MEDICAL SERVICE VOL. 42 No. 3 MARCH-1985

Item

Title
MEDICAL SERVICE VOL. 42 No. 3 MARCH-1985
extracted text
are the industrial chemicals slowly poisoning us? • correcting genetic
defects during pregnancy • healthy youth: pur best resource • a sensible
approach to asthma • conserve your vital force • to kill or not to kill?
medical ethics forum.

medical
service

official house journal
of the catholic
hospital association of India

"the love of Christ
urges us" 2 cor 5 :14

vol 42

editorial board

no .3

march 1985

contents

dr c m francis
dr ravi narayan

dr prem chandran john
dr daleep mukarji
mr augustin veliyath
fr george lobo sj
' prof george joseph

1

editorial

2

2

are the industrial chemicals slowly poisoning us?
niranjan desai

3

correcting genetic defects during pregnancy
john newell

7

healthy youth : our best resource
dr halfdan mahler

9

primary health care : a volunteer's experience
lisa cabrera

11

conserve your vital force
armand t fabella

18

some suggestions to improve nutrition in these
hard days
j d pathak

25

to kill or not to kill ?
mrs rosamma ninan

30

medical ethics forum
fr george lobo sj

32

dr paul neelamkavil

3

fr edwin m j

4

5

editor

■

. fr john vattamattom svd

6
I
1

f

7

cover design

p m isaac bangalore

8

9
published by the catholic
hospital association of india
cb.ci centre, goldakkhana
new delhi-110001

printed at kalpana printing
house new delhi-110016

,,Articles and statements published in this journal
do not necessarily reflect the policies and views of
the catholic hospital association of india”

EDITORIAL
A New Orientation

The Church in India has addressed herself to the needs of the people
in this country especially in the fields of education and health for more
than a century and particularly after Independence. Singing of praises by
government officials, politicians and others, in these two fields of services
are no rare occurances in any part of our vast country. There is no doubt,
as single minority community, our contribution in the service to the nation is
substantial, even out of proportion to our number. Yet, inspite of all these we
can not forget or ignore the hard reality that more than 80% of our people
particularly in rural areas are without proper health care facilities and in many
cases even without minimum facilities like safe drinking water, sanitation etc.

One scene that can be noticed so commonly in all parts of this vast
country, and particularly in urban areas, is that the co-existance of the so
called ''Five Star" hospitals, sophisticated health care institutions on the one
hand, whether owned and/or run by private organisations or individuals or
by government itself, and people with chronic illness living in hutments
and slums etc. on the other, who are unable to reach these institutions of
excellence not because of distance, but because of various types of bar­
riers, the cost-factor being the main. In spite of all these, we as Catholic
health care institutions have a special mission towards these neglected ones
in the society. In order to fulfill this mission, we may have to re-think
about our. commitment and we need to re-orient ourselves to meet this
need.
Though we can be proud of our professional expertise, personal devotion
and commitment and caring concern for the person of the patient through
our hundreds of health care institutions, we should not be led to a state
complacency, a possible danger we may enter into if we are not careful.
What we need today is to re-orient ourselves to see beyond our institutions,
however excellent they are, and see the persons' environment and community.
This going beyond is the new vocation and mandate of the
health care personnel and health care institutions. Our new orien­
tation should also be to pay particular attention to the poorest of
the poor, following Christ's own preferential option for the poor.
This calls for a new type of health care personnel, a new approach,
new techniques and above all new education and training. Since vast
majority of our health care personnel work in places other than their own
native places, special attention will have to be paid to orient them to the
customs, cultures, values etc. of the.place of their work. Hence, to make
our health care appostolate more meaningful today, a new orientation is
the need of the hour.

Are the Industrial Chemica Is Slowly Poisoning Us ?
—Niranian Desai

Over 2000 people have died and thousands
have been disabled by the leakage of Methyl
Iso-cyanate (MIC) gas at the Union Carbide
pesticide factory in Bhopal (Madhya Pradesh)
since 2nd December 1984. This is the worst
industrial disaster ever recorded in the history
of the world.
Slowly frightening after-effects of the gas
are coming to light. Gas victims have deve­
loped cerebral paralysis, a disease which
paralyses the nervous system.

According to American public health ex­
perts, the area affected by the poisonous gas
leakage may face, for years to come, a health
crisis of a severity "unparalleled in peace time."
It is reported that according to the experts,
the eyes or lungs of a considerable percentage
of the population would be greatly impaired.
Sooner or later many victims are expected to
succumb to suffocating onslaughts of emphy­
sema, asthma, bronchitis or such diseases as
pneumonia.
According to a chemist, "No one knows
what sort of long term after-effects the MIC
gas can cause to human beings. Human
beings were never exposed to this kind of
pollution and no amount of laboratory studies
could predict its after-effects".

Synthetic Toxic Chemicals
Because the Bhopal disaster struck in a
stupendous way, we are horrified by the tra­
gedy. But, are we aware how the chemicals
are slowly poisoning mankind without their
being aware of it? Now, let us have a look
at the way the synthetic toxic chemicals are
causing havoc on mother earth.
March 1985

The introduction of new chemical products
into the environment since World War II has
been responsible for the increased cancer
rate since then. In 1900, cancer was the
cause of death for about 3 per cent of the total
deaths in the USA. But by 1975, cancer
annually caused 20 per cent of the deaths in
that country. The World Health Organisa­
tion has stated that environmental factors
Tause 60 to 80 per cent of all cancers. En­
vironmental factors include many kinds of
exposures, from cigarette smoke to contami­
nated water and to chemicals in the places of
work. Most of the people who are suffering
from heart disease, the number one killer in
the USA, are living in areas of high air pollu­
tion.

