MEDICAL SERVICE VOL. 40 No. 9 NOVEMBER-1983
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- Title
- MEDICAL SERVICE VOL. 40 No. 9 NOVEMBER-1983
- extracted text
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COMMUNITY HEALTH CELL
326, V Main, I Block
Korambngala
Bangalore»560034
India
ion • don't measure your age by your years • vitan
legal education • medical ethics forum-31 •
■n respect life • food preservation
november 1983
medical
service
official house journal
of the catholic
hospital association of India
"the love of . Christ
urges us" 2 cor 5 : 14
vol 40
editorial board
dr c m francis
dr ravi narayan
dr prem chandran john
dr daleep mukarji
mr augustin veliyath
fr george lobo sj
contents
1
editorial
2
2
retrieval from retardation
dr j I kulkarni
5
don't measure your age by your years
harold shryock
11
vitamin a in human nutrition
dr savitri yadav and prof b n raman
17
legal education-4
bonded labour system II—implementing
authorities
19
medical ethics forum-31
fr george v lobo s j
24
7
diocesan level celebration on "respect life"
25
8
chai news and notes
31
9
food preservation
surindra jain
39
3
editor
4
fr john vattamattom svd
5
§
cover design
p m isaac bangalore
published by the catholic
hospital association of India
c b c i centre, goldakkhana
new delhi-110001
printed at kalpana printing
house new delhi-110016
november 1983
no 9
"Articles and statements published in this journal
do not necessarily reflect the policies and views of
the catholic hospital association of india"
EDITORIAL
The New Delhi edition of the Indian Express dated 9th December, 1983
had the following news with the heading : ‘'one lakh children to die of
hunger in three daysl". "In the next three days one lakh children in the
developing world will die silently of hunger, malnutrition and poverty, in the
last 12 months, the equivalent of the entire underfive population of the
United States has been wiped out. On a European scale, this is equivalent
to the combined young child populations of Britain, France, Italy, Spain
and West Germany.
Thirty per cent of the children born every year in the Third World do
not live till the age of five. Of those who manage to survive, three out of
four do not have access to proper health care facilities and three out of five
do not get regular supplies of clean drinking water
"
Taken from the WHO source, the report also included the break up of
the total child deaths from immunable diseases in 1980. Accordingly out of
50, 55, 000 children who died in the year 1980, 5000 died of diphtheria,
50,000 of polio myelitis, 12, lakh of neo-natal tetanus, 16 lakh of «whooping cough and 22 lakh of measles. Yet we know today that with
reasonable care most of these deaths could be prevented. But this is as
though they had to die so that others may live in more comfort.
Two thousand years ago many a childern had to die, because one man
wanted live in peace, because his life was threatened by a child. Those
children who were killed at the time of the divine Child of Bethlahem were
the silent victims of just one man's interest.
Coming back to the statistical report mentioned earlier, the question
necessarily to be asked is: Why should these children die at this tender age?
Yet we know that India has a major share of these silent victims. But they
are not the only victims. What about the several millions who are killed
every year, who have not even had the chance of seeing the light of the
day, who are silent victims within the womb of their mothers ? They
have to die, so that others may live in 'comfort'. Then, at the time of
Christ, there were only a few victims for the sake of one Herod, but now
they run into millions in different places for the sake of many Herods.
What have we to do in such a situation ? Can we afford to be insensitive?
Or can we do something ? Can we console ourselves saying "What can we
do ? This is a very complex and huge problem?" Can we have that
necessary political will, that radical commitment to the cause of these silent
victims in response to the call of the Divine Babe of Bethlahem? This
is the time to think over it. Christmas is a time of joy and happiness to all.
Yet can we have a meaningful Christmas, unless we have done our bit in
defence of these millions of silent victims, both born and unborn.
Every year December 28 is celebrated as Holy Innocents' Day to
commemorate the silent victims at the time of Christ. During Christmas
season and particularly on that day, of Holy Innocents, let us make it an
occasion to reflect on our responsibilities to be sensitive to the grave
situation we are in today with millions of children dying of malnutrition and
neglect, being killed before they are born, going blind after they are
born. Let this year's Christmas celebration make us a bit more sensitive to
such situations and lead us to a determination to DO something about it at
our own level.
What does a Child need ?
Very simple things :
Enough food to eat and pure water to drink;
A house to live in, clothes to wear;
A school to study in and books to read;
Space to run about and play;
And a toy or two to play with;
Medical care and protection against sickness
AND MOST OF ALL THE KNOWLEDGE
THAT SOMEONE CARES
Courtesy
UNICEF
Retrieval from Retardation
What Community Can Achieve with Professional Help
—by Dr J L Kulkarni
Mental retardation is irreversible, at
present levels of scientific knowledge and
medical competence. But in most cases,
it could have been avoided, even in an
adverse context of poverty.
The extended arm of professional support
enables a community to be aware of, and
escape, the common causes of mental
retardation, writes J L KULKARNI from
his direct experience in prevention,
detection and rehabilitation.
A mentally retarded child puts the family
out of gear economically and psycho-socially.
Even with advanced scientific research, no
cure has been found for mental retardation.
It continues to be among the most handi
capping of childhood disabilities. The aim
of this article is to show that there is an
alternative to despair.
Defining the problem
Mental retardation is not mental illness.
Rather, it is a state of arrested development
of intelligence, because of factors affecting
the developing brain. It is associated with
a diminished capacity for adaptive behaviour.
Broadly, the three main criteria which help
recognize a mentally retarded child are:
(a) low intelligence, (b) low standard of
behaviour and (c) low achievement in rela
tion to peers.
Global experience shows that a high
incidence of mental retardation has strong
correlation with poverty, malnutrition and
poor health care. Which suggests a basic
approach for preventive action; and also
explains the large numbers of the mentally
retarded, especially in developing countries.
November 1983
Extent of prevalence
In India alone, there are about 15
million mentally retarded; or over 2.5
percent of the population. Of this 75 percent
are mildly retarded; 20 percent moderately
and five percent severely. As the data are
based on hospital figures and sample sur
veys, it is likely that the total number may
have been underestimated. Indeed, most of
the time the mildly retarded go undetected
if they get absorbed in jobs demanding
relatively low intelligence, such as cattle
grazing and helping on the farm. So too, if
the child does not attend school. Once
literacy spreads in India, it is possible that
the country will be confronted with more
cases of mental retardation than presently
reckoned.
Any strategy against mental retardation
must take into account its causes. Medical
science identifies more than 2,000 of them.
These causes could be grouped for conveni
ence, as prenatal, natal and post-natal. Many
of them are preventable, particularly those
related to malnutrition and diseases caused
by infection or environmental deficiencies of
micronutrients such as iodine leading to con
ditions like cretinism.
Categories of causes
Among the pre-natal causes of mental
retardation are a number of genetically
determined disorders, foetal infections and
irradiation and a number of unknown or
indefinite causes associated with placentarelated abnormality, toxemia of pregnancy,
prematurity, maternal medication, poisoning,
nutritional deficiency, infection or trauma.
5
At the time of birth, mental retardation of
the child could be caused by injury, infection
haemorrhage, lack of oxygen, low blood,
sugar, etc. In the post-natal phase, typical
causes of mental retardation are cerebral
infection, meningitis, encephalitis, abscess,
trauma, poisoning, accidents and complica
tions consequent on vaccination and diseases
like pertussis, small-pox and rabies. This
array of causes suggests that mental retarda
tion is not inevitable. Most of the causes
can be controlled.
The three elements in managing mentally
retarded children are (a) prevention, (b)
early detection and intervention and (c)
rehabilitation.
Prevention is paramount
Prevention is a paramount concern
because mental retardation is, at the present
level of knowledge, irreversible. And the
first step to prevention is educating the
public on various causes of mental retardation,
such as,
— Ways to prevent or treat infectious
diseases
— Dangers of drugs, toxic factors,
irradiation and blood group incompa
tibility;
— The importance of immunization as
well as nutrition; and
— Removing
misconceptions
mental retardation.
about
Genetic counselling
At the professional level, prevention
starts at the time prospective partners in
marriage are matched. Genetic counselling
helps to discourage inbreeding. Consanguinous marriages are common especially in the
south of India, where some studies have
shown over 40 percent of mentally retarded
6
children were first or second cousins. This
proportion in North India was around 8
percent, as seen from studies in that part
of the country. Screening for blood group
compatibility of couples should be done as a
matter of course. Genetic counselling should
become similarly common for couples at risk,
that is, those with a family history of mental
retardation on either side.
Care and support
Once a mother at risk conceives, sound
nutritional support and obsteric care are
essential. More so if she suffers from dia- .
betes. If complications are treated promptly
and adequately, it would be possible to pre
vent low birth weight babies who are prone
to mental retardation.
Obstetric care to prevent birth trauma and
comprehensive advice after birth should pre
vent a major part of the continuing incidence
of mental retardation in India. The health
care system in the country gives low priority
to preventing mental retardation. This situa
tion needs to be corrected simultaneously
with a step-up of public awareness about
mental retardation. This dual thrust will be
promoted by action at two levels—by a pro
fessional interdisciplinary team, and secondly,
at the people's level.
What professionals can do
The professional team responsible for pre
venting mental retardation, is best located at
a major hospital or a teaching institution. It
should have facilities for detailed case work.
