Articles

Article List. 
1. Children in Need
2.  A Call to care
3. Living with hope
4. The Gaps & Margins 


Children in Need

A baby announces his arrival by a cry.  This loud cry is nothing but an indication of an urgent need.  The need is for a breath of air which is vital for establishing spontaneous respiration, and normal blood circulation.  That need expressed through a cry is symbolic of the several million needs that a growing child would express all through life.

However, apart from the usual needs which are provided for in the pleasant setting of the home there are some other needs that are extraordinary or special in nature.  These needs about which I shall refer to here are needs which would require specialised attention because of the nature and complexity of the needs.

It is natural for many of us to be aware of the needs of migrant children, children living in slums, those in child labour, displaced children, or children exposed to social crimes etc.  No doubt these children are children who have special needs.  My intention is not to discuss about those children here but to highlight on the needs of some other categories of children who live and grow up in the normal setting of a home, whose needs have a broad spectrum of expressions.

I. WHO ARE CHILDREN IN NEED?
a. Gifted children
b. Slow learners
c. Clumsy children
d. Hyperactive children
e. Passive children
f. Defiant children
g. Chronically ill children
h. Disabled children

II. APPROACH TO CHILDREN IN NEED
I shall define the above categories of children, mention their needs and suggest some ways to respond to them.  While we consider these needs it is very important that a child is a dynamic person.  A child who was passive may suddenly become hyperactive.  A child who was diligent and consistent in his studies may become a slow learner.  Parents who thought of their child as clumsy may be delighted to see him become very delicate and precise with his hands and do highly skilled activities with great ease and freedom.  All these changes may take place depending on the velocity of the growth of the child as well as the environmental stimuli that he or she will receive periodically.

It is therefore necessary to understand that every child is a growing person who is his or her process of growth and development would acquire greater precision, judgement, knowledge and wisdom or may remain static or regress in his performance.

It is difficult to distinguish a child who is ordinarily growing up from that of another child who has got more manifest or explicit needs unless the parents or caregivers are alert to watch their children grow up.  A recognition of the need as and when they arise is the first step in understanding the children.

a. Gifted children
It was a customary practice to categorise children on the basis of their intelligence quotient (IQ). About 10 - 15% of  children were reported to have an IQ above 100%.  In the pages of the history we come across the names of several geniuses who contributed significant in the field of science, arts, drama, music etc.

Let me illustrate this from the example of a child whom I saw a few months back. The mother was very concerned about her child who was getting sent out of the class for his misbehaviour almost everyday. He was doing well in the class always.  The sudden poor performance in the class tests combined with frequent punishment made the mother  wonder whether her child was regressing in his performance.  During her conversationwith the teacher she happened to find out that her son usually finished the class work  earlier than the other children and would often fidget or disturb other children while he waited for them to finish. The teacher would lose patience with him because of his distractibility.  The mother very was concerned about this. She went back to the teacher and asked her whether she could consider giving him an extra sum or an extra writing work to do if he happened to finish earlier so that he would still be occupied while the other children are finishing their work, to which the teacher obliged. Following this change of approach, her son’s performance improved. He soon returned to his old self taking interest in the class and performing well.

The mother who narrated this story to me was seeking for further help in keeping her child involved in creative activities during his leisure time. This example is representative of several children who are branded by their parents or teachers as naughty or fidgety. The reason for this so called troublesome or irksome behaviour may be because of the under utilisation of their time, abilities or skills.   It is important therefore for us to recognise that a naughty behaviour or fidgeting nature or restlessness is not necessarily because of an inherent learning difficulty or weakness of the child but because of the undiscovered ability of the child who is just bubbling to express himself in some active form. 

The usual reason why children with special abilities resorts to doing something that is irritating or attention seeking is because other attempts which the child may have made to advance himself in promoting or developing his skills may not have received approval or appreciation from the parents. May be because the parents did not take adequate note of his motivation the child almost gave up attempting what he could achieve.  That silent retreat the child from pursuing his skill will often cause internal turmoil leading to anger and disappointment.  An angry or disappointed child is often restless, unhappy or fidgety.   On some other occasion a gifted child would feel frustrated when he does not accomplish what he has desired for himself.  This may be because of the practical difficulties that he encountered while setting out on his task or entertaining an ambitious plan disproportionate to what he could achieve at that time.

The most important thing therefore would be to recognise those who are gifted in some special ways.  When a child of 2 years is showing undue interest in playing with colour pencils by way of scribbling or drawing or looking at pictures with rapt attention it is important for the parents to affirm and encourage his artistic inclinations.  When you have a three year old child able to sing nursery rhymes or join singing the songs that adults would sing and show a special ability to keep tune, the parents can foster the hidden musical talents of the child. There may be situations where a child finishes his home work with a lot of interest and is ready to read or talk about many matters, then you know that you are dealing with a child whose intellectual understanding is ahead of his chronological age.   There would be many different ways like this where a child would express his or her enhanced level of skills in some areas.

The parents or other care givers do well by taking note of this and appropriately fostering the development of the child.  This can be provided by introducing the child to music, singing, painting, drawing, reading, hobbies of his choice etc.,  If this is not done the child may show disinterest or perform badly, or sometimes resort to attention seeking behaviour like temper tantrums.  The reason why children resort to these forms of expression of their need is because till about 7 or 8 years, children are inclined to express through their behaviour and non-verbal communication than through verbalisation.  Because the precise concept and symbolic understanding are in early stages of development that a young child would often indicate his need through a form of behaviour that the adults are sure to respond to.

The way to respond to the needs of children who are gifted would be by being quick to recognise their needs.    A toddler or a preschooler needs many interactive play activities covering a wide area of his interests.   By observing the strengths and weaknesses during the play we can study every child.  When a child is particularly between 2-5 years, this is a very important step that parents should not miss.  In fact, even an idea about his future vocation or career could be got at that young age if parents have taken enough time to understand the learning and behavioural pattern of the child.  Child watching is therefore an art that parents have to re-discover in order to enrich their children in the areas where they are most gifted.  This provides an augmented learning opportunity for the child.  Gifted children have to be encouraged rather than branded as trouble-makers.

It is a pity that our curriculum of learning in the schools is so tailor made for the average children that it need not necessarily match with the emotional and intellectual needs of those who are gifted. Our teachers can also be sometimes stereotyped and monotonous in their approach that they may miss recognising those children who have greater insights and wider perspective. When this is the pattern prevalent in most of our schools it becomes all the more important for the parents to provide for their children, when they observe exceptional abilities in their children. 

b. Slow learners
The other day I was asking a 5 year old child to copy a circle, triangle, rectangle and a square. The child took longer time than what was needed and seemed to struggle to copy them. I was keen to find out why the child was struggling. I demonstrated once how to copy them.  After the child observed the way I did it, it took no time for the child to complete the task.  This led me to ask the parents as to how the learning process takes place at home. To my surprise I found that often this child was expected to do certain things without any demonstration of the steps needed for the child to understand. Taking a clue from this experience I was able to demonstrate how some of the tasks that he took a long time to do, could be made easier by clarifying the steps involved.

A good proportion of our children who do not do well in any task or an examination or memory test or a creative activities are those who have missed the grasp of the know how to do things.   Because their peers can do without an explanation of steps involved to complete the task, it is presumed that this group of children should also cope without the needed explanation or demonstration.

Some children would need to see a weighing scale and see weights before they could get the concept of measure of 500 gm or 1000 gms. Others can remember better about the sources of water if they have seek lake, ponds, rivers or an ocean.   It is beyond them to imaging effectively otherwise.  We take many things for granted as we deal with the learning process of our children.  We expect them to know without giving them an experience.  When we eliminate smaller successive steps needed to make learning easy and understandable some children would cope with them by the exercise of their abstract thinking whereas others cannot stretch their imagination beyond a certain limit.

What may be responsible to make a child slow learner is because of the lack of clarity with which we present facts and informations to the child.  I am not minimising the fact but there may be some children who have genuine difficulty in memory, reading, understanding, writing, comprehensive or interpretative thinking.  Such children with specific learning needs would also initially present as slow learners.  But, sooner or later their learning difficulties would get expressed in one or two specific areas needing attention and remedial approach.

We need to understand slow learners by a careful analysis of the reasons responsible for the pattern.  Many of the slow learners may benefit by repetition, demonstration and     clarification. What they need is more time as well as assistance to enhance their understanding by appropriate examples and illustrations.   The other group of children who have specific learning difficulties due to reading or writing difficulties may not pick up in their understanding or in their performance by this approach.  In fact they may do poorly in spite of this special attention.  If that were to happen, that child would need a careful medical and psychological evaluation.

A child who has been doing well may be suddenly noticed to have difficulty in learning.  There may be a precipitating event for this.  The usual events that affect the children are the arrival of another baby in the house, mother returning to work after having been at home for sometime, the sudden change of teacher in the class, the separation from one of the close friends, emotional trauma because of fear, fright, or grief etc.,  It is sometimes surprising how a trivial event can prejudice the mind of a child arousing undesirable emotions of confusion and anxiety.

The way to approach the child who has regresses from his past performance is by engaging the child in interactive games or by creating many unpleasant occasions in the home by which the child is given an opportunity to shed his or her inhibitions and to talk about events or experience that torment the child.  Some children may so withdraw that one may have to use direct or indirect questions in a non-threatening way till we can complete the puzzle from the clues the child may give. This careful and patient approach may reveal issues which may be directly responsible for difficulties that have recently surfaced.

