Until a month ago, I was working in the above physical setting for the last ten years! It was earlier an annexe to the autopsy hall, which was converted to function as Child Development Centre in 2012.
Since a month after retiring from the work at the Medical College, I work in the physical setting below! It was garage, which is now converted into a transit corner to locate the office of ASHIRVAD, the charitable trust that Anna and I have been associated with from 1983.
During this transition, there are losses and gains.
What fascinates and satisfies me is the resemblance of this modified garage, to the first one room ASHIRVAD Child Development Centre, started at 18 Vardarajulu road, Egmore, Chennai, in 1983. We started the child development work from a similar room like the one above, with the room having been made ready to be a play room for children, for making observations about their developmental needs.
How refreshing it is to recall that we return to a similar ambience and physical setting from where we began the journey of forty years into child development.
The forty years started with Annie, a three years old girl coming with her mother, after two days of starting the Child Development centre on 14 November, 1983.
Annie came crying, stiff and frozen without being able to move. If she attempted to move, she would become stiff and go arching backwards with intense cry in distress. Her mother carried her on her shoulders, travelling ten kilometres in public transport to visit us. I knew at the first sight that she needed muscle relaxants. The ideal drug would have been Baclofen which was not available in Chennai at that time. The drug I prescribed hesitantly was Diazepam, knowing that while providing muscle relaxation, it could make Annie drowsy during the day. So with no evidence in my favour, I used half the therapeutic dose in eight hourly dose, seeing the distress of the child and the desperate situation of the mother, who could not sleep well for months as her child got up and became stiff. The crying intensified the stiffness because of persistence of the startle reflex.
When the family returned a week alter, Annie was comfortable on her mother's shoulder, relaxed and moving her body, allowing a detailed clinical examination, which was not possible in the previous time.
That experience of Diazepam being a good enough muscle relaxant, when used in half therapeutic dose, became the first discovery in the first week of the forty years of the journey in Child Development. Anna through her double blind study later in 1999 proved that a single dose of Diazepam at bed time can be as effective as eight hourly dose to offer muscle relaxation in children with Central Motor Disorder, without causing any sedation. This was published in two international journals. I notice that Diazepam has reappeared in text books, recommended for use as a muscle relaxant in spasticity.
The idea to think laterally started in that one room Child Development Centre in 1983. Now Anna and I shall, all being well, attempt to summarise some important discoveries we have been given to experience in the last forty years, while we begin to work from the transit corner above!
A friend asked me to summarise the last forty years. It came to me, that our journey was to befriend children with neuro-developmental needs, know and be known of them and be companions to their hurting parents.
The logo of ASHIRVAD is 'Taking sides' along with the picture of a child, supported by two hands to move forward!
We begin again similar to where we started forty years ago, to go on another journey of recalling and narrating discoveries and insights that we have been given!
M.C.Mathew(text and photo)
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