I was invited to give a presentation on neuro-developmental monitoring of High-Risk Infants at a meeting of Paediatricians in 1987 at Chennai, which was my first occasion to meet with Paediatricians in Chennai since Anna and I relocated to live and work in Chennai 1983. A senior paediatrician walked up to me after the meeting to thank me for my presentation and for using several photographs to illustrate the different clinical examination cues. She was Dr Rachel Chacko, who since then became a regular visitor to ASHIRVAD Child Development Centre at Anna Nagar, Chennai. What held my attention during that first meeting was the respect and regard with which she greeted me although it was our first meeting. She introduced herself as a senior Paediatrician, who retired from the Institute of Paediatrics, Madras Medial College. From the sight of many coming to greet her and sharing recollections of her teaching and guidance, I knew that she was held in high esteem by Paediatricians.
Dr Chacko surprised Anna and me a few days later by dropping in to ASHIRVAD Child Development Centre located at AD 80, Anna Nagar. She came with a packet of snacks, which I found out later that, it was her regular way of sharing her thoughtfulness with others, whenever she visited friends. She related to us warmly and endearingly as if she knew us for long.
When she came to find out that it was through the arrival and home call of our daughter Anita in 1981, when I was in the Paediatric faculty at the Christian Medial college, Vellore, (CMCV) that we were guided to provide a facility for children who were neuro-developmentally challenged, she sat listening surprised and amazed. She had many associations and friends at CMCV. Dr Chacko had many pleasant memories of her association with Professor Malathi Jadhav, under whom I worked at CMCV. Dr Chacko had a phenomenal memory for details.
Anna and I sensed that she felt moved when we mentioned the home call of our daughter. That was when she started talking about her double loss- her husband who was a professor at Madras Medical College in a plane crash and her son who was a medical student at CMCV in a freak car accident. Listening to her story of trying times and traumatic experiences, we felt that she was a person who had endured a lot in life. Her gracious and kind ways would have emerged from the formative experiences of these painful encounters, while she was in her middle age. The responsible way she rose to the occasion to be a single parent to her three daughters and their families touched us, because she although still lived with grief and loss, had found her way forward to be larger and generous than usual, in thought and deed.
During the conversation she mentioned that she first heard about us from Dr Willian Cutting, a consultant Paediatrician in Edinburgh, who had worked earlier at CMCV and in a mission hospital in Andhra Pradesh. Dr Chacko was looking forward to meeting us since then. She left after giving a generous donation for ASHIRVAD.
Anna and I were touched by her visit as we were at Chennai only for four years by then and were still looking for senior friends, who could be in a mentoring role, while we were engaged in a developing the new specialty of Developmental Paediatrics, which was first of such an initiative in the country at that time. Although there were activities to support children with neuro-developmental needs through special schools and vocational Centres in different parts in India, it was the first time a stand-alone Child Development Centre was started. Anna and I were looking for opportunities to get integrated with the Paediatricians and present to them about the role of a Child Development Centre in developmental monitoring of children with neuro-developmental departure.
About a week after the visit of Dr Chacko, we noticed that there were enquiries from Paediatricians and referrals of children, so much so we could welcome children only by prior appointment. It was when Dr Chacko visited us a week later, we realised that she had visited or telephoned many Paediatricians in the city to make them aware of the activities at the Child Developmental Centre. An invitation came from the Institute of Child Health, Chennai to make a presentation to the faculty and post-graduate students about the neuro-developmental follow up of high-risk infants. It was Dr Chacko who got that organised. That opening which Dr Chacko provided, continued to be a valuable opportunity to present to the post-graduates through bedside clinics and seminars some foundations on Developmental Neurology, till we relocated the Child Development Centre at CMCV in 1997. By then Dr Chacko had become a spokesperson for ASHIRVAD Christian Concern for Child Care and an advocate for early neuro-developmental intervention when children had developmental challenges.
Anna and I visited her home at Nungambakkam to convey our appreciation for her thoughtfulness and kindness. We were in for a surprise when we visited her. Dr Chacko had close association with St Andrew’s church where Anna and I were worshipping members since 1987. The Church had a project to support adults with developmental needs-ASHA. Dr Chacko had already spoken to the Presbyter of the church to invite us to start a project for children in partnership with ASHIRVAD. Late Mr Johny Samuel, the Sessions Clerk of the church and Re Peter Miller, the then presbyter and subsequently Rev David Singh came forward to request ASHIRVAD to partner with the Church to start play groups for children in the church campus. We conducted a two-week enabling programme for volunteers from the church to lead the play group. This became a programme for about forty children in less than six months and the church built a custom-made building in its premise and started a regular school for developmentally challenged children, which now functions as one of the leading schools in Chennai with good facilities even up to vocational preparation of children. All of these valuable services got started because Dr Chacko thought about it and contributed liberally towards it financially.