What has happened today is that very young children grow up on their own with both parents being away at work. The care givers or servants are not very sensitive about the needs of children.  So children may end up being occupied with television, or other passive activities. The creative and inquisitive spirits of children are suppressed by these.  A plant in the garden can be eaten away by pests and destroyed in just one day.  Plants need daily  attention if it has to grow and blossom. A child needs attention for development.  Just providing a shelter to live, food to eat, clothes to wear, help to complete the home work or providing entertainment do not constitute the total environment that the children need. They need to have companions to talk to, adults to interact with and friends to play with.

Having said this I must also make it clear that some children may remain as slow learners and others may pick up well when the environment is made more suitable for them.  There may be yet another group who do well in spite of their learning difficulties and complete well with their peers.  Whatever may be the outcome, after we have identified and provided the support, it is important for parents to receive them as their children and to acknowledge their gifts and to recognise their potentials.  Our projected expectations must get transformed into real expectations so that our children are liberated to become what they can be rather than being forced to conform to our expectations. 

What strikes us most in the example of Hannah in 1 Samuel Chap 1:22 is her desire to offer Samuel at the temple after she had weaned him.  Both Hannah and Elkannah recognised that Samuel need to be cared for and personally looked after before he could be independent or ready for a life apart from them in the temple.  The concept of giving children the needed and special attention when they need it most is an important Biblical foundation that parents ought to recognise. When we have a pressure to return to work or need additional financial resources to support the family or other contingencies to cope with, none of us should do it at the risk of prematurely separating our children from the benefit of our proximity and full attention.  No form of substitute to augment the growth and development of a child is good as the loving input that can come from caring parents.  I say this because it is this availability and presence of the parents that may prevent our children from growing up with gaps in their understanding or becoming slow learners. 

c. Clumsy Children
I remember seeing a child who would pick up anything that he noticed and drop it on the ground or pull apart if it happens to be a toy.  In this process of playing with toys he showed very poor manual dexterity, manipulative skills of the hands or creative enthusiasm.  He would take building blocks and throw them to hear the sounds they make rather than put them together to form shapes and patterns. The mother was visibly concerned about this tendency because of its apparent destructive pattern. At home he keeps his table most untidy and leaves his soiled clothes anywhere.  He had a shabby handwriting and kept his books untidy. He often came back from the school soaked in dirt.  He would leave the table messy while having his meal. He also caused social embarrassment to the parents because he behaved in a crowd unlike his peers in a manner that made him stand out.

Listening to the story of this child and observing him during the preliminary interview it was more or less clear that he belonged to the group of children who had a clumsy pattern in behaviour and performance. This disorderly and aesthetically unpleasant behaviour that we see in some children may be because of variety of causes.  The common causes may be an immature development of the fine coordination skills and a lack of synchronised blending between the thinking process and peripheral activity.  Some may have a very minimal neuro-developmental delay which could be overcome by appropriate corrective measures.  Apart from the disorderly behaviour and performance, they may also have associated difficulties like a very short attention span or poor concentration ability.  Occasionally there may be associated with learning difficulties or poor memory or practical skills.

The net effect of this clumsy behaviour would be reflected in many aspects of the child’s behaviour.  Consequently, the child gets corrected or scolded repeatedly for the clumsy pattern both at home and in the classroom. The other children mark him as one who cannot do certain things like the way they do. He does not do very well in competitive sports or  activities which sometimes cause him to have a low esteem of himself. It may also be seen that such children lose their initiative and withdraw from belonging to a peer group because of the complex that they develop. 

Here again our approach to such children should be by understanding the child as a person. It is only when he is doing activities where manipulative or coordination skills are involved that he may manifest this clumsy pattern. He usually does well in reading, understanding, expression and conversation etc.,  It is very important to strengthen him in these areas where he is proficient and give him an advantage over others by an extra help so that he acquires mastery in some of these skills.   A child who is conscious of his clumsy pattern may not want to risk himself doing activities where his weakness would be exposed but would want to do things where he can perform like others or better than others.  In stead of consistently correcting him about his clumsy pattern the approach has to be positive. 

During the process of involvement with the child that I referred to earlier we had to teach him to walk slowly as against his normal habit of waking fast or running.    We had to teach him to hold an object with both hands rather than with one hand to avoid dropping it.   We demonstrated ways by which he could play with toys that will give him fascination and pleasure.  The cause and effect phenomenon with various toys were introduced to him which gave him many options while playing with them.  He was introduced to fine manipulative skills involving his hands like hammering nails on to wood, fixing screws on to a board, drawing, painting, copying and exercises like playing with play dough, splashing water, painting on the table with fingers using a slimy soap solution etc.  The child over a period of time recognised how he could overcome the difficulties that he encountered by giving more attention to what he was doing and by doing it slowly.  The fine movements of the hands gradually became easy and effortless. This gradual improvement gave him satisfaction and confidence to try consistently to make his skills more fine and precise.  The parents were delighted in his progress because he responded to these special efforts delightfully.

There are certain things that some of us cannot do.  When King Saul decided to give his armour to David to fight Goliath it was too heavy for David to wear.  He felt immobilised in that armour.  It was only when David was given an opportunity to be himself and to exercise himself others discovered what a measure of resources he had at his disposal.  This is a good example to remind us of the potentials of our children.  So often we are inclined to force our views and pattern of learning that we are not patient to give them an opportunity to express their original self or allow them to be what they are and to exercise their natural skills.  What appears clumsy to us may not after all matter in the long run!

d. Hyperactive children
While I was travelling in the train once I had the pleasant surprise of travelling with a family whom I knew.  The older child in the family was a book worm and sat quietly reading with rapt attention and great interest.  At 7 years he exceeded in his skill of understanding, perception and observation.  The younger child of 3 years was different altogether.  Excepting for those hours when he slept I could hardly see him sit in one place.  He changed his activities from one thing to another in quick succession.  He would occasionally disturb his older brother by pulling his book away; he would open his mother’s bag and pull out things and spread them; he would switch on and switch off the light and fan; he would open the window shutters of the train and close; he would want to climb on to the sleeping berth and get down; he would leave the meal half way to do something else; he would enter into conversation with somebody but soon get drawn towards something that he saw outside.  Looking at this child and his multitude of activities I was reminded of many children who also show similar pattern of behaviour in their early childhood.  Some people refer to these children as hyperactive.

A lot of research is being done to find out the causes of hyperactivity in children.  We now blame various synthetic foods that children consume like beverages, fruit drinks etc., Even natural products like chocolate, cocoa or some vegetables are incriminated.  It is also shown that children who have a hyperactive behaviour may benefit by the withdrawal of some of the incriminating food items particularly those containing colouring agents and preservatives.  While this may be true there are many children who develop hyperactive behaviour because they have not received adequate attention or sustained contact with care givers or sustained satisfaction from activities that he is introduced to.

The frequent jumping from one activity to another is a compensatory mechanism to find his choice for pleasure.  There may be another group of children who are hyperactive because of a neurological insult that they suffered, in which case there may be associated difficulties also.  A smaller section of children who are hyperactive may do so because of sibling rivalry, defiance to parental control or easy distractability.  Younger children with hyperactive behaviour may be doing so because of the basic difficulty to discriminate from several auditory and visual stimuli that they receive and stay with what is pleasant.

When a child has a tendency for hyperactivity he becomes an object of attention.  The co-passengers who liked the parents to keep the child quiet were discussing as to why the child was showing that hyperactive nature.  As for me I did not feel very disturbed because I knew that here was a child who was gifted in some areas and was constantly seeking for something that would match with his needs.  When he was given a book to colour he sat with that book and coloured many pictures with great interest.  This was an eye-opener to the parents as to how they could keep him involved in activities without having to control him or restrict him.

If he is not approached in this fashion what might happen in a home setting or in a school is that the child is at the risk of being scolded and punished frequently.  In our attempt to keep a child quiet we suppress his interests and inquisitiveness.  We also do not provide enough occupation that will match with his expectation.  No wonder that he sometimes becomes a nuisance to other siblings and peers.  This profile he projects about himself is not his creation alone.  He or she remains as a child who is not understood well.  He does not have the vocabulary or the expressive ability to make his needs known to those around him.  I am not minimising the possibility of some organic processes which would have to be dealt with by appropriate measures.  While that may be true in some children, the usual approach that we shall adopt to begin with is by studying the child, his interaction and the environment in which he grows.

The beginning has to be made by creating an environment where children and their needs are understood.  Unfortunately children have to put up with the behaviour and attitude of the adults.  The adults are not always conditioned to recognise the special needs of children.  That may be the reason why even the disciples of Jesus Christ forbid the parents from bringing the children to the Lord Jesus Christ (Matt: 19:13).  The disciples could not see the value of children being blessed.  That act of Jesus taking them to his lap and offering them his care, love, attention and blessing was a very needed affirmative step for the children.  Jesus in so doing, was demonstrating to the parents and others standing by, the value of such intimate personal interaction.  The disciples with their adult oriented thinking and self-centred inclinations could not recognise what would make those children delightful!

Adults are the usual immediate contacts that children have at home and outside.  We need to get inclined to them in order to respond to their needs.  It is in so doing that we may be able to circumvent the problems of restlessness and hyperactivity.  This also would mean using techniques such as rewarding when a desirable behaviour is achieved, reminding the child to abstain from destructive tendency, and eliminating precipitating factors thataggravate restlessness in the child.

