieldwork, which is also known as field instruction, field
placement, field education, practicum or internship is therefore an integral component of social
work education.
The term “filed work” is made up of two words-filed and work. The word ‘filed’ has different
meanings in different contexts. Webster’s dictionary has defined it as an area of observation or a
locality of operation. Sociological dictionary defines it as a place outside the school or university
where we carry out different activities to understand certain aspects of a society. Work refers to
the task that is done in such a place. Thus, field work refers to an activity or a series of activities
that is/are carried out outside the school or university for a particular purpose.

Some definitions of Field Work are:

Good and Hatt defined field work as “a study of people and their culture in their natural
situation.” Dr. Professor M.A Momen (1970) said as the definition of Field work, "Field work
is designed to help guide a student to develop hi9s skill and competence for his independent
professional functioning and carrying out appropriate responsibilities"

In the words of W.A. Friedlander, "Field work is designed to integrate the academicknowledge,
practical understanding and personal skills of the student by personal contact and to direct the
clients". (Friedlander; 1963)

According to Hamilton and Else "A consciously planned set of experiences occurring in a
practice setting designed to move students from their initial level of understanding, skills and
attitudes to levels associated with autonomous social work practice" (1983).

According to Oxford Advanced Learners Dictionary, "Field work is a research or study that is
done in the real world rather than in the laboratory or classroom".

According to the syllabus of BSS (Hon’s)- “Field work consists of supervised practice in
problem solving activities with the recipients of social work services which enable students to
learn to apply and test social work skills necessary for professional practice. The education

6
experience in field work is designed to integrate practice with theoretical knowledge. The
minimum required time for field work is 420 hours in approved social welfare or development
agencies to be spread over 60 working days beyond final report writing”. In addition, 10 days
will be allotted for final report writing. Each student is required to write a final report on his/her
work which will be examined by the supervisors responsible for field instruction during field
work. There will be a viva-voce examination for this course at the end of the session. Every
student must face an inclusive viva about his work.

1.6 Historical Background of Field Practicum in Bangladesh

Social Work education has started its journey in Bangladesh during the period of Pakistan
through a short time training course by the help of the United Nations in 1953 and social work
education and training was extended afterwards. College of Social Welfare and Research was
established in 1958 and being included under Dhaka University. This college starts its
educational programs in the session of 1958-59 with 55 students. Afterwards in 1973 it’s
renamed as the institute of Social Welfare and Research (ISWR) under Dhaka University. In
1974 social work was included in the curriculum of graduation (pass) and Higher Secondary
level as an optional course. Shahjalal University of Science and Technology started this subject
as a B.S.S (Honors) course in the session of 1993-94. At present this University is providing
Honors and master's degrees. On the other hand, National University was established in 1992 and
from the start of its establishment it has been teaching this subject to the colleges under it.
According to the data of 2001, master's Courses are being taught by 17 colleges and Honors
course by the 32 colleges under National University. (Islam 2002:319). Rajshahi University is
also providing graduation and post-graduation degrees in this discipline.

On the view of field work social work is a dynamic and updated discipline than the other
discipline of arts and social science faculty. But field work is not a readymade product of the
present time. It shows an aged history like social work education. Initial stages of fieldwork were
not systematic and organized. One of the great pioneers of social work, Mary Richmond, first
introduced social work practice and she wrote a dramatic and historical book named “Social
Diagnosis”. Which worth, P.I. Park and has inaugurated field practice at the Chicago University
of America to evaluate and monitor urban poverty by their students. Dr. Emerson took the
initiative to send the medical student to a social agency at John Hopkins University in 1902.
Academy of Social Service Department of the People’s Republic of Bangladesh has organized
short training course for its Social Service officers and field worker in 1963. Generally, three-

7
type training is organized by the department like internal training, primary training and reefers
course.
From the mid 18th century to the end of the 19th century social work has evolved from societies
to assist and reform a year of full-time academic study. Now all over the world there are many
courses on social work education. After the independence from then British, India, Pakistan was
facing many socio-economic problems and government sought United Nations help. After the
government requested the UN sent an expert team. According to their recommendation a short
course of three months was introduced in 1953 to produce skilled social workers.
In Pakistan Period the first short term in service social work training course held in 1952 at
Karachi jointly sponsored by the government of Pakistan and united Nations technical Assistants
Administration, was under the direction and supervision of United Nations consultants and their
Pakistani colleagues. Three days were given classroom work and two days to supervise field
dimension. The curriculum of this course was divided into three major phases, these are:
1. Orientation
2. Social work techniques
3. Fieldwork

In the meaning V-AID program in 1953 and urban community development program were
expanding quickly by the government and voluntary organizations. As a result, concerned
authority felt the need of starting higher education on social work and in 1959 Dhaka University
started MA course on social work and established social work college and research center which
was inaugurated by Lt. Colonel Azam khan on 19th March 1963 for its own building. In 1958-59
Social welfare College & Research, in 1965-65. Rajshahi University & in 1992-93, Shahajalal
University & under National University started Hon’s & master's degree with compulsory Field
work.

1.7 Goals and objective of field Practicum

Field practicum affords experiential assessment and evaluation of student’s development and
progress of becoming a helping profession. The general objectives of field work are focused on
the following:

 Students should learn to apply social work methods in the solution of given individual,
group or community problems.
 To learn to start with factual material as the basis for professional intervention and
through appropriate study and diagnosis to move forward step by step to the
implementation of a plan of action.

8
  To learn the organizational framework of service. They can understand agency structure
and policy and how to facilitate such policy. They become familiar with the differing
institutional styles and tempos of agencies associated with various fields of practice.
 To gain knowledge regarding community structure and process. They know the kinds of
formal and informal groups, voluntary and governmental agencies, individual institutions
and forces that constitute a community. They can utilize community resources in support
of social welfare goals.

M. A. Momen mentions five goals and objectives of FW education in his book “Field Work
Manual.” These are as follows:

 To gain real work practice knowledge;

 It aims to allow the student to himself or herself;
 To develop a professional sense of discipline;
 To gain self-confidence;
 To fell himself/herself a social worker with beginning

According to American Social Work Council, the objectives of practical training are:

 Making contribution for getting student acquainted comprehensively with all types of
social work profession. Creating a due environment to make students self-conscious.
Along with studies the attitude and the skill of the students should have a balanced
display in the classroom.
 Making opportunities available to the students to apply social work methods and be
experienced.
 Taking necessary steps so that students can acquire primary experience of social work
profession.

1.8 Values of Field Work

The primary mission of the social work profession is to enhance human well-being and help to
meet the basic human needs of all people, with particular attention to the needs and
empowerment of people who are vulnerable, oppressed, and living in poverty. Keeping this
mission in view while practicing social work, The National Association Social Workers,
(NASW) developed the following core values-

9
Service: Field workers primary goal is to help people in need and to address social problems.
Field workers elevate service to others above self-interest. Social workers draw on their
knowledge, values, and skills to help people in need and to address social problems. Social
workers are encouraged to volunteer some portion of their professional skills with no expectation
of significant financial return.

Social Justice: Field workers challenge social injustice. Social workers pursue social change,
particularly with and on behalf of vulnerable and oppressed individuals and groups of people.
Social workers‟ social change efforts are focused primarily on issues of poverty, unemployment,
discrimination, and other forms of social injustice. These activities seek to promote sensitivity to
and knowledge about oppression and cultural and ethnic diversity. Field workers strive to ensure
access to needed information, services, and resources; equality of opportunity; and meaningful
participation in decision making for all people.

Dignity and Worth of the Person: Field workers respect the inherent dignity and worth of the
person. Field workers treat each person in a caring and respectful fashion, mindful of individual
differences and cultural and ethnic diversity. Social workers promote clients’ socially responsible
self-determination. Field workers seek to enhance clients‟ capacity and opportunity to change
and to address their own needs. Field workers are cognizant of their dual responsibility to clients
and to broader society. They seek to resolve conflicts between clients‟ interests and the broader
society’s interests in a socially responsible manner consistent with the values, ethical principles,
and ethical standards of the profession.

Importance of Human Relationships: Field workers recognize the central importance of human
relationships. Social workers understand that relationships between and among people are an
important vehicle for change. Field workers engage people as partners in the helping process.
Social workers seek to strengthen relationships among people in a purposeful effort to promote,
restore, maintain, and enhance the well-being of individuals, families, social groups,
organizations, and communities.

Integrity: Field workers behave in a trustworthy manner. Social workers are continually aware
of the profession’s mission, values, ethical principles, and ethical standards and practice in a
manner consistent with them. Field workers act honestly and responsibly and promote ethical
practices on the part of the organizations with which they are affiliated.
Competence: Field workers practice within their areas of competence and develop and enhance
their professional expertise. Social workers continually strive to increase their professional

10
knowledge and skills and to apply them in practice. Field workers should aspire to contribute to
the knowledge base of the profession.

1.9 Importance of Field Practicum

Social Work is a subject with high educative value and practical training is indispensable along
with textual and classroom knowledge. And the way to acquire this real knowledge is getting
learned about practical training. Field work is important, and students should be helped to
develop the attitude of mind ideas them to make connections between study & relief. It is vital
that this should be done if students are to become professional practitioners in the field rather
than goods nature & amateurs of techniques applying narrow skills.

The necessity of fieldwork practice in social work is so important. Without it we cannot acquire
practical knowledge. It is the pre-training of the employee. If we want to achieve social work’s
goal, we must need field work. It is believed that in professional social work education,
knowledge alone is not enough and the development of skill in Practice is necessary. Field work
provides students with genuine experience in applying social work methods and enables them to
become familiar with the real world of Practice, to relate academic theory to concrete real it is
found in the agency setting. The importance of field practicum in social work given below:

1) To increase skill: Field work practice increases the student’s skill. Field work students
can apply theoretical knowledge and be skilled. Practical uses of social work knowledge:
It is the great sector of practicing social work knowledge.
2) To build up theory: field work is helpful to build up theory. When we practice field work,
we can test the social work methods, principles, values, and ethics.
3) To know the limitations of social work methods: when we practice fieldwork education,
we will find out the limitation of the social work method.
4) To identify the relation with agency: if we identify the agency's method to relate social
work, we must need field work practicum.
5) To evaluate the social work: field work practicum is the greatest strategy to evaluate the
social work.
6) Work with others: to give opportunity for the students to learn to work with other
professional and voluntary workers. So fieldwork practicum is very important.
7) Deeper awareness and problem solving fieldwork practicum is very important to help the
student to develop deeper awareness of himself and his party in the problem-solving
process.

11
 8) To know office administration: the students can understand how to work under
administrative and organizational structure and they can learn how an office is governed
and what kind of routine needs to be established.

By the rule of thumbs method, in “Field Work Manual” M.A. Momen has mentioned the
following importance of field work practice:
Application of social work knowledge: Through the field work, the students can learn how to
apply social work methods in the situation of given individuals, groups or communities problems.
It also helps the students to apply the theory & principle of social work into actual practice. The
students acquire knowledge of social work & are given an opportunity to try a variety of social
work methods, skills & techniques.

Exposed to agency practice: They are exposed to agency practice in which they are in a
systematic, preplanned approach to solve problem processes such as study, diagnosis & treatment.

Achieve self-awareness & Discipline: The students achieve self-awareness & discipline to use
them as a helper & as agent of change in an individual & group situation.

Use of organizational structure: The students develop facility in the use of organizational
structure. They come to know foster & use relationships within a structure & gain insight
regarding his/her network of relationships in the organization.

Familiar with administrative procedure & process: The students become familiar with
administrative procedure & process. They learn how to run an office, what kind of routine needs
to be established, how to facilitate administrative arrangements relevant to the discharge of the
responsibilities of their own assignment.

Opportunity to learn the organizational framework of services: The students have an

opportunity to learn the organizational framework of services. They understand structure &
policy & how to facilitate such policy through practice.

Acquire with causes of the problem: The students acquire significant substance substitute
knowledge in the specified field of practice characterized by the agency. They become acquired
with causes of the problem & with social welfare programs, agency structure, laws, & policies,
related to its solution.

12
Acquire knowledge regarding community structure and process: The students acquire
knowledge regarding community structure and process. They know the formal, groups & force
that a community. They should have the ability to utilize community resources in support of
social welfare.

It is clearer that in the social work profession, fieldwork or practical training is utmost important.
Above all, social work is a wonderful combination of theoretical and practical knowledge and
skill. That’s why field work is emergently crucial for the professional social work or apprentice
social workers

1.10 Scopes of Field Practicum in Bangladesh

Field practicum is a discipline which is limited by several processes. This is not an isolated
process, within the framework of an administrative practice in the field. The method is applied to
social work practice and field work talking the problem. It’s a comprehensive and extensive
range. Various field of Knowledge, skills, practice which is to archive to specific case, a social
worker who provides the opportunity. There are some important areas in Bangladesh.

Medical and Non–Medical Setting

Medical social work is one of the few fields in Bangladesh that applies social work in providing
services to the clientele. On the other hand, medical setting is none of the largest and oldest in the
country for the professional orientation of the of student of social work discipline. The setting
comprises government and non–government hospital, clinics and other health related agencies.
Psychiatric Setting
Psychiatric social work is an important part of medical social work. It works to resolve the
mental health problem of the patients. Mental patients need a long- term counseling service. That
is why mental hospitals including the psychiatric section of other hospital social including
psychiatric section of other hospital social workers are working for to help the patients. PG
hospital, mental hospital, mental health unit, medical college and hospitals are practices field
work regularly in Bangladesh.

Correctional Setting
Patients are provided after completing correction. Any act against the law, constitution or custom
of society is office. And the offender must be punished according to the law. But punishment is
not the solution. The offenders should be given a chance to resolve their offensive mind, so that

13
they can be mentally prepared not to make some mistakes. This is called correction .In social
work words no man born as offender, they becomes offender as the impact of social environment
So the social workers make a positive environment in which they can overcome their problems
with ethical values, which is called correctional service .The first and last saying of social work
and correctional service and correctional agencies is “take to liability”. The agencies take all
liabilities of the offenders. Social workers communicate constantly with client.

1.11 Inter-relationship between Social Work Education and Field Practicum

Modern social work education has two dimensions:
1 Theoretical
2 Practical
A social worker gains knowledge about society, social problems, property, social structure, social
values, human behavior, social work process when practical training enable them to use this
knowledge acquired knowledge in this field for real life purposes. Thus, practical training is
required for social workers to solve social problems of human beings/society for modern social
work. Taking notice of this requirement, higher education has been provided with practical
training courses in its syllabus about social work, through which students can apply theoretical
knowledge for the solution of problems. The Social and Economic Council of United Nations
recognized social work as a profession in 1951 and formulated the following decisions. Social
Work is a profession based on trained male and female and who are obtained theoretical and
practical knowledge in social work degree from established and recognized educational
institutions is mandatory to fulfill by them. Social Work is a practical education, which is learned
through theoretical study of society and social work. This is because ‘public good’ can be
affected only by applying theoretical knowledge in real life in a scientific way. And practical
training helps apprentices to be full-hedged social workers by planning of applying theoretical
knowledge in practical life. And these together make social work education and practical training
inter-dependent upon each other.

1.12 Conclusion
Fieldwork is an integral part of social work education. Historically the profession of social work
has considered fieldwork a primary means of providing the students with the opportunity to
acquire knowledge value and skills. Simply we can say fieldwork refers to the process or
approach in which social knowledge, value, principles, and other social work-related disciplines
are exercised in the arena of social service welfare and sustainable development.

14
 Chapter Two
Hospital social service. Hospital social service in Bangladesh.
Hospital social service office, Dhaka medical college and hospital.

2.1 Introduction
Medical social work is a sub-discipline of social work, also known as hospital social service.
Medical social workers typically work in a hospital, outpatient clinic, community health agency,
skilled nursing facility, long-term care facility or hospice. They work with patients and their
families in need of psychosocial help. Medical social workers assess the psychosocial
functioning of patients and families and intervene as necessary. A large portion of people in the
world are facing health issues every other day. Some of them get well only by taking necessary
medicines suggested by the doctors, some people need to get admitted into the hospital for
proper observation and care. It is said that a person becomes the most helpless when he gets sick.
This helplessness adds a new dimension when the patient is economically unstable and has no
one to look after. A hospital social worker connects patients and families with resources,
provides education, and conducts mental health assessments.

2.2 Meaning of Hospital Social Service

Hospital social service is a service based on social work knowledge and skills where the
psychosocial factors behind the diseases are studied and helps the client to improve his mental
state and necessary steps are taken for his recovery and rehabilitation besides giving emphasis
on preventive care. Interventions may include Connecting patients and families to necessary
resources and support in the community such as

· Preventive care
· providing psychotherapy
· Supportive counseling
· grief counseling or
· Helping a patient to expand and strengthen their network of social support.

According to Robert L. Barker "The medical social work practice that occurs in hospitals and
other health care settings to facilitate good health, prevent illness and aid physically ill patients
and their families to resolve the social and psychological problems related to the illness. Medical

15
 Social Work also sensitize other health care providers about the Social psychological aspects of
illness" Medical Social Work is the branch of social work and it deals with the social, physical
and psychological aspects of patients.

According to Skidmore and Thackeray, “Medical Social Work is the application of social
work knowledge, skill, attitudes and values to the field to health and medicine” (1964:73).

According to Russell H. Kurtz "Medical social work is a social work practiced in responsible
relationship to medicine and public health within the structure and programs of health and
medical care."