Dr Chacko was known to be a facilitator of new initiatives. She was an active leader of the Women’s Doctors Association in Chennai which was a meaningful support for women doctors in different circumstances of life. Some faced stress at work-place, home, marriage, bringing up children, etc. Anna and I remember stories of women who needed various forms of support, whom Dr Chacko would reach out to help by connecting them with counsellors and being in touch with them herself regularly. It was this need that led her to start a women’s prayer group which met almost every week. It was this group which took up the responsibility of visiting women living in difficult circumstances to offer various forms of support and provisions.
I remember number of occasions when Dr Chacko was not only altruistic but also a generous giver. Although Dr Chacko had retired, there were still many families who came to visit her with their children. It was not her habit to solicit a consultation fee. She received what was given and did not mind if a family did not give. Most of what she received was given away for charitable purposes. ASHIRVAD benefitted from her gracious giving. Anna and I remember her telling us once that God blessed her abundantly. She inherited the house which her husband had built and when that was sold there was enough for her to give to her daughters and for her to live on. Therefore, all the gifts she received from families who visited for health care were given away to support others.
Her driver was a senior citizen. I was touched once when I saw her bringing a packet of food and goodies after attending a formal lunch in a function. Dr Chacko had a special concern for her domestic workers and others who were in some way or other associated with her. I remember this from our own experience. Every time she visited ASHIRVAD Child Development Centre, she would notice the staff and go to them to meet and chat. Often, she carried a chocolate bar in her bag for each of them. She dropped in to greet them on their birthdays.
From 1989, Dr Chacko was member of the board of trustees of ASHIRVAD. The board met twice in a year and Dr Chacko hosted the lunch for the board each time. It was her interest to see expand ASHIRVAD activities which led to the beginning of the Early Learning Centre at Nagpur under the leadership of Mrs Pushpa Waghmare. Looking back, Dr Chacko was an inspiration for us to trust the prospects of the work we were engaged in. Even after ten years and our active presence in Chennai, the concept of a Child Development Centre was not well conceived in professional circles.
The Spastic Society of Tamil Nadu had established a facility for developmentally challenged children at Taramani. Dr Chacko was a consultant to them. When they wanted to have design to create a park for children who visited the centre, Dr Chacko requested us to propose the design. I recall that as an interesting and stimulating experience as such a facility of a play area for developmentally challenged children did not exist anywhere in Chennai at that time. Thanks to Dr Chacko’s interest in this project, that when the play area was completed and dedicated, it gave parents and other organizations an idea of how such a facility can be valuable for developmentally challenged children.
Another time when Dr Chacko helped us when we were in a dilemma, was when Mr Mani Ratnam, a well- known film producer from Chennai approached us to help him to create a story line for a film on a developmentally challenged child. Mr Mani Ratnam along with a few from his crew, came every day for a month to the Child Development Centre to observe the services and interact with us and parents. As this project was evolving, we had a hesitation as to whether we were pursuing a right cause. We had a suspicion whether the intention of the film maker was commercial or for social education to create more awareness about further attention and facilities needed for such children and their families. Dr Chacko having known Mr Mani Ratnam and his earlier films helped us to proceed in sharing our experiences and in contributing ideas towards the story line.
The film, Anjali, a story centred around a child who was receiving developmental support at ASHIRVAD Child Development Centre, when it was released became a hit and an eye opener about the deficits in the services for such children. During the next one year about thirty-five special schools sprang up in different parts of Tamil Nadu, especially in smaller towns and rural areas. Later Mr Mani Ratnam mentioned that he had approached us after going to the other centres in the city to have an experience of the approach and understand issues related to supporting children with developmental needs. It was at ASHIRVAD he was satisfied with a wholistic approach towards children, their siblings and parents. But for Dr Chacko, we would have missed this opportunity to be of some help in assisting this project.
Dr Chacko kept insisting that the specialty of Developmental Paediatrics needed an expression in a Medical College to train Paediatric specialists in the science and art of child development and early neuro-developmental intervention. She had conversations with Dr William Cutting during his annual visit to Chennai. It was during his visit in 1991, he happened to visit CMCV and mentioned to its director about the need of starting a specialty of Developmental Paediatrics at the Christian Medical College Vellore. I remember hearing from Dr Chacko that she too had mentioned about inviting ASHIRVAD to start a Developmental Paediatrics unit at CMCV to Dr Benjamin Pulimood and Dr V.I.Mathen, who were senior administrators at CMCV at that time. The discussion that started in 1992 led to CMCV inviting ASHIRVAD Christian Concern for Child Care to enter into a Memorandum of Understanding to start the Developmental Paediatrics Unit at CMCV in 1997 to coincide with the 100th anniversary of CMCV, which was to fall on 2000. There were four other departments started before the Centenary year. That was the first full-fledged academic department of Developmental Paediatrics in any Medical school at that time. Thanks to the foresight of Dr Chacko to help us to move in this direction.