It is here that parents may require counselling and guidance from a qualified professional person.  A child may have to be introduced to a behaviour modification whereby he engages in creative activities.  Some children would require lot of physical activity like running, playing games like foot ball etc. to expend their unspent energy.  This is particularly true when the child is confined to a tiny little flat in a crowded part of the city.  Children would also require personal times with both the parents on a regular basis so that through meaningful interaction, children are constantly made aware of who and what they are.

e. Passive Children
A family who came for consultation recently at the centre where I work was very concerned about their 4 year old child who preferred to spend most of his time all by himself, often not doing much except play with his friends once in a while.  The most interesting occupation for the child was to watch television and video programmes and because the child enjoyed that, the parents would screen for him a variety of programmes from the video library.  So much so, during the week end he would spend 12 hours watching television and about 1-2 hours every day during the week days.  What worried the parents was the difference that they noticed in him not from his older brother when he was of the same age.  The older child, who is now 8 years, used to spend most of his time, when he was around 4, drawing, painting, playing with toys, singing, reading etc.  I discovered during the conversation that four years back they did not have a video cassette recorder and the television programme did not cover such a wide variety because of which the television was not used very much at home.  It was evident from this narration of the events of the family that what occupied the child most of the time was the programmes on the television and the video that the child did not have an opportunity to pursue other creative interests.  It was a pure lack of awareness of other options at his disposal that made this child passive.

There are other children who may be passive because an older child in the family may dominate and push him or her aside to a lesser role.  Some other children may withdraw because of the fear of being punished.  There may be some children who develop a passive nature because everything is being done for them so that he or she does not have to ask questions or search for anything.  In some families children are forbidden from playing with the toys lest they are broken.  They are told not to touch this or that or take that or go there that the child is left without many choices.  The freedom of choice and expression may be consequently so badly limited that he resigns to be quiet and withdrawn.  It is also true that sometimes children become very withdrawn because of a psychological trauma or emotional instability.

Whatever may be the underlying factor, the beginning to overcome this particular problem can be made by offering individual time for the child.  The father or mother or the caregiver may have to spend short periods of time talking, reading, playing, singing or going for a walk with the child each day so that child is introduced to a variety of experiences that he may not have been aware of.  It is also important to gradually increase the child’s participation in various activities that will help him to discover himself and thereby find pleasure in what he is doing.  It may take sometime for a child to move from a passive role to a role where he or she would take initiative because he or she may still lack confidence.  Restoring confidence by tolerating the mistakes that he may commit is the first step.  It is but natural that these children may not prefer the company of peers or go out to play on their own initiative.  This has to be understood and an alternate opportunity be given by an adult or an older child to play with him individually. 

During this process of interaction and involvement one may also discover something that was suppressed in the child.  May be it was an inherent ability or an emotion.  As one gets a clue what is simmering underneath, it is necessary to act appropriately to facilitate further expression of that need as well as give affirmation to that child.

Of all the children in need I believe it is the passive children who stand the risk of losing out a lot by not having experiences that peers would have.  Because he is not a demanding type or full of initiative he may easily lag behind or remain left out or forgotten.  It is the responsibility of the alert adults in the family to take the side of that child who is showing a tendency to be quiet, withdrawn or passive so that he also has the benefit of learning experience during this time of adjustment.

What comes to my mind is the example of a girl servant who was in the house of Naman (2 Kings 5: 2-4).  It was that servant who alerted Naman’s wife about prophet Elisha who had the power to heal.  Here was a child who was fully alert and cognizant of the need of Naman.  A slave by profession she used her intuition and presence of mind to be of great value in the life of Naman and of his family.  Perhaps the timely suggestion from this little girl changed the course of Naman and his family.  This is what I regard as the potential gift of our children.  If only they can be encouraged to be part of the family, playing a role in the conversation, discussions and decision makings of the family, then lot of wisdom would come to us from the experiences and intuitive understanding of children.  It is unfortunate that because of the dominant personality of the adults, we relegate our children to a passive role of following the adults’ decision and logic.  I feel it is important for Christian parents to set their children free from some of these bondages, restrictions and inhibitions that they find the home environment most conducive to exercise their freedom to express verbally and non-verbally.  A child should be sought after as a person in his or her merit in the family.

f. Defiant Children
One of the first expressions that any child would show is the expression of ‘no’.  Many research scholars have looked at this tendency that is seen from the first few months.  A baby when offered milk in a bottle may use his hands to push it away indicating thereby that he does not like that milk.  He may indicate negatively by crying when he is given milk forcefully.  Another child may cry when asked to go to bed at a particular time.  Most children would end up expressing negatively more times than they would express positively.

This tendency to say ‘no’ may be an infantile response which is a natural defence mechanism by which a  child who is tiny and who runs the risk of being dwarfed by others can still have his interests entertained and looked after.  When a child develops more expressive abilities and clarity of thinking he would acquire a balance in his expression and the negative approach becomes less pronounced.   But there are some children who retain this negative approach in such a way that they seem to question, challenge or defend anything that is presented before them or told to do.  This is not a peculiar phenomenon confined to children alone.  When Jesus told the story of the two brothers (Matt 21:28-29) where one of them initially refused to go to work and later went was referring to that strange impulsive trend of behaviour that most of us retain in our personality from our childhood.

How then can one distinguish between a natural self defence to safeguard one’s interest from that of a tendency of defiance used by a child to assert negatively.  This is best done by studying the context in which the child appears to be defiant.  It is but natural that a toddler and a preschooler would impulsively confront something that is forced upon him.  When he is asked to do the same thing in a non-threatening and suggestive way it is likely that he would respond differently.  When you ask a child to go to bed at 8 O’clock and say “It’s time to go to bed, you better go to bed” he might tend to ask “why should I?”  Whereas if the father were to say “come with me son, let’s go to your bed; I am going to read a story to you”, his response would be very positive and welcoming – following the story it is but natural that he would fall asleep.  It is therefore important to study the mannerism and behaviour of a child when he or she appears to be defiant.  He may be reacting to the way that he or she is dealt with and develop a predominantly negative approach to everything.  If a child would respond differently when the way in which we discuss and present the matter is changed then it only means that the child may have a sensitive personality which needs to be recognised.  We would have to make him involved in decision making through dialogue.  Our authoritarian approach is represented by many children.  Our friendly and pleasant approach is the one that would bring out the best in every child and thereby give him a sense of participation.  When a child decides to do something on his own he does it better than when he is forced to do.

When the child has got a negative approach even after the environment and the way in which he is approached are altered it is important to use a counselling approach like the transactional analysis model to study the inner dynamics of a child.  The inner dynamics of a child is a reflection of the dynamics of relationship in the family.  A child picks up that which he observes and develops that as his style especially when that works to his benefit.  If he sees a confrontational and defiant mood prevailing in the relationship between the husband and the wife it is but natural that he picks up that.  If he sees the father or mother very dominating and forceful then he may or she may develop that attitude and behaviour.  He may even borrow attitudes shown by his peers or teachers.  This careful analysis of the dynamics in the family and environment would give a clue to the underlying cause.

The usual approach therefore in dealing with a child who is defiant is by personal interaction.  Using force by way of corporal punishment, repeated scolding etc., have no role to bring about a change.  In fact, they have a detrimental effect on the child.  It is by frequent explanations, reminders and gentle persuasion that we may encourage the child to see reason and logic.

If an older child is developing a defiant attitude which he did not have earlier it may be the early indication of the onset of the pre-adolescent change that is taking place.  This may have to be viewed with greater care and attention because a questioning mind at the pre-adolescent stage can be turned to a discovering mind for the benefit of the child and the family.

The admonition of St. Paul in Ephesians Chap 6:4 “parents do not provoke (exasperate) your children, instead bring them up in the training and instruction of the Lord” is a reminder to us about what we do to our children.  A defiant child is at the risk of being provoked by our forceful and aggressive approach.  Instead what is needed is to train and to instruct him to be mature and wise. Training and instruction are best done by example and by demonstration.  A child is more quick to follow that which he sees and practice them in his life than believe in something which has been theoretically presented to him.

g. Children with Chronic Illness
There are many types of illnesses that have a prolonged course in children.  The commonest among them are bronchial asthma, various types of skin or respiratory allergy, kidney diseases like nephritic syndrome, blood disorders like haemolytic anaemia (Thallasemia), malignant diseases like Leukemia or tumors of various nature, convulsive disorders etc., There may be other illnesses that may make a child ill frequently leading to physical and emotional difficulties.

The reason why children have difficulties to cope with chronic illnesses is because of the need to take medicines regularly, undergo procedures like blood transfusion, hospitalisation or miss classes intermittently or withdraw from certain sports like swimming, cycling, mountain climbing etc., because of the risks involved.  Children as a result of being deprived of some of the normal experiences of early childhood may feel resentful and blame themselves or others for the predicament in which he or she is.  Apart from this they have to cope with physical pain, discomfort and suffering also.

The after effects of the illness in the child would lead to many consequences.  A child with bronchial asthma who enjoyed sports very much shared his concerns with me once.  Before the onset of asthma he used to be a sprinter getting most of the prizes.  But now because every exercise predisposes him to have as asthmatic attack he cannot participate in his favourite sports activities.  He talked about this with great concern and anger.  Because he is not fulfilled in one area where he excelled once he tends to lag behind in his study and other creative abilities.  This causes concern to him and to the parents.  It took a while for me to figure out other areas where he was interested.  He was musically gifted.  After a while of discussion and interaction with him he could be persuaded to learn playing piano, join the choir in the school and the children’s choir in the city and develop a few hobbies.  He did like the idea of modelling with clay and plaster of paris.    He also was able to develop skills in making pencil sketches of human faces and scenery.  All these changes from his most favoured sports to a less adventurous type of activities required a great deal of interaction and persuasion.  It involved preparing a child to come to terms with his special situation and to accept something that is required to make the best out of what is still left with him.  This transition was not easy.  It took nearly 6 months for the family to believe that he would make a transition without any serious dislocation to his academic excellence.  It was wonderful to see how that child put the same efforts and enthusiasm as he used to for outdoor sports to develop some of the creative skills!