According to Clarkson, “Medical Social Work is a specialized branch of social work practiced
in hospitals, clinics, community health centers and sometime in general practice” (1974).

Professionals in this field typically work with other disciplines such as medicine, nursing,
physical, occupational, speech and recreational treatment. The role of a medical social worker is
to "restore balance in an individual’s personal, family and social life", to help that person
maintain or recover his/her health and strengthen his/her ability to adapt and reintegrate into
society. Purpose of Hospital Social Service-

• Helping people facing illness, trauma-related crises, or disability to understand.

• Manage the psychosocial impact on their and on significant relationships and to make decisions
and plan for Facilitating adaptive coping patterns and adjustment to chronic illness or disability
and assisting with reintegration or adaptation to new environments.
• Participating in multidisciplinary teams and providing insight and understanding of the
psychosocial dimensions of the medical circumstances affecting patients and families.
• Identifying and arranging community support and practical resources to facilitate discharge from
hospital or transfer to alternative care facilities.
• Assessing the needs of selected patient populations, planning and implementing appropriate
programs, networking with community organizations, and developing
services to meet these needs, including support and psycho educational groups, educational
forums, socialization, and reintegration activities.

• Identifying potential neglect, abuse, and exploitation in vulnerable populations and involving
authorized agencies.
• Supporting institutional goals and purposes and encouraging institutional responsiveness to
patient needs.
• Assisting with anticipatory grief and mourning, counseling people facing death, and providing
other bereavement-related services to members of the family, including making practical
arrangements.

16
 2.3 Hospital Social service in Bangladesh
Diseases make people helpless by severely disrupting their normal lives. Illness is unbearable
for the suffering poor patients. The importance and effectiveness of hospital social work is
immense in ensuring that the morbidly poor receive their basic right to medical care.

Through hospital social service activities, along with mental, family, social, economic, illness
related support to the poor and helpless patients and by collecting other information necessary
for the good treatment of the patient, doctors and hospital authorities are also supported for the
recovery of the patient.

· To increase the mental strength of the patient, to bear the cost of the treatment,
· To provide various information to the doctor about the patient's disease and the cause of the
disease, and
· To assist in his rehabilitation after the treatment.

2.4 History
Hospital social work is a specialized field of social work. Hospital social work is also known as
Medical social work. As a sub-discipline of social work hospital social work aims to assist
people with illness to deal with psychological, social and economic crisis which are threatening
to them. Rapid and radical social changes are characteristics of post-industrial urbanized society.
The Industrial revolution as an unmixed blessing brought rapid and radical social changes. These
changes result in a changed role of individual and family. It has loosened social and family ties.
Due to the attraction to luxurious life or in search of job people become interested in living in
urban areas. Living in urban area was costly. Urban facilities were not available for the people of
the low-income group. Maintaining a large family in urban areas is always difficult. So, people
started to migrate to urban areas alone or with only their wife and children. As a result, large
joint families broke into small/nuclear families. The children, elder and dependent persons
became insecure. In the pre-industrial period problems were unilateral. After industrial
revolutions these problems turned into multilateral problems because of complex socio-cultural
factors. In many cases, these problems cannot be solved only through individual attempts and
Outside assistance becomes essential. Social work has emerged to help people so that they can
solve their problems effectively with their own resources.Social work includes all aspects of

17
 human life to ensure comprehensive welfare. Medical setting is one of the fields of social work.
Hospital social work deals with psychological, social and economic problems of patients
contributing to their illness. Medical social work was first introduced at Massachusetts Hospital,
Boston, USA in 1905. At present it is well established in most of the hospitals of developed
countries. Medical social work is also practiced in developing countries such as Bangladesh,
India, Pakistan, etc. Medical Social Worker works in a medical setting with a group of doctors,
nurses and hospital staffs. Doctors only deal with physical problems, Medial social worker deals
with psychosocial aspect of a patient and help the physician in treatment and discharge planning.

In Bangladesh medical/hospital social service was introduced during the 1958. This service was
first launched in Dhaka Medical College Hospital in 1959 and at present the service is running
in 10 government and private hospitals at the city corporation and district level nationwide
through the Department of Social Services. Also, this program has been extended to 342
upazilas at the upazila level through the Upazila Patient Welfare Association.

2.5 Services provided by the department of hospital. Social services.

· Assistance in obtaining hospitalization and treatment, Free medicines, assistive devices, artificial
organs, various medical supplies and food supplies or cash financial assistance for procurement
of these provision of wearable clothing.
· Cash assistance for blood donation or purchase Provision of nutritious food
· Rehabilitation of unwanted children and rehabilitation of patients who are unwanted in the family
due to disease.
· Assistance in shifting to hospital/ medical center, Informing patients about health awareness, first
aid and mentally disturbed patient or patient in case of severe illness, operation etc.
· Assistance in establishing family and social contact with the patient and morale support by
providing counseling to relatives of arranging cremation of anonymous poor deceased.
· Cash financial assistance after remission of disease.

From then till now it has been continuing and expanding its activity throughout the country. But
the matter of our concern is that no comprehensive study has been done on it after 1969. So, it
has been decided to conduct a study titled “Medical social work in Bangladesh” to know the
present status of hospital social service in Bangladesh, its limitations and necessary
recommendations for improvement.

18
2.6 Hospital social services office, Dhaka medical college and hospital.
Subsequence
The important service activities of the Hospital Social Service Office run by the Department of
Social Services under the Ministry of Social Welfare are directly related to the service of poor
patients. Through this program, the poor, helpless and distressed patients who come to the
hospital will be assisted in their medical expenses, the mental development of the patient will
be provided with various guidelines and after the treatment, the patient will be provided with
the necessary overall support. Patient Welfare Associations, registered voluntary social welfare
organizations by the Department of Social Services, assist in the smooth implementation of
hospital social service activities and collection of donations/grants. This association, under the
direct supervision of the hospital authorities, is tirelessly working for the overall welfare of the
poor, helpless and poor patients in the hospital.

Hospital introduction
The traditional Dhaka Medical College Hospital started its journey on July 1, 1946. Dhaka
Medical College Hospital is the last refuge of patients coming from all over Bangladesh and
referred from different hospitals. At present, the country's largest hospital with 38 departments,
13 units, 2600 beds and 4,491 employees including directors, deputy directors, assistant
directors, doctors, nurses are engaged in providing services to patients. The number of beds
here including burn unit is 2000 but patients are often admitted above 4000.
Introduction to hospital social service activities
The first hospital social service program in Bangladesh was started in 1958 through Dhaka
Medical College Hospital. At present, Dhaka Medical College Hospital is conducting hospital
social service activities with the sanctioned 5 manpower. Among them 3 Social Service
Officers, 1 Office Assistant cum Computer Numerologist and Weight Office Assistant. The
hospital social service program helps in reintegration as healthy and normal citizens of society
by providing financial and emotional support to the treatment of the poor, helpless and sick
patients coming to the hospital. At present, through 'Rogi Kalyan Samiti', every month and
average of 300 patients are being provided with financial support and 500-3000 patients with
psycho-social support.

Patient Welfare Association

Patient Welfare Association directed by Department of Social Services Administration under
ministry of social welfare is an important service activities of hospital social services offices are
directly related to patient care. Through this program, the poor, indigent sick patients coming to

19
the hospital are supported in the medical expenses, providing various guidelines including the
mental development of the patient and providing the necessary overall support to the patient
after the treatment. 'Rogi Kalyan Samiti', a voluntary social welfare organization registered by
the Department of Social Services, assists in the smooth implementation of hospital social
service activities and collection of donations. This association, which is managed under the
direct supervision of the hospital authorities, is working tirelessly for the poor, helpless and
poor patients in the hospital. 'Patients Welfare Association Dhaka Medical College Hospital'
came into being through registration under the Voluntary Social Welfare Organizations
(Registration and Regulation) Ordinance, 1961 bearing Reg.No.-ob67. Activities of the
association in implementation, there are three council’s namely executive council, general
counsel and advisory council with 21 members. The director of the hospital served as the ex-
officio president of the Rogi Kalya Samiti and the senior social service officer of the hospital
social service office as the ex-officio general secretary. A table is given below:

Designation Number

Chairperson (Chief of the 1 (The director of

hospital) DMCH)

Deputy Chairperson 2
Secretary (Social Service Officer) 1

Join Secretary 1

Publicity Secretary 1

Rehabilitation Secretary 1

Treasurer 1

General Member 13
Total Member 21

Figure: Structures of Patients Welfare Association. (Source: Opinion of my supervisor named

Tanzida Sir)

20
2.7 Target Groups of the agency

1) Low-income families living near Dhaka Medical College Hospital

2) Elderly individuals in need of social support

3) Single mothers and their children

4) Individuals with disabilities

5) Homeless individuals

6) Orphaned or abandoned children

7) Victims of domestic violence

8) Patients with chronic illnesses requiring ongoing social services

9) Mental health patients in need of counseling and support

10) Unemployed individuals seeking assistance with job placement

11) Individuals in need of financial assistance for medical treatments

12) Patients and their families in need of emotional and psychological support

13) Street children and adolescents in need of rehabilitation and education support

14) Those poor patients who need material support like medicine, blood, artificial limbs, and
clothes etc. 15) Babies without parents

16) Those who have no relatives and family to take care of themselves.

21
17) Those who are frightened of going through an operation procedure or taking other medical
services. 18) Autistic and physically handicapped babies.

19) Destitute and disadvantaged women.

20) Mentally depressed and psychologically ill persons

21) Those who need rehabilitation and reintegration with family members and society

2.8 Strategies of the Agency

The Social Service Office of Dhaka Medical College Hospital is responsible for aiding and
supporting patients and their families. Here are 20 strategies that they might employ:

a) Providing financial assistance to disadvantaged patients.

b) Assisting in arranging transportation for patients who cannot afford it.

c) Offering counseling services to patients and their families to help them cope with their illness.

d) Coordinating with other organizations and NGOs to provide additional support to patients.

e) Facilitating the donation of medical equipment and supplies.

f) Assisting patients in navigating the healthcare system and accessing appropriate medical
services.

g) Organizing health education programs to raise awareness about health issues.

h) Offering support groups for patients and their families to share experiences and provide
emotional support.

i) Providing information about available government schemes and policies for healthcare benefits.

j) Facilitating the coordination of blood donations for patients in need.

k) Organizing health camps in rural areas to reach underprivileged communities.

22
l) Collaborating with local community leaders and organizations to provide healthcare services to
marginalized groups.
m) Assisting in the coordination of medical camps and charitable events for the underprivileged.
n) Offering vocational training programs for patients with disabilities or long-term illnesses.

o) Advocating for the rights and welfare of patients in need.

p) Facilitating the provision of free or discounted healthcare services to those who cannot afford
them.
q) Coordinating with social workers and volunteers to provide emotional and social support to
patients.
r) Conducting research and surveys to identify the needs and challenges faced by patients and
their families. 33
s) Working closely with government agencies and policymakers to advocate for improved
healthcare services.
t) Maintaining a database of resources and services available to support patients and their
families. These strategies aim to provide comprehensive support to patients, improve access to
healthcare services, and promote the overall well-being of the community.

2.9 Organogram of Hospital Social Services of DMCH

Hospital Social Services are directly under the Ministry of Social Welfare's Department of Social
Services (DSS). The agency's staff is comprised of three service employees, one office assistant,
and one Member of Lower Subordinate Staff (MLSS)

SL. Name of the Personnel Designation

No
1 Depika Rani Shaha Social Service Officer

2 Shilpi Bhoumik Social Service Officer

3 Syeda Tanzida Hasan Social Service Officer

4 Sumaiya Islam Office Assistant Cum-Computer

5 Monirul Islam Office Assistant

23
 2.10 Aims and objectives
The main aim and objective of the Patient Welfare Association is to provide financial and
psycho- social support to the poor, helpless and destitute patients who come to the hospital and
are under treatment to complete and implement the medical services by removing all possible
obstacles in getting medical services. Our services
· To help and guidance in admitting and obtaining medical care for distressed, destitute and poor
patients coming to the hospital.
· Necessary medicine, diagnosis of diseases of distressed, helpless and poor patients Cost of tests,
blood products, pals, wheelchairs, crutches, paraphernalia, medical aids, pneumatic beds,
dialyzers, transport fares, mortuary fares.
· Providing all medical care to abandoned newborn babies, unidentified patients, disabled and
elderly patients admitted to the hospital and arranging for rehabilitation in various institutions of
the Department of Social Services if necessary
· Family planning, maternal and child health care, cleanliness, prevention of communicable
diseases through regular indoor and outdoor patient counseling and upliftment.
· Expenditure on organization of seminars, workshops etc. and publication and dissemination of
promotional leaflets, posters etc. with a view to creating public awareness about the menace of
infectious and communicable diseases.
· Operation and post-operation trace disorders and duration Enhancing the patient's morale and
courage in case of illness.
· Providing motivation and counseling to boost the morale of abused women and children who
come to the hospital's One Stop Crisis Center and provide immediate services.
· To provide priority services and assistance to elderly, widowed and widowed women and
disabled patients in coming under social security schemes.
· To provide blood to the needy and needy patients by storing blood in blood donation programs at
different times and days.
· Provide assistance to other hospitals directed to call patients to facilitate treatment including
patient visits and family reunification as necessary.

Supervision of field workers students

Undergraduate (Honor’s) and Postgraduate students studying social welfare/social work in
public universities and public and private colleges complete 60 (sixty) working days of practical
training under the supervision of the Hospital Social Service Office as part of their course. As
Apprentice Social Workers under the supervision of Hospital Social Services Office, they
provide motivation and counseling to patients and their guardians in various fields regarding

24
 health, nutrition, family planning, child health care, autism awareness, infectious and
communicable diseases, cleanliness etc. Assists patients in various fields including ticketing for
patients, arranging admissions, seeing doctors for related diseases, distribution, blood collection,
aiding in diagnostic tests. About 500 students receive training through the hospital social
service office every year.

Source of income
· Bangladesh National Social Welfare Council and other sources received.
· Financial donations, cash received as zakat through philanthropic individuals and institutions of
the society.
· Medical aid received through philanthropic individuals and institutions. General or life members.
· Cash received through various income-enhancing programs.

Financial management
The Hospital Social Service Officer receives the donated money and goods through specific
receipts and pads of the Patient Welfare Association and deposits it as the bank concerned.
Anyone can also pay the donation directly as a bank with prior intimation if required. All bank
accounts are managed under the joint signature of the general secretary treasurer with the
permission of the president of the association.

A secure future for abandoned newborns

At various times, abandoned newborn babies are admitted to the Neonatal Department of Dhaka
Medical College Hospital. For the well-being of new-born children admitted through passerby
or the police, apart from the intensive care of the doctor, the Patient Welfare Association of the
Hospital Social Service Office provides all the medicines, diapers, baby clothes and other
necessary materials. After all these children recovered, the hospital authorities sent them to the
hospital social service officer for rehabilitation. The Hospital Social Service Officer arranges
rehabilitation for them in various institutions including “Chhotamoni Nivas” of the Department
of Social Services for their safe future. So far 122 abandoned newborn children have been
rehabilitated in Chhotamoni Nibas, Azimpur, Dhaka, under Department of Social Services.

25
2.11 Conclusion
The Bangladeshi people are still reluctant in their health and health care due to their
unawareness and extreme poverty. They feel fear to go to the doctor thinking of the high cost.
At first, they search for a village quack and if their diseases take an epidemic form, they rush
away to the health centers or medical personnel. These practices lead them to poor health and
consequently a country deprived of skilled and efficient human resources. For building a
prosperous nation, health care services should reach in the hand of the poor people. It can be
ensured only by providing community and home-based services with the help of professional
social workers. Social workers can improve the health condition of the poor people through
community awareness programs and by taking other preventive measures that are called
community medicine.

26
 CHAPTER THREE
Duties and Performances
3.1 Introduction
The important service activities of the Hospital Social Service Office run by the Department of
Social Services under the Ministry of Social Welfare are directly related to the service of poor
patients. Through this program, the poor, helpless and distressed patients who come to the
hospital will be assisted in their medical expenses, the mental development of the patient will
be provided with various guidelines and after the treatment, the patient will be provided with
the necessary overall support. Patient Welfare Associations, registered voluntary social welfare
organizations by the Department of Social Services, assist in the smooth implementation of
hospital social service activities and collection of donations/grants. This association, under the
direct supervision of the hospital authorities, is tirelessly working for the overall welfare of the
poor, helpless and poor patients in the hospital.

3.2 Performing Duties and Responsibilities Assigned by Institute Supervisor

In the meantime, of my field practicum in hospital social services department under Dhaka
medical college hospital I was assigned some duties and responsibilities by my institute
supervisor that has been stated below:

1. Carrying out assignment as given by the institute supervisor must be Completed 60 working
days of the field practicum.

2. Conducting case studies of at least 6 persons and presenting those cases in fieldwork report
including 3 of the cases to supervisory conference.
3. Doing all the tasks assigned by agency supervisors Understanding existing clientele systems.
4. To apply social work knowledge, skills, values, approaches, methods and techniques.
5. Obeying agency supervisor and maintaining good relationships with other personnel of the
agency.
6. Keeping the daily record in the process recording book and submit process recording at least
once a week to both agency supervisor and institute supervisor. To keep the record of the name
and address of the beneficiaries.

7. To study some books relating to fieldwork, medical social work and so on To Understand
existing social service delivery system.