Complete physical, neurological and psychoological evaluations should be possible,
I eading to professional diagnosis and planned
investigation. Facilities should be available
for the team to carry out biomedical and
chromosomal
(heredity-related)
studies.
Ideally, the team should comprise an obste
trician, preferably with current knowledge of
genetics and child neurology, psychologists
Medical Service
and social workers well-versed in child
development speech occupational, and
physio-therapists, biochemist and cyto-geneticist. As mental handicap is usually asso
ciated with one or another of various other
handicaps, the services of orthopaedic,
ophthalmic and ENT surgeons as well as
neurologists and psychiatrists should be on
top.
A city experience
An example would illustrate. In Bombay
city and suburbs, some 29 institutions and
8 special sections in municipal schools are
involved in work relating to mental retarda
tion, particularly the training of the hand
icapped children. Significantly, the majority
of these institutions are voluntarily organised,
though some are partially aided by govern
ment. The work of one of them (Shrimati
Motibai.Thackersey Institute of Research in
the Field of Mental Retardation) may be
briefly recounted to explain the value of a
strong professional team in containing the
problem of mental retardation among chil
dren.
Over a period of five years, 1978-83
about 2,500 mentally handicapped children
were investigated at this centre. Out of them
500 have been absorbed in the Special
School and Vocational Training Centre. The
remaining have either been absorbed in
neafby schools or guided to get integrated
in family business or farming. Cases from
all part of India and also from neighbouring
countries are received by the centre.
On an average three new cases are
investigated daily, by a multidisciplinary team
led by a paediatrician. The 'developmental
clinic' assesses infants at risk from birth to
30 months. An EEG unit detects disorders
of the brain. A speech audiology unit detects
hearing disorders. There is an infant therapy
clinic and a unit for children who are pro
fessionally retarded or emotionally disturbed.
A biomedical and cyto-genetic laboratory
November 1983
supports the system. Around 150 children
received vocational training at the Sheltered
Workshop. The Special School has 350 to
400 children who are trained and taught in
four languages (English, Hindi, Marathi and
Gujarati); the children being grouped accord
ing to language and intelligence quotient. The
children working at the vocational training
centre are given a stipend as incentive, Rs. 50
to 150 a month. This is feasible partly be
cause the centre works at a profit from
sales from its weaving, screen printing and
carpentry sections. Once the child begins to
contribute to the family income, the child,
despite its disability, is no longer an econo
mic burden and is accepted better at home.
When the mentally retarded are no more
entirely dependent on someone else, they
are no more unwanted.
Work in the community
Professional team work at central loca
tions must be reinforced by work among the
people. This is principally a matter of raising
awareness. The team planning to educate
the masses should understand prevalent
beliefs, attitudes and superstitions concern
ing mental retardation. This is the first step
in clearing misconceptions and wrong beliefs.
The mainstay of this effort is the com
munity health worker. He or she needs to
be trained to convey messages, to different-.
iate between mental illness and mental
retardation, and to detect a mentally retarded
child and to bring the case to the notice of
the doctor at the nearest health centre.
Means of communication
Messages on mental retardation are best
transmitted to the community by the parent
of a mentally retarded child. Once the parent
realises the importance of early detection,
treatment and training of the child, she will
be able to motivate more people to collabo
7
rate and work against mental retardation.
This is so because what she conveys to the
community is first-hand knowledge.
ally retarded child or person is a member of
the community as much as another, and has
the basic right to live, to work and to leisure.
The village school teacher can play a key
role in detecting a mentally retarded child,
for nothing reveals the condition better than
the subdued pace of progress at school,
One with the community
Till 10 to 15 years ago it was thought that
a prudent dispensation would be to admit a
mentally retarded person (who could no
longer be cared for at home) to an institution
removed from the life of the community.
Today it is accepted that the great majority
of the retarded do not stand in need of any
such institution and may indeed be harmed
by it. Rehabilitation now aims at integration
in the community. 'Normalising' does not
mean ignoring the retardation or forcing
normal expectations upon a mentally retarded
person.
Among the ways successfully tried to
enhance public understanding of mental re
tardation are films screened on market
days and at village fairs, to emphasise
achievements by the mentally handicapped.
An exhibition of goods handcrafed. by the
mentally retarded has a decisive influence
on public opinion about their potential for
economic contribution.
Doctor in the locality
Public interest in preventing mental re
tardation and its consequences can be
sustained only if the doctor at the nearby
health centre has a complementing sense of
social responsibility. For this he must have
a high index of suspicion wherever factors in
family, pregnancy and pre-natal period place
the infant at risk. He should also be able to
do periodic check-up of infants and school
children to detect deviation from normal
development indicating brain damage. It
should also be possible for him to do simple
screening tests for detecting metabolic dis
orders.
Experience shows that a strong link-up
of professional and popular efforts make a
difference in preventing, detecting and inter
vening in mental retardation among children.
Given the 'state of the art' as well as the
human condition, mental retardation may not
be eliminated altogether. Rehabiliation is,
therefore, a necessary component of any
strategy against mental retardation. A ment
November 1983
From dependency to acceptance
Community life for the mentally retarded
depends on public support and public accept
ance. In a country like India where the
majority live in villages, rehabilitation should
be oriented to simple repetitive tasks not
involving much exertion of the brain. Weav
ing, cattle grazing, helping on the farm, etc.
are areas traditionally open to the mildly
retarded and should be recognised as appro
priate options now and in the future. How
ever, small the earnings or contribution may
be, a mentally retarded person will be
accepted by the family and community, if he
shares in some measure the common econo
mic burden. The fact that this is possible has
been proved and is increasingly being reco
gnized by voluntary organizations working in
this field, with or without government help.
Dr. J. L. Kulkarni is a paediatrician and
chief medical officer of Shrimati Motibai
Thackersey Institute of Research in the
Field of Mental Retardation. Sewri Hill,
Sewri Road, Bombay-400 033
Courtesy : ‘FUTURE', UNICEF
9
Don’t Measure Your Age by Your Years
— by Harold Shryock, M.D.
Physiologically, some people are younger at 55 than others at 45
Life is progressive. It moves on year by
year regardless of whether the individual
wants it or not. And there is no turning
back.
Advantages and disadvantages come with
the passing of time. Physically, the human
body tends to wear out. This takes place at
a faster rate if a person pursues a careless
way of life and at a lower rate if he consis
tently follows simple rules of conservative
living.
Mentally, emotionally, and spiritually,
there are cumulative advantages with each
year that passes. Life can become more
meaningful and more rewarding for an opti
mistic individual who spends his talents and
energies in worth-while undertakings.
It is in this sense that* the later years of
life can be the best of all.
Every human being is endowed at birth
with a certain reserve supply of vital energy.
The exact amount varies from person to
person. The major contribution to this quota
of precious dynamic force is made by one's
parents through channels of heredity, some
children being born with plenty of vigour
and resistance to disease and others with a
relatively meagre quantity.
The person who lives carelessly or who
experiences serious illness during his lifetime
or who falls victim to major, life-threatening
accidents uses up his supply of vital force at
a more rapid rate than the person who grows
up under fortunate circumstance and who
lives conservatively.
During youth and early adulthood, when
vigour is abundant and life flows easily, it is
November 1983
hard for a person to be conservative in the
use of his physical assets. Overwork, loss
of sleep, and overindulgence all take their
toll. But at this phase of life the individual
is prone to reason, "I would rather live it up
now even though it does take a few years
off the end of my life."
But when this same person comes to the
late 50's and 60's his attitude changes. Life
is still sweet, and he chafes under the limit
ations of reduced vigour and a greater
tendency to illness.
And so the question logically enters our
thinking. Is it too late when a person passes
his physical prime to redeem the past and
regain what he lost by the indiscretions and
wasted energies of previous years ?
It is not possible for an older person to
have restored to him the same measure of
vitality he possessed in his younger years.
But he can husband the resources he still
possesses, and, by using them wisely,
stretch them out for a longer period of time.
In the meantime he can reap the benefits of
a planned health programme which will
make life during his declining years more
comfortable and more enjoyable than it
would have been had he continued in his
"don't care" attitude toward matters of
health.
A prime example of what a carefully
planned health programme can do for a
person in his later years is provided by the
late President Eisenhower. Dwight Eisen
hower was never a weakling. As a military
man he had kept himself in reasonably good
condition. But the war years drew heavily
11
on his reserve of vital energy. As commander
in chief of the Allied Forces in Europe he
bore the strain of long hours of work, of
excessive responsibility, and of intense
anxiety over the welfare of those for whom
he was responsible. Also, he was a smoker,
which in itself had hastened the process of
aging within the organs and tissues of the
body. To his credit, Eisenhower discontinued
smoking, on the recommendation of his phy
sician, before he was called to the Presi
dency.
During his first term in office, President
Eisenhower suffered two major illnesses,
either one of which might have incapacitated
an even younger man. In September 1955,
he suffered a heart attack, and in June 1956,
he was stricken with ileitis, which required
major surgery. These ailments focused
earnest attention on the President's state of
health. Many would have said that it was
too late for him to benefit from a health
building regimen. Nevertheless, the Presi
dent's doctor, in consultation with the best
medical specialists of the nation, instituted
such a programme.
Dr. Howard Snyder, Eisenhower's physi
cian, summarized the formula for maintaining
the President's health as follows: ''Proper
diet, avoidance of excessive fatigue, plenty
of rest, lots of moderate exercise, frequent
physical examination, a controlled temper."