Anna and I remember many occasions when we struggled a bit in the initial years wondering how much our initiative at Chennai would bear fruits! The Child Development Centre was situated in a modest building and did not receive much attention for a while. On such occasions, we turned to Dr Chacko to receive encouragement and inspiration. She was a teacher with an interest in the wholistic development of her students. A patient listener and full of empathy, she often diffused the stresses of living in a city where we had no roots. Her prayerful attitude and faith in God brought blessings to us when we needed it most. We looked forward to her telephone calls because there was concern and thoughtfulness beyond our expectations.
We felt touched by her keen interest in our children. Dr Chacko was a vocalist and musically talented. On the occasions she came home, she was keen to listen to our older son play the piano and hum tunes while he was playing. She brought encouragements to both our children in the way she enquired about their academic performance and extra-curricular activities.
Although, it was Dr Chacko who mooted the idea of relocating the Child Development Centre at CMCV, we knew that she felt sad when we finally moved in February, 1997. She decided to visit us a few weeks after our move. One of her daughters with her husband lived and worked in CMCV. Once she told us that her frequency of visits to Vellore increased since our relocation to CMCV. Every time she came to Vellore, we had an opportunity to recollect the experiences at Chennai. I found her keenly following all the events taking place in the new Developmental Paediatrics Unit. In the first year itself, we exceeded welcoming 4000 children, which was a surprise even to the administration. What a jump it was from 1200 children at Chennai in a year to 4000 or so in the first year and 6000 or so in the next year. The prediction Dr Chacko and Dr Cutting made about our services becoming more accessible to children took place from the very first year onwards.
We watched Dr Chacko ageing gracefully and having limitations in her mobility in the subsequent years. Yet her spirit of caring and bearing others upon her heart did not decline. Her faith in God and prayerful attitude grew even more in her latter years. There were other challenges in the family that she had to cope with. Every time we met her in Chennai or at Vellore, we felt the warmth with which she spoke about our common friends. She was grateful for her memory although she was physically getting weaker.
Although our contact with her became infrequent since we retired from CMC Vellore, and relocated in Kerala, there were occasions to renew contact with her or receive news about her. The news of her home call reached us rather late and we missed an opportunity to be with others and her family who would have celebrated many memories of a life, well lived in the service of people whom God brought to her life.
I look back over our association with Dr Chacko for about twenty years. She was unto us a companion and benevolent friend who saw us through some of the adjustments in life with her kind and steadfast support. We wonder whether our experiment with Child Development Centre at Chennai would have succeeded without her active involvement with us and ASHIRVAD! We found her as a person of an unusual ability to relate and care for people. She recognised even the unspoken needs of friends and colleagues and reached out to them in an unassuming way. Her generosity was her second nature. She was a conduit of the goodness of God. She turned her loss and pain to live as a feeling person, ever ready to bring comfort and hope.
Dr Chacko grew up professionally when Paediatrics was not a specialty at the undergraduate or post graduate training level in India. After her post graduate training in General Medicine, she spent time in the UK to complete her training in Paediatrics. Dr Chacko belonged to the first generation of Paediatricians in India. Dr Chacko was a pioneer and a path finder for many in Chennai. I came across at least twenty paediatricians who went on to train in Paediatrics due to the influence that Dr Chacko had on them. What impressed them about her was her way of examining children in an entertaining way. Her keen sense of observations and intuitive sense dominated her clinical examination. A Paediatrician told me, how Dr Chacko influenced her to train in Paediatrics. When she was a house surgeon, a mother came to the out-patient service area with her crying child. Dr Chacko listening to the tone and pitch of child’s cry wondered whether it was because of Otitis Media! The middle ear examination confirmed this. That made a deep impression upon her. She later became a well-known academician, researcher and went on to become the director of the institute of Child Health at Chennai.
There are some exceptional human beings we come across uncommonly. Dr Rachel Chacko was one among them. She leaves behind many memories to cherish. Anna and I celebrate her life and feel her loss from our midst. She brought cheer and comfort to many! We were one such family who received her goodness abundantly.
Let me conclude by quoting what Dr Chacko wrote about ASHRIVAD in a book that was published in 1998.
Drs Anna and M.C.Mathew are co-founders of ASHIRVAD Christian Concern for Child Care and retired as professors from Christian Medical College, Vellore. Since then they worked at PIMS Pondicherry and MOSC Medical College, Kolenchery, Kerala.
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