This is a small illustration of the several changes that will have to be considered when a child is afflicted with a chronic or terminal illness.  Sometimes a child may have to be given home tutoring because he is unable to go to school.  On such occasions parents may have to invite friends to come to visit him.  There may be some situation where a child may have to be altogether isolated for fear of contracting infection in which case he has to be given occupation that will remove the fear and boredom of loneliness.  Very often what is most difficult is to persuade children to accept medication and to go through medical procedures that are needed.  It is here children will require counselling and emotional support.  No child likes to be different from the other children and if they have developed a complex of being different from others and treated different it can affect their confidence o fight the struggles ahead.

When we have children with chronic illness going through this cycle of sickness and recovery the course of this may have two effects on the child.  The first is that the disease process affects the growth of the child.  And secondly every episode of illness makes the child vulnerable to more complications affecting the longevity of life.  When a child has to cope with these physical realities, it is important to create an environment to augment the sense of fulfilment for the child.  Sometimes the course of illness may be such that it may prevent the child from developing into his full potential.

A child subdued in this fashion is a person who may suffer distress inwardly.  Not only that he needs understanding and intimate personal companionship but also requires a spiritual enlightenment that gives him hope and assurance beyond the visible realm of suffering and anxiety.  Leading the child to a personal faith in Jesus Christ and the experience of Christian hope, may be a stabilising anchor for our children. The way that we introduce a child to a personal faith in Jesus Christ and to the experience of God’s love in his life will very much depend upon the personality and the make up of the child.  Often story telling from the Scripture and simple explanations from the stories Jesus told would be good ways to introduce the child to an experience of a God who loves.  This is best done by parents themselves as well as by others who know the child at close quarters.

A child having a chronic illness requires additional care in the area of his learning.  It is a pity if he loses academically that when he recovers he would lag behind his peers.  I think every effort has to be made to augment the learning of this children by additional coaching whenever it is possible.

The other area that needs to be looked after is their nutritional needs.  Because of the frequent illnesses their physical growth may be affected which can, to a certain extent be prevented by careful monitoring and nutritional supplementation.  By offering the child palatable and balanced food the additional requirement of calories and proteins can be supplemented.

The family also may have to adjust to the needs of the child especially if the family has to spend lot of their time and financial resources.  The parents have to be careful to be available adequately for other children and to keep sufficiently in reserve for their financial needs.

Our approach to children with chronic illness has to be based on our Christian perspective.  What comes to my mind is the example of the widow (2 Kings 4:1-7) who approached Elisa for a favour when her creditor had threatened to take her two children as slaves.  In response to Elisa’s question about what was still left with her she replied that she had little oil.  From the subsequent details of that incidence we realise how that little portion of oil had been enough to fill several jars which the widow could sell to pay back what she owed.  The potential of that “little” to become a bigger resource was made possible because she was ready to do something with the little that was still left.  In God’s economy nothing is insignificant or too small to be of any value or use.  In fact He specialises in multiplying and using small resources that are available with human beings.  He is a God who chooses the foolish things of the world to confound the wise.  Therefore, it is very important that we value whatever is there in our children even if it appears to be little.  When our children have various forms of chronic or terminal illness what is still left in them can become a means of grace and blessings to themselves and to the rest of the family.

h. Disabled Children
Annie is a seven year old girl whom we have known for the last four years.  Her difficulties to sit, walk, talk, eat and dress herself are pronounced.  That is how she has been viewed by her parents, neighbours and friends.  She is often referred to as spastic.  This was the filter through which I also saw her, until one day her mother told that on certain mornings she showed an unusual excitement.  It was easier to feed or bathe her on those mornings.  She would also go through the morning routine with cheer and ease.

It took a while for her mother to associate this cheerful disposition with those days when she would be going for a play group for children with special needs.  On the days when she did not go, she would drag herself to the corner in her house where toys were kept and draw the attention of others with sounds, or by throwing the toys on the ground, or by temper tantrums.

The mother narrated this observation one day to us.  That helped us to look at the new dimension of a child’s inner world, that seemed to be masked by our preoccupation with the visible disability.

This happened at the same time when we were sincerely seeking to understand the meaning and impact of disability in a child or in her/his family.  The medical model that I was trained into, consisted of diagnosing every medical illness, whether it is tuberculosis, pneumonia or anything of that sort.  For every medical diagnosis the criteria of symptoms and signs need to be fulfilled.  The treatment commenced following the diagnosis.  We refer to such a person needing treatment as a patient.

I gradually realized that there were some children, who did not have an active disease or an illness and yet were different.  They could not benefit significantly from any medicines we might prescribe.  They do not just have some symptoms and signs, but a different level of ability of understanding, speech, mobility and habits of eating, dressing etc.,  These children suffer permanently from the impact of an illness which occurred before birth, at birth or after birth.  The illness belongs to the past, but its after effects continue through life.  So whether it is Cerebral Palsy or Hearing impairment or poliomyelitis they are all an outcome of an illness, and the present state is not an illness or disease.  If it is not an illness, then the person who has this after effect is not a patient – instead he or she is a person having a special need.
            When Annie’s mother narrated the way Annie felt on different mornings, she was pointing our attention to the inner dynamics of a person and her needs.  We, who were used to look for symptoms and signs to diagnose a medical condition, had erred in branding her as spastic.  Her feelings were not paralysed.  Her interests did not lack an expression.  Her intentions were not inhibited.  The visible functions like walking, eating etc., suffered because of spasms of muscles, but many other functions like heartbeat, respiration, seeing, hearing, feeling of pain, and understanding language were just as they ought to have been.
            Here is a child who is disadvantaged more than disabled because she cannot function the way others do.  These deficiencies become limitations for growth and development because what a child learns normally through exploration, social contact, limitation, group play etc., are denied to such a child.  They cannot function in certain areas as others do.

Every society is geared to look after the needs of those in the majority.  Majority of us do not need a ramp to climb a bus, a wheel chair to move about, Braille books to read or augmentation of sounds to hear.  We plan our living, housing, education, working environment etc., keeping in view the needs of the majority.  These children who are different from the majority and cannot cope with what is meant for the majority, thus become victims of neglect or indifference.

What is the story of a child with disability?  He has no play school to go to.  There are so few special schools that not even one percent of disabled children can go to such a school.  The facilities for advanced learning, or vocational training do not match up with the needs and demands of most children with disability.  Consequently they have no occupation to belong to.  They are left within the confines of their home only to suffer in loneliness, isolation and deprivation.   These children need our attention and care.

The parents of children with disability is another group that have a special experience to cope with.  We live in a society where everything that is different from the normal is viewed with curiosity.  A child who walks, talks and behaves differently becomes an “object” of attention and comments.  The parents find it hard to come to terms with the disability in their child.  The shock created by the birth of a child who is different from the “normal” turns into a cycle of grief, anger, depression and fear. 

Friends and relatives may stay away from interaction with the parents because they do not know what and how to stay.  The medical opinion may not be reassuring, because the child has special needs requiring assistance to sit, stand, eat, drink etc., and the parents are tired of providing it without a respite.  In stead of all that they invest in their child the response of the child is very little or rather slow.  The emotional weariness, physical tiredness, financial burden and social alienation afflict the parents and other children in the family.  The child, because of whom this situation has arisen in the family, often becomes the victim of their frustration and anger.

A child develops proportionate to the attention that we give.  Our input of love, nurture, care, communication and instruction are the major contributions for the development of a normal child.  The more we give, by way of these services the greater are the chances for the child to develop in all these facilities.  How much more then, it is necessary for us to provide this service to a handicapped child who would require patience, attention and constant care.  It is very important therefore to recognise that a child with disability would need additional care, more so if we desire that the child develops all the God given faculties in due course of time.  This is the basic principle that should change our attitude and approach to a disabled child.

This would necessarily mean that the basic training and care of a child would have to begin at home.  Having come to accept such children the parents would have to begin playing, talking and caring for such children as they would do to any other child.  The child would take a longer time to recognise the love lavished.  He would need a longer time even to be disciplined and structured into an order.  It is here that the parents would find the going most hard.  Their time would be spent mostly around this child, because of the special care he or she requires.  This may be at the cost of caring for other children and attending to other needs.

It is in this area, there is a special need for Christian volunteers to help.  A neighbour or friend with a special interest for such a family and the child would do a great deal of service by spending some time periodically every week so that the family receives a good deal of emotional and physical encouragement through such an involvement.   It is for the same reason that a Day care centre or play group would be an ideal help for the parents.  The parents would benefit from this help, before the child is ready to go to a special school.

Our churches, Christian hospitals and community health programmes need to bring this neglected group of children into their orbit of ministry.  Volunteers are needed to conduct play groups for them.  They can also then visit them, read to them, take Sunday school lessons for them and support their family with love and care.  We do not need a big infrastructure to do this.  What we need is people with this calling and motivation.  We would love to see many Christian caring groups springing up.  Because we often receive more than what we give, there is this invitation to go to the handicapped and receive their friendship.