And thanks to his following such a pro
gramme, which did a great deal for him even
late in life, Eisenhower was able to carry
through a second term in the White House
and thus, at 70 to become the nation's oldest
President up to that time.
The rate of aging
One's effective age cannot be measured
by the number of his birthdays. Even among
friends one's age is judged by comparisons
more than by chronology. The rate at which.
12
the human body ages differs with individuals.
Some are younger at 55, physiologically
speaking, than others at 45. And, except for
serious accidents or major diseases, the
person who is "young" at 55 will live
longer than the one who is already "old" at
45.
Certain factors speed up or retard the
aging process. One authority in the field
states that a young person may vary his life
expectancy by as ]much as 30 years
depending upon his pattern of life. The
person who lives in the country has a fiveyear advantage over one who lives in town.
Even being married has its influence, with a
husband or wife being five years better off
than one who is single, divorced, or
widowed. Keeping one's weight at a normal
level definitely helps. Overweight persons
become susceptible to many of the diseases
that shorten life. Being 25 per cent over
weight carries a four-year disadvantage;
being 45 per cent overweight, a seven-year
disadvantage; and 66 per cent overweight,
a 15 year disadvantage. A pack-a-day
smoker pays the price of a seven-year shor
tening of life, and one who smokes two
packs a day carries a 12 year disadvant
age.
Let us make this comparison a little
clearer by contrasting the situation of an un
married, heavy-smoking taxi driver who
follows a devil-may-care attitude toward
healthful living, with that of his sister, who
is happily married, lives on a farm, does not
smoke and avoids, other forms of dissipa
tion. The sister has a three-year advantage
because she is a woman, a five-year bonus
because she is married, another five-year
lead because she lives in the country, and a
12 year advantage because she does not
smoke. Thus the sister has a 25 year longer
prospect of life than does her brother who
lives carelessly.
Medical Service
Life expectancy has increased a great deal
within the present century. In 1900, less
than half (40 per cent) of live-born babies
could be expected to live until age 65.
Successful conquest of communicable and
infectious diseases has reduced death in the
younger years to the extent that now about
three-fourths of live-born babies may be
expected to reach age 65. This means that
the number of older people in our population
has increased both relatively and actually.
In 1900, about 4 per cent of the population
consisted of persons 65 years of age or
older. This percentage has grown until, in
recent years, more than nine per cent of the
population is 65 or above.
Activity
As a person becomes older, his remaining
store of vital energy declines. For this reason
it is wise for an older person . to slow down
his pace of living. This does not mean that
he must restrain his enjoyment of life or that
he has to walk with a cane or even that he
has to avoid the activities that he always
enjoyed. Instead, it means that he should
practice moderation. If his work is strenuous,
he should work fewer hours per day. He
should take more time for leisure and re
creation.
their supply of vital energy by being inactive.
They feel they are in danger of wearing out.
But by inactivity, both mental and physical,
they are in greater danger of rusting out than
of wearing out. Activity is necessary for
continued health. Physical activity quickens
the circulation of the blood and thus helps to
maintain a favourable condition in all organs
of the body, particularly the brain. Mental
activity aids one in being optimistic. And
with the continued use of the brain comes a
magic response by which all other organs
benefit.
Winston Churchill at age 60 reportedly
announced his impending retirement from
public office. Then came World War II, and
Churchill rallied to what he considered a
patriotic duty. Marvellously his vigour, both
physical and mental, continued strong for
another 20 years and made him perhaps
the greatest statesman. in the history of
Great Britain.
Many an older person, unable to do what
he used to do, is tempted to fight back. But
this does not increase his quota of energy.
Rather it wastes it through unnecessary emo
tional expenditure. It is much better, as one
becomes older, to stay within the new limita
tions of energy. By practicing a little selfimposed mental discipline, an older person
can be just as happy as in former years and
can become reconciled to slowing down by
discovering that life can be just as enjoyable
when taken at a slower pace.
It is easy to speculate on what Churchill's
future might have been had he allowed him
self to become inactive soon after the age of
60. Inactivity and a passive attitude would
have brought about a physiological decline in
all the organs of his body, including his
brain, and very probably he would have died
several years earlier. Extremes of activity
should be avoided even more in later years
than during one's prime. A moderate pro
gramme of exercise is good, but excessive
exertion may overtax the heart. The desir
able amount of exercise for any particular
person depends on what has been his pre
vious way of life. One accustomed to a
great deal of physical activity needs only to
practice moderation as he becomes older.
But the elderly who have neglected exercise
should now be cautious as they gradually
build up tolerance for activity.
Some persons, with a false understanding
of the principles involved, try to preserve
Referring again to President Eisenhower,
it should be recalled that his doctor insisted
November 1983
13
that he take regular physical exercise, but
that he do it with moderation. The President
•liked to play golf, and this proved to be wellsuited to his needs.
They should seek advice, from time to time,
of someone who understands the principles
of nutrition to make sure that their reduced
diet is adequate.
Walking is a good exercise, and so is
bicycling; but playing tennis or sprinting a
mile at a time is too strenuous for most
persons past 60.
How a person lives
A person's life is not measured entirely
by years. One who wastes his vital energies
by careless living reduces his capacity to live
buoyantly. Not only does he pay the penalty
of a shorter life span, but his personal capa
cities remain at a lower level. The enjoyment
that one derives from life is related to the
amount of energy he possesses. With an
adequate supply, he tends to be happy and
optimistic. But if through carelessness in his
pattern of living he dissipates his bank
account of vital energy, he will be sickly,
moody, and disinterested in life.
One's mental outlook has its influence on
how fast he uses his quota of vital enegry.
Cheerfulness, courage, faith, and humour all
contribute to the efficient use of one's store
of energy. The opposite emotions of sadness,
fear, and anxiety use up energy unnecessarily.
A person's outlook on life has an important
influence on his state of health.
Courtesy: HERALD OF HEALTH
Nutrition
As a person becomes older, he needs
fewer calories per day than when he was
younger. There is danger now that he will
continue to follow his same habits of eating
and thus become overweight. Overweight is a
handicap at any age, but particularly in later
years. The more weight a person carries, the
greater, are the physiological demands on his
heart, on his blood vessels, on his kidneys,
and on his other vital organs.
Certain food elements are more essential
than others. Not so many calories are needed
now, but the need for adequate amount of
protein, vitamins, and minerals continues. In
reducing the amount of food they eat, olds
ters should therefore take precautions not to
deprive themselves of nutritional essentials.
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November 1983
15
Vitamin A in Human Nutrition
by Dr. Savitri Yadav, Prof. B.N. Raman
It is a common belief that vitamins are a
source of energy in our body. This is not
true, for they do not provide energy them
selves but help in release of energy present
in proteins, fats and carbohydrates. Vitamins
are essential food factors to be included in a
diet for maintaining proper health and vitality.
Term vitamin was coined by Casimir Funk in
1912 for a dietary factor, chemically a nitro
gen containing substance 'amine', essential
for life (Vita).
Vitamins are complex organic compounds
required in a small quantity for normal
growth and health. They play an important
role in regulating numerous biochemical reac
tions in the cells of our body. These
biochemical reactions-are essential for growth
and energy and catalysed by enzymes pre
sent in the cells. Vitamins are co-factors for
these enzymes and essential for their acti
vities.
Vitamin A was the first fat soluble vita
min to be discovered. It is related to yellow
coloured vegetable pigment present in car
rots, yellow corn, mangoes, green leafy
vegetables, tomatoes and papaya. This pig
ment is known as carotene and is a pre
cursor of Vitamin A. In animal foods such
as liver, butter, milk, cheese and eggs Vita
min A is present in a larger quantity in ready
made form. Vegetable oils as such do not
contain Vitamin A.
It is a heat stable Vitamin. In customary
cooking practices such as boiling, heating,
and frying and baking to a moderate temper
ature for a short time, it is not destroyed. It
is also quite stable to prolonged storage,
moderate heat, weak acids and alkalies. If
fat is rancid or kept in open air or exposed to
November 1983
ultraviolet rays Vitamin A is very rapidly
destroyed.
AIFanimals and human beings, to a large
extent, fulfil their Vitamin A demand from
carotene produced by plants. In human body
a considerable quantity of ingested carotene
is converted into Vitamin A and therefore
inclusion of green leafy vegetables, carrots,
tomatoes and papayas in diet is significant
in preventing Vitamin A deficiency. All kinds
of dietary fats help in absorption of Vitamin
A and carotene in the small intestine. Abs
ence of fat in a diet minimizes absorption
and leads to Vitamin A deficiency. The
blood brings absorbed Vitamin A to the liver
and all other ceils. When available in excess
the liver stores Vitamin A for future need.
Functions
Vitamin A performs several functions in
our body. It is essential for maintaining
vision in dim light. The rods of the retina in
our eyes contain Vitamin A and help us in
seeing in dim light. It is our common ex
perience that when we enter a cinema hall
from a region of bright light to dim light we
feel difficulty in seeing objects especially if
the movie is on. After a lapse of time our
eyes adapt to dim light and objects start
appearing more clearly. This is called Dark
Adaptation. In Vitamin A deficiency the
eyes take longer time to adapt. This Delayed
Dark Adaptation is the first and earliest sign
of Vitamin A deficiency. In severe Vitamin
A deficiency the eyes fail totally to adapt and
Night Blindness ensues.