27
8. Understanding and acquire skill in the administration department of social service Dhaka
medical college and hospital to Show the highest degree of professionalism.
9. To Understand and appreciate the professional duties and responsibilities in social work
agency
10. Developing the skill in social work by focusing on social work values and knowledge to
maintain time and discipline of the agency like as official formality.

11. Abide by the rules and regulations of the agency To Prepare report on field practicum by
following proper rules and regulations instructed by institute supervisor.

3.3 Performing Duties and Responsibilities Assigned by Agency Supervisor

During my field practicum I was assigned to the following various tasks, duties and
responsibilities from my agency supervisor in the department of social services of Dhaka
medical college hospital (DMCH). Those duties are in bellow:

1. Going to the agency in time and obeying the agency supervisor.

2. Listening and attending supervisory conferences.
3. Keeping the daily record in the process recording book.
4. Using social work and skills effectively in the knowledge problem solving process.
5. I have to visit different wards and units to know the places of units and departments of
Dhaka medical college so I can move all over this place in accordance with my duties
need.
6. Sometimes I help poor patients in doing necessary procedures for applying for help to our
agency.
7. Providing financial and others support to the patients who have been applied for help.
8. Assisting the unknown and destitute patients having no attendant by providing necessary
support.
9. I was helping to collect blood for needy patients who have no capacity to manage it.
10. It’s one of my regular duties to help outdoor patients by informing our office activities
about the poor and needy patients.
11. Informing the agency supervisor about any problems of the hospital under the area of
hospital social services.
12. Generally, I meet with the agency supervisor on a regular basis with assigned tasks.
13. To Purchase and distribute medicine provided by the hospital social services department
14. Helping the patients in the process of his\her pathological testing.
15. Sometimes I refer the patients to the hospital, doctor where the service is better based on
the capacity Money/donation collection.

28
 16. Taking case history of indoor patients and making a formal study for the supporting
purpose.
17. To provide case work services to the person Documentation and record keeping.
18. Sometimes I provide psychosocial support to patients to increase his\her strength to
overcome situations.
19. I Provide follow up services to the patients with psychosocial problems and health
education to the patients who are interested.
20. Communicate with family members of the patients and rehabilitate patients in their
family, society and workplace.

3.4 Performed Duties and Responsibilities during in agency

During my field practicum I have been assigned to some tasks and responsibilities to my
agency. During my 60 working days of field practicum in a hospital setting I applied social
work knowledge, skills, values, methods and techniques they have learned during their
academic courses. While I was placed in department of social services of Dhaka medical
college and hospital, I was assigned many duties and responsibilities from my institute
supervisor and agency supervisor and. I performed most of the duties and responsibilities that
has been stated below:

1. Every working day I have reached the agency at 8:30 AM and leave the agency after 2:00
PM as officials’ instruction of my agency supervisor.
2. During my field practicum, I completed the 60 working days of my fieldwork agency.
3. I have maintained the process recording book regularly and I have kept all my work
records in accordance with rules.
4. I attended the supervisory conference with my institute supervisor once a week. I have
listed the number of beneficiaries of those I have served.
5. I have submitted my process recording book to the agency and institute supervisor. I tried
to understand existing social service delivery systems, existing clientele systems and
problem-solving processes at micro and macro level.
6. Providing social case work services to 6 patients
7. Purchased medicine from the drug house and distributed to more than 200 patients in
several wards at the hospital.
8. I used to visit different wards, units and departments of the hospital regularly to know the
condition of the patients I solved psycho-social complexities to provide psychosocial
support.
9. Collecting data about the social, economic condition;
10. Learning about the different unit and department of agency;

29
 11. Learning the structure, objectives, goals and programs of the agency;
12. Making follow up with full attention to the client
13. Completing some psychosocial treatment providing information to the patients about
different wards, unit and department.
14. Helping some poor patients to consult with doctors I provided cash money to some
patients for transportation cost. I helped patients in doing necessary pathological tests and
provided medicine from the medicine store to outdoor patients giving advice to the
ignorant patient in the outdoor departments.
15. Many days, I visited the outdoor patient's department (OPD) to collect information about
the coming patient in the hospital.
16. During my total working period, I have maintained good relationships with all the staff
and personnel of my agency.
I provided counseling, motivation and psychosocial support to many patients I did some
administrative tasks of my agency I regularly provided instructional services to outdoor patients
of the hospital I reviewed some related books on medical social works during my field practice I
provided material help to some patients with the help of our agency.

In my 60 working days, I have helped many patients admitted to Dhaka Medical in various ways.
Some of them are mentioned in the list below.

Seria Name Age Ward Bed Address Given Services

l no.
1 Abdul Baten 56 312 05 Cumilla Medicine

2 Wahab Mia 72 701 34 Norshingdi Medicine

3 Monira 43 602 25 Sirajganj Money

Begum
4 Kawsar Alam 39 313 02 Gazipur Medicine

5 Shahjada 26 101 13 Faridpur Money

Nayeem
6 Amir Hamja 21 601 27 Lokkhipur Money

7 Rima Akter 33 702 Ex-7 Narayanganj Money

8 Jamirun 45 418 20 Rajshahi Medicine

30
 Begum
9 Abdul 59 420 14 Panchagarh Medicine
Kashem
10 Maimuna 22 PICU 07 Pabna Medicine
Akter days
11 Habibullah 3mon 209 05 Hobiganj Medicine
ths
12 Easin 6 303 25 Bogra OT Instruments

13 Fatema Akter 32 Burn 02 Dhaka Money

HDU
14 Sharif Morol 43 701 34 Gopalganj Money

15 Rasel Mia 31 602 20 Mymansing Medicine

h

16 Mst Zayeda 40 418 X1 Netrokona Case History

17 Suleman Mia 55 312 23 Dhaka Medicine

18 Hamida 43 504 12 Brahmanbar OT Instruments

Akter ia
19 Nornabi 33 312 03 Sirajganj Medicine

20 Md Hanif 37 601 45 Tangail Money

21 Shawon 21 502 23 Rangpur Medicine

Mridha
22 Nipu Gosh 23 701 33 Cumilla Money

23 Shamima 43 Chemo Feni Medicine

Akter Outdoo
r
24 Monti 23 313 21 Khagrachari Medicine
Tripura
25 Obaidul 43 115 05 Khulna Medicine
Hoque

31
26 Hamidul 29 204 12 Brahmanbar Medicine
Huda ia
27 Rehena Akter 63 502 43 Chittagonj Medicine

28 Shimu 42 419 04 Bagerhat Money

Begum
29 Farjana Akter 33 319 05 Dhaka Money

30 Ratul Ahmed 24 702 46 Dhaka Medicine

31 Kashem Mia 65 200 12 Narayanganj Medicine

32 Mainuddin 50 ICU 06 Kishorgonj Medicine

Mia

33 Sabbir 29 312 13 Dhaka Blood

Ahmed

34 Tarabanu 56 801 29 Jenaidah Case History

Begum
35 Nurnahar 44 802 44 Natore OT instruments
Begum
36 Asif Molla 41 205 09 Norail Wheelchair

37 Shahen Alam 43 115 05 Kustia Medicine

39 Arman 32 601 34 Dhaka Medicine

Ahmed
40 Abdur Rouf 26 702 EX- Khulna Money
10
41 Fahmida 33 319 23 Gaibandha Medicine
Akter
42 Salma 54 503 12 Pirozpur Medicine
Begum
43 Monir 42 303 30 Rajshahi Medicine
Hossain
44 Shimul 27 312 08 Bogra OT Instruments
Ahmed

32
45 Harun 76 305 15 Sherpur Medicine
Munshi
46 Kamrul 43 308 13 Cumilla Medicine
Hasan
47 Nirobn 2 209 35 Dhaka Money

48 Maliha 4 206 26 Faridpur OT Instruments

49 Tonima 6 209 34 Mowlovibaz Money

ar
50 Robiul 43 108 15 Lokkhirpur Medicine
Ahmed
51 Kamrunnahar 54 109 45 Norshingdi Money
Begum
52 Sabina Akter 33 419 35 Rongpur Medicine

53 Rinvi Rani 24 519 23 Bagerhat OT Instruments

54 Ikbal Ahmed 55 602 33 Manikganj Medicine

55 Jewel Sheikh 45 702 43 Rajbari Medicine

56 Ritu Akter 23 503 56 Jhalokathi Medicine

57 Munni 34 505 09 Brahmanbar Medicine

Begum ia
58 Irin Akter 40 504 07 Dhaka OT Instruments

59 Munim 28 601 23 Cumilla Medicine

Hasan
60 Rifat Ahmed 32 418 45 Sylhet Money

61 Mehedi 35 312 01 Dhaka Medicine

Hasan
62 Alamgir 29 312 03 Sirajganj Case History
Hossain
63 Shamim Mia 23 109 13 Narayanganj Money

33
64 Alauddin 65 115 32 Borguna Medicine
Khan
65 Shobuj Mulla 46 200 29 Rajbari Medicine

66 Farida 74 108 23 Sherpur Money

Begum
67 Easmin Akter 33 503 26 Chandpur Money

68 Rakib Ahmed 15 303 05 Gaibandha Medicine

69 Selim Mia 46 313 18 Dhaka Medicine

70 Tonni Rani 27 702 21 Panchagarh Medicine

71 Moyna Barua 46 419 24 Dhaka OT Instruments

72 Shejeda 68 520 26 Feni Medicine

Begum

73 Ruman 33 418 12 Chittagong OT Instruments

74 Syeda Era 24 503 18 Brahmanbar Medicine

ia
75 Esmatara 35 200 20 Natore Medicine
Begum
76 Saidul Hoque 44 101 23 Pabna Medicine

77 Golap Mia 30 602 45 Rongpur OT Instruments

78 Modhu Pal 56 602 47 Nuakhali Medicine

79 Sanjay 34 520 21 Sylhet Medicine

Malakar
80 Asma Akter 34 419 13 Bogra Medicine

81 Osmam Goni 35 642 42 Patuakhali Case Hiatory

82 Shiba 57 305 19 Brahmanbri Medicine

Bormon a

34
83 Asad Ahmed 72 305 20 Feni Medicine

84 Raisul Islam 33 313 14 Sirajganj Money

85 Mamun MIa 46 601 54 Lokkhipur Medicine

86 Shimu 32 702 33 Pabna Medicine

Begum
87 Runa Akter 26 504 27 Chandpur Medicine

88 Ashraful 44 313 44 Dhaka Case History

Alam
89 Falguni 28 504 13 Narayanganj OT Instruments
Karmakar
90 Kadu Mia 77 802 43 Cumilla Money

91 Rahman MIa 74 502 12 Sylhet Medicine

92 Jerin Akter 18 419 10 Munshiganj Money

93 Alim khan 43 702 05 Pabna Medicine

94 Hamid Mia 47 115 08 Cumilla Medicine

95 Robin 25 204 23 Faridur OT Instruments

Hossain
96 Rafi Ahmed 28 101 17 Hobiganj Money

97 Farzana 30 200 13 Feni OT Instruments

Akter
98 Kripa Das 34 109 19 Cox'sbazar Medicine

99 Selina Akter 57 108 18 Sylhet Medicine

100 Ibrahim 67 602 46 Dhaka Medicine

Khalil

35
3.5 Conclusion
Social work is a helping profession which fundamentally and radically aims to assist the
individuals, groups and community to cope with their complex socio-economic and
psychological problems through enabling themselves so that they can solve their problem by
helping themselves. It is a professional and academic discipline that seeks to improve the quality
of life and subjective well-being of individuals, families, couples, groups, and communities
through research, policy, community organizing, direct practice, crisis intervention, and teaching
for the benefit of those affected by social disadvantages such as poverty, mental and physical
illness or disability, and social injustice, including violations of their civil liberties and human
rights. The profession is dedicated to the pursuit of social justice and the well-being of oppressed
and marginalized individuals and communities.

36
 CHAPTER FOUR
Application of social work knowledge, methods, techniques and
approaches

4.1 Introduction
Social work is a helping profession which aim is to help the individuals, groups and
community to cope with their problems through enabling them so that they can solve their
problems by themselves. It, in modern times, is a profession subject which has two facts-
theoretical and practical. Theoretical education is confined within the classroom only whereas
practical side rings students out of the classrooms and engages them in actual practice field.
This practical side of social work education is called fieldwork practice. Simply, fieldwork is a
way of getting social work students used to with the diver’s fields of social work interventions.
This orientation takes place at various social services agencies where students become engaged
with a variety of actions and programs of these agencies, aiming at providing services to their
clients. It is worth noting that the activities of the students at their respective agencies are
educationally directed and supervised by a professional social worker. It is considered as a
critical component of social work education, and it is in the field that academic knowledge,
values, ethics and skills are integrated with real world experience in a planned way to produce
component social workers.

4.2 Application of social work Knowledge & principles in field work

As a trainee social worker, I have used social work knowledge & principles in the problem-
solving process:

 Principles of Acceptance
 Principles of Communication
 Principles of Participation
 Principles of Confidentiality
 Principles of self-determination
 Principles of self-awareness
 Principles of individualization (Hossain and Alauddin, 1970)

I have applied these principles to solve the problems of my clients. I have used the Principles of
Acceptance in the level of first impression with the client every time. I tried to welcome them
with a smile and friendly behavior. Using the Principle of Communication I was able to

37
communicate with the client and I have given them the opportunity to communicate with me, so
that their problems could come into bud. I have encouraged the client to participate in their
problem-solving process and ensure the right of self-determination in their problem-solving
process. Thus, I have used both the Principles of Participation and self-determination. Ensuring
them that their Personal Information is completely safe and remains untold and will only be used
in departmental use, I must use the Principle of Confidentiality. Besides these I have also
followed the Principles of Individualization and Principle of Self Determination. I have tried to
apply Principles of Self- Awareness also. "A person with a problem comes to a place where a
professional representative helps him by a given process" the popular words of Pearlman (1988)
be in my mind every moment of my job as a social worker, whenever I depart to use social case
work for solving the problem of my client's problem.

4.3 Application of Social Work Methods

Scientific social work today has emerged as a problem-solving profession. Compared to other
disciplines, professional social work is relatively young. This profession helps individuals,
groups and communities to find solutions for their problems. Finding solutions to problems
enhances the quality of life and fosters development.

I have to do all my assigned duties during the field work practice and tried to make the case
studies in a disciplined way by the help of social work methods and techniques. I have handled
the cases with the help of the basic methods of social case Work that means Psycho-social
Study, Diagnosis, Treatment, evaluation and Follow-up. Besides these, I practice the basic and
auxiliary methods of social work too. The total values, principles, code of ethics & methods I
have practiced from the beginning to the end in my field work practicum are in the following
manners.

Primary Method
Social case work has three types of primary methods in problem solving process.
1. Social case work
2. Social group work.
3. Community work.

In my field practicum, I have got a scope to use social case work method. Social case work is a
primary method of social work. It is concerned with the adjustment & development of individuals
towards more satisfying relations in different situations. Short descriptions about social case
work are given below;

38
Social Casework
Social casework has been defined by different social scientists from different aspects. Such as
According to Warner Bohem “Social casework is a method of social work which intervenes in
the psycho-social aspects of a person’s life.

1. To Improve
2. To Restore
3. To Maintain
4. To Enhance

His social functioning by improving his role performance.”

Marry Richmond says that “Social casework may be different as the art of doing different thing
with different people cooperating with them to achieve some of their own and society’s
betterment.”
According to W. A. Friedlander, “Social case work which helps to individual’s client to effect
better social relationship and a social adjustment that makes it possible for him to lead a
satisfying and useful life.”

According to H. H. Perlman, “Social case work is a process by some human welfare agencies to
help individuals to cope more effectively with their problems of social functioning.”

According to Linton B. Swift, “Social case work is the art of assisting the knowledge in
developing and making use of his personal capacity to deal with his problems which he faces in
his social environment.”

The above definitions reveal the fact that social case work is related to the psycho social
treatment of the client who is in problem and seeks the help of case worker or problem solving
agencies. Social case work establishes adjustments between individual capacities and resources.
It consists of the study of mental, emotional and social factors. In social case work an individual,
group situation or phenomena is recognized as a unit of study and various units are studied
properly.

Objectives of Social Casework

There are some objectives of social casework. These are as follow-
1. To make good rapport with the common people.
2. To find out and understand and solve the internal problems of individuals.
3. To strengthen one's ego power.
4. To prevent problem

39
5. To develop internal resources.
6. To restore social functioning
7. To compensate psychological damage
8. To create opportunities for growth and development.

Elements of social casework

About the elements of social casework, Helen Harris Perlman says that, “A person with a
problem comes to a place where a professional representative helps him by a given process”. It is
known as the 5P's theory. According to this definition, there are five elements of social casework.
These are-

1. Person
2. Problem
3. Place
4. Professional representative
5. Process
Process of Social Casework
Process means a series of actions. But in the social casework practice, process refers to a series of
actions which are taken with a view to helping the clients and to solve the problems. But this
doesn’t mean that all the problems of the clients can be solved by the case worker. A caseworker
selects the problem-solving process by observing the client's motion, emotion, desires and
abilities. If he cannot find out or select the problem-solving process for the client, then he can
refer him to others. In problem solving process, there are five phases.
Intake
Intake is an administrative procedure and not a process of social casework to take in the person
with a problem, for example admitting him or enrolling him as a client of the agency. After this
phase the case worker can assess the needs and problems of the applicant person and how and
where his needs can be best met.