The handicapped children are wounded healers.  They will share their broken self with anyone who will regard their friendship.  Becoming their friends is a journey into adventure.

III. PARENTS WHO ARE IN NEED
When we consider children who are in various kinds of special needs we ought to recognise the special needs of their parents. Each category of children about whom we have referred to earlier would require attention, extra care and even therapy.  This is emotionally taxing on the parents.  When there are other stresses in the family like the arrival of another child or sickness or bereavement it is unlikely that the family may be able to continue providing the same magnitude of care and attention for a child who is in a special situation of need.

Forming parent support groups to help parents who have children with special needs is a welcome step.  Then there may have to be a special provision made through volunteers and friends who would take responsibility to relieve the family periodically by taking care for the needs of the child.  The parents need respite care facility if they are required to provide care on a long term basis.

The role of Christian fellowship and the church is very valuable.  The church being a caring community must immediately rally round parents in need and provide that sense of encouragement and friendship.  This is possible when the Church is able to orientate some of its members to be involved in this form of caring ministry as their vocation.

We are in a changing society where parents are under pressure to provide for their children from within the limited resources that they have.  The needs of the children are also on the increase.  The cost of education, medical care and providing for their physical needs are on the increase.  Most of the middle income group families and the low income group families would encounter total financial disaster when they have to provide for something unusual in nature. It is also important therefore that as congregations we take the responsibility of providing financial support when there are special stress situation in the families.  It is in so providing that we would demonstrate the vital link that exists in the body of Jesus Christ.  As members of the body of Christ we have a responsibility to bear each other’s burden, in a spirit of service and love.

When Jesus saw the people hungry (Matt 14:6) upon whom he had compassion, his response was to ask the disciples to provide for their physical need.  In turning to the disciples to provide food, Jesus was expressing his dependency on what they already had.  He was not searching for a resource proportionate to the need of that time but was seeking for whatever they had to be made available, which could be a means of blessing to those in need.  I think as those who belong to various congregations in our local churches we need to accept that every congregation has something that it can share in times of need with people around them.  Whatever is made available can become a means of blessing in the hands of our Lord for that family, who is facing a need.

It is very important that we seek out families in need so that they are not made to suffer more than what they can bear, or feel crushed by the burdens they have to bear.  Such a sensitive and caring response has to be forthcoming from every Christian community. 

BUILDING UP OUR CHILDREN
In our approach to children we ought to emphasise on helping our children learn that on teaching.  This would mean that we may have to use every creative and innovative approach to meet the spoken and unspoken needs of children rather than justify ourselves by having done our duties, by strictly following the conventional approach of teaching or training our children.  Every child who has a special need would therefore require individualised learning programme that would enhance the development of a child.

A child in need can be greatly helped by his brother or sister in the family.  It is very important therefore to make other children aware of the special needs that the child may have and to orientate the siblings about ways and means by which the special needs can be met.  The older children in the family can be parent substitutes for providing personal care.  Often children approach their younger ones with tremendous understanding, patience and love.  In making the older children responsible in some measure we are also introducing to them a spirit of caring. This can be a very meaningful investment in the growth of the older children who later on might even consider the caring ministry as their vocation.

Every child who is in need has to be introduced to an understanding of himself or herself by constant interaction and discussion.  Explanations, clarifications and reminders must come much more commonly than correction.  Corrections may become less needed if a child’s attitude and behaviour can be constantly modified by positive information and healthy encouragement.

The abilities of our children may be different from our expectations.  When there is so much pressure to push children to a medical or engineering or other professional courses let us remember that what they are naturally endowed to become must be encouraged somehow.  Parents or relatives should resist from the temptation of comparing the performance of two children in the family.  The children will invariably have different interests, aptitudes, abilities and inclinations.

And yet they deserve equal attention, appreciation and encouragement.  The difference in their performance in the academic realm should not predispose them to be regarded differently in the family.  Let us also not be jealous of children in our neighbours or relatives’ family.  Each child is special and unique that there is no better child to compare with.  In our foolishness if we say to any child, “you are no good” “you are useless” “you will end up nowhere”, we inflict psychic injury to our children and subject them to pressure and fear.  The teachers in the schools who are impulsively vocal with similar hurts and abuses actually distance children from themselves and from the pursuit of their optimum abilities.  What we render to our children in word and deed make the fabric of their personality.  Let us lavish good intentions on them.  We should also avoid pampering our children lest they have an exalted view of themselves and their identity.

We cannot spoil a child is any measure of love because “Love is patient, love is kind.  It does not envy.  It does not boast, it is not proud.  It is not rude, it is not self seeking, it is not easily angered.  It keeps no record of wrongs.  Love does not delight in evil, but rejoices with the truth.  It always protects, always trusts, always hopes, always preserves.  Love never fails” (1 Cor. 13: 4-8).

CONCLUSION
In our understanding of Children we may have to begin all over again.  We have been made to approach children as miniature adults.  Everytime we have gathered a new information about child care we have added that bit of information to the existing understanding that we have acquired.  What we ultimately have is a conglomeration of various ideas that we exercise in our approach to the nurture and care of our children.  Jesus referred to in Luke Chap 5:v:36 about the danger of adding a new patch to an old garment.  The new and the old cannot match and therefore are not compatible.  I suspect this holds true in our approach to children.  We need to have a new orientation about children and thereby being totally freed from our prejudices and traditional thinking. 

This new understanding of the child and his need must be based on a Biblical framework of looking at a child as a person who is created in the image of God.  He or she bears within himself or herself that inherent potential that can grow and blossom into what he or she is destined to be.  What is in that earthen vessel is so precious that it is with a great sense of awe and wonder that we ought to view that gift who is sent into our home as part of God’s plan.  Helping him or her to become that person through whom God’s grace will become more manifest, in this broken world is possible only when our homes become a place where children are made comfortable to live, grow and express themselves!
  
Dr. M.C. Mathew is Paediatrician presently working as a Consultant in Developmental Paediatrics at AHIRVAD, Child Development and Research Centre, AD 80, 5th Avenue, Anna Nagar, Madras 600 040.