In addition to its role in dark adaptation
Vitamin A helps in keeping other parts of the
eyes such as cornea, conjunctivae, and tear
17
producing organs healthy. In Vitamin A
deficiency tear production stops making the
eyes dry and prone to infection. Eventually,
the cornea loses transparency leading to
blindness.
Coverings of our skin, digestive, respira
tory, genital and urinary tracts are made up
of tiny epithelial cells. Vitamin A maintains
integrity and health of these cells in outer
covering and inner lining. In Vitamin A
deficiency sweating stops altogether, the
skin becomes dry and rough with full of
cracks. A healthy skin is smooth and shining
and offers a great resistance to bacterial in
vasion. Cellular resistance is greatly lowered
in dry and cracked skin and the person be
comes an easy prey for bacterial and parasitic
infections. Doubtless to say, Vitamin A pro
vides good protection against infections but
excessive intake of it does not confer any
additional immunity.
Vitamin A is essential for both bone and
tissue growth. In a severe and prolonged
Vitamin A deficiency during childhood the
growth retardation is more marked and
lasting. Vitamin A plays a very important
role in production of sperms in males and
ova in females. Prolonged Vitamin A starva
tion in famine and war victims is invariably
associated with sterility in both the sexes.
18
During pregnancy Vitamin A deficiency affects
foetal development very adversely and even
may cause abortion.
Daily requirement
Recommended Daily Allowance of Vita
min A varies with age, sex and physical state
of the body. An adult requires 5000 I.U per
day. In early childhood the requirement is
about 1,500 to 2,000 I.U. and it increases
with age and reaches maximum during
adolescence—a period of active and rapid
growth when requirement reaches to-6,000
to 7,000 I.U daily. During pregnancy and
lactation the body demands are higher; there
fore, 6,000 I.U. for a pregnant female and
8,000 I.U. for a lactating mother is recom
mended.
Toxicity
If Vitamin A is consumed in larger quant
ity for a long period it is equally harmful to
health. Once the liver and tissues get
saturated and over-loaded, the excess of
Vitamin A in the body produces toxic symp
toms such as loss of appetite, drying of skin,
falling of hair, irregular bone growth, pains
in bones and joints. Thus if Vitamin A
deficiency is harmful excessive intake is more
dangerous.
Courtesy: Nursing Journal of India.
Medical Service
LEGAL EDUCATION—4
Bonded Labour System
PART II
Implementing Authorities
1.
District Magistrate
The State Governments have been
authorised to confer powers and impose
duties on District Magistrates to ensure
effective enforcement of the provisions of
the Act. A District Magistrate is. authorized
to appoint an officer subordinate to him and
delegate to him all or any of his powers and
duties.
It is the duty of this official to promote
the welfare of the freed bonded labourer by
securing and protecting his economic intere
sts so that he may not have any occasion to
contract any further bonded debt.
2.
Note
The Sub-divisional Magistrate or a person
nominated by him is the Chairman of
Vigilance Committee at the subdivisional
level. Other members of the Committee are
nominated as in the case of the District
Vigilance Committee.
Functions of Vigilance Committee
The functions of the Vigilance Committee
are :
1. to advise the District Magistrate or
any officer authorised by him, regard
ing the effective implementation of
the provisions of the Act;
Vigilance Committees
Every State Government is expected to
set up Vigilance Committees at. the district
and Sub-divisional levels to assist the
District/Sub-divisional Magistrate in the
release and rehabilitation of the bonded
labourer.
District Vigilance Committee shall have
the following members:
a.
The District Magistrate or his nomi
nee as Chairman.
b.
5 3 Scheduled Castes and Scheduled
Tribes representatives nominated by
the Magistrate.
c.
3 nominated social workers.
d.
3 [representative of the official or
non-official agencies connected with
rural development.
e.
One representatives of the financial
and credit institutions in the district.
November 1983
>
2.
to provide for the economic and
social rehabilitation of freed bonded
labourers;
3.
to canalise adequate credit to the
freed bonded labourers through rural
banks and cooperative societies;
to maintain records and follow-up
the cases in which cognizance of the
offence has been taken under the
Act;
5. to conduct surveys to detect cases
of bonded labour;
6. to defend any suit instituted against
a freed bonded labourer (or a mem
ber of his family or any other person
dependent on him) for the recovery
of any bonded debt claimed by a
creditor;
7. to maintain registers containing the
address of freed bonded labourers,
their occupation, income and means
of livelihood, etc.
4.
19
Jurisdiction of Civil Courts Barred
To ensure that implementation of the
provisions of the Act is not hampered by
procedural delays and inequality of access to
a court of justice, civil courts are barred
from entertaining any cases pertaining to
‘t his Act.
No Civil Court has the power to grant any
injunction with regard to anything that is done
or intended to be done under this Act
(Section 25).
Protection of Action taken in Good
Faith
Section 24 bars any person from institut
ing a suit, prosecution or other legal proce
edings against any State Government or any
officer of the State Government, or any
member of Vigilance Committee for anything
done in good faith for the implementation of
the Act.
Does the practice of bonded labour
violate the Fundamental Rights of the
workers ?
The bonded labour system that exists in
India is an exploitative and unjust labour
practice. It is a form of forced labour.
Article 23 of the Indian Constitution prohibits
all forced labour and hence the enforcement
of such labour practice is a violation of a
worker's Fundamental Right.
In the Asiad workers case (People's
Union for Democratic Rights V. Union
of India AIR 1982 SC 1473) it was held
that :
"Article.23 of the Constitution strikes at
forced labour in whatever form it may
manifest itself because it is violative of
human dignity and is contrary to basic
human values .... Every form of forced
labour 'begar' or otherwise, is within the
20
inhibition of Article 23 and it makes no
difference whether the person who is for
ced to give his labour or service to ano
ther is remunerated or not. Even if
remuneration is paid, labour, supplied by
a person would be hit by this Article if it
is forced labour, that is, labour supplied
not willingly but as a result of force
or compulsion."
*
"This Article strikes at every form of for
ced labour even if it has its origin in a
contract voluntarily entered into by the
person obliged to provide labour or
service. The reason is that it offends
against human dignity to compel a person
to provide labour or service to another if
he does not wish to do so, even though
it be in breach of the contract entered
into by him."
"Where a person provides labour or
service to another for remuneration
which is less than the minimum wage, the
labour or service provided by him clearly
falls within the scope and ambit of the
words 'forced labour' under Article 23.
The word 'force' must therefore be
construed to include not only physical or
legal force but also force arising from the
compulsion of economic circumstances
which leaves no choice of alternatives to
a person in want and compels him to
provide labour or service even though the
remuneration received for it is less than
the minimum wage.''
Since the bonded labour system deprives
a person of his choice of alternative employ
ment and compels him to adopt one parti
cular course of action, it violates his right
to freedom under Article 19 of the Constitu
tion viz., freedom to practice any profession
and freedom to move freely throughout india.
This practice also deprives him of his life and
the liberty guaranteed by Article 21, through
Medical Service
an illegal labour contract and non-payment
of just wage etc.
What are the legal remedies available
to bonded labourers ?
»
1.
Inform the District Magistrate/SubDivisional Magistrate or members of
the Vigilance Committee/ regarding
the facts and circumstances of the
bonded labour system practised in
the locality/ either individually or
through an organisation. The infor
mation could be submitted in the
form of an affidavit. A copy of the
affidavit could be kept for future
reference.
2.
File a writ petition in the High Court
under Article 226 or in the Supreme
Court under Article 32 for the
enforcement of Fundamental Rights.
The State Government, the District
Magistrate/Sub- Divisional Magistrate
and Vigilance Committee could be
made respondents.
3.
Make a complaint, regarding non
payment of the statutory minimum
wage in the labour court of the
area.
4.
File an F.I.R. in the nearest police
station for harassment, threat, phy
sical assault etc., by the creditor.
Who are entitled to move the court for
the enforcement of the Fundamental
Rights of a bonded labourer ?
According to the. ruling of the Supreme
Court in the Asiad workers case (AIR 1982
SC 1473), when legal rights of an individual
or of a class of persons are violated and if by
reason of poverty or disability they cannot
approach the court for judicial redress, any
public spirited individual or institution acting
bona fide may approach the court for judi
November 1983
cial redress even by addressing a letter to
the court which shall consider it as a writ
petition and take action on it. Thus the
Supreme Court has enlarged the concept of
'locus standi' to enable social workers and
social welfare organisations to take up legal
issues on behalf of the weaker sections of
society.
Note
Many cases regarding bonded labourers
working in stone quarries in Uttar Pradesh,
Andhra Pradesh and Haryana have been filed
in the Supreme Court in the form of Public
Interest Litigations by social activists and
social welfare organisations. In such cases
the Supreme Court has appointed commis
sions consisting of social scientists, judges
and lawyers to verify the facts alleged in the
writ petitions. In such Public Interest
Litigation cases the Court generally exempts
the petitioner from paying court fees and in
case of need provides advocates to handle
the case on behalf of bonded labourers.