Psycho-social study
Social investigation is a psycho-social process. It is the initial phase in which the worker gains
his first understanding of the kind of help his client’s needs. The worker must understand what
the client sees his problem as, what he think can be done about it, what he himself/herself tried
to do about it, and what are the reasons the client has identified for his present difficulty.
Perlman has given the following contents of the case work study in the beginning phase:

 The nature of the problem

 The significance of this problem
40
  The causes of the problem.
 The efforts made to cope with problem solving
 The nature of the solutions or ends sought by the case work agency.
 The actual nature of the agency and its problem-solving means in relation the client and
his problems.

Assessment
Based on the study of the problem in its past, present and future setting and the client’s positive
and negative reactions and interactions, the internal pressure and environmental factors the case
worker assess or diagnose the client’s problematic situation. Diagnosis is an explanation
formulated in the light of known fact.

Types of diagnosis
Perlman has described three types of diagnosis that is carried on in social case work process.
These are:

 Dynamic diagnosis
 Clinical diagnosis
 Etiological diagnosis

Treatment plan
The process of intervention or treatment begins with initial contact with the client. The process of
treatment passes through many phases i.e.

 Initial phase
 Motivation and role induction
 Primary contract
 Diagnosis and assessment
 Establishing treatment goals
 Developing
 Preparation for actual treatment
 Treatment in practice
 Monitoring and evaluating the effects of treatment and
 Planning of follow up termination of therapeutic relationship.

Evaluation
In social case work evaluation is the process in which worker tries to find out the effectiveness
and success of the process. It is an activity which shows whether the social case work process has

41
active the desired goals or not. Social case worker evaluates the connection of the program and
its effectiveness inner strength gained by the client and the success of himself in helping the
client.
Termination and Follow-up
Here termination means ending the process of social case work intervention process. The
termination process is decided mutually by client and counselor. Termination is the stage when
the worker has the confidence in the client ability to cope with the present and future situation.

Social group work

Hussain & Alauddin (Introduction to Social Work Method), Social group work is a method of
social work that attempts to reduce or eliminate blockings that hamper the smooth interaction
among the group members.

According to Konopka,1963, “Social Group Work is a method of social work which helps the
individuals to enhance their social functioning through purposeful group interaction and cope
more effectively with their personal, group or community problems."

Through this group work method, I have provided services to clients. I have given group
counseling to the clients about living a healthy life, eating nutritious food. I have motivated
them to give medicine to their children.

Components of Social Group work

 The group member

 Social group work agency
 The group worker
 The social group work process

Principles of social group work

a. Principle of planned group formation

b. Principle of specific objectives.
c. Principle of worker-group relationship
d. Principle of individualization
e. Principle of self-determination
f. Principle of flexible functional organization
g. Principle of progressive program
h. Principle of resource utilization

42
i. Principle of evaluation.

Community social work

Community social work is about encouraging people to discover their resources and possibilities
to work for positive change in their community. People have the right to participate in decision
making processes that affect them.

According to BARCLAY, "Community social work is a basic method of social work which starts
from problems affecting individual or groups, the responsibilities and resources of social work
departments and informal organizations, it seeks to support, enable and formal and informal
relationships.

In the words of Murry G. Ross,"Community organisation is a process by which a community

identity its needs or objectives, orders these needs or objectives, develops the confidence and
will to work at these needs or objectives, finds the resources to deal with these needs or
objectives, takes action in respect to them, and in so doing extends and develops cooperative
and collaborative attitude and practices in the community.

Social work with community is a generalist practice method that enables individuals and groups
to achieve a more desirable level of life satisfaction as well as more effective levels of
adaptation.

Nature of community social work

 It fights against poverty and social exclusion
 It aims to include service users as full and active citizen
 It challenges discrimination by race, disability, age, religion, Gender and sexual
orientation.
 It is about people working together.
 It promotes participation in decision making and gives people more power.
 It works to prevent problems.
 It encourages people to learn skills and knowledge and confidence through taking actions.
 It supports joint work. Action can range from individual self-help to lobbying and
campaigning.
 It supports joint work. Action can range from individual self-help to lobbying and
campaigning.

Elements of community social work

1. Community

43
2. Needs of community
3. Representative and
4 Process

In my field practicum, I have got a scope to use social case work method, social group work
method and community organization method. These are primary methods of social work.

4.4 Application of Social work Techniques in performing field work

During field work I have applied some methods and techniques of social work. Those are given
below-

1. Case study
This is a kind of qualitative analysis. I used this method to collect in-depth data about the clients
and to explore the prevailing situation of their daily life. Case study is the process of
psychosocial study of a case that is affected by various psychosocial problems.

2. Interviewing
Through face-to-face interviews, I collected data, facts and information concerning their
problems for diagnosis and treatment. Interview is the process to collect information about a case
for diagnosis and treatment plan.

3. Observation
Following this technique, I observed and took notes on their physical expression such excitability,
cheerfulness, gloom and frustration as well as sulky situation through participation. Sometimes I
followed his/her psychological conditions to find out problems.

4. Listening
To know the problem of the client deeply, I did let them speak first. Then I talked. I followed the
technique due to facilitate the clients to be free in speaking and express their grievances to me
frankly. I am always trying to listen to their problems in interviews and home visits.

5. Questioning
To obtain specifically necessary information and to lead the client’s conversation from pointless
to fruitful channels, sometimes questioned them. I ask them again and again for accurate
information. This question must be relevant to the client.

6. Psycho-social assessment
Psycho-social assessment is important for case study. It started with an interview and continued
to problem solving. I follow the case history and I finding out psycho-social problem. It was
completed 60 working days.

44
7. Document Analysis
Document Analysis is the process of secondary source of information. Previous reports records
are important for document analysis. It’s the process of information collecting. It helps the social
worker to draw investigation. I am collecting some documents from this agency.

Application of social work Approaches

I have to do all my assigned duties during the field work practice and tried to make the case
studies in a disciplined way by the help of social work approaches. I have handled the cases
with the help of the basic approaches of Social case Work. Approach a process that helps us to
explain the motivating forces behind human behavior and impact of social values & socio
cultural practices. Approaches used in case work are mentioned as follow:

1. Psycho Analytical Approach

This approach is based on analytical thinking and concept. The founder of psychoanalytic
Approach was Sigmund Freud. While his theories were considered shocking at the time and
continue to create debate and controversy, his work had a profound influence on a number of
disciplines, including psychology, sociology, anthropology, literature, and art. The term
Psychoanalysis is used to refer to many aspects of Freud’s work and research, including Freudian
therapy and the research methodology he used to develop his theories. Freud relied heavily upon
his observations and case studies of his patients when he formed his theory of personality
development. Sigmund Freud developed this approach to study important role played by
unconscious process in behavior.

2. Behavioral Modification Approach

The behavioral perspective arose in the early twentieth century as a reaction against the
unscientific methods of psychoanalysis. Behavioral psychologists believed that the study of
subjective experience did not provide acceptable scientific data, because such observations were
not open to verification by other investigators. In their view, only the study of directly observable
behavior and the stimuli and the reinforcing conditions that control it could serve as a basis for
understanding human behavior, normal or abnormal.

The behavioral perspective is organized around a central theme: the role of learning in Human
behavior. Although this perspective was initially developed through research in the laboratory
rather than through clinical practice with disturbed individuals, its implications for explaining
and treating maladaptive behavior soon became evident. Learning is any relatively permanent
change in behavior, or behavior potential, produced by experience. Learning is a key process in
human behavior.

45
3. System Approach
System theory was postulated by Ludwig Von Bertalanffy, a biologist, to describe a
comprehensive model to understand the living system. Application of system theory to social
work practice comes from Pincus and Minahan. This system theory of social work become
popular and reached its height with the inclusion of this theory in the publication of Major
American Textbook by Howard Goldstein in 1973.This text was widely used for social case work
training course. The system approach of social case work is based on social system theory. A
system was defined by Von Bertalanffy (1968) as “a complex of interactive elements”. In a more
lucid way, a system “a system is a complex whole made of components parts in mutual
interactive relationship to other parts.” system means a set of elements, mutual relationship,
functional as whole purposeful act and same goal.
This approach is useful in social work practice in the following ways: -
It helps social workers perceive a better understanding of the social environment. 2.It helps identify
practice principles that apply across different contexts.
It can help integrate social work theories and unify the profession.
In this approach we assess the relationship pattern of the member of sub system as well as member of
supra system. Function of system and communication pattern of each member of system & assessment of
the functional structure of the system.

4. Psychosocial Approach
This approach has great contribution on psychosocial study of the person and psychosocial
treatment. It was one of the first models to be developed and applied to practice of social case
work. Its psychological origin dates back to 1920’s when psycho analytical principal and theory
were incorporated into the then largely sociological approach of case work(Medical Approach of
Mary Richmond). Essentially this approach has Freudian theory base modified and adapted for
the use of social work practice. So this approach is developed by Garden Hamilton and Florence
Hollis. The theory of Garden Hamilton was known as “Diagnostic Approach “ the philosophy of
Social case Work in 1941 in which word Diagnostic was used to Expressed psychosocial problem.

5. Problem Solving Approach

In this approach, social worker does not attempt to solve the client’s problem, as problem are
believed to be able to solve only by the person who is experiencing it. So, role of social worker is
to reinforce existing resources within the client’s own personality and his environment, both
human and materials, so that the person may solve own problem. There is an assumption of
human competence to solve their own problem. The relationship between social worker and the
client is the major medium of helping, with this relationship the person with problem is supported
and nurtured , and can experienced respect , acceptance ,empathy and carrying with this
relationship the client’s motivation and confidences increased to solve the problem. Pearlman

46
saw casework as process, problem solving process. In that process the relationship between case
worker and client was essential to the movement or work to problem solving .the professional
relationship was perceived as being purposeful, accepting, supportive &Nurturing. According to
Pearlman, the process of helping consist of 4 interrelated elements, known as 4Ps, person,
problem, place, process.

6. Functional Approach
The origin and development of functional approach are attributed to the School of Social Work,
University Of Pennsylvania, Jessie Thaft and Virginia Robinson is the pioneers of this theory. A
functional approach developed out of a growing negative reaction of the mainstream of social
work caught up in psychoanalytic thought.

4.5 Conclusion
Social work in its theoretical aspects is based on the knowledge of human relations with regard
to the solution of psychosocial problems. In its applied aspect, social work is a professional
service based on scientific methods and skills. In the field of social sciences, social work
occupies a very important role. Every social problem is the outcome of many external and
internal factors. Therefore, when dealing with the individual's problems, it is essential to deal
with his experiences and reactions towards the problems. Besides, proper recognition of the
individual is also essential with regard to the solution of a problem. Therefore, in the field of
social work, the main task of social worker is to develop the self-direction and self-dependence
of an individual. In social case work an individual, group, situation or phenomena is recognized
as a unit of study and various aspects of the units are studied properly.

47
 CHAPTER FIVE
Presentation of Selected Case Studies
5.1 Introduction
Case study is a problem-solving process. Through case study in filedwork we understand the
problem of a person and solve the problem. Case-study analysis is a crucial part of field
practicum. I worked as a social worker at the Department of Social Services in Dhaka Medical
College Hospital. In my field practicum, I encountered various types of cases. Selected case
studies
Here I present 5 conducted case studies.

5.2 Case Profile – 01

Background of the Case
The client’s name is Mst Zayeda. She is a 40years old illiterate woman who lives in a remote
village of Netrokona with her family. Her right hand swelled from rheumatic fever and later
developed an infection. Her husband Md Selim brought her to the DMCH and admitted in Burn
unit of DMCH. Then her hand had to be amputated. When I went to her ward to give medicine to
her, I found that her physical and mental condition was very bad. Then I took her as my case.

Patient's Profile

Personal Information of the Patient

Name Mst Zayeda
Age 40 years

Sex Female

Marital Status Married

Father/Husband’s Name Md Selim
Mother’s name Amena Khatun
Education N/A

Profession Housewife

Address Nandanagar, Kalikapur, Durgapur, Netrokona.

48
 Hospital Related Information
Problem Diagnosis Hand Infection

Department Burn and Surgery

Bed No X1
Ward 418 (Unit- Orange)

Registration no 4027\05
Admission Date 28/12/2023
Case Recording Date 15/01/24
1st Interview 15/01/24

2nd Interview 18/01/24

3rd Interview 23/01/24

4th Interview 29/01/24

Case Termination 07/02/24

Supervisory Doctor Dr. Md Mahfuzur Rahman.

Family Related Information

SL Name Age Education Profession Relation

No

1 Md Selim 49 Illiterate Farmer Husband

2 Mst Monira 25 SSC Housewife Daughter

3 Mst Masuma 23 SSC Housewife Daughter
4 Mst Marium 20 SSC Student Daughter

History of Illness
Three months ago, Zayeda suddenly got rheumetic fever. Her right hand was swollen from
rheumatic fever, then she was admitted to Mymensingh Medical College Hospital. The situation

49
worsens there, the hand rots due to infection. She was then shifted to Dhaka Medical College
hospital and later her hand had to be amputated.

The Rationale of Taking Case.

The first time I met Zayeda, she was very serious. I talked with her and her husband. After
talking with them I realized that the patient’s physical and mental condition is so critical because
her right hand had to be amputated. Their financial condition is also critical. Because the patient
has no son, and her husband is a farmer and it’s not possible for him to bear the hospital expenses
and family costs as well. Because of the above critical condition, I decided to take her as a case.

Rapport buildup
Rapport build-up is so important before commencing planned treatment because collecting deep
information and giving effective problem solutions to clients is impossible without establishing
rapport as an apprentice social worker. I used the following techniques for establishing rapport.

 Acceptance: I accepted Zayeda giving her full dignity and respect. I gave assurance to
solve her problem. As a result, she also accepted the giving importance.
 Communication: I maintained regular communication with Zayeda and her family
members and tried to understand her needs and information about the problem.
 Participation: Establishing rapport is impossible without ensuring the participation of
the client in the problem-solving process. So, I ensured participation of Zayeda in every
step of the problem-solving process.
 Confidentiality: I assured Zayeda to hide all her information, as a result, she believed me
fully and she promised that she didn’t hide any information in her life.
 Individuality: I knew all clients are individuals. Their problem, patterns of problems,
causes of the problem, solution process, expectation, etc. are iterant from others. So, I
applied the individuality principle for establishing rapport with Zayeda. I tried to solve
her problem according to real findings and her needs.
 Self-confidentiality: Every client has their own view and wants to ensure those needs. So,
I tried to ensure Zayeda helps me to establish rapport.

Psycho-social Study
In social casework psycho-social study is a very important phase. As an apprentice social worker
to know details information about Zayeda I complete a Psycho-social study.

In this stage, I can apply some techniques. This technique is given below-

50
Interview: The interview is the main way to collect client information. To complete the
interview I went to my patient Zayeda’s ward and follow some steps for a fruitful interview-
During staying time of Zayeda in Dhaka Medical College and Hospital made her 4 interviews
during my working days.

1st interview: This was the first day of Zayeda and my interview. Today her physical and
mental condition was not normal. I had to talk with her husband and I talked with him for a few
minutes. I tried to give mental support.

2nd interview: On this day, I saw that physical condition of Zayeda was not so much improved,
and mental condition also. So, I helped to remove her mental depression and gave some advices.

3rd interview: On this day, physical condition of Zayeda was improved but mental condition
was not so much improved. She was very much tensed about her hand and family condition.
Because the condition of her family is getting worse due to her condition. So, I tried my best to
counsel her.

4th interview: On this day, Zayeda’s physical and mental condition was fine. I provided her
different kinds of information related to her treatment. I advised her to follow the rules and
regulations which were given by the assigned doctor.

Source of collecting data:

I collected data from both primary and secondary sources.

1. Primary Source:
 Client herself
 Client’s husband
 Client’s Children

2. Secondary Source:
 Hospital Documents
 Doctor

Physical Condition
Zayeda was facing some physical complexities due to the side effect of the medicine. For
example, dizziness, weakness, unable to move.

Mental Condition:

51
She was mentally weak and depressed. Her disease was stressful for her as she was unable to lead
a normal life. Besides, she was tensed about his family members as well.

Economic condition:
The economic condition of Zayeda’s family is not so good. Her husband is the only earning
member of her family. Her husband’s economic status is given bellow-

Profession Farmer

Monthly Income 10000/-

Personal Property Poor
Family property Poor
Ability of Treatment Disabled

Helping Relatives Absent

Social Condition:
The client belongs to an insolvent family. But she and her family have a good relationship with
neighbors, and relatives. So, considering the patient’s overall condition, it can be said that her
social status was good. My patient was very upset and worried about her present problems.
Assessment of Problem:
From my interview as well as the hospital’s documents, I got some problems with my client. I
also talked to the duty doctor, and he told me the whole problem and I noted down those
problems. Such as-

 Physical illness;
 Financial crisis;
 Breakdown mentally;
 Hopelessness;
 Frustration;
 Mental depression;

Social work intervention of the problem:

 I helped to get 3000/- TK from the hospital social service office for buying medicine;
 I helped her to get 2 Albotin which is 14800/- TK from the hospital social service office;
 Establishing regular communication and counseling;
 Helped her to take medicine regularly;

52
  Provided mental support to the patient as well as her family;
 Tried to increase awareness among the patient family members

Evaluation
I am an apprentice social worker so basically, I tried to apply my classroom knowledge to solve
Zayeda’s mental problem. She contacted me cordially. So, it was possible to look after her to
come around quickly. It was also possible within a few days. I tried to help her from myself with
the help of my agency. So, they were grateful to me for my assistance.