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A Call to Care
Annie is a sever-year-old girl whom we have known for the last four years. Her difficulties to sit, walk, talk, eat and dress herself are pronounced. That is how she has been viewed by her parents, neighbours and friends. She is often referred to as spastic. This was the filter through which we also saw her, until one day her mother told us that on certain mornings she showed an unusual excitement. It was easier to feed or bathe her on those mornings. She would go through the morning routine with cheer and ease on some days.
It took a while for her mother to associate this cheerful disposition with those days when she would be going for a play group for children with special needs. On the days when she did not go, she would drag herself to the corner in her house where toys were kept and draw the attention of others with sounds, or by throwing the toys on the ground, or by temper tantrums.
The mother narrated this observation one day to us. That helped us to look at the new dimension of a child’s inner world, that seemed to be masked by our preoccupation with the visible disability.
Persons and not patients
This happened at the same time when we were sincerely seeking to understand the meaning and impact of disability in a child or in her/his family. The medical model that we were trained into, consisted of diagnosing every medical illness, whether it is tuberculosis, pneumonia or anything of that sort. For every medical diagnosis the criteria of symptoms and signs need to be fulfilled. The treatment commenced following the diagnosis. We refer to such a person needing treatment as a patient.
We gradually realized that there were some children, who did not have an active disease or an illness and yet were different. They could not benefit significantly from any medicines we might prescribe. They do not just have some symptoms and signs, but a different level of ability of understanding, speech, mobility and habits of eating, dressing etc. These children suffer permanently from the impact of illness which occurred before birth, at birth or after birth. The illness belongs to the past, but its after affects continue through life. So whether it is cerebral palsy or hearing impairment or poliomyelitis they are all an outcome of an illness, and the present state is not an illness or disease. If it is not an illness, then the persons who has this after effect is not a patient either – instead he or she is a person having a special need.
When Annie’s mother narrated the way Annie felt on different mornings, she was pointing our attention to the inner dynamics of a person and her needs. We, who were used to look for symptoms and signs to diagnose a medical condition, had erred in branding her as spastic. Her feelings were not paralysed. Her interests did not lack an expression. Her intentions were not inhibited. The visible functions like walking, eating etc. suffered because of spasms of muscles, but many other functions like heartbeat, respiration, seeing, hearing, feeling of pain, and understanding language were just as they ought to have been.
Disadvantages more than Disabled
Here is a child who is disadvantaged because she cannot function the way others do. These deficiencies become limitations for growth and development because what a child learns normally through exploration, social contact, imitation, group play etc., are denied to such a child. They cannot function in certain areas as others do.
Every society is geared to look after the needs of those in the majority. Majority of us do not need a ramp to climb a bus, a wheel chair to move about, Braille books to read or magnification of sounds to hear. We plan our living, housing, education, working environment etc. keeping in view the needs of the majority. These children who are different from the majority and cannot cope with what is meant for the majority, thus become victims of neglect or indifference.
Should they suffer in this way? This was the question that moved us to take an interest in these children. This interest grew into a response when we had our second child born with special needs.During those four months of her life, she warmed our hearts with her love and affection in spite of her special needs. She symbolised to us the needs of many such children. She represented to us the state of indifference and lack of opportunities that many like her may suffer from.
For the disciples of Jesus Christ, the children were an interference (Matt. 19.13). The disciples resented their presence and reacted adversely to their parents. They could not tolerate the children who had come to take away their legitimate time with Jesus.
Is that not the way the society views children with special needs? Should a country, so limited in resources such as ours, spend so much time and money to create facilities and opportunities for children who are just a small minority; (There are about 5 million disabled children in India) when we do not have adequate facilities for the remaining 200 million children in India? When the needs of the majority are not adequately met, should we concentrate on a “small” section of children, whose needs are difficult to be met?
Calling for a creative response
Jesus had time for the children who were brought to him. His response was appropriate to the needs of the children. What the children needed was his availability and blessing (Matt. 19:14).Nobody could deny this to them, not even the disciples.
Those men who carried the paralysed man (Luke 5:17-25), focus our attention on their compassion and creativity. They were available for the paralysed man. To take him to Jesus was their mission.No matter what it involved by way of risks, hard work or overcoming difficulties, they were ready.What followed was forgiveness (Luke 5:20) and physical restoration (Luke 5:24). This was made possible because these man attributed value to this paralysed person. His paralysed body did not make him less eligible for human consideration or divine grace. What those men demonstrated was a creative and co-operative effort in response to a human need.
This is what Dr. Paul Brand demonstrated about 30 years ago. Dr. Brand saw the pathetic state of those who suffered with leprosy in South India. They bore marks and scars of their disease on their body. They suffered from social alienation and emotional deprivation. They were left to their destiny of disfigurement and suffering. The disease which affected them became the source of social stigma. The stigma of the disease made the sufferer feel worthless.
At such a time, Dr. Brand’s entry into the scene by advocating treatment of the disease, designing new surgical procedures to lessen their disfigurement and turning their abilities to creative occupations of pottery, carpentry and other self-employment schemes marked the beginning of a series of new measures taken by Christian hospitals, churches, voluntary organizations and the government to respond to this need. That small beginning opened a new field of opportunities for patients of leprosy.
This is an opportunity for Christians who have an instinct of pioneering. The children with various forms of handicaps wait for an opportunity to develop, learn, relate to others, express themselves and to participate in activities their peers engage in. Normally a 3 year-old child has a play school to go to. A 6 year-old has a school to go to. An 18 year-old has a college to go to. A 25 year-old may find a job to go to.
What is the story of a child with disability? He has no play school to go to. There are so few special schools that not even one percent of disabled children can go to such a school. The facilities for advanced learning, or vocational training do not match up with the needs and demands of most children with disability. Consequently they have no occupation to belong to. They are left within the confines of their home only to suffer in loneliness, isolation and deprivation. These children need our attention and care.
The parents of children with disability is another group that have a special experience to cope with.We live in a society where everything that is different from the normal is viewed with curiosity. A child who walks, talks and behaves differently becomes an “object” of attention and comments. The parents find it hard to come to terms with the disability in their child. The shock created by the birth of a child who is different from the “normal” turns into a cycle of grief, anger, depression and fear.
Friends and relatives may stay away from interaction with the parents because they do not know what and how to say. The medical opinion may not be reassuring, because the child has special needs requiring assistance to sit, stand, eat, drink etc., the parents are tired of providing it without a respite. In spite of all that they invest in their child, the response of the child is very little or rather slow. The emotional weariness, physical tiredness, financial burden and social alienation afflict the parents and other children in the family. The child, because of whom this situation has arisen in the family, often becomes the victim of their frustration and anger.
A small beginning
ASHIRVAD, a Christian concern for child care, is a philosophy of caring (and not an institution) that responds to children and parents with special needs. At its child development and research centre, the following facilities for Christian with special needs exist: Training of parents to care for their children, parent counselling and orientation, training volunteers to organize play group in the community, equipment, toy, tape and book libraries, and networking of parents of disabled children for fellowship and mutural support. The need based research for improving the facilities for children, encouraging Christian hospitals and churches to start caring programmes, becoming a resource centre for childhood disability and rehabilitation are the other areas where the new developments are taking place.
Any caring programmes may encounter difficulties of not finding personnel, financial resources and physical facilities. Many professionally trained personnel are usually reluctant to invest their talents and experience on handicapped children because the returns are not proportionate to the input.Many donor agencies or voluntary organizations do not like to invest on a programme that may not become self-sufficient ultimately. These being the serious limitations that we encountered, the emphasis in the last four years has been to train personnel for this ministry and enlist the participation of Friends of ASHIRVAD to support this programme in prayer. We are encouraged by the growing interest of Christian in this concern for children.
Jesus concentrated on a small group of 12 to pass on his mission. They became the messengers of this mission when they were truly “converted.” We are attracted by this model of being small and remaining small. We want to concentrate on sharing this vision with others, and to encourage them to respond to the needs of children in their own creative way.
All of us can begin
Two years ago about 10 children with handicaps were taken through a series of Bible study and discussion by Rev. David Singh and Miss. Hazel Bradley of St. Andrews ChurchMadras. This helped the children to come to a personal faith in Jesus Christ. They were subsequently confirmed to be full members of the congregation. The congregation attempts to bring these children into the life of the congregation through its ministry among the handicapped (ASHA), and making these children share in the worship services in many practical ways. The members of the congregation consider it a privilege to be involved in the lives of these children because children share their love and affection in a guileless manner. Friendship with the disabled people is a means to learn lessons in love, simplicity and kindness.
Our Churches, Christian hospitals and community health programmes need to bring this neglected group of children into their orbit of ministry. Volunteers are needed to conduct play groups for them.They can also then visit them, read to them, take Sunday school lessons for them and support their family with love and care. We do not need a big infrastructure to do this. What we need is people with this calling and motivation. We would love to see many Christian caring groups springing up.Because we often receive more than what we give, there is this invitation to go to the handicapped and receive their friendship.
Henry Nouwen is an accomplished theologian who used to lecture at Harward in pastoral theology.His books, discourses and retreats have had a profound effect in leading Christian to a journey into Christ. His popularity and accomplishments left him sterile. He felt the lack of an adventure in his life. He feared becoming a leader who only “talked down” to others. Instead he desired a ministry of mutuality where he would be enriched by those with whom he would share his life and ministry. So Neuman left Harward, 2 years ago, to live at L’arch community in Toronto, where handicapped people and care-givers live together and share their lives.
He writes about this experience in his latest book, IN THE NAME OF JESUS: “These broken (handicapped), wounded and completely unpretentious people forced me to let go of my relevant self – the self that can do things, show things, prove things, build things and forced me to reclaim the un-adorned self in which I am completely vulnerable, open to receive and give love, regardless of an accomplishment.” Neuman was learning in 2 years what he could not learn in 20 years at Harward.
Jean Vanier invites us on a journey to “Go and live among the poor in spirit and they will hear you.”The handicapped children are wounded healers. They share their broken self with anyone who will regard their friendship. Becoming their friends is a journey into adventure. In an adventure, it is the first step that is difficult. The inner dynamism of adventure, it is the first step that is difficult. The inner dynamism of adventure and the excitement of new discoveries will take hold of us once we have begun, blotting out all power of hesitation, for the onward journey.
So the CALL TO CARE comes to us!



Anna and M.C. Mathew, Kirkspire, 18:8; August 1990. 


Some Christian agencies are well-known. Others are not. All of them, however, are trying to do their best despite serious constraints. We felt all the readers of kirkspire need to know of these, pray and demonstrate their involvement in practical ways.