Rehabilitation of bonded labourers
■ One of the most important provisions of
the Act relates to rehabilitation of freed
bonded labourers. The District Magistrate
and Vigilance Committees have been
entrusted with responsibility for the econo
mic and social rehabilitation of freed bonded
labourers. This
proposed
government
machinery has an obligation to provide socio
economic development programmes for the
improvement of their living conditions. In
several places this administrative machinery
has been found inefficient in the implementa
tion of the provisions of the Act. As long as
bonded labourers are not made aware of
their exploitation and are not organised to
demand their rights, social legislation of this
kind will not make any substantial impact
on their lives. Committed lawyers, social
21
activists, voluntary organisations and public
spirited persons can play a major role in
supporting -ignorant and illiterate
bonded
labourers in their struggle to eradicate this
exploitative labour system and to find the
economic means to live with human dignity.
For further information in legal matters
contact:
Director, Legal Aid'
Indian Social Institute
Lodi Road, New Delhi 110 003
Tel. 622379, 624760
* Gram. Insocin
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23
Medical Ethics Forum-31
by Fr. George V. Lobo. S.J.
Place of Ethics in Defining Medicine" in the
Journal of the American Medical Associa
Common usage today applies the term
tion March 11, 1983, p. 1306).
profession to any activity that is done com
All trades and human activities are ex
petently. If one is trained for a job and
pected
to be honest, industrious, reliable
does it well we say: "He or she is a
and
disposed
to secure the good of persons.
professional." This use distinguishes such
But medicine has a special claim to be a
activity from that of the amateur who often
profession since it touches the most basic
does not get paid for the activity and is also.
less skilled as compared to the professional. human values of life and health. Moreover,
While this usage may be valid, it would be the patient turns for help in matters that are
helpful to see the deeper meaning of the often private, intimate and at times even
word, especially as it applies to the shameful. The patient is confronted with
traditionally
respected professions like his or her vulnerability and mortality and the
medical professional is called upon to help
medicine and law.
in his or her struggle for survival or revival.
A medical professional is not only
Human freedom and dignity are at stake.
specially skilled. He makes public profession
The doctor or nurse should stand in awe
of a devotion to his particular sphere of acti
before the mystery of life and death, health
vity. He or she knowingly and freely profes and sickness, in spite of his drugs and
ses his/her devotion to the task of healing. gadgets he or she is to be neither a proud
This has been well expressed in a recent master nor servile technician. He or she is
article: "It is a matter not only of the mind at the service of the powers of healing
and hand but also of the heart, not only inherent in the human person or at the
of intellect and skill but also of character.
mysterious passage from earthly life to
For it is only as a member of a community eternal life.
and as a being willing and able to devote
Hence technology should not be the
himself to others and to serve some higher dominating factor in the physician-patient
good that a man makes a public confession relationship. It; should be entirely at the
of his way of life. To profess is an ethical service of the process of integral healing. It
act, and it makes the professional a should never be used to unduly manipulate
moral being, who prospectively affirms the patient but should promote his freedom
also the moral nature of his activity."
and well-being. Thereby, the profession of
(Leon Kass "Professing Ethically: On the a doctor or nurse becomes a true vocation.
Medicine as Profession
24
Medical Service
Diocesan Level Celebration on “Respect Life”
I Celebration of Pro-Life Activities in
Ambikapur Health Association
A meeting of Ambikapur Health As
sociation was held in Ambikapur Bishop's
House on September 22 and 23, 1983.
The subject
of
the
meeting
was
"Promotion of Pro-Life Activities and
Celebration of the Theme Respect Life".
There were 32 participants from 16 out of 17
health centres. Among them were 14 sister
Nurses, 8 lay Nurses, 19 Village Health
Promoters, 12 Catholic Sabha members,
14 Mahila Sangh members, and 5 others.
The Seminar started in the evening with
a Bible Seminar. It was followed by slide
show in two parts; (1) Now life begins, (2)
Abortion: how it is. The participants were
much impressed with the slide show. The
chief guest was Rt. Rev. Bishop Philip Ekka.
The next day there was a very meaningful
Concelebrated Mass. After Holy Mass the
Bishop inaugurated a small exhibition. Twe
nty eye-catching, colourful and impressive
charts with appropriate Hindi texts were
displayed.
After the inauguration of the exhibition,
there was a talk by the Bishop. He stressed
chiefly three things in a very simple and
effective way. He said :—
1.
Only God is at the beginning of our
life and the Lord of us all.
2.
Abortion is the rejection of God's
plan.
3.
The right
Planning.
path is Natural Family
The following questions were given for
the
group
discussion1
which
followed :—
November 1983
When does huma^life begin ?
Is killing through abortion and killing
a big person the same ? Why ?
3. What methods are adopted for
abortion in the villages ? Why is the
foetus aborted.
1.
2.
4.
How can you prevent abortion ?
In the discussion, one very striking answer
given was that many people think that
human life begins after five months of
pregnancy, when the mother feels the
movements of the foetus. They believe that
before this period, they can do anything to
it, as if it were a mass of flesh or blood.
The participants were much impressed
by the seminar and asked to conduct the
same type of seminar in all the health centres
as soon as possible. They went home with
a resolution :
1.
To pass on the knowledge regarding
the beginning of life and the dangers
of abortion to the Catholic Sabha,
Mahila Sangh, group meetings and
td individuals.
2. They will try to prevent abortion and
allow pregnancies to continue.
II Celebration of Pro-Life Activities in
Ooty Diocess
The Catholic Hospital Association of India,
Ootacamund Diocese unit, celebrated the
'Pro-Life Activities, day on September 12,
1983. About 25 members consisting of doc
tors and persons in charge of all hospitals
and dispensaries of Ooty Diocese participa
ted. The meeting started with a prayer by
Rev. Fr. Patrick.
Rev. Fr. Joseph Antonysamy, Treasurer
of CHAI, welcomed all present and in his
25
inaugural address emphasised on responsible
parenthood. He said that couples must be
responsible. Normal families are unable to
decide the norms
their family with regard
to pro-life activities, but under all circumsta
nces abortion must be avoided and unborn
baby must be protected since life begins from
the moment of conception. We can eliminate
human problems but we cannot eliminate
human life.
Mr. N.P. Ralph, Project Officer, USSS,
who spoke on 'Respect Life' quoted III John
verse 2 'Beloved I pray that in all things thou
mayest prosper and be in health even as thy
soul prospereth," and said that God
created man in His own image and loved
him as His own body. So God's creation
must be respected and killings and belittling
of beings must be avoided. Social institu
tions must enter into motivating people to
create love and affection to respect life
in all circumstances.
Rev. Fr. Joseph Patrick in his keynote
address expressed that in marriage man and
woman are given a share in the creative
activity of God. Man and woman are co
redeemers, as God made man in His own
image. The Church is Christ's body. Jesus
wants to sanctify His body and submit it to
the Father without pollution. Conscience
is the voice of God and everybody must
act according to His conscience. He men
tioned that procreation is not recreation. He
referred to Pope's exhortation on family life
that abortion must be prohibited. He said
in Pro-Life activities and NFP the Catholic
hospitals, institutions and societies are not
much co-operative.
Rt. Rev. Dr. Aruldas James, Bishop of
Ootacamund, who celebrated Mass at noon,
in his message, emphasised that as God
created man in His own image, infant killing
is a sin and His creation must be respected.
God wants man to glorify Him. God lives
rn man and His life is in abundance in His
26
creation. God said 'thou shalt not kill’ and
man had no power to kill. He said that the
Centurian's child was cured in one word by
Jesus, and therefore especially Sisters in
hospitals should show compassion towards
the sick. We must also have a consoling
ministry as Jesus taught us, since everyone,
good or bad, had Christ in him.
In the group discussion held in the
afternoon session, it was felt that hospitals
could help couples with problems and social
workers can help NFP and pro-life activities.
Abortion must be prohibited at any cost. It
was also desired that orientation and training
have to be given in marriage counselling,
marriage, ante-natal and post-natal care.
The Diocesan Co-ordinator of NFP said
that 46,000 couples are following NFP in
Tamil Nadu for limiting and spacing of
births. In Uthagai Diocese alone, about
1634 couples are currently following NFP in
ovulation method.
The meeting ended at 4.30 p.m. with
Vote of Thanks.
Ill Report on Respect Life Seminar held
on October 18, 1983 at St. Joseph's Ca
thedral premises, Mysore
A Motivation Seminar on Respect Life was
held on October 18, 1983 at St. Josephs,
Cathedral Campus, Mysore, as per program
mes printed in the leaflet and circulated
Medical Service
earlier with a brief introduction. As soon as
the registration was over, an invocation
hymn was sung and relevant Scripture from
Genesis was read out, followed by a prayer.
Then Bishop M. Fernandes inaugurated the
Seminar by lighting the lamp. Sr. Rose Mary,
Karnataka Regional Co-ordinator, welcomed
the distinguished guests, the speakers and
the participants.
The first talk was given by Fr. Santosh
Ravi Kamath, S.J., on Respect Life from the
point of theological aspect. It was also
summarised in Kannada by Fr. Prabhu.
Dr. G. Pais, M.D., who is actively
involved in social service spoke in Kannada
on the subject at the family and social level
in the growing modern world. He explained
down-to-earth situations the crucial burning
problems of the family and society of today,
the fast perishing values of life and the
means of preserving them.
Miss Padmini, M.S. Ph. D., addressed the
audience on Respect Life at the level of
educational institutions. Her talk was also
summarised in Kannada by Fr. Prabhu.
have their own Secretary to report back their
group findings to the general session. The
groups then gathered for the general session
and reported their findings for discussion.