Follow-Up
During the case study week, I visit my client every day from 15-01-2024 to 07-02-24. I talk to
my client’s husband about my client’s illness. Then I assured my client that there is no matter to
worry about and that she will be alright after taking medicine.

5.3 Case Profile - 02

Background of the Case

My client's name is Tarabanu, a 56years old women who lives in Jenaidah with her family. She
has been suffering from thalassemia for the last 5 years. My patient Tarabanu’s condition
decreases day by day. So, her son Akbar Mia came to Dhaka Medical College and Hospital and
admitted her. When I went to her ward to give medicine to her, I found that her physical and
mental condition was very bad. Then I took her as my case.

Patient's Profile
Personal Information of the Patient
Name Tarabanu Begum

Age 56years
Sex Female
Marital Status Widowed
Father/Husband’s Name Badshah Mia

53
 Mother’s name Rehena Akter
Education N/A
Profession N/A
Address Karaigachi, Bishakhali, Jenaidah

Hospital Related Information

Problem Diagnosis Thalassemia

Department Hematology

Bed No 29
Ward 801 (New building)
Registration no 3585\205
Admission Date 06/01/2024
Case Recording Date 16/01/24
1st interview 16/01/24

2nd Interview 20/01/24

3rd Interview 24/01/24

Case Termination 01/02/24

Supervisory Doctor Dr. MA Mamman

Family Related Information

SL Name Age Education Profession Relation
No
1 Akbar Mia 40 Primary Rickshaw Son
Puller

54
 2 Khadiza Akter 32 Primary Housewife Daughte
r in law
3 Tamanna 12 Class-5 Student Grand
daughter
4 Rakib 9 Class-3 Student Grand son

History of Illness
Five years ago, Tarabanu fell ill suddenly, she was then taken to jessore Medical and diagnosed
with thalassemia and continued treatment in her house. As Tarabanu’s condition worsened for
the few days, her son brought her to Dhaka Medical and admitted at the hematology department.

The Rationale of Taking Case.

The first time I met Tarabanu, she was very serious and weak. I talked with her and her son||
After talking with them I realized that the patient’s physical and mental condition is so critical.
Their financial condition is also critical. Because the patient has a son, and he is a rickshaw puller
and it’s not possible for him to bear the hospital expenses and family costs as well. Because of
the above critical condition, I decided to take her as a case.

Rapport buildup
|Rapport build-up is so important before commencing planned treatment because collecting deep
information and giving effective problem solutions to clients is impossible without establishing
rapport as an apprentice social worker. I used the following techniques for establishing rapport.

 Acceptance: I accepted Tarabanu giving her full dignity and respect. I gave assurance to
solve her problem. As a result, she also accepted the giving importance.
 Communication: I maintained regular communication with Tarabanu and her family
members and tried to understand her needs and information about the problem.
 Participation: Establishing rapport is impossible without ensuring the participation of
the client in the problem-solving process. So, I ensured participation of Tarabanu in every
step of the problem-solving process.
 Confidentiality: I assured Tarabanu to hide all her information, as a result, she believed
me fully and she promised that she didn’t hide any information in her life.
 Individuality: I knew all clients are individuals. Their problem, patterns of problems,
causes of the problem, solution process, expectation, etc. are iterant from others. So, I

55
 applied the individuality principle for establishing rapport with Tarabanu. I tried to solve
her problem according to real findings and her needs.
 Self-confidentiality: Every client has their own view and wants to ensure those needs. So,
I tried to ensure Tarabanu helps me to establish rapport.

Psycho-social Study
In social casework psycho-social study is a very important phase. As an apprentice social worker
to know details information about Tarabanu I complete a Psycho-social study.

In this stage, I can apply some techniques. This technique is given below-

Interview: The interview is the main way to collect client information. To complete the
interview I went to my patient Tarabanu’s ward and followed some steps for a fruitful
interview- During staying time of Tarabanu in Dhaka Medical College and Hospital made her 3
interviews during my working days.

1st interview: This was the first day of Tarabanu and my interview. Today her physical and
mental condition was not normal. I had to talk with her son and I talked with him for a few
minutes. I tried to give mental support.

2nd interview: On this day, I saw that the physical condition of Tarabanu was not so much
improved, and mental condition also. So, I helped to remove her mental depression and gave
some advice.

3rd interview: On this day, Tarabanu’s physical and mental condition was fine. I provided her
different kinds of information related to her treatment. I advised her to follow the rules and
regulations which were given by the assigned doctor.

Source of collecting data:

I collected data from both primary and secondary sources.
1. Primary Source:

 Client herself
 Client’s son
2. Secondary Source:

 Hospital Documents
 Doctor

Physical Condition|

56
She was facing some physical complexities due to the side effect of the medicine. For example
dizziness, weakness, unable to move leg and hands easily. Then she was referred to a neurologist
for this problem.

Mental Condition:
She was mentally weak and depressed. Her disease was stressful for her as she was unable to
lead a normal life. Besides, she was tensed about his family members as well|

Economic condition:
The economic condition of Tarabanu’s family is not so good. Her son is the only earning member
of her family. Her husband’s economic status is given bellow
Profession Rickshow Puller

Monthly Income 13000/-

Personal Property Poor
Family property Poor
Ability of Treatment Disabled
Helping Relatives Absent
|
Social Condition

The client belongs to an insolvent family. But she and her family have a good relationship with
neighbors, and relatives. So, considering the patient’s overall condition, it can be said that her
social status was good. My patient was very upset and worried about her present problems.

Assessment of Problem:
From my interview as well as the hospital’s documents, I had some problems with my client. I
also talked to the duty doctor, and he told me the whole problem and I noted down those
problems. Such as-

 Physical illness;
 Financial crisis;
 Breakdown mentally;
 Hopelessness;
 Frustration;
 Mental depression;

57
Social work intervention of the problem:|
 I helped to get 4500/- TK from the hospital social service office for buying medicine;
 I helped her to get 3 bags of blood from the hospital social service office;
 Establishing regular communication and counseling;
 Helped her to take medicine regularly;
 Provided mental support to the patient as well as her family;
 Tried to increase awareness among the patient family members

Evaluation

I am an apprentice social worker so basically, I tried to apply my classroom knowledge to solve

Tarabanu’s mental problem. She contacted me cordially. So, it was possible to look after her to
come around quickly. It was also possible within a few days. I tried to help her by myself with
the help of my agency. So, they were grateful to me for my assistance. As an apprentice social
worker, I’ve tried to use social work’s knowledge, skills and values to minimize the client’s
problem and make her able to solve her problem on her own. The client is much better than the
first day and improving every other day. Her son and family members were more careful about
her than before.

Follow-Up]

During the case study week, I visit my client every day from 16-01-2024 to 01-02-24. I talked to
my client’s husband about my client’s illness. Then I assured my client that there was no matter
to worry about and that she would be alright after taking medicine.

5.4 Case Profile - 03

Background of the Case

Alamgir Hossain a 29years old man who lives in Sirajganj. He was an Imam of a Mosque. For
the last few months, he has been suffering from oral cancer. His brother Md Shaheen brought
him to the Dhaka Medical College Hospital and admitted him. When I went to his ward to give
medicine to him, I found that his physical and mental condition was very bad. Then I took him
as my case.|

Patient's Profile

58
Personal Information of the Patient
Name Alamgir Hossain
Age 29years
Sex Male
Marital Status Married
Father/Husband’s Name Jelhak Ali
Mother’s name Ismatara Begum
Education Fazil
Profession Imam
Address Aknadighi, Sirajganj, Sirajganj

Hospital Related Information

Problem Diagnosis Oral Cancer

Department Oncology

Bed No 03
Ward 312 (Old building)
Registration no 8210\06
Admission Date 02/01/2024
Case Recording Date 18/01/24

1st interview 18/01/24

2nd Interview 22/01/24

3rd Interview 27/01/24

4th Interview 30/01/24

Case Termination 08/02/24

Supervisory Doctor Dr. Md Saidul Islam

59
Family Related Information

SL Name Age Education Profession Relation

No
1 Jelhak Ali 52 Primary Farmer Father

2 Ismatara 45 Primary Housewife Mother

Begum

3 Tahmina 22 SSC Housewife Wife

Akter
4 Fahmida 03 -- -- Daughter

5 Arman 01 -- -- Son

6 Md Shaheen 25 Honours Student Brother

History of Illness|
A few months ago, Alamgir got a wound inside his mouth. Then he brought medicine from the
village pharmacy and started using it, but the wound was not reducing. At some point it turned
into an infection. Then when his condition worsened, he was brought to Dhaka Medical College
OPD. The doctor gave him some tests after he was diagnosed with oral cancer. Then he was
admitted to Dhaka Medical College Hospital.

The Rationale of Taking Case.

The first time I met Alamgir, he was very serious. I talked with him and his brother.|After talking
with them I realized that the patient’s physical and mental condition is so critical. Their financial
condition is also critical because he is an Imam of a mosque, he is only earning member of his
family. His family is not able to bear his treatment cost. Because of the above critical condition, I
decided to take him as a case.

Rapport buildup|
Rapport build-up is so important before commencing planned treatment because collecting deep
information and giving effective problem solutions to clients is impossible without establishing
rapport as an apprentice social worker. I used the following techniques for establishing rapport.

 Acceptance: I accepted Alamgir giving his full dignity and respect. I gave assurance to
solve his problem. As a result, he also accepted the giving importance.

60
  Communication: I maintained regular communication with Alamgir and his family
members and tried to understand his needs and information about the problem.
 Participation: Establishing rapport is impossible without ensuring the participation of
the client in the problem-solving process. So, I ensured participation of Alamgir in every
step of the problem-solving process.
 Confidentiality: I assured Alamgir to hide all his information, as a result, he believed me
fully and he promised that he didn’t hide any information in his life.
 Individuality: I knew all clients are individuals. Their problem, patterns of problems,
causes of the problem, solution process, expectation, etc. are iterant from others. So, I
applied the individuality principle for establishing rapport with Alamgir. I tried to solve
his problem according to real findings and his needs.
 Self-confidentiality: Every client has their own view and wants to ensure those needs. So,
I tried to ensure Alamgir helps me to establish rapport.

Psycho-social Study
In social casework psycho-social study is a very important phase. As an apprentice social worker
to know details information about Alamgir I complete a Psycho-social study.
In this stage, I can apply some techniques. This technique is given below-
Interview: The interview is the main way to collect client information. To complete the
interview I went to my patient Alamgir’s ward and follow some steps for a fruitful interview-
During staying time of Alamgir in Dhaka Medical College and Hospital made his 4 interviews
during my working days.
1st interview: This was the first day of Alamgir and my interview. Today her physical and
mental condition was not normal. I had to talk with his brother, and I talked with him for a few
minutes. I tried to give mental support.
2nd interview: On this day, I saw that the physical condition of Alamgir was not so much
improved, and mental condition also. So, I helped to remove his mental depression and gave
some advice.
3rd interview: On this day, the physical condition of Alamgir was improved but mental
condition was not so much improved. He was very tense about his hand and family condition.
Because the condition of his family is getting worse due to his condition. So, I tried my best to
counsel him.
4th interview: On this day, Alamgir’s physical and mental condition was fine. I provided him
with different kinds of information related to his treatment. I advised him to follow the rules
and regulations which were given by the assigned doctor.

Source of collecting data:

I collected data from both primary and secondary sources.
61
 1. Primary Source:
 Client himself
 Client’s Brother
 Client's wife (over phone)
2. Secondary Source:
 Hospital Documents
 Doctor

Physical Condition
His physical condition was not good. He was suffering from pain, irritation, dizziness etc.

Mental Condition
He was mentally weak and depressed. His disease was stressful for him as he was unable to
lead a normal life. Besides, he was tense about his family members as well.

Economic condition:
The economic condition of Alamgir’s family is not so good. He is the only earning member of his
family. His family's economic status is given bellow|
Profession Imam of a Mosque

Monthly Income 12000/-

Personal Property Poor
Family property Poor
Ability of Treatment Disabled
Helping Relatives Absent

Social Condition:
The client belongs to an insolvent family. But he and his family have a good relationship with
neighbors, and relatives. So, considering the patient’s overall condition, it can be said that his
social status was good. My patient was very upset and worried about his present problems.

Assessment of Problem
From my interview as well as the hospital’s documents, I had some problems with my client. I
also talked to the duty doctor, and he told me the whole problem and I noted down those
problems. Such as-

62
  Physical illness;
 Financial crisis;
 Breakdown mentally;
 Hopelessness;
 Frustration;
 Mental depression;

Social work intervention of the problem:

 I helped to get 5000/- TK from the hospital social service office for buying medicine;
 I helped him to get chemo medicine from the hospital social service office;
 Establishing regular communication and counseling;
 Helped him to take medicine regularly;
 Provided mental support to the patient as well as his family;
 Tried to increase awareness among the patient family members

Evaluation
I am an apprentice social worker so basically, I tried to apply my classroom knowledge to solve
Alamgir’s mental problem. He contacted me cordially. So, it was possible to look after him to
come around quickly. It was also possible within a few days. I tried to help him by myself with
the help of my agency. So, they were grateful to me for my assistance.

Follow-Up
During the case study week, I visit my client every day from 18-01-2024 to 08-02-24. I talked to
my client’s husband about my client’s illness. Then I assured my client that there was no matter
to worry about and that he would be alright after taking medicine.

5.5 Case Profile - 04

Background of the Case
Osman Goni, a 35years old man who lives in Patuakhali with his family. For the last three years
Osman has been suffering from Arsenic poisoning or arsenicosis. For several months it was in
very bad condition and at one stage skin cancer developed in his hand. Now half of one hand
and the wrist of the other hand have been amputated.

Patient's Profile

63
Personal Information of the Patient
Name Osman Goni

Age 35years
Sex Male
Marital Status Married
Father/Husband’s Name Md. Akram Mia
Mother’s name Rokeya Akter
Education primary
Profession Tailor
Address Doshmina, Golachipa, Patuakhali

Hospital Related Information

Problem Diagnosis Arsenic Poisoning

Department Burn and Plastic Surgery

Bed No 42

Ward 642 (Burn)

Registration no 4151\04
Admission Date 08/11/2023

Case Recording Date 21/01/24

1st interview 21/01/24

2nd Interview 25/01/24

3rd Interview 29/01/24

Case Termination 10/02/24

Supervisory Doctor Dr. M. Touhidul Hoque

64
 Family Related Information
SL Name Age Education Profession Relation
No
1 Md Akram Mia 66 Farmer Father

2 Rokeya Akter 52 Housewife Mother

3 Rubina Akter 28 Primary Housewife Wife

4 Mahin 10 Class-4 -- Son

5 Masum 8 Class-3 -- Son

6 Zomirun Bibi 82 -- Grand Mother

History of Illness
Three years ago, Osman noticed dark spots on both hands, which were later found to be due to
Arsenic poisoning. Arsenic later causes skin cancer. Currently he is admitted to Dhaka Medical
College Hospital for two months and has had to amputate half of one hand and the wrist of the
other hand.

The Rationale of Taking Case.

The first time I met Osman, he was very serious. I talked with him and his wife. After talking
with them I realized that the patient’s physical and mental condition is so critical. Their financial
condition is also critical because Osman is a tailor, and he is the only earning member of his
family. His family is not able to bear his treatment cost. Because of the above critical condition, I
decided to take him as a case.

Rapport buildup|
Rapport build-up is so important before commencing planned treatment because collecting deep
information and giving effective problem solutions to clients is impossible without establishing
rapport as an apprentice social worker. I used the following techniques for establishing rapport.

 Acceptance: I accepted Osman giving his full dignity and respect. I gave assurance to
solve his problem. As a result, he also accepted the giving importance.
 Communication: I maintained regular communication with Osman and his family
members and tried to understand his needs and information about the problem.

65
  Participation: Establishing rapport is impossible without ensuring the participation of
the client in the problem-solving process. So, I ensured participation of Osman in every
step of the problem-solving process.
 Confidentiality: I assured Osman to hide all his information, as a result, he believed me
fully and he promised that he didn’t hide any information in his life.
 Individuality: I knew all clients are individuals. Their problem, patterns of problems,
causes of the problem, solution process, expectation, etc. are iterant from others. So, I
applied the individuality principle for establishing rapport with Osman. I tried to solve his
problem according to real findings and his needs.
 Self-confidentiality: Every client has their own view and wants to ensure those needs. So,
I tried to ensure Osman helps me to establish rapport.

Psycho-social Study
In social casework psycho-social study is a very important phase. As an apprentice social worker
to know details information about Osman I complete a Psycho-social study.

In this stage, I can apply some techniques. This technique is given below-
Interview: The interview is the main way to collect client information. To complete the
interview, I went to my patient Osman’s ward and followed some steps for a fruitful interview-
During staying time of Osman in Dhaka Medical College and Hospital made his 3 interviews
during my working days.
1st interview: This was the first day of Osman and my interview. Today her physical and
mental condition was not normal. I had to talk with his wife, and I talked with him for a few
minutes. I tried to give mental support.
2nd interview: On this day, I saw that the physical condition of Osman was not so much
improved, and mental condition also. So, I helped to remove his mental depression and gave
some advice.
3rd interview: On this day, Osman’s physical and mental condition was fine. I provided him
with different kinds of information related to his treatment. I advised him to follow the rules
and regulations which were given by the assigned doctor.