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Living with Hope


Living with Hope
The words of the late Martin Luther King resonate in my ears as I sit down to write this article. “I have the audacity to believe that people every where can have three meals a day for their bodies; education and culture for their minds and dignity, equality and freedom for their spirits. I believe that what self centred men have torn down, the other centred people can build up. I still believe that one day humanity will bow before the altar of God and be crowned triumphant over war and bloodshed and non-violent redemptive goodwill will proclaim the rule over the land. And the lion and the lamb shall lie down together and every man shall sit under his own vine and fig tree and none shall be afraid – I still believe that we shall overcome…”
Martin Luther King spoke of his dream, while he was fighting the battle against racial discrimination in the United States of America. He hoped for an atmosphere of fraternal relationship between people of different races, where caste, colour and creed would not come in the way of people living in harmony and peace. This living hope sustained Martin Luther in his relentless struggle against the forces that divided people. In South India, we have the example of Dr. Paul Brand. He was moved on seeing the misery and sufferings of people with leprosy and worked towards overcoming the social stigma and alienation from which they suffered. Dr. Brand pioneered to establish facilities for the reconstruction of their deformed hands and feet, in order to prepare them for self employment. His approach of using their residual abilities to gain skills for income generating programmes has brought about a gradual change in the lifestyle of those affected by leprosy, so much so the rehabilitation of those with leprosy has become a part and parcel of the treatment itself. Dr. Brand lived with the dream to bring hope into the lives of outcast people.
Many of us live in close proximity with human misery and suffering. Our newspapers, journals and televisions tell us the sad story of the world we live in – children dying of starvation, refugees suffering in deprivation, victims of AIDS suffering in loneliness, etc. These awful scenes in the world invade our lives, leaving us perplexed. We are witnesses of the gloomy socio economic scenario and poverty in the developing countries. We are distressed by the crises in families, divorces, child abuse, substance abuse, etc. We are alarmed by the environmental pollution and the threat to flora and fauna caused by industrialisation.
Can we live with hope in the midst of these situations? Let us look at the basis of our “hope”:
1.
Our hope is based on a historical reality
2.
Our hope is based on a personal reality
3.
Our hope is based on an escatological reality
1. Our hope is based on a historical reality
We were recently reading the book, “When Hitler stole Pink Rabbit”, by Judith Kerr during our family time. This book is about the experiences of a Jewish family in exile from Germany during the time of Hitler. The father who was the bread winner of the household, was a journalist by profession. He had sensed and written about the danger signals in the offing even before Hitler came to power in Germany. When Hitler won the general election, it was more or less clear that he was determined to react adversely towards the Jews. Fearing this, the family first went to Switzerland and then to France. The author vividly and movingly describes the travail that the family goes through during their exile. The children faced difficulties in learning foreign languages before they could settle into school. The mother started learning to cook, because she was used to having maids. They had to live in a very small flat, without many furniture or facilities. The children had lost their toys and books due to their sudden exit from Berlin. The father could not find newspapers which would publish his articles for sometime. There was lingering anxiety about how they would live with no source of income. The story is full of their trying experiences and yet what stands out in the book is not just the list of these miseries, but the hope with which they faced these difficulties. There was always something to look forward to.
Finally Max, their older son did exceedingly well in the school and got a certificate of honour. Anna who struggled to learn French got a special prize from the Mayor of Paris for the composition she wrote in French. The family was invited to a holiday by a family during Christmas which they could not have managed on their own. A family friend offered them the use of their sewing machine for mending clothes. Anna got a gift of dress material just when she needed some warm clothes. The father was acknowledged for his film script. And the list goes on. The book is a story of hope that sustains people in the midst of anxiety and despair.
It is important to realise that all through the ages, human history is a blend of the good and bad times. Historically the human race is gifted with the spirit of resilence and the instinct to overcome. Many expeditions to conquer Mount Everest in the Himalayas had met with immense difficulties, until Edmund Hillary and Tensing Norgay finally accomplished this heroic task for the first time. The tragic outcome that many encountered while making this expedition did not deter Edmund and Tensing from going forward with their vision. The greatest gift that human beings are endowed with is this gift of hope that leads people into a new world of discovery and adventure.
“Hope springs eternal in the human breast”, said Alexander Pope in his “Essay on Man”. Human beings are blessed with this gift because they are created in the image of God. The God of creation is a God who affirms hope. The story of creation reveals that God places his hope in those whom He has created. The story of the people of Israel moving out of their bondage from Egypt and journeying through the wilderness is a testimony to the historic reality of how hope sustains people in the midst of travail, stress and suffering. The lives of Shadrach, Meschach and Abednego in the book of Daniel1, portray the anchor they found in God who was the reason for their hope. This living hope kept them steadfast in their faith inspite of the threat to their own lives.
Hope is in fact an attribute of God. The advent of Jesus into human history is the most significant expression of hope that one can find. Jesus lived an ordinary life with His disciples and others. His 33 years of sojourn in this world was a life, in many ways, very similar to what anyone would go through. The last 3½ years of His life was lived in active involvement and contrast with people. During this period, He encountered people who lived lives that were very distressing. There was Zacchaeus, wanting to see Jesus because He had no peace;2 one woman who had a chronic bleeding disorder waiting to touch the garment of Jesus in the hope of being cured;3 Martha and Mary hopefully waiting for Jesus to bring Lazarus back to life;4 These are good illustrations that remind us that even today Jesus brings hope when we turn to him.
The Nazarene manifesto is the proclamation of the historical reality of hope in God. “The spirit of the Lord is upon me, because He anointed me to preach the gospel to the poor. He has sent me to proclaim release to the captives and recovery of sight to the blind, to
set free those who are downtrodden, to proclaim the favourable year of the Lord” (Luke 4:18,19).
Jesus pointed to a hope that is everlasting, which is God’s gift to those who turn to God in faith, in response to His love. Because we are created in the very likeness of God, some of the attributes of God are given to us as gifts in our own personality. Hope is a historical reality because God’s view of mankind is characterised by hope and man’s view of God is characterised by hope. It is not the environment or the circumstances that determine the quality of this hope. Circumstances and events of history cannot subdue a reality which is God-centred and God-initiated.
Every baby announces his or her arrival into the world with a cry of hope. The cry is an indicator of all being well with the baby. In fact the obstetrician and others waiting to welcome the baby would feel terribly concerned if the baby did not cry. This cry isnot an expression of pain or distress, in fact it announces life at birth, made possible by the re-routing of the blood circulation, pumping of the heart and the opening up of the lugns to receive air. The baby for several hours before the birth descends through the birth canal and with successive contractions of the womb gets moulded to pass through the narrow birth passage. As a paediatrician having been involved in welcoming many babies at their birth, I have been inspired by this spontaneous instinct of babies to express their arrival in spite of the odds they face. All of us are gifted with this hope from our childhood. We inherit this from God, who is the author of our creation.
2. Our hope is based on a personal reality
Each of us has a personal biography. The way we live, behave and respond to various situations are often determined by patterns that were established by our childhood experiences. Our perspectives about ourselves, about the world in which we live, about others, etc., are largely influenced by our experiences. Most of us have an inner filter which is largely constituted by past experiences. The inner filter represents our experiences of joys, hurts, success, failures, etc. It is this inner filter which determines the optic through which we look at ourselves and the world around us.
About 10 years back, I went through various trying and difficult times in my life. The difficulties that I had to face made me behave in a way that I used to behave as a child. I
was impulsive in my responses; I moved from one activity to another to find fulfilment in my life; I related to people with caution and suspicion; I considered my work as the only expression of my life; I was living each day but not in a state of contentment or peace; Life had become a routine without the true sense of well being. I was part of the Church fellowship and had leadership responsibilities in Christian organisations. The scripture has been my source of strength and inspiration. I would read and understand the scripture and yet not experience it’s lasting influence or transforming impact in my life. I knew that I was accomplishing many things professionally but then my accomplishments did not make me feel fulfilled, either.
It was during this time that I was invited to participate in the Life Revision Seminar at Rasa, in Switzerland, by Dr Hans Burki. That year, 1983 was a year of many ups and downs. At the life Revision Seminar, considerable time was spent to go into one’s personal biography. Each of us was required to look at our life in periods of 7 years. This was meant to relive the experiences of childhood in a relaxing and comforting atmosphere when we were ready to face the experiences and memories of childhood. I began this journey into my childhood with hesitation because I had by then begun to look at my childhood as a difficult period. Since that first occasion, I have been to other seminars with Dr Hans Burki and in each of these seminars, I have had an opportunity of making further journey into my childhood. Everytime I made this journey, I was made aware of events and experiences that have made me what I am today. There were treasures hidden within the fabric of my childhood which I could not discover till I was introduced to this journey into my childhood. As a child, I realized I looked at events and experiences negatively and critically. I carried with me that critical and negative attitude, which made me lose sight of the treasures and values that those experiences have cumulatively brought into my life.
Let me summarise those experiences.
a.
Life is a journey
b.
Life is a treasury
c.
Life is a mystery.
a. Life is a journey
I am amazed at the way that the Psalmist in Psalm 139 (vs 13-16) describes how each one of us is formed in our mother’s womb. The presence of God accompanies every person, from conception. The God of eternity becomes the companion of every person in this journey of life which originates at conception, in its visible form and from then on it is a journey into the fullness of this companionship. The journey toward this ultimate reality is the journey into life and is also the journey into death.
The story of the pilgrim in John Bunyan’s book, “Pilgrim’s Progress” portrays the experiences of this journey. The pilgrim did not give up at any time, no matter what difficulties he encountered in this journey. He was so captivated by the vision of his destiny, that the obstacles did not matter. His journey was characterised by a sense of call and mission. His ultimate purpose was to reach his destination and not to get help up by the subtle and distracting events of the journey. The experiences on the way made him mature, confident and ready to face the ultimate reality of his call.
Jesus lived in communion with His father, and had His mind fixed on His mission. The Greeks came to honour Him5, with the attractive offer of making Him the King of the Jews. The people who followed Him, made him feel important because of the miracles and wonders He performed. None of these things became so important for Jesus that He desired to change the course of His life. Even His triumphant entry into Jerusalem and the welcome that He had received from many people did not stop Him from going through the final suffering of the Garden of Gethsamane, the trial before Pilate and the agonising death on the cross. For Jesus, life was a journey into the full purposes of God. His resurrection affirmed the hope with which He lived, ministered, suffered and died. Life is therefore a journey toward something greater than what we already know. It is a journey to know Him and to be known of Him.
b. Life is a treasury
Most of my childhood experiences remained isolated and detached from my life. Some of the experiences were joyful but seemed irrelevant to life; some experiences appeared too complicated to make any sense; some experiences seemed too ordinary to have any significance and some others appeared too distressing to be of any meaning today. And, yet, the journey into those very experiences released new energy that came from integrating them into my life. To discover some of the strands that have been chosen to
weave the fabric of my life, has been a valuable asset, bringing with it an optic of openness and expectation to see the purpose and meaning in every event.
The story of Joseph in Genesis tells us how Joseph6 discovered the reality that his past life was a treasury to learn from. Joseph received a special coat from his father, following which he became the object of his brothers’ envy. The dream that Joseph had, was another reason for his brothers’ anger. Joseph was put into a pit, by his brothers in anger, from where he was rescued and sold to the Hebrews. At Potipher’s hosue he was wrongly accused of being immoral and was cast into a prison. While in the prison, he interpreted the Pharoah’s dream. Eventually he became the ruler under Pharoah, rescuing the people from the effects of the famine. Joseph’s brothers and finally his father found favour and welcome from Joseph. Recalling the story of his miserable experiences since his brothers disowned him and sold him, Joseph said, “You meant it for evil, but God turned it in my favour”. Instead of being resentful towards his brothers who caused him harm, Joseph discovered that the trying experiences were the threads that God used to weave a beautiful pattern in his life.
To be able to look back at one’s life and to be able to look forward into one’s future, in this hopeful way, is the greatest of all gifts that we can receive from God. Life is therefore a journey into discovery – discovering the treasures that are otherwise likely to be lost in the midst of preoccupations. It is this ability to value experiences of life that hope can bring into our lives.
c. Life is a mystery
For many of us life becomes mundane sooner or later. This is largely because life takes a predictable course. We can control our circumstances, manage our time and condition our living. We plan our day and move from one plan to the other. We are inclined to get what we want and master our environment in order to do so.
Looking at the life of Elijah7 at the brook of Cherith, we are given a glimpse of the mystery that we are not ordinarily accustomed to. At the brook, Elijah got his food from the bird and the drink from the brook. The brook finally dried up and he was asked by God to move to another place. There he saw a woman collecting some sticks. The widow who had just enough oil and flour for that day, became the source for Elijah’s
survival. The widow and her son had plenty to live on from then on, because of the blessings she received through her ministry to Elijah. Elijah had come to the end of his own resources at the brook; this lady and her son also had come to the end of their resources. Both Elijah and this widow had nothing more left at their disposal. when all that they had, had come to an end, God’s abundant resources were available to them. This is a mystery that we cannot easily comprehend.
When we see life as a mystery we will encounter these realities in our daily living. Often we look at events and feel discouraged because everything seems to have come to an end. There are other times when we can still see the sun shine behind the clouds. Life has a dimension beyond the visible and beyond our understanding. We need to have the openness, to be surprised by events and experiences. We are the created beings called to share in the creative purpose of God. The creative purpose of God takes us beyond our logical understanding to see His unexpected intervention. This mysterious dimension of life has to be experientially understood. Moses8 in seeing the burning bush, became aware of this mystery. The fire did not consume the bush – a contradiction to his logic which drew him to the transforming point in his life. He removed the sandals from his feet and acknowledged the mystery and surrendered his life to the God of mystery.
As for me, life was well ordered and predictable for most part of my life, until the birth of our second child who was seriously ill at birth. Her short life of 4 months and subsequent death, opened our eyes to view life as a mystery. The intense pain and agony of those days led Anna and me to wait on God for His healing touch. That valley experience of depression and despair, became a means to receive a new vision for children with disability. Children with disability till then conveyed a message of hopelessness to us. Gradually, we were able to see them as messengers of God bearing in their fragile and weak bodies, the message of love, gentleness, humility and grace. The presence of these children in our midst conveys a message of human helplessness that constantly highlights the mystery of life. These children suffer in their body. Their parents suffer emotionally. And yet it is this encounter with suffering that may bring healing and restoration in the lives of some people.
The L’Arche movement symbolises this hope. Jean Vanier and his colleagues at L’Arche spend their lives living and caring for those who have disabilities in their body or mind. In
so doing they articulate this hope in the goodness of God and value for those whom He has created.
3. Our hope is based on an escatological reality
In the redemptive purposes of God, He has made the provision for an eternal dimension to our lives. This eternal dimension has two aspects. We have a life beyond death. Jesus will return to be among those who belong to Him. Both these dimensions of the escatological reality are not visible to our naked eyes. It is the Bible which tells us of this dual reality.
Alvin Toffler in his book “Future Shock”, talks about environmental pollution, unethical practices in medicine, industrialisation and its after effects on human civilisation, political instability, economic inequality, etc. This book is all about the ugly events that would endanger the very existence of the human species on the face of the earth. The book graphically and incisively analyses the harmful effects of urbanisation and the explosion of knowledge. He looks at modernisation and technological advancement as a threat beyond control. The book is a glorious assertion of human limitations. Our advancements, present technology and scientific climate do not ensure our well being. We may make many more new discoveries. We may travel to other planets. The possibilities are immense for the future, however the end of all these things is again distress and vanity. “Again I saw all the oppressions that are practised under the sun… Then I saw that all toil and all skill in work come from a man’s envy of his neighbour. This also is vanity and a striving after wind.” (Eccles 4:1,4).
We live in an age where hope itself is interpreted as a sign of weakness. All around us we see people caught in the rat race to assert themselves and strengthen their position. That alone seems to be the guarantee for their stability. The story of the man building his house on the sand aptly illustrates the present trend of humanity. Our scientific perspectives and technological achievements appear to make us more and more strong and this strength is perceived as a source of our hope. And yet such a foundation for hope is fragile and vulnerable because of its human limitations.
The “hope” referred to in the Scripture has an eternal and everlasting dimension. Stephen9 when he was being stoned, spoke of this hope in words that were divinely
inspired. He looked up to heaven and saw the heavens open and angels ascending and descending. Stephen suffered in his body, but his hope in the eternal reality of God and God’s purpose was alive and real. It is to this perspective that we need to move on, in order to live triumphantly. Paul reminds us, if we have hope only in this world, we are of all people most miserable, but if we hope for what we do not have, we wait for it patiently10.
The blessedness of this hope has its impact on us in our daily living. We live in the awareness of this reality of God and His purpose because of which eternity begins in our hearts right now. Eternity is a symbol of communion with god. That communion with God begins in the silence of our heart. It is in return and rest, we find our salvation. It is in quietness and confidence we find our strength11. it is by returning to the very centre of our lives where Christ has made His abode, that we can enter into this reality of hope.
We can live with hope because Jesus said, “I am with you always”12.
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M.C. Mathew is a consultant in developmental paediatrics, attached to ASHIRVAD, Child Development & Research Centre, AD 80, 5th Avenue, Anna Nagar, Madras 600 040, India.