Fr. Santosh Ravi Kamath, S.J., functioned as a
moderator and kept the whole audience very
lively.
After tea at 4 p.m. a movie on 'Abortion
is a Woman's Decision' was presented on the
screen with a very good impressive moral
lesson. The story of the movie was sum
marised in Kannada by Mr. Susairaj.
Bishop Fernandes then gave a message to
the audience to be committed people for the
cause of Respect Life in their own area
according to their capacity. He also an
nounced that he would buy the particular
film, have it translated in Kannada and sent
it everywhere for the benefit of the public.
Finally Sr. Beatrice gave a Vote of Thanks
and before the Seminar ended at 5 p.m. all
were given cyclostyled copies of the speeches
an d questions in a file.
Dr. Richard Fernandes, M.B.B.S., pre
sented the topic at the level of health institu
tions. He explained at length how the
patient becomes taken for granted and what
should be and could be done so that he
becomes a person in the sight of medical
personnel. His talk was summarised in
Kannada by Sr. Texera.
Before a 15-minute coffee break the par
ticipants were asked to look around, go
through the posters and come back with
questions, if any.
A good lunch with chicken biryani was
served, after which the participants assembled
in the hall. Eight groups with their respective
questions were announced for dis.cussion in
separate rooms. The groups were asked to
November 1983
Hospital Sunday Celebrations
IV The Archdiocese of Madras-Mylapore
together with the Church of South India
celebrated Hospital Day at the diocesan level
at Good Shepherd Convent Auditorium,
Madras, on Sunday the 16th October, 1983,
The theme chosen for the celebrations was
27
12th September was the final day. The
culmination of the weeklong celebrations
brought all around the altar of the sacrifice,
beautifully decorated with lights and flowers.
Loudspeaker arrangements were made for
carrying the sentiments of praise and thanks
to the good Lord, as the congregation prayed
in hymns and Bhajans. In his homily, Fr.
Charles Almeida stressed the essential role
of faith and prayer in the process of healing
and health. Refreshments were served to
the guests and well-wishers of the hospital.
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28
Medical Service
'Respect Life'. Forty-two hospitals, dispen
saries and health centres of the Archdiocese
along with other health institutions belonging
to the Church of South India participated in
the programme.
The various health institutions in the
diocese started by putting up a colourful,
educative and illuminative exhibition on the
theme 'Respect Life'. Various aspects and
stages of life were brought out and illustra
ted on the exhibition. People visited the
exhibition in large numbers.
The public meeting was presided over by
His Grace Archbishop R. Arulappa of
Madras-Mylapore. Dr. John lype of Vellore
Dist. Hospital spoke about the preciousness
of life and how life has become cheap by
the misuse or abuse of life. Dr. Saulina
Arnold, Director of Madras Counselling
Centre, emphasised on the personal and
human approach while visiting the sick in the
hospital.
The public meeting concluded with cul
tural programmes and a Vote of Thanks by
Rev. Kurian Thomas, Director of Madras
Social Service Society, on behalf, of the
Dioceses and Churches in Madras.
Some medical institutions could not keep
up the Hospital Sunday Celebrations on the
3rd Sunday of March, this year. They cele
brated later on a convenient day. Some
reports received are given in brief below:St. Thomas Dispensary, Gengapattu
Village, hl. A. Dist., had their Hospital Sunday
Celebrations on the theme 'Respect Life' on
23rd October, 1983. The celebrations
started in the afternoon at 3 p.m. with Holy
Mass. In his homily, Fr. Johnson mentioned
Jesus Christ as the healer of body and soul
and that the healing ministry is being conti
nued in the Church through the Holy Spirit.
He appealed to the people not to indulge in
any activities against human life. Dr. J. Pathi-
November 1983
nathan, M.B.B.S., spoke at length on
'Respect Life’ to the big gathering, pointing
out the dangers of abortion which destroys
human life created by God. He requested
the people to follow NFP. This gathering
was then divided into ten groups and there
were serious group discussions on abortion,
birth control, sterilisation, laproscopic method
and NFP. Several questions were raised,
doubts were cleared and people agreed to
observe NFP. There was also a film show on
NFP. The function ended with the Papal
Anthem at 8 p.m.
In St Joseph's Health Centre, Lou rdepuram, Trivandrum, it was a short program
me which started in the afternoon with an
hour of prayer on the theme 'Respect Life'.
There were about 200 participants, mostly
(MCH) mothers and a few patients. A talk
was given on abortion, questions were
allowed, and doubts were cleared. After
refreshments, there was a drama on the
theme 'Respect Life' with a good moral
lesson.
Hospital Sunday Celebrations in St. Ann's
Dispensary, Maiiapuram, Hyderabad, were
held on 10th September, 1983. After the
Holy Mass, a talk on the importance of God
given life of human beings was delivered.
People were convinced that abortion is
murder and is a crime against God's com
mandment of love. None likes to be mur
29
dered and surely none likes his/her own
child to be murdered. The people hoped
and prayed that this dreadful evil and cruelty
will come to an end for the love of unborn
children and for the love of God the Father.
than 400 Christians and non-Christians
participated in the Service.
Participants
brought their children and Father conducted
a special blessing ceremony for them during
Holy Mass.
Our Lady of Providence Hospital, Basna,
(Raipur Dist.), celebrated Hospital Sunday
for the first time on 18th September, 1983,
with all the jubilation which it could have
had. Catholic as well as Hindus participated
in the celebrations with great enthusiasm.
The hospital varandah was well decorated
with a holy picture of Jesus, the great healer.
The Catechist gave a talk in the local langu
age Oriya on the theme 'Respect Life'.
Euthanasia was also explained by him. Then
followed a bhajan, reading of the relevant
Gospel, a short explanation on Jesus's
healing ministry and a shared prayer. The
hostel girls pdt up a little entertainment
and showed the healing ministry of Jesus
in a dramatic form. Some film strips on
health education were also shown. Finally,
there was a resolution to respect life more
than ever.
Colourful celebrations were held on the
18th October, 1983, by Holy Redeemer
Health Centre, Chuekedema, Nagaland,
beginning with Holy Mass. In his homily
Fr. Sebastian well brought out the theme
suggested by CHAI 'Respect Life'. More
30
September 12th was a day of rejoicing
for all at Mariampur Hospital, Kanpur. The
hospital is named after Mary who is the
patron and protectress of the Hospital. Each
year's celebration is different and new, and
novelty is the norm of change and growth.
This year's celebration lasted for one whole
week commencing on 5th September '83
with an hour of prayer in the Hospital Chapel
by the hospital staff and all its inmates.
September 6-11th were devoted to fun and
frolic, games and sports, singing and dancing,
fashion parade, followed by prize distribution.
On the 11th there was a sumptuous dinner.
Medical Service
CHAI
NEWS
NOTES
TIMUC
(Training Institute for Mentally
Under Developed Children)
It was a long cherished dream of the
Social Welfare Society, Thathampally, to
start a shelter for the mentally under
developed children. Considerable thought
and encouragement have been given and
efforts have been made for realising this
dream by
Shri M. K. Joseph Malayil, the oldest
member of the Board of Directors of the
Social Welfare Society; .
His Grace Most Rev. Dr. Antony Padiyara,
patron of the Society and Archbishop of
Changanacherry; and
Rt. Rev. Dr. Michael Arattukulam, patron
of the Society, and his Co-adjustor Bishop
Rt. Rev. Dr. Peter Chenaparampil. Rt.
Rev. Dr. Peter Chenaparampil has been
the motive force for the immediate start
ing of the TIMUC and has been closely
associated with this
On 28th September, 1983, TIMUC was
inaugurated by Mr. K.P. Ramachandran Nair,
Honourable Minister for Health of the
State.
Rt. Rev. Dr. Peter Chenaparampil blessed
the institute and presided over the meeting.
He declared that he would always be happy
to help the training institute in any way
possible.
Among others who were there to witness
the happy inauguration of the TIMUC were
Mr. E. Shahulhameed, I.A.S., Dist. Collector,
Rev. Fr. Thomas Felix, C.M.I., Director of the
ASHA KEN DRAM at Ernakulam and the
Institute for Mentally Retarded at Trivandrum.
The students were there with their parents
who gave bouquets to the distinguished
guests.
The TIMUC has been fortunate in having
the services of Rev. Sr. Betsy, S.A.B.S., who
completed her training in Trivandrum and
Ernakulam and is very happy to work for the
Mentally Underdeveloped Children.
TIMUC is obliged to the Vineetha Con
ference for the help and guidance given so
far and their continued advice and help are
earnestly solicited.
Bethany Nature Cure and Yoga
Centre, Nalanchira,
Trivandrum-15
Bethany Fathers started a Nature Cure
Centre in 1976 at Bethany Hills in
Trivandrum. On August 19, 1982, this
November 1983
31
Centre was shifted to Bethany Nagar
(Mekonam), equipped with modern ameni
ties and facilities.
A little beyond the
outskirts of the Trivandrum City (about
8 km. away from the railway station) the
centre is easily accessible to all. It has a
peaceful atmosphere. This centre provi
des nature cure treatment, counselling
and yoga classes. The centre has a
newly-built beautiful building with general
and special rooms and a small library con
sisting of books on naturopathy.
The following are the prominent treat
ments:
1.
