18 September, 2023

Flowering while under a shade!



The above two photos of two branches of a jasmine plant in our courtyard showed different colour complexions in their leaves. This made me stop to explore the mystery of this phenomenon. Both branches have been there for a while, self evident from the similar flowers they bear and the buds in the growing branches. 

What I noticed was that the branch, shown in the first photo was under the shade of a bush, not adequately exposed to the sunlight unlike the other branch receiving the sunshine and  rich of Chlorophyl. 

This sight brought memories of a season in my own life when I lived in the cloud of misunderstanding and alienation, which made Anna and I feel depleted of an inner experience of contentment and purpose. 

Anna and I had moved to Chennai to offer services in Child development for Neuro-developmentally challenged children in 1983 and started a Child Development Centre in 1983. We went to Chennai on the invitation of two friends, who made arrangements for us to get started with this service in Chennai. We had known them for several years and felt their support to take this step to start a clinical support service for developmentally challenged children at a time, when such a facility did not exist in India with the full time availability of a Paediatrician. 

However, from about six months of our time we sensed how there were pressures coming upon us to follow a path which these friends proposed for us. Right from the start, it became clear to Anna and  myself that we need to set up a service, which had an academic content and credibility, as the discipline of Developmental Paediatrics did not exist in India in any medical college at that time. In fact, the sub-specialties of Paediatrics did not exist at that time.

Knowing that we were pathfinders to define the content and contour of the discipline of Developmental Paediatrics, we developed a protocol of practice at the Child Development Centre which had a teaching, training and research component. The wish of our friends were, that we would just be a service provider and visit homes of children with neuro-developental needs and offer counselling and friendship. I could not consider that as the primary objective of our service as anything new needed a fabric of academic credentials and content to make a speciality emerge for more doctors to take an interest in this discipline. 

Following this disagreement, Anna and I struggled being alone in a city to find our way forward. Even for Paediatricians, the normal pattern was to refer a Neuro-developmentally challenged child to a special school. The special schools received children after six years, which meant that children till that age did not receive facilitating support to optimise their developmental prospects. 

However the mind block of the paediatricians could be overcome when they got to know the benefits, children would receive, if from the time they are observed to have developmental delay, are offered home based developmental support. 

Our initial enthusiasm with which we moved to Chennai got diffused and a sense of weariness had set in. The first photo above represents the sense of anaemic existence, with those who offered support initially, turning indifferent! We were able to offer developmental support for some families. But we did not feel sought after, for such a service as the value of such a service was not still not recognised. 

I felt that the developmental needs of children could be compounded by sleep disturbances, vitamin deficiencies, cortical electrical rhythm dysfunction, recurrent infection, malnutrition, Gastro-esophageal Reflux disease, spasticity restricting the movements of a child, lack of child development support for children and parents were not well informed about the needs of such a child, etc. 

It was the Neurologists who reported on the EEG done on children whom we referred, who gave me the first feed back, that Cortical Electrical Dysfunction was noticed in some EEG recordings, although children did not have clinical history of seizures. When the MRI facility became available in the Apollo Hospital in 1984, I requested some families to have MRI of brain done. The radiologists were surprised by some findings in some children which could not have been clinically identifiable. The blood tests revealed deficiencies which needed treatment. I was not aware of common occurrence of vitamin D deficiency in Neuro-developmentally challenged children till 1987. 

The Neuro-developmental follow up programme that evolved at the Child Development Centre got noticed by Neurologists and Paediatricians, which created an opportunity to make presentations in clinical fora, on Child Development of Neuro-developmentally challenged children. 

It was the visit of Dr Rachel Chacko, a retired professor of Paediatrics from Madras Medical College which eased a big pressure that had come upon us by that time of 'feeling alone' while we were struggling to keep the services going under pressure of finding financial support and social acceptance. The church we went to at that time did not reach out to sense our needs. Friends were skeptical. But Dr Chacko would drop in regularly to encourage and give us feed back on the significance of waht we were pursuing. She became a spokesperson of the idea of child development of Neuro-developmentally challenged children among her Paediatric colleagues.

The second photo of the branch of jasmine flowering with healthy looking leaves represent the longing with which Anna and I lived between 1983 and 1986. The transition happened when we had an opportunity to go to the Institute of Child Health, in London for training in child development and rehabilitation. 

That happened when the friends in the Bible Medical Missionary Fellowship in London office facilitated and supported us to be in London as a family, for me to complete that training programme. That was a turning point in the story of ASHIRVAD, which was the trust that was formed in 1983 to start the Child Development Centre in Chennai. 

Since then there was no turning back!  There was a  momentum of starting different services through ASHIRVAD at Chennai, Nagpur, Vellore, Pondicherry and  Kolenchery. 

Let me confess that some of us would feel like being in the shadow and shade of others who are indifferent towards us. That is also one season, which we patiently can go through, knowing that it is only one season. The season in our lives would change when we live with hope and trust in God, who accompanies us during the peeks and valleys of our lives. 

Yesterday, as I saw this contrasting sight in a jasmine plant, with one branch under the shadow of a bush, and looking starved of sunlight, I remembered that, it too is only for a season! The plant will grow beyond the bush that hides it and would receive the sunlight to be replenished!

Life is a celebration and is not lived hidden under a bushel!


M.C.Mathew(text and photo)

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