Source of collecting data:

I collected data from both primary and secondary sources.
1. Primary Source:
 Client himself
 Client’s wife
 Client's brother

66
 2. Secondary Source:
 Hospital Documents
 Doctor

Physical Condition|

He was facing some physical complexities due to the side effect of the medicine. For example
dizziness, weakness, unable to move legs easily. Then he was referred to a neurologist for this
problem.

Mental Condition:
He was mentally weak and depressed. His disease was stressful for him as he was unable to lead a normal
life. Besides, he was tense about his family members as well.

Economic condition:
The economic condition of Osman’s family is not so good. He is the only earning member of his
family. His family's economic status is given bellow-
Profession Tailor

Monthly Income 15000/-

Personal Property Poor

Family property Poor

Ability of Treatment Disabled

Helping Relatives Absent

Social Condition:
The client belongs to an insolvent family. But he and his family have a good relationship with
neighbors, and relatives. So, considering the patient’s overall condition, it can be said that his
social status was good. My patient was very upset and worried about his present problems.

Assessment of Problem:
From my interview as well as the hospital’s documents, I had some problems with my client. I
also talked to the duty doctor, and he told me the whole problem and I noted down those
problems. Such as-

 Physical illness;
 Financial crisis;
 Breakdown mentally;

67
  Hopelessness;
 Frustration;
 Mental depression;

Social work intervention of the problem|

 I helped to get 4000/- TK from the hospital social service office for buying medicine;
 I helped him 3 Albotin (22200 TK) from the hospital social service office;
 Establishing regular communication and counseling;
 Helped him to take medicine regularly;
 Provided mental support to the patient as well as his family;
 Tried to increase awareness among the patient family members|

Evaluation
I am an apprentice social worker so basically, I tried to apply my classroom knowledge to solve
Osman’s mental problem. He contacted me cordially. So, it was possible to look after him to
come around quickly. It was also possible within a few days. I tried to help him by myself with
the help of my agency. So, they were grateful to me for my assistance.
Follow-Up
During the case study week, I visit my client every day from 21-01-2024 to 10-02-24. I talked to
my client’s husband about my client’s illness. Then I assured my client that there was no matter
to worry about and that he would be alright after taking medicine.

5.6 Case Profile - 05

Background of the Case

Md Ashraful Alom, a 44years old man who lives in Mirpur with his family. He was a CNG
driver. He is suffering from brain cancer. His wife Rima took him to the Dhaka Medical College
Hospital and admitted him.

Patient's Profile

Personal Information of the Patient

Name Md Ashraful Alam

Age 44years
Sex Male

68
 Marital Status Married
Father/Husband’s Name Abdul Hamid Ali
Mother’s name Majeda Khatun
Education primary
Profession CNG Driver
Address Uttar Bisil, Mirpur-01, Dhaka

Hospital Related Information

Problem Diagnosis Brain Cancer

Department Oncology

Bed No 44
Ward 313 (Old Building)
Registration no 638\26
Admission Date 03/01/2023
Case Recording Date 04/02/24
1st interview 04/02/24

2nd Interview 07/01/24

3rd Interview 10/01/24

Case Termination 15/02/24

Supervisory Doctor Dr. Abdul Hakim

Family Related Information

SL Name Age Education Profession Relation
No
1 Abdul Hamid 71 -- -- Father
Ali

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 2 Majeda 59 -- Housewife Mother
Khatun

3 Rima Akter 36 Primary Housewife Wife

4 Mim 11 Class-5 -- Daughter

5 Maria 8 Class-3 -- Daughter

History of Illness
Two years ago, Ashraful was diagnosed with a brain tumor that turned into cancer. The tumor
was removed by surgery on his head. Now he is undergoing cancer treatment.

The Rationale of Taking Case

The first time I met Ashraful, he was very serious. I talked with him and his wife. After talking
with them I realized that the patient’s physical and mental condition is so critical. Their financial
condition is also critical because Osman is a CNG Driver, and he is the only earning member of
his family. His family is not able to bear his treatment cost. Because of the above critical
condition, I decided to take him as a case.

Rapport buildup
Rapport build-up is so important before commencing planned treatment because collecting deep
information and giving effective problem solutions to clients is impossible without establishing
rapport as an apprentice social worker. I used the following techniques for establishing rapport.

 Acceptance: I accepted Ashraful giving his full dignity and respect. I gave assurance to
solve his problem. As a result, he also accepted the giving importance.
 Communication: I maintained regular communication with Ashraful and his family
members and tried to understand his needs and information about the problem.
 Participation: Establishing rapport is impossible without ensuring the participation of
the client in the problem-solving process. So, I ensured participation of Ashraful in every
step of the problem-solving process.
 Confidentiality: I assured Ashraful to hide all his information, as a result, he believed me
fully and he promised that he didn’t hide any information in his life.
 Individuality: I knew all clients are individuals. Their problem, patterns of problems,
causes of the problem, solution process, expectation, etc. are iterant from others. So, I

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 applied the individuality principle for establishing rapport with Ashraful. I tried to solve
his problem according to real findings and his needs.
 Self-confidentiality: Every client has their own view and wants to ensure those needs. So,
I tried to ensure Ashraful helps me to establish rapport.

Psycho-social Study
In social casework psycho-social study is a very important phase. As an apprentice social worker
to know details information about Ashraful I complete a Psycho-social study.

In this stage, I can apply some techniques. This technique is given below-
Interview: The interview is the main way to collect client information. To complete the
interview, I went to my patient Osman’s ward and followed some steps for a fruitful interview-
During staying time of Ashraful in Dhaka Medical College and Hospital made his 3 interviews
during my working days.
1st interview: This was the first day of Ashraful and my interview. Today her physical and
mental condition was not normal. I had to talk with his wife, and I talked with him for a few
minutes. I tried to give mental support.
2nd interview: On this day, I saw that the physical condition of Ashraful was not so much
improved, and mental condition also. So, I helped to remove his mental depression and gave
some advice.

3rd interview: On this day, Ashraful’s physical and mental condition was fine. I provided him
with different kinds of information related to his treatment. I advised him to follow the rules
and regulations which were given by the assigned doctor.

Source of collecting data:

I collected data from both primary and secondary sources.
1. Primary Source:
 Client himself
 Client’ Wife
 Client’s Children
2. Secondary Source:
 Hospital Documents
 Doctor
 Clients Neighbors (over phone)

Physical Condition

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He was facing some physical complexities due to the side effect of the medicine. For example,
dizziness, weakness, unable to move legs and hands easily. Then he was referred to a neurologist
for this problem.

Mental Condition:
He was mentally weak and depressed. His disease was stressful for him as he was unable to lead
a normal life. Besides, he was tense about his family members as well.

Economic condition:
The economic condition of Ashraful’s family is not so good. He is the only earning member of
his family. His family's economic status is given bellow-
Profession CNG Driver
Monthly Income 25000/-
Personal Property Poor
Family property Poor
Ability of Treatment Disabled
Helping Relatives Absent

Social Condition:
The client belongs to an insolvent family. But he and his family have a good relationship with
neighbors, and relatives. So, considering the patient’s overall condition, it can be said that his
social status was good. My patient was very upset and worried about his present problems.

Assessment of Problem:
From my interview as well as the hospital’s documents, I had some problems with my client. I
also talked to the duty doctor, and he told me the whole problem and I noted down those
problems. Such as-

 Physical illness;
 Financial crisis;
 Breakdown mentally;
 Hopelessness;
 Frustration;
 Mental depression;

Social work intervention of the problem

 I helped to get 5000/- TK from the hospital social service office for buying medicine;

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  I helped him 3 Albotin (22200 TK) from the hospital social service office;
 Establishing regular communication and counseling;
 Helped him to take medicine regularly;
 Provided mental support to the patient as well as his family;
 Tried to increase awareness among the patient family members

Evaluation
I am an apprentice social worker so basically, I tried to apply my classroom knowledge to solve
Osman’s mental problem. He contacted me cordially. So, it was possible to look after him to
come around quickly. It was also possible within a few days. I tried to help him by myself with
the help of my agency. So, they were grateful to me for my assistance. As an apprentice social
worker, I’ve tried to use social work’s knowledge, skills and values to minimize the client’s
problem and make her able to solve her problem by her own. The client is much better than the
first day and improving every other day. His wife and family members were more careful about
her than before.

Follow-Up
During the case study week, I visit my client every day from 04-02-2024 to 15-02-24. I talked to
my client’s husband about my client’s illness. Then I assured my client that there was no matter
to worry about and that he would be alright after taking medicine.

5.7 Conclusion
By doing case studies we can apply the social work knowledge practically and help troubled
people to solve their problems. Through case studies we can bring positive changes.

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 CHAPTER SIX
A Short research on ‘Challenges and Opportunities of indoor
patients under Hospital Social Services Office: A study on Dhaka
Medical College Hospital.

6.1 Introduction
Dhaka Medical College Hospital (DMCH) is the oldest tertiary-level hospital located at the heart
of Dhaka, Bangladesh. This hospital started its journey on 10 July 1946. In Dhaka medical
college hospital, there are Both outdoor and indoor departments. Dhaka Medical College
Hospital is considered one of Bangladesh's cheapest and best medical services. Patients from
different corners of the country can have reliable and cheapest medical services. In Dhaka
Medical College Hospital, indoor departments are situated in the old building, new building and
burn unit of Dhaka medical college hospital. There are several Department in Dhaka Medical
College Hospital. There are a lot of limitations and challenges for the patients in the indoor
department under hospital social services office. Through our Study titled, "Challenges and
opportunities of indoor patients under hospital social services office : A study on Dhaka Medical
College Hospital.", we have tried to identify those challenges and opportunities for patients
coming from different corners of the country. We have also looked over the health issues of the
coming patient. In this Study, we have tried to figure out the overall scenario of the coming
patient, such as social demographic information and economic status

6.2 Objectives of the study

1. To know the socioeconomic and demographic condition of indoor patients of Dhaka
Medical College Hospital.
2. To explore the opportunities for indoor patients of Dhaka Medical College Hospital.
3. To understand the challenges of indoor patients of Dhaka Medical College Hospital.

Operational definition of the key concept

Indoor patient: Indoor Patients Department (IPD) refers to the areas of the hospital where
patients are accommodated after being admitted, based on doctor's/specialist's assessment.

Dhaka Medical College Hospital

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Dhaka Medical College Hospital (DMCH) is the oldest tertiary-level hospital located at the heart
of Dhaka., Bangladesh. This hospital started its journey on 10 July 1946 as 200 bedded field
hospital for the British Indian armed forces (Dhaka Medical College Hospital, n.d.)

6.3 Research Methodology

Methodology is the most important part of any research design. Methodology is considered with
data collection, data processing, and data analysis. This study will use qualitative methods design,
a procedure for collecting and analyzing qualitative data to understand a research problem more
thoroughly.

Main Method

To enable a thorough investigation of the challenges and opportunities for indoor patients in
Dhaka Medical College Hospital, a single case study method has been chosen as the research's
design. The case study will concentrate on the socio-demographic information of indoor patients,
their economic conditions, their health issues and the challenges and opportunities for the indoor
patients in DMCH.

Area of the Study

The area of the study will be the indoor patients of DMCH those who received support from the
hospital social services office, Dhaka Medical College Hospital.

Study Population and Sampling Unit

This study will include indoor patients from various wards of Dhaka Medical college Hospital.
Socio-demographic information about indoor patients, their socio-economic conditions, their
health issues and the challenges and opportunities they are getting in the indoor department will
all be investigated.

Sampling Techniques and Sample size

We will use purposive sampling technique for selecting participants, and the sample size will be
21.

Source of Data

To conduct the study successfully, the primary data sources will be the indoor patients of
different departments of Dhaka Medical College Hospital. The secondary data sources will be the
admission file of the patients, published literature, news, articles, journals, books, etc.

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6.4 Data collection techniques and tools
As the study will be conducted using the case study method, qualitative data will be collected
through in-depth interviews. Furthermore, observation will also be employed to gather qualitative
data. In this study, the questionnaire will be used as a technique for data collection. Here, data
will be collected through questions and case studies through face-to-face interviews. We will
conduct some key informant interviews.

6.5 Data Analysis

After completing the data collection from the field, all gathered data will be carefully reviewed
and organized based on their unique characteristics. This information will then be translated into
English for analysis. The insights obtained will be grouped into categories that align with the
research objectives, making them easy to refer to and analyze. These organized notes will serve
as the foundation for descriptive thematic analysis. Throughout this process, quotes from the
respondents will be included to provide context and authenticity where needed. The qualitative
analysis will involve describing and explaining the emerging themes and concepts in a narrative
manner. This approach will ensure that the information is accurate and well interpreted, presented
in a clear and coherent narrative form. The qualitative analysis will be completed using a
descriptive way. In analyzing qualitative data, a description and explanation of themes and
concepts will be given in a narrative way. Interpretation will ensure the accuracy of the
information in narrative form.

Ethical Consideration

In this study, all the ethical means will be used to collect information. We will ensure anonymity
to all the respondents. We will try our level best to be nonjudgmental irrespective of gender, race,
caste, religion, etc. Personal relationships will be avoided with the expected respondents strictly.
We will maintain confidentiality about the data collected from the respondents and we will not
disclose any information to others. All the data collected from the respondents will be used only
for the purposes of doing research.

6.6 Findings of the Study

In this research, we gathered data from twenty-one people who came to the indoor department of
Dhaka Medical College Hospital for treatment. We used a structured interview schedule to gather
their socio-demographic and economic information about their health issues, their challenges,
and the opportunities they are getting in the indoor patient department at DMCH. We have found
various categories of them which are described below.

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Socioeconomic and Demographic Information

This study was conducted on 21 respondents. In-depth study was done to collect detailed
information. At the very beginning of our data collection, we have classified the respondents by
their age, sex, educational background, places of origin, present address, religion and occupation.

1. Number of Respondents

From the furnished data respondents are from various areas of the country. A total of 21
interviews were conducted as a case study. The case studies are not stories but realities of life,
not for only these respondents but also for all people in Bangladesh to a lesser or even greater
extent. They are the representatives of the whole.

2. Age of the Respondents

Most of the respondents are aged 20 to 60 years old. There are 10 respondents are belonging to
age 40-50 years old. Children are less involved in this study because children's patients are less
coming for help from hospital social services.

3. Religion of the Respondents

A major portion of the total population of Bangladesh is from the religion ‘Islam’. In this study,
we found that there were 15 respondents were from Islam. Six patients were from Hindu religion.

4. Level of Education of the Respondents

This study shows that the education level of most of the respondents was up to primary level,
secondary, and higher secondary level. Most of the respondents are uneducated. They have no
idea about education and how to sign on the welfare form.

5. Marital Status of the respondents

After analyzing the data of the study, we found that the maximum respondents were married.
There was one respondent whose marital status was widow, one was separated, and three
respondents were students whose marital status was single. From the findings, we can say that
there are a lot of respondents, and they represent all types of marital status.

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6. Place of Origin

The respondents of this study were from various areas of Bangladesh. Most of the respondents
were from Mymensingh, Sherpur, Patuakhali, Feni,Barishal, Dhaka and Cumilla. Here, most of
the respondents were from Barisal and fewer from Sherpur.

7. Occupation

In this study, after analyzing the data we found that most of the respondents are Farmers,
housewife, and students. Here, housewife are the most needy than farmers. They are the highest
number of respondents of the study.

8. Gender

This study was conducted on 21 respondents. Most of the respondents were women. Here, 13
respondents were women and rest of all are men.

9. Economic conditions

Most of the respondents economic conditions are very low. They have no capacity to bear their
medical cost. So, they came to the hospital social services office so that they can cope with this
situation and overcome their problems.

6.7 Opportunities of Indoor Patients

The presence of hospital social services might offer financial assistance and support to eligible
indoor patients.This study shows that collaborative efforts with NGOs and community
organizations might create additional opportunities for social and economic improvement.
Opportunities for indoor patients within the context of hospital social services encompass various
avenues to improve their well-being and enhance their overall quality of life. Here are key
aspects related to the opportunities for indoor patients.

1.Financial Assistance

Hospital social services play a vital role in assessing the financial needs of indoor patients. They
may provide assistance in navigating insurance processes, identifying potential sources of
financial support, and helping patients access available funds for medical expenses. From this
study we found that hospital social services identifying and leveraging available resources,
including government programs, charitable organizations, and hospital-specific funds, to provide
financial support to eligible patients. Providing emergency financial assistance for immediate
needs, such as medications, transportation, or housing, to help alleviate the financial burden

78
during times of crisis. This study shows that most of the indoor patients are coming for help from
the hospital social services office. Many of the respondents were said they took assistance from
the hospital social service office. One of them named Arifa Akter said,

"I took assistance from hospital social services office. They gave me 14,000 taka for my
operation. They bought operation instruments and gave it to me. My economic conditions is very
poor. Hospital social services office helped me to complete my OT".

Above all, we can say that financial assistance within hospital social services plays a crucial role
in ensuring that healthcare remains accessible to individuals and families, irrespective of their
financial circumstances. It requires a personalized and compassionate approach to address the
unique financial challenges faced by each patient.