Hydrotherapy: Steam bath, spinal
bath, immersion bath, hot/cold neu
tral alternative bath, foot bath, packs
and fomentation etc.
2.
Mud therapy: Mud bath full and
local.
3.
Massage therapy: Full and local
massage with oil and powder.
4.
Helio therapy: Sun bath, green leaves
baths.
5.
Chromotherapy:
colour treatment.
6.
Electro therapy: Infrared light, vibra
tors.
7.
Magneto therapy:
application.
8.
Diet therapy: Strict natural diet is
observed.
No outside food is
allowed. Smoking, alcohol and non
vegetarian food are strictly prohibited.
9.
Yoga therapy: Yogasanas, pranayana, surya namaskara, bandhs, rela
xing techniques.
10.
Prayer: Meditations, bhajans, coun
selling.
Thermolen,
Local
other
magnetic
(For more details, please write to the
Centre).
32
Report and Recommendation of
the Seminar on Leadership
Training for Integra! Develop
ment Organised by Tamilnadu
Social Service Society in colla
boration with Coady Inter
national Institute, Canada,
from 28.2.83 to 11.8.83 at
Jeeva Jothi Ashram,
Coimbatore.
God desires us to develop the faculties
He has given us and live a full life in a
Society aiming at physical, spiritual, intellec
tual, cultural and social development of man,
in spite of several constraints. It is in this
context we have to view' the Mission of Jesus
Christ who came to announce the Good News
to the poor. The Church has committed
itself to continue the Mission of Christ keep
ing in mind this final goal of God's own
creation and salvation and establishing a just
Society as envisioned in the sacred scriptures.
Recent Popes and the Second Vatican
Council have contributed to shape this aware
ness through various encyclicals and
documents. It is in this mission of the Church
for the growth of the disadvantaged that pro
mpted the establishment of Social Service
Societies in all dioceses of Tamil Nadu and
Pondicherry aiming at attaining fullness of
life for all men. The objectives which the
Diocesan Societies set for themselves were
many varied such as performing work of
charity to the poor and needy irrespective of
caste, creed or race, undertaking welfare
activities in order to improve the living condi
tions of the weaker sections. Over the past
two decades the Social Service Societies in
Tamil Nadu and Pondicherry were involved
in implementing various socio-economic wel
fare activities, mostly charity-based and
relief-oriented, with government resources
and aid from various donor agencies in India
and abroad.
Medical Service
A new thinking has evolved aiming at
people-based
community
development
action. Hence motivation programmes were
conducted at the Diocesan Parish and Village
levels in order to enable the local communit
ies to organise themselves and to take up
leadership roles in the people-based develop
ment activities.
w
The need of a common forum to promote
concerted action in the field of development
in Tamil Nadu led to the establishment of
Tamil Nadu Social Service Society (TSSS)
with membership restricted to 13 Diocesan
Societies. This society aimed at formulating
common plans of action and rendering train
ing and evaluatory services to member socie
ties, besides serving as a liaison and repre
sentative body of member societies and
the govt, or local bodies or funding agencies.
To achieve a unified approach at the
regional level it was decided to conduct a
Regional Seminar on Leadership Training for
Integral Development in collaboration with
Coady International Institute of Canada with
definite objectives. While the talks on various
topics provided the necessary ideas, the
workshop enabled the seminar participants to
study critically the present development
action undertaken by the Social Service
Societies, their structures, their past experi
ences in the field and their mode of funding.
Keeping in mind the main objectivies, it was
decided among other things that the goal of
the Societies must be to enable the disavant
aged to achieve their integral growth as a
necessary condition for the establishment of
a just society.
To achieve this goal the Seminar proposed
a 15-point Plan of Action.
Shelter for well being and defence against Kiddies diseases.
HAPIKAL DROPS : For Jaundice, Liver, Dysfunction and loss of Appetite.
MEGRON DROPS : A powerful and dependable carminative drops
VITATON DROPS : For promotion of Physical and Mental growth, health, vigour and for
teething period
MORMON!L
: Anthelminthic
(For Adults)
VIGOTEX Capsules
1
VITATON Syrup
J
A tonic for health, strength, vigour and vitality
Manufactured by:
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Room No. 233, Princes Street, (S.G. Marg),
Bombay-400 002
Dealers in Drugs, Chemicals, Medicines, Tablets, Injections etc. and also leading suppliers
to Catholic Hospitals, Dispensaries, Health Centres, Clinics, Govt, and semi Govt, as well as
Charitable Institutions.
N.B. Please enroll your name for mailing price lists, literature etc.
November 1983
33
Meals Without Meat
If you are looking for vitamins
look at the vegetable kingdom,
r
During the World War II meat shortage,
many housewives learned about tasty, nutri
tious meatless dishes. Because animal fats
began to be suspected of playing a part in
producing hardening of the arteries — arterio
sclerosis — and coronary heart disease, these
women, and their daughters, have taken
another look at meatless menus to avoid the
harmful effects of meat fats.
Can good health and adequate nutrition
be maintained on a meatless diet ? Even
today some people doubt this, but they can.
Multiplied thousands of Indians are doing
that very thing. What do they eat ? Can
they possibly get enough protein and iron in
their diet ? What about vitamins ?
Let us check a few facts. It is true that
beef protein is a good-quality protein, nutri
tionally speaking. But most people overload
their system with it. The average American
man needs only about one ounce of protein
daily. For good measure two ounces is
plenty. It is easy for him to get this amount
and the proper kind of protein from sources
other than meat.
Eggs have an even better protein than
meat, and milk protein is as good as beef
protein. But let us look to the vegetable
kingdom for high-quality protein.
Soybeans and channa (chickpeas) contain
perfect protein. Most other legumes (beans,
peas, lentils, peanuts, and the like) contain
slightly less perfect protein. Interestingly
enough, the protein fractions that legumes
November 1983
— by Lloyd K Rosenvold
lack are abundant in whole grains. The
normal use of whole grains in the diet supp
lies that slight lack and balances the legume
protein into a perfect protein. The resulting
protein is every bit as nutritious as that of
meat.
Whole grains furnish a good form of
protein. In the United States of America we
depend largely on wheat as our staple grain.
Whole-grain wheat has an excellent grade of
protein. So do whole-grain rice, whole
grain rye, and whole-grain oats. Most
grains are a little low in certain protein com
ponents, but the very things they need are
supplied in abundance by legume proteins.
Legumes and whole grains complement each
other into perfect proteins. Our* Creator
thought of everything when He planned
provisions for the human race. .
Nuts are one of the finest souces of pro
tein in the world. Many people eat them
after they have been made hard to digest by
deep-fat frying and heavy salting. Try them
fresh and without salt. Enjoy the natural
nutty flavour.
Fruits and leafy vegetables contain excell
ent proteins, although in small quantities.
Potatoes contain a high-quality protein. Irish
potatoes were a staple food of the husky
Irish immigrants who came to America's
shores a century or so ago.
Hulled sunflower seeds are a delicacy
enjoyed by many people. The Russians have
used them for centuries. Sunflower seeds
contain 17 per cent of high-quality protein.
35
tive for haemoglobin formation than lean
Other sources of the best protein are
beef, liver, and egg yolk.
various food yeasts (brewer's yeast torula
People think that meat is a good source
yeast and others) and wheat-germ flakes.
Wheat germ is the heart of the wheat berry, of vitamins. Actually, meat (except for
that living part destined to reproduce its liver, kidney and entrails) is a poor source of
kind. Most people never taste the wheat vitamins. Muscle meat is a fair source of
germ, for they eat only white bread. Many some of the B vitamins, but whole grains and
health-conscious men and women are using
legumes are far superior sources. Vitamin E
this millers' castoff food as a delicious food
is most abundant in seeds. Vitamins A and
supplement — truly the best part of the
C are lacking in steak, but are amply supplied
wheat.
in fruits and vegetables. If you are looking
A fact many people are not aware of is for vitamins, look at the vegetable kingdom.
that meat is one of the poorest food sources
The fat of meat is mostly of the satura
of all minerals except phosphorus, which is ted kind, which has been incriminated as a
also abundant in grains and legumes. A cause of hardening of the arteries. The
laboratory analysis of beef might reveal a natural fat of the vegetable kingdom is
fair iron content (most meat contain much
largely the unsaturated fat, which tends to
blood), but it is not in a form readily avail
prevent hardening of the arteries—an added
able to the human body.
dividend enjoyed by people who prefer a
Dried beans contain three times as much vegetarian diet.
iron as does beef. Peas, wheat, and oatmeal
Most meat is highly seasoned by the cook
contain twipe as much. Beef iron is only and by thd gourmet at the table. Many
about 11 per cent available to the human
people would not enjoy meat unless it was
body, whereas iron from vegetable sources
highly seasoned with salt, spices, and fat.
is largely digestible and available as human
Studies show that it is the fat flavours of
nutrition.*
meat that people crave, not the protein.