REFERENCES:
1. Daniel : Chapters 3 & 4
2. Luke : 19: 1-10
3. Luke : 8: 43-48
4. John : 11: 1-45
5. John : 12: 20-26
6. Genesis : Chapters 37, 39, 40, 41, 42
43, 44, 45 and 46.
7. I Kings : 17: 1-24
8. Exodus : 3: 1-9
9. Acts : 7:55
10. Romans : 8:25
11. Isaiah : 30:15
12. Matthew : 28:20
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 CHRISTIAN PRESENCE IN THE GAPS  AND  MARGINS OF HUMAN NEED.

The Bible offers us many   missiological perspectives which prepare us for contemplative action.  In Biblical times, the Jewish Rabbi would not ordinarily converse or be in direct contact with women. There was a questionable gap in their attitudes towards women.  Women were expected to have a subservient status at home and in the social hierarchy. They lived reduced lives on account of this social indifference. Jesus addressed this in a radical way by consciously including women in His engagements. He visited the home of Martha and Mary. He turned to a woman of Samaria for a drink of water at a well. He liberated a woman about to be stoned for her immoral behaviour, from the clutches of a self-righteous crowd. He healed the sickness of Peter’s mother-in-law. He brought back to life Jaurus’s daughter. These and other pro-active attitudes of Jesus towards women filled the then existing gap with a new consciousness about the value of women. In every civilized society, there will be several such gaps which need the Christian response. It is attitude which determines human behaviour and initiates a creative responses.

The medical fraternity needs a revision of thinking on the several gaps which exist in health care practices in India. One gap which is of much significance is ‘ whole person care ’ - integrating well being in the body, mind and spirit. Modern day health care is mostly curative and disease centered. Many people suffer emotionally, socially, economically and their concerns are not addressed. The new age movement has attempted to fill this gap with alternative therapies, meditation and yoga therapy, well being clinics, integration therapy, holiday resorts, etc.

Christian presence, through the ages, has traditionally brought about significant changes in the frontiers of human need and suffering.  This has also been the story in our country where there are innumerable examples of Christians standing in the gap and meeting the need. Today however, Christian facilities to respond to whole person care are just a few in this country. There is a great need for Christian health care professionals, churches, voluntary organizations to come forth with a major thrust on offering counseling services, de-addiction therapy, retreats for de-stressing and renewal, family and marriage enrichment programme, life-style modification, well-being clinics etc! In many parts of the world,  church premises are open during the week days to carry out such facilities! Care group teams, consisting of doctors, therapists, counselors, pastor, lay people etc can be formed in every congregation to offer support services to make the whole person care a reality. This will have an immediate impact on personal transformation. An effective and silent way of Christian presence in the community!

The majority of our people live in the margins of society in our country. The urban settlers living in slums, farm workers, small time farmers, migrant workers, street children, domestic helpers, adolescent population, tribals, those affected by HIV, those suffering from chronic or terminal illnesses, etc. Their number is in millions. They neither have access to health insurance, or subsidised health care facilities in most institutions. There is evidence now that the health care expenditure is a major reason for pushing them to debt, poverty and distress. Fortunately the government initiatives of national rural health mission, micro-financing, employment generation programme etc will hopefully make a difference. This is another opportunity for Christian presence and response. More Christian initiatives are desperately needed to articulate our compassionate vision for people in need.  

The gaps and margins of human need are often forgotten or neglected. There were several gaps in Zachaeus’ life where there was no support. He lived with these gaps to wholeness in his personal life - loneliness, stress, guilt… He was alienated from the others bcause they looked down on him and ignored him. Jesus recognised his need and called out to him. He met him at his level of needs and invited Zaccheaus to fellowship with him. Zacheus was able to make a wholehearted response because Jesus was there with Him in the gap. He was led into a journey of recovery of personhood, renewal of purpose and restoration of a relationship with God and man. This is the pilgrimage we are invited to enter into - to reach out to the gaps and margins of human need and make our personal and corporate responses.
M.C.Mathew.



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