2. Psychosocial Support

Social workers within the hospital social services office offer emotional and psychological
support to indoor patients. From this study we found that they may conduct assessments to
identify patients' mental health needs and connect them with counseling services or support
groups. We identified that social services officer provide psychological support to the helpless
patients. Providing emotional counseling to patients facing chronic illnesses, medical challenges,
or major life changes, helping them cope with the emotional impact of their situations.
Implementing stress management strategies and coping mechanisms for patients dealing with the
stressors associated with illness, treatment, and hospitalization. There are many patients who are
mentally broken. They don't know what to do. Then hospital social services officer motivated
them mentally. Most of the respondents said that they took mental support from the hospital
social services office. One of the respondents Amina Begum said,

"I am totally broken for my physical conditions. I don't know what to do. Then I went to the
hospital social services office. They gave me some knowledge how can I cope with this situation.
And also provided some medicine for my wellbeing. That was very helpful for me to overcome
this situation". Above all, we can say that psychological support within hospital social services is
integral to the overall care of patients, recognizing the interconnectedness of physical and mental
health. It aims to promote resilience, enhance coping mechanisms, and improve the overall
quality of life for individuals facing healthcare challenges.

3. Educational Support

From this study we found that hospital social services office providing information and education
about medical conditions, treatment options, and available resources to indoor patients. This
empowers patients to make informed decisions about their healthcare and fosters a sense of

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autonomy. Providing information about medical conditions, treatment options, and medications
to enhance patients' understanding of their health. Offering educational materials in accessible
formats to accommodate different learning styles and literacy levels. We identified that hospital
social services office assisting patients in understanding and navigating the complex healthcare
system, including explaining medical procedures, appointment scheduling, and insurance
processes. Many of the respondents said the same things. One of them kulsum said, "I have no
knowledge about Dhaka medical College hospital and its treatment procedure. So, I went to the
hospital social services office and they gave me full instructions about Dhaka medical college
hospital. They provide direction how can I overcome my situation. That was very helpful for me
to cope with this situation".

Educational support plays a vital role in enhancing patients' overall health outcomes by
empowering them with the information and skills necessary for self-care and informed decision-
making.

4.Community Resources and Referrals

From this study we found that hospital social services officer connect patients with external
resources and community support services. This can include referrals to local agencies, non-
profits, or government programs that offer additional assistance related to housing, transportation,
and other social determinants of health. Community resources and referrals provided by hospital
social services involve connecting patients with external support systems and services beyond the
healthcare facility. We found that many of the patients are went to the hospital social services
office for help. But hospital social services office have no enough capacity to help this patients.
Then hospital social services office refer this patients to the governments and non-government
organisations to help this helpless patients. Most of the respondents are said the same things.
One of them Akkas Ali said, "My economic conditions is very low. I can't bear my treatment cost
so that I went to the hospital social services for help. But hospital social services office have no
enough capacity to help my conditions. Then hospital social services office refer me to the Akij
Group of Company. They help me so much and I overcome my situation from their help. I always
thanked for them".

From this study we can say that establishing strong partnerships with various community
resources, hospital social services contribute to a comprehensive approach to patient care,
addressing not only medical needs but also the broader socio-economic factors influencing health
and well-being.

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5. Coordination of Care

This study shows that hospital social services collaborate with healthcare teams to ensure a
holistic approach to patient care. They facilitate communication between patients, families, and
medical professionals, contributing to coordinated and comprehensive treatment plans. The
coordination of care by hospital social services involves ensuring a seamless and comprehensive
approach to meeting the diverse needs of patients. We found that hospital social services office
serving as advocates for patients to ensure their preferences and needs are communicated and
considered in the decision-making process, fostering a patient-centered approach. They
collaborating with healthcare professionals, including doctors, nurses, therapists, and other
specialists, to create integrated and cohesive care plans for patients. We found that most of the
respondents are provided same opinion about this matter. One of them named Asma bengum said,
"I have no knowledge about hospital treatment procedure. Treatment procedure was very
complex. Hospital social services office help me about this matter. They collaborating with
healthcare professionals, including doctors, nurses, therapists, and other specialists, to create
integrated and cohesive care plans for me. That was very helpful for me to cope with this
situation".

Above all, we can say that effective coordination of care by hospital social services contributes to
improved patient outcomes, increased satisfaction, and a more holistic approach to healthcare that
addresses the diverse needs of individuals.

6.8 Challenges of Indoor Patients

From this study we found that lack of awareness about available social services may be a primary
challenge for indoor patients. Administrative bottlenecks or bureaucratic hurdles might hinder the
efficient delivery of social services to indoor patients. Insufficient resources and staffing within
the hospital's social services office could lead to challenges in meeting the diverse needs of
indoor patients. There are may challenges of indoor patients which are given in the below:

1. Resource Constraints

In this study we found that limited staffing and financial resources within the social services
office may hinder their ability to address the diverse and complex needs of all indoor patients
effectively. Insufficient staffing levels may hinder the ability of the social services office to
adequately address the high demand for services, leading to delays and reduced capacity to
support patients. Budget constraints may limit the availability of funds for social service

81
programs, impacting the range and depth of assistance that can be provided to indoor patients.
We identified that limited resources for staff training and professional development may affect
the ability of social services officer to stay updated on best practices and innovative approaches
in patient care. Most of the respondents are said the similar things. One of them named Asma
Khatun sai, "have a severe problem in my body. My economic conditions is very poor. I need
some help so that I went to the hospital social services office for help. They provide some
medicine to wellbeing for my health. But I need more help. Then they said they have no enough
capacity or resources to provide more money or medicine for me. They have some limitations".

From this study we can say that addressing resource constraints requires strategic planning,
advocacy for increased funding, and innovative approaches to maximize the impact of available
resources in meeting the needs of indoor patients effectively.

2. Bureaucratic Challenges

In this study we found that administrative hurdles and bureaucratic complexities within the
healthcare system can impede the timely delivery of social services, causing delays in assistance
for patients in need. Bureaucratic challenges within hospital social services can create barriers to
the efficient delivery of support. Here are we found some key aspects of bureaucratic challenges:

a. Complex administrative procedures and paperwork may slow down the delivery of social
services, causing delays in providing timely assistance to patients.

b. Lengthy approval processes for financial assistance, referrals, or specialized services may
impede the ability to quickly address the urgent needs of indoor patients.

c. Excessive documentation requirements may place a burden on both social workers and patients,
potentially leading to frustration and hindering the streamlined provision.

d. Inefficient communication between different departments within the healthcare system may
result in delays in coordinating care and accessing necessary resources for patients.

From this study we found that most of the patients are facing bureaucratic challenges to take help
from the hospital social services office. One of the respondents name Afia Akter said,

"When I went to the hospital social services office I waited some hour for welfare form. When
they gave me welfare form then I went to ward and feel it by the doctor. Then I submitted this
form to the hospital social services office. Then they told me come in the next day. It was a very
complex system to take help from hospital social services office".

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Above all, we say that addressing bureaucratic challenges involves streamlining processes,
advocating for flexibility in decision-making, and fostering improved communication and
collaboration across departments to enhance the overall efficiency of hospital social services.

3. Lack of Awareness

From this study we found that indoor patients might not be fully aware of the services provided
by the hospital social services office, leading to underutilization of available resources. The lack
of awareness about hospital social services can be a significant obstacle to patients accessing the
support they need. Here we found some key aspects related to the lack of awareness.

a. Insufficient efforts to disseminate information about available social services may result in
patients being unaware of the support systems in place within the healthcare facility.

b. Inadequate communication channels between healthcare providers and patients may contribute
to a lack of awareness about the existence and scope of social services.

c. Language differences between healthcare providers and patients may impede effective
communication, leading to misunderstandings and a lack of awareness about available support.

d. Patients with low health literacy levels may struggle to understand information about social
services, contributing to a lack of awareness about how these services can benefit them.

From this study we found that lack of awareness is a significant reasons for indoor patients to
take help from the hospital social services office. Most of the respondents said the same things.
One of them name Altaf Mahmud said, "I have no knowledge about hospital social services
office. I don’t know how to take help from the office. Due to my lack of knowledge I took help
from hospital social services lately. If I have knowledge about this procedure I took help very
early and overcome my situation".

Above all, we can say that addressing the lack of awareness requires implementing targeted
communication strategies, utilizing diverse communication channels, and ensuring cultural and
linguistic competence in outreach efforts. Ongoing education campaigns and community
engagement initiatives can play a crucial role in overcoming this challenge.

4. Limited Scope of Services

The social services office may not cover all aspects of patients' needs, leaving gaps in support for
certain social determinants of health, such as housing, transportation, or legal assistance. The
limited scope of services within hospital social services can impact the ability to address the

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diverse needs of patients comprehensively. Here we found some key aspects related to the limited
scope of services.

a. Social services may primarily focus on addressing immediate needs, such as financial
assistance or crisis intervention, leaving long-term socio-economic challenges unaddressed.

b. A narrow range of programs may limit the ability to provide holistic support, especially if
certain social determinants of health, such as education or vocational training, are not adequately
covered.

c. Services may be tailored to specific populations, potentially leaving out individuals or groups
with unique needs that fall outside the specialized scope.

d. A lack of emphasis on preventive services and proactive interventions may result in missed
opportunities to address issues before they escalate into crises. In this area we talk to the hospital
social services officer Dipika Rani Saha. She said, "I have limited scope to help the poor patients.
I have not enough capacity or resources to fulfill all the requirements of the patients. We focused
the primary needs of the patients and fulfill it immediately. If we have enough capacity we
focused on the next needs of the patients". Expanding the scope of social services involves
strategic planning, collaboration with external partners, and a commitment to addressing both
immediate needs and underlying factors that contribute to patients' overall well-being. It may also
require ongoing assessment and adaptation to meet the evolving needs of the patient population.

6.9 Summary of the Findings

This research was conducted to gather data from patients who came to the indoor patients of
Dhaka Medical College Hospital (DMCH) under social services office for help. The aim was to
understand their socio-demographic and economic information, health issues, challenges, and
opportunities they are facing in the indoor patient at DMCH under Hospital social services
officer. A structured interview schedule was used to gather the information from 21 patients. The
research found that most patients came from outside Dhaka, with middle-aged people between
31 and 64 being the majority. The number of male patients was less than that of female patients,
with most female patients being housewives. Patients with various professions were also seen in
the indoor department, including farmers, people from cottage industries, service holders, and
students. Most respondents were illiterate, with most having received secondary education. The
leading source of funding was from NGOs and Government organizations. Patients suffered
from diseases ranging from 0 months to over a year, with most coming to the medical
department for consultation. One-tenth of the participants had mental health issues, while others
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had gynecological problems and health problems at a young age. Overloading, broker's violence,
lack of information, prolonged service, non-cooperation, and an unhygienic environment were
some of the problems faced by the patients. Most people came to DMCH for low-cost and better
treatment by experienced doctors. Some patients complained about the behavior and services of
doctors and staff. Most of the patients knew about the Social Service Office, and most of them
had received services from the office. The research showed that most patients faced various
problems getting services from DMCH, with the majority coming for low-cost and better
treatment from experienced doctors. Many of them complained about the behavior and services
of doctors and staff. Most patients knew about the Social Service Office, but only a tiny
percentage had received services from the office.

6.10 Limitations
We faced many barriers to conducting this research paper. Firstly, we need more time to conduct
research. Secondly, most of the respondents were illiterate and did not want to participate in this
research at the beginning, and we had to convince them and understand our research topic.
Besides, there needs to be more literature about the challenges and opportunities of the indoor
patients of Dhaka Medical College Hospital.

6.11 Recommendations
As Dhaka Medical College Hospital is famous for cheap and better treatment in Bangladesh,
every day, a huge number of poor, lower middle-class patients visit it for better treatment at a
cheaper rate. As a result, the pressure of patients on the doctor and hospital administration is
more than in any other hospital in the country. Sometimes it is hard to provide equal and accurate
services to all of the patients of the hospital. In this research, we explored the challenges and
opportunities for patients coming to the indoors of the hospital. From our findings, we can
recommend some changes and policies to help provide better services to all patients. These are
below:

 The number of staff at the hospital social services office should be increased.
 The services of the hospital social service office should be spread to all the patients.
 To increase coordination and integration between the functions of the hospital and social
service department.
 To ensure active involvement of the apprentice social worker with the entire treatment
process so that they could contribute more to the effective treatment of patients.

85
  An apprentice social worker should get full consent to work with the patients.

6.11 Conclusion
This study has concentrated on collecting sociodemographic and economic information about
indoor patients. We have also identified the obstacles and opportunities facing patients in the
Dhaka College of Medicine indoor department. This study aims to determine the health concerns
of indoor patients. This Study will assist policymakers in identifying the limitations of the indoor
patient department. By informing policymakers about the issues we have uncovered, this Study
has the potential to alter the overall situation of Dhaka Medical College Hospital's indoor patients.

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 CHAPTER SEVEN
Inter Agency Visit to Hospital Social Services Office, BSMMU

7.1 Introduction
Social work is complete with field practice. In field practice, each social worker must also know
about their agency and the other agency. By comparing the activities of other agencies, it is
possible to gain more knowledge. It helps the social worker to improve their performance and
bring changes to the policies to provide better services to the client. In our assigned duties and
responsibilities, there was a part known as an inter-agency visit. We visited one of the
Department of Social Services in a government hospital named Bangobondhu Sheikh Mujib
Medical University (BSMMU). We gathered experiences and learned practically about their
working functions and service-providing procedures by visiting. This chapter is all about the
experiences and knowledge from our inter-agency visit.

Historical Background of the Agency

Establishment of the Bangabandhu Sheikh Mujib Medical University was an upgrade of the
Institute of Postgraduate Medicine and Research (IPGMR). IPGMR was established in December
1965, as a Government-controlled postgraduate institute for medical research and studies.It was
renamed as Bangabandhu Sheikh Mujib Medical University by the Act 1, 1998 of Jatiyo
Sangshad after the first President of Bangladesh, Bangabandhu Sheikh Mujibur Rahman.In 1973,
the Government of the People's Republic of Bangladesh expanded the Hospital Social Service
Program (previously known as PG Hospital) to the present Bangabandhu Sheikh Mujib Medical
University in order to provide all-round cooperation in the treatment of patients.

7.2 Introduction of Bangabandhu Sheikh Mujib Medical University

The Bangobondhu Sheikh Mujib Medical University (BSMMU) was established in 1998. It is
located at Shabag, Dhaka. Bangabandhu Sheikh Mujib Medical University is ranked among the
best in the world due to its multifaceted activities and success in special higher education and
research. Bangabandhu Sheikh Mujib Medical University established in 1998 is the first public
medical university in Bangladesh. There are MD, PhD, MS, MPhil, MDS, Diploma and FCPS
post graduate courses. There are two outdoor for outpatient services. Outdoor-1 (OPD-1)
Outdoor-2 (OPD-2)

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Services provided at Outdoor-1 (OPD-1)

01. Medicine 02. Vascular surgery 03. Cardiac Surgery 04, Cardiology 05. Physical Medicine 06.
Chest disease 07. Children's kidney 08. Pediatric Gastroenterology 09. Child section 10.
Neurology 11. Child Neurology and Endocrinology 12. Kidney 13. Hematology 14. Liver 15.
Gastroenterology 16. Rheumatology 17. Child Hematology 18. Skin and sex 19. Oncology 20.
Endocrinology 21. Anesthesia 22. Psychiatry

*To provide guidance services, Sevabooth-1, Patient Welfare Association, Hospital Social
Services Office, Department of Social Services.

Service provided at outdoor-2 (OPD-2)

01. General surgery 02. Nose, Ear and Throat Department 04. Department of Ox and Gynecology
05. Family planning 06. Child surgery 09. Neurosurgery 08. Department of Ophthalmology 09. in
the sense

* To provide guidance services, Sevabooth-2, Patient Welfare Association, Hospital Social

Services Office, Department of Social Services.

* Outdoor service is provided daily from 8:00 am to 2:00 pm from Saturday to Thursday except
Friday. Specialist doctors also provide outdoor evening services from 3 pm to 6 pm through
special tickets. All outdoor department services are provided to indoor patients. Number of Beds-
1551, Number of Wards-59, Number of Paying Beds-760, Number of Non-Paying Beds-791,
Number of Cabins-124.Institute of Pediatric Neurodisorder and Autism (IPNA) in Block F for
children with Autism and Neurodevelopmental Disorders runs a specialized school with
healthcare for such children.

7.3 Experience of Visiting the Agency

When we visited the social services department at Bangobondhu Sheikh Mujib Medical
University on 08 February 2024. We started by visiting their help desk and internal offices. We
tried to understand their working functions. They described to us how they provide help to poor
patients. We learned about their sources of funds and the procedure for getting help from them.
We also noticed some patients there waiting to receive the services. We also found the office
very neat and clean and the environment was amiable. We spent almost two hour there and
gathered much experience.

Objective of the Agency

The main objective of Hospital Social Services in Bangobondhu Sheikh Mujib Medical
University (BSMMU) is to help poor, helpless and destitute patients. The agency is run based on
the following specific objectives:

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  To provide financial and material aid like medicine, wheel chair, blood, dress and
artificial organ to the poor patient.
 To build up good relationship with doctors, nurses and other staffs of the hospital.
 To help the poor and ignorant patient to get admitted in the hospital.
 To build up good relationship between doctors and patient so that patient can discuss in
details about his illness.
 To communicate with the family members of the patient during the long-term treatment
process.
 Providing mental support for those patients who are afraid of going through operation
procedure.
 To make up an arrangement of referral services for further treatment.
 To follow up after discharged patient from the hospital.
 To provide rehabilitation for the poor patient and engage him any job or resource system.
 To arrange proper system of transportation.
 To help the patient in getting necessary treatment and provide comprehensive services to
them.