A few years ago some nutritionists disco
Food from the vegetable kingdom has its
vered what vegetarian physicians have long
own delicate flavours and needs little sea
known — that meat in the diet will not pre soning. When you choose the meatless
vent anaemia. One writer on nutrition said :
way of life, you learn to enjoy natural food
"It comes as somewhat of a surprise to learn flavours, you avoid many diseases that are
that a diet composed entirely of meat will
found in or are transmitted by meat, and
regularly cause severe anaemia in mice.” you largely avoid the saturated fats, which
"Beef induced the most severe anaemia, but produce damage to the blood circulatory
pork had a similar effect. Chicken muscle
system.
was slightly less effective in causing anae
There was a day when some people
mia.”
regarded vegetarianism as a passing fad. It
People mistakenly believe that they need is not a fad and it certainly is not passing,
but is a continuing way of life. It is the
what they call good red meat to build red
blood. The truth of the matter is that ordi oldest diet known to the human race. Man's
anatomy is quite different from that of the
nary muscle meat is an exceedingly poor
carnivores.
blood builder and. in view of the animal
Are you looking for a diet to give you
experiments cited, may actually be a cause of
better health ? A better way of life ? Less
anaemia. Food from the vegetable kingdom
illness ? Try a diet without meat. You will
Is still our best blood builder. Actually, the
be pleased with the results.
iron of whole wheat and bran is more effec
Courtesy: HERALD OF HEALTH
36
Medical Service
Tears
— by Dr. Mervya Hardinge
Tennyson, the English poet laureate of
the past century, wrote : "Tears, idle tears, I
know not what they mean." At that time
little was known of the function of tears, but
in today's intense search for knowledge,
even tears have come in for some serious
consideration. The findings are intriguing.
Everyone knows that crying makes
copious tears flow from the eye. But not
everyone is aware that our eyes are moist
with a film of tears all the time. The source
of tears, whether spasmodically copious or a
continuous film, is not in the eye itself.
They are mobilised in thin, five-cent-sized
glands tucked away just above the outer
corner of each eye. These are the lachrymal
(tear-producing) glands, the tear-manufactur
ing centres where fluid is extracted from the
blood and discharged over the eyeballs.
We are not ordinarily aware of the tears
that moisten our eye surfaces continuously,
unless they come so copiously that they fill
the eyes to the brim or overflow down the
cheeks.
But it is the tears that pass
unnoticed to which we owe much of the
comfort and the sight of our eyes. As the
glands pour out their continual flow of
moisture, the eyelids, flicking with the
speed of lightning, act as windscreen
wipers using the invisible tears as "water"
with which to cleanse and moisten the eye
ball. Dust particles are swished away, and
drying of the corneal membrane overlying the
pupil is prevented. If it were not for this
constant moistening, the exposed eye sur
faces would become dry, irritated, and
painful. Before-long, injury to the delicate
tissues would cause blindness.
November 1983
Tears not only lubricate the cornea, the
transparent layer covering the iris and pupil
of the eye, but they fill in the irregularities
of its surface and this improves its optical
efficiency. They also act as a disinfectant
solution due to their content of lysozyme,
an enzyme that breaks down cell walls of
many germs.
It is of interest that the presence of
lysozyme in tears was first reported by Sir
Alexander Fleming, the discoverer of
penicillin.
Composition of Tears
Tears are not just plain water, as we all
know from their salty taste. They contain a
number of minerals, a trace of protein, and
a little glucose. Actually, the film of tears
that covers the front of the human eye is
said to consist of three layers laid down by
different types of glands. Next to the
cornea is a protective mucoid film produced
by glands in the white of the eye, then a
watery one secreted by the lachrymal,
glands proper, and finally, a superficial oily
layer attributed to glands located in the
lining of the eyelids. As the eyelids flick the
tear fluid across the front of the eye, they
sweep it toward small openings at the inner
corner of the eye next to the nose. Here the
tears are sucked down the nasal tear duct
where they moisten the inside of the nose.
This is why your nose runs when you cry.
Besides a continual invisible flow of
tears, human beings at times give away to
an unrestrainable outpouring termed "crying"
or "weeping". Crying by adults is usually
the result of deep emotion. It may be
37
triggered by a heart-rending bereavement
grief, sorrow, disappointment, regret, or even
frustrated anger. Sometimes tears overflow
with a sudden relief from anxiety or in
response to great joy.
healing element of time lessens the frequency
of the grief spells and lengthens the periods
of calm until the emotions stabilise. In
blocked grief, increased emotional problems
may be prolonged. Whether in men, women,
or children, a bottled-up agony is traumatic.
Infants cry with their first breath, but they
Now that women's lib is striving to equalise
usually shed no tears for two or three weeks.
the differences between the sexes, perhaps
A baby's first cry gets air into its lungs.
women will permit men and boys to share
After that it cries when it is hungry, uncom
their relief through tears by allowing them an
fortable, or when it wants attention for any
untainted liberty to weep their heart's anguish
reason, sometimes just to be noticed and
away !
loved. As a child learns to speak, it cries
Tears, far from being an idle waste of
less, but still finds that crying usually gets a
quicker response from grown-ups than a
unknown value, are being recognised by
science as complex solutions having specific
quiet request.
functions
to perform. Physiologically, they
In most cultures women and children are
protect,
moisten,
disinfect, and wash the eyes
more free to cry than the male members of
and
moisten
the
lining of the nose. Emo
the family, even rather young boys. For
tionally, they act as an overflow outlet for
men and boys it is considered unmanly to
relief of feeling strained to the bursting-point.
give way to tears. Dr. E James Lieberman,
To
give way to tears is neither unwomanly
assistant clinical professor of psychiatry.
nor
Unmanly; it is normal.
Harvard University, questions the wholeso
We
live in a world stalked by tragedy.
meness of this antigrief psychology.
He
Wars, earthquakes, cyclones, tornadoes,
suggests, for example, that failure to weep
floods, famines, accidents, bereavements,
at the funeral of a loved one may be a sign
illness, calamities by land, sea, and air are
of blocked grief. A stony-faced emotional
ever with us. As long as these conditions
paralysis helps no one, and neither does a
exist, we shall have floods of tears. But
chaotic hysteria, but a reasonable expression
let us look up and live for a better day. The
of grief gives an outlet for the emotions and
Good Book promises a change in conditions
eases the tension.
on our earth when "God shall wipe away all
Healing Element
tears from their eyes; and«'there shall be no
more death, neither sorrow, nor crying."
ft is said that grief comes in waves of
Revelation 21 : 4.
distress lasting from several minutes to an
hour, followed by a period of relief. The
Courtesy: HERALD OF HEALTH
38
Medical Service
Food Preservation
There is nothing like consuming fresh
foods; they have better taste, appearance.
colour, etc. But foods like milk, meat, fish,
poultry, vegetables and fruits, etc., the so ca
lled perishable foods tend to get sploit soon.
Even under most cautious conditions, we
cannot manage to keep them fresh for too
long and that is why these foodstuffs are
often preserved to lengthen their shelf life.
Preservation of foods has many advant
ages like preventing the spoilage of foods,
easy availability, easy transportation and
storage, economical and these foods also add
variety to our meals.
Have you thought of what the effect of
food preservation is on the nutrient content
of those foods? Well the handling storage
and preservation of food often involves
changes in nutritive value, most of which are
undesirable. However, these depend mainly
upon the type of foodstuff, its nutrient con
tent, method of preservation it is subjected
to time and temperature of cooking food,
additive and other things added to lengthen
the storage time, etc.
There are various method of food preser
vation. The freezing process, if properly
conducted, is generally regarded as the best
method of long-term food preservation.
Drying Process
It appears to offer good nutrient retention
with the exception of ascorbic acid and Bcarotene losses. Protein quality deterioration
due to drying or evaporation are minimal.
The losses of water-soluble vitamins other
than ascorbic acid, during drying average 5
per cent. Oil soluble vitamins in milk are not
lost in either drying or evaporation.
Blanching and Cooling
Losses of Vitamin C and thiamine that
occur during water blanching and water cool
ing of vegetables, Vitamin C often amounts
to about 10 per cent to 50 per cent and
losses of Vitamin B-1 are often about 9 per
November 1983
—by Miss Surindra Jain
cent to 60 per cent depending upon the
product arid conditions. Loss of water
soluble vitamins occur primarily by leaching.
One purpose of blanching is to render the
product more resistant to vitamin losses dur
ing frozen storage (inactivate enzymes).
Vitamin C, B-1, B-2 and carotene from vege
tables during frozen storage is saved.
Chemical/Additives
Food additives are substances other than
the basic foodstuffs which are put into foods
during production, processing and packaging.
Potassium Metabisulphate
It has great effect on thiamine. In fact
these are not allowed in meats or foods
recognized as a good source of thiamine.
Acids
Citric acid, tartaric acid, lactic acid, etc.,
when used in the preserved foods, lowers
the pH of the medium which converts the
Vitamin A to its biologically less active form.
Vitamin B12 is also inactivated in the presence
of mild acids. The enzymatic properties are
also lost. However, there is no adverse
effect on the utilization of proteins.
High Sugar Processing
Jams, Jeliies, preservatives, etc., have
app. 2/3rd portion as sugar. Only a small
portion is having fruits and vegetables which
does not appear to have a significant loss of
nutrient.
Though there are nutrient losses during
preservation and storage of foods, neverthe
less. in the modern era, when the social
responsibilities of man and especially house
wife have increased so much that she cannot
devote herself fully towards food, she has to
but (depend upon) bank upon the great
variety of preserved foods which are often
available at hand. 1n other words in spite of
all these nutrient losses which occur while
processing food preservation is a boon for
the housewife. Food processing is also
essential to feed the population.
Courtesy : HOME SCIENCE
39
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