7.4 Organogram
Hospital Social Service Program is a subsidiary program of Bangabandhu Sheikh Mujib Medical
University. Two professional social service officers of the Department of Social Services,
appointed by the Ministry of Social Services, are in charge of these activities. There is an office
assistant and an office support staff(Office Sohayok) to assist the social service officers.

Administrative Personnel of BSMMU:

Serial Name of the personnel Designation

01 Sitara Yesmin Social services Officer

02 Khurshida Pervin Social services Officer

03 Sumaiya Rahman Office Assistant and computer Operator

04 Meruna Akter Office assistance

05 Al Amin Social worker cum computer operator.

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Bangabandhu Sheikh Mujib Medical University is a private institution but its social service
department is a public institution. The officers and employees of this department and all their
functions and salaries are managed and controlled by the Ministry of Social Welfare of the
Government of Bangladesh. The officers and employees of this department have always devoted
themselves to the welfare of the patients of Bangabandhu Sheikh Mujib Medical University.

Apart from this, under the Hospital Social Service Officer, apprentice social workers from
various universities and colleges work for the welfare of patients.

Source of Fund
The agency offers multiple services to BSMMU patients. However, the agency's resources and
assets come from the following sources:

 Donation from the National Social Welfare Council

 Donation from the Akiz Group
 Donations from different doctors
 Subscription fees for general members and lifetime members
 Jakat fund
 Donations from different people and organizations
 Bank interest
 Income due to goods
Function of the Agency
The hospital social services department at the Bangobondhu Sheikh Mujib Medical University
provides multiple services. According to the Department of Social Services (DSS), the agency
has the following function:

 Paying the cost of medicine, all types of medical tests, diet, conveyance
 Financial assistance to patients' families during their illness
 Helping the doctors with the medical treatment of the patient after collecting
socioeconomic data
 Finding the poor and troubled patients outside the hospital so they can be included in the
social work program
 Counseling with respect to the inability to follow the suggested treatment or instructions
of the doctors so that the illiterate patients can benefit from those treatments
 Helping the patient with clothes, artificial limbs, spectacles, blood
 Helping mentally and emotionally disturbed patients with their mental
 Provide counseling and guidance on family planning, child health care, and make them
aware of all types of contagious diseases.
 Follow up with patients to ensure their overall health and well-being.

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  Unclaimed babies are arranged to be admitted to the baby registry.
 If necessary, helpless and poor patients are given microcredit to alleviate their poverty
and are included in the poverty alleviation program.

7.5 Contribution of the Agency to the National Level

The Department of Social Services in the Bangobondhu Sheikh Mujib Medical University
(BSMMU) has made significant contributions to the field of social services at the national level
in Bangladesh. Some of the key contributions of the department are as follows:

 Providing quality care and support: The department is known for providing high-
quality social services to patients and their families, including counseling, support groups
and other forms of emotional and psychological support.
 Innovative programs: The department has developed and implemented innovative
programs and initiatives to address the social and emotional needs of patients and their
families, such as support groups for patients with chronic illnesses and their caregivers.
 Research and advocacy: The department has been active in conducting research on the
social and emotional needs of patients and advocating for greater recognition and support
for these needs in the healthcare system.

 Collaborative partnerships: The department has established collaborative partnerships

with other healthcare institutions and organizations to enhance the provision of social
services and support to patients and their families.

The contributions of the Department of Social Services in BSMMU to the field of social services
in Bangladesh have helped to raise awareness of the importance of addressing the social and
emotional needs of patients and their families, and to enhance the quality of care and support
provided in the healthcare system.

A Brief Comparison between the Department of Social Services of DMCH and BSMMU
As we have worked in the department of social services of Dhaka Medical College Hospital, we
know everything about their services. After visiting the department of social services at
Bangobondhu Sheikh Mujib Medical University, we have observed their functions also. Though
the maximum activities of these two organizations are quite the same, both are under the Ministry
of Social Welfare. However, we noticed some slight differences between the agencies' activities.
These are described below:

Crowdedness of patients: As Dhaka Medical College Hospital is one of the best government
hospitals in Bangladesh, most poor patients rush to this to get treatment at a cheaper rate. So, the
crowdedness of patients in the social services department always remains high. On the other hand,
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though Bangobondhu Sheikh Mujib Medical University, there is no crowdedness of patients
because of its wideness.

The procedure of getting services: There is a difference between the procedure of providing
services too. In DMCH, we saw that the poor patients got the application form at a particular time
every day. However, in BSMMU, there is no fixed time. As the number of patients is deficient,
there are no fixed times for getting services from the social services department. Poor, needy
patients can get services from 9 am to 2 pm daily.

Funds: In DMCH, the social services department has different types of funds, such as the Patient
Welfare Funds, Akij Welfare Trust, Burnt Welfare Funds, Cancer Donor Funds, Child Cancer
Funds, and Jakat Funds. The department provides different types of services to poor patients with
the help of these funds. Besides, they collect subscription fees from their lifetime members.
However, the BSMMU mainly uses donations from the National Social Welfare Council,
subscription fees from general members and lifetime members, the Jakat fund, and donations
from different people and organizations.

Re-application process: In DMCH, a patient can only get served once a week and take the
application from the department. However, in the BSMMU, a client can only receive services
once a month.

Time duration of getting services: In DMCH, applicants must collect the application form one
day before and submit it by fulfilling. They got the services the day after they collected the form.
However, in the emergency cases like ICU patients and dead bodies, they can get the service
immediately. However, in BSMMU, we noticed that the patients are getting service instantly. We
found the reason behind this. It happens due to the lower number of patients there.

7.6 Nature of Coordination between the Two Agencies

The nature of coordination between the Department of Social Services in Dhaka Medical College
Hospital (DMCH) and the Department of Social Services in The Bangobondhu Sheikh Mujib
Medical University (BSMMU) can be described as follows:

 Joint efforts: The two departments work together to ensure the provision of high-quality
social services to patients and their families in both hospitals.
 Collaborative projects: The departments collaborate on various projects and initiatives
to enhance the social services provided to patients.
 Information sharing: They share information and resources to ensure that patients
receive the best possible care and support.
 Regular communication: The departments maintain regular communication and
coordination through meetings, conferences, and other forums.

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  Inter-departmental referrals: Patients may be referred from one department to the other
based on their specific needs and the resources available at each hospital.
 Joint training and development initiatives: The departments collaborate on training
and development initiatives to enhance the skills and knowledge of social services staff.

The coordination between the two departments is essential to ensure the provision of high-quality
social services to patients in both hospitals. It helps to promote a coordinated and integrated
approach to patient care, and to share best practices and knowledge between the departments.

7.7 Conclusion
Visiting any organization broadens the existing knowledge. It is essential to make the employee
of an organization to another organization to make a good relationship with others. Also, it helps
to identify our own lacks and limitations. It also makes an excellent opportunity to improve
performance. As an intern hospital social worker of the department of social services of Dhaka
Medical College Hospital, the visit to the social services department of Bangobondhu Sheikh
Mujib Medical University was a great opportunity for us.

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 CHAPTER EIGHT
ACHIEVEMENT, LIMITATION AND RECOMMENDATION

8.1 Introduction
Field work in social work is designed to give student opportunities for practical experience in
the Community setting, organization and administration of agency services and various
program areas. Practical training gives a chance to a student to observe the role of a social
worker in total problem solving process. About this statement it is said that, the objective of the
fieldwork program in social work education is to provide the student with actual experience in
applying social work methods and enable him or her to become familiar with real work of
practice. That is to relate academic theory to concrete reality as found in the agency setting. It
also aims to allow the student to test himself/herself to develop sense of professional discipline
to gain self-confidence and to feel him or herself a social worker with beginning competence,
components of the social work profession and its varied roles.

8.2 Achievement of field practicum

The ideal field placement offers students a focus on the methods of direct practice, policy
development and implementation, and other social work special projects and research activities.
In 60 working days of my field work, I had a lot of experience in the real life situation under
medical social work. It’s also called hospital social service. As an apprentice social worker I
was placed in Hospital Social Service office, Dhaka medical college and hospital. There was a
favorable atmosphere to apply social work knowledge and techniques in my place. As a novice
social worker I worked with different types of serious patient some of them are solvent, life rate
and some are very poor and illiterate. All of them increase my experience. When I went to take
cases, I got opportunities to make interview and able to interact with them very closely. I have
talked with each client to know about them and their life stories. Then various issues came into
light.

My Experiences as an Intern Social Worker I worked a short period of sixty working days in
hospital Social Service office, Dhaka medical college and hospital as an intern social worker
and gathered many experiences from it. Social work is a practice-based profession. So, a social
worker has to acquire knowledge from real world on subjects like the nature of human
behaviors, social relation, cultural values, environments etc. Field work is a place where a
student of social work

94
can apply his class room knowledge in practically. Only field work practice helps to create
relationship between theoretical knowledge and practical knowledge. This short period of time
sixty (60) working days I worked under Dipika Rani Saha is agency supervisor in the hospital
Social service office, Dhaka medical college and hospital as my agency. I learned and obtained
lot of experiences and developed my skill in certain fields of social work. Only the theory inside
the classroom or in library cannot provide the worker this type of knowledge. It requires
practical experience besides the theory to perform his duty perfectly. I used my theoretical
knowledge and gathered the following experiences:

1. I made an observation that various types of patients come to DMCH from many place
round the country, talking to them, I gathered experience on their social status,
acceptance, beliefs, power, rights, duties, ideas, values, ethics, language, culture, lifestyle,
religion, family, conception about others, prejudice, roams, philosophy, accountability etc.
2. Before my field work practicum, I had misconception on hospital social service in our
country. Now I came to know the necessity of hospital social service and field work
practice.
3. By consulting with doctors and dealing with patients, I came to know the names of many
diseases, their characteristics, the way of prevention and cure or getting relief etc.
4. I got an excellent opportunity of providing flawless service to the clients not deviating
from the code of ethics of social welfare in any complicate and emotional moments.
5. Rapport build up is an important part in social work. In the field work practice at DMCH
gained necessary knowledge on the methods of rapport building and how to develop it.
6. Social work believes in individual confidentiality, I used this principle and grows the
confidence in the mind of my client and has found out various sensitive information
regarding their disease;
7. I have acquired the mentality to face any adverse situation when I deal with the client;
8. I came to know how to take a compete interview of clients and gained practical
knowledge on the techniques, terms and conditions of an interview. I realized the
importance of the principle of acceptance.
9. I learnt the way of specifying the aims and objectives of institutions or agencies, and how
to achieve these during my field work practice.
10. I have acquired knowledge on every side of proper planning from formulation to
implementation.
11. I have got practical experience on conducting follow- up to know matters like the
development of a patient’s condition, their demands and needs etc.
12. I got the opportunity to develop intricacy with people of every level of society by serving
them. I could realize especially the real picture of the majority of the people of how much
they are poor ignorant, illiterate, helpless and disdained.

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8.3 Strengths and Weaknesses of Field Practicum Agency
I am a student of social welfare and research in University of Dhaka. I come to Dhaka Medical
College and Hospital for my field work practice. It is completely new experience for me. I
faced some problem during my work.

8.4 Strengths of Field Practicum Agency

Remarkable strengths of Hospital social service office, Dhaka medical college and hospital are in
below:

 Here I get opportunity to apply the values and ethics of the profession and to develop the
capacity to work constructively with the value dilemmas, conflicts, and ambiguities
inherent in the practice of social work.
 I get scope to test the social work methods, principle, values, and ethics.
 I also get opportunity to work with other professional and voluntary workers.
 Field work is the greatest strategy to evaluate the social work.
 I get scope of growing awareness of self with clients, staff and larger systems in relation
to practice.
 I work under administrative and organizational structure and learn how an office is
governed and what kind of routine needs to be established.
 I get the chance to develop the ability to work collaboratively with other professional as a
professional social worker.
 I get the scope to develop and demonstrate the skills of critical thinking through social
history of patients.
 I get the clear concept about human behavior, attitude, values etc.

8.5 Weaknesses of Field Practicum Agency

Some major weakness or demerits of my field practicum agency which make a strong barriers to
make this field work fruitful. Those are:

 The doctors and other hospital stuffs are not introduced with the working style of a social
worker. Here is lack of scope. Several time we faced that the doctor visit the rooms or the
on-duty doctors are not co-operating with us or feel disturb by us.
 I have failed to build up rapport in some cases because of having ignorance, illiteracy and
fear about treatment process.

96
  My limitation goes on maintaining the principle of confidentiality as interviews were
taken in front of other.
 I could not ensure sustainable material help to my client.
 Sometimes I had complication in contacting with doctors and nurses.
 The working environment of the social welfare department is noisy and caucus.
 Sometimes client’s express indifference in giving information.
 Sometime we don’t fulfill the patients’ expectations. The patient’s expectation is not in
our control then we need to handle the patient diplomatically.
 Here are lack of knowledge and scope of counseling. Sometimes the doctors and nurses
felt disturbed and they thought we are against of their treatment.
 Sometimes we faced lack of actual knowledge about the management of psychiatric
patient. They don’t like share the actual information about the psychological problem.

8.6 Strengths and Weaknesses of institute of social welfare and research,

University of Dhaka. Strengths of institute of social welfare and research,
university of Dhaka by the scope of Field Practicum
Students of Social Work are getting many facilities. Now the strengths of institute of social
welfare and research given below:

 Students can learn to apply social work methods in the solution of given individual
ground or community problems.

 The students are getting scope to develop facility in the use of organizational structure,
particularly the committee.
 The students are achieving self-awareness and disciplined use of self as a helper and
group situations.
 The students can learn the organizational framework of services.
 The student becomes familiar with administrative procedures and processes.
 The student can acquire knowledge regarding community structure and procures.
 The student can acquire significant substantive knowledge in the specific field of practice
characterized by the agency in which he/ she is placed.
 The student can acquire competence in recording and reporting (process records minutes,
monthly reports, administrative correspondence, etc.).

97
  The student can acquire and try out a variety of social work methods, skills and
techniques.
 Field work helps the students to realize the theory, methods and principles of social work
in practice which facilitates them to develop professional self.

Weaknesses of institute of social welfare and research, University of Dhaka

There I can’t see any such serious weaknesses of Weaknesses of institute of social welfare and
research, University of Dhaka. But if

 There is a scope of a joint orientation program of Institute Supervisor and Agency

Supervisor, it will be great for the apprentice social worker.
 If apprentice social worker gets chance to choose the agency for field practicum by own,
then student can do great job in the field practicum.

8.7 Recommendations
Recommendations to institute of social welfare and research, University of Dhaka:

 Organize a joint orientation program of Institute Supervisor and Agency Supervisor.

 Create a scope that students can choice the agency by their own.

Recommendations to Department of Social service of Dhaka medical college and hospital

There are some following steps to combat the existing barriers and to make more programs.
Every day, I took the information about my client’s physical and mental condition. And I helped
him as an apprentice social worker, as much as possible with the help of my agency. Some
following steps should be taken off by department of social service, Dhaka medical college and
hospital:

 The doctors, nurses, and authority of Dhaka medical college and hospital should be more
heart-felt and cooperative and maintain a standard of good conduct.
 More discipline should be maintained at the time of medicine distribution.
 Emphasis should be given on the publicity about hospital social service at the root level.
 Beside case work, group work and community work can be practiced.
 Rehabilitation programs can be extended to rehabilitate the poor and destitute, helpless
patients.
 More skilled manpower should be involved to fertilize the services.
 Hospital social work should be included in the medical syllabus.

98
  Conference needs to be effective to enhance students’ skill in problem solving and being
professional social workers.

8.8 Conclusion
After completing my field work, I can realize that field work occupies central role to make
skilled and experienced social worker as well as provides great opportunity to pertain
theoretical knowledge into real world. Field practicum is only means through which an
apprentice social worker can assimilate and enhance his/her knowledge, dexterity and
experience to solve the client's problems more accurately and systematic manner under an
organization structure. I work as an apprentice social worker in my own community for 40
working days. During that period, I have learnt many things every day. I have verified and
listed my theoretical knowledge in the light of practical situation. It was such an experiences
that will be enlightened me in an illuminated way in my future working life. As long as I was
student, I was not much sentient about the actual situation that our society is in. This practical
training has given me practical knowledge of the issues and problems faced by the people
specially the poor section of our community. I have tried to apply various methods of social
work during fieldwork training. This field practicum is the greatest experience of my life

99
 CONCLUDING REMARKS
After completing my field work, I realized that field work occupies a central role in making
skilled and experienced social workers as well as providing great opportunity to pertain
theoretical knowledge into real world. Field practicum is only means through which an
apprentice social worker can assimilate and enhance his/her knowledge, dexterity and experience
to solve the client's problems more accurately and systematic manner under an organization
structure. I work as an apprentice social worker in Hospital Social Service office, Dhaka medical
college and hospital for 60 working days. During that period, I learnt many things every day. I
have verified and listed my theoretical knowledge in the light of practical situation. If I was a
student, I was not very sentient about the actual situation that our life is in. This practical training
has given me practical knowledge of the issues and problems faced by the people, especially the
poor section of our country. I have tried to apply various methods of social work during
fieldwork training. This field practicum is the greatest experience of my life.

100
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