* Cadmium, a metal used in rubber tyres,
plastics, pigments and as a plating on metal,
is believed to cause high blood pressure,
which results in heart disease. Scientists
believe that carbon monoxide and lead also
cause heart disease. Lead pollution causes
brain damage in children. Two-thirds or
more of all lead intake for adults is attributed to
food which absorbs the metal from contami­
nated water and soil or from pesticides.
Dr. Ralph Dougherty of Florida State Uni­
versity has stated that exposures to toxic chemi­
cals decreases male fertility. According to
him, sperm density in American males has
declined in the past*30 years steadily from an
average of 100 million cells per millilitre be­
fore 1950 to averages of 50 to 80 million cells
today. Concentrations of trichlrophenol,
a metabolite .of the herbicide 2, 4, 5,-T and
Silver, were found to contribute to the declin­
ing sperm counts. •

3

It has been found by researchers that most
cancer-causing chemicals also induce birth
defects and gene mutations. A scientists
conference on mutagens in 1979 concluded,
"In all likelihood, environmental mutagens
contribute to a large and costly genetic health
burden." Scientists have found more than
100 organic compounds in human unblical
cords, including halogenated hydrocarbons,
plastic components, food preservatives, car­
cinogens, benzene, carbon tetrachloride and
chloroform.
Safety Measures in Plants

The links between the many forms of pol­
lution can best be understood by briefly con­
sidering the steps of production. Getting
the raw materials by mining or otherwise can
pollute water and air, and expose workers to
dust and dangerous conditions. At the manu­
facturing stage, workers can be further expos­
ed to dusts and hazardous chemicals. During
manufacture, wastes are produced, which
are dumped on the land or let out into the air
or water. The ultimate product itself, like
pesticides, is a further source of contamina­
tion. If the product is not recycled, it will
add to the nation's immense pile of waste, as
is being faced by the advanced countries.

Failure to control dangerous substances
and the unwillingness to spend the money
to reduce the dangers, create both occupatio­
nal and environmental hazards. An unsafe
plant can demolish the health not only of its
workers, but also all the people living around
that area. This is what exactly happened at
Bhopal on 2nd December 1984. Then comes
the product, such as pesticides, which can
threaten the health of people thousands of
kilometres away.

Now, let us see how some of the chemicals
effect our lives. In the USA, the National
Cancer Institute and the National Institute for
Occupational Safety and Health analysed
4

the potential risk for workers exposed to 9
substances. The results are really staggering.
1. Arsenic : The risk ratio of workers
potentially exposed—the number of cancers
expected, compared to that in a normal popu­
lation—is from 3 to 8 times higher for lung
cancer.

2. Benzene : The risk ratio of • workers
potentially exposed for leukamia (blood can­
cer) is 2 to 7 times higher.
3. Coal tar pitch volatiles and coke oven
emissions : The risk ratio of potentially ex­
posed workers is from 2 to 6 times higher for
lung, larynx, skin and scrotum cancer.

4. Vinyl chloride : The risk ratio of po­
tentially exposed workers, are 200, 4 and 1.9
times higher respectively for cancer of the liver,
brain and lung cancer.
5. Chromium : The risk ratio of poten­
tially exposed, workers is from 3 to 4 times
higher for nasal cavity and sinus, lung and
larynx cancer.

6. Iron Oxide : The risk ratio for the po­
tentially exposed workers is from 2 to 5 times
higher for lung and larynx cancer.

7. Nickel: The risk ratio for the potentially
exposed workers is from 5 to 10 times higher
for lung cancer.
8. Petroleum distillates : The risk ratio
of potentially exposed workers is from 2 to 6
times higher for lung and larymx cancer.
9. Asbestos : Between 8 and 11 mil­
lion workers have been exposed, in the USA
since World War II. More than 2.15 million
of them are expected to die of cancer. The
NCI and NIOSH researchers have opined
that asbestos alone would represent about 17
percent of all cancers detected annually in
the USA.
Medical Service

Considering the enormity of the danger
due to the manufacture and use of asbestos,
the US Government has banned all manufac­
ture and use of asbestos in the country. All
the schools, who are the major consumers of
asbestos, have been instructed to remove the
material from their premises forthwith.
Apart from cancer, diseases of the lungs are
also a particular occupational hazard. Wor­
kers employed in coal mines, textile weaving
and ship building have been exposed to dusts,
on the job that will kill many of them. Death
from these diseases comes usually after a
long latency period, mostly after the worker
has retired, that people fail to take notice of
its seriousness.

Acid rain'. One of the most significant
threats that are beyond the control of any one
country is the "acid rain". Acid rain is formed
by sulphur-di-oxide primarily emitted from
coal-based power plants, and nitrogen-oxide
much of which comes from automobile ex­
hausts, that mix with water in the atmosphere
and are returned to the earth as precipitation,
sometimes as acidic as vinegar

According to official estimates, in the next
20 years, 48,000 lakes in Canada will be ren­
dered lifeless by acid rains. About 15,000
lakes in Sweden are fishless because of pol­
lution from smoke stacks in England, France
and Germany.
The depletion of the earth's ozone layer is
caused primarily by the release of fluorocar­
bons used as propellents in refrigerators, auto
air-conditioners, aerosols and other products.
Depletion of ozone would reduce the protec­
tion from the ultraviolet radiation of the sun
that the atmosphere affords. More ultra­
violet rays would generate more frequent
incidence of cancer.

Like air pollution, water pollution is also
a major cause for diseases in the modern world.
One way of water pollution is through indus­
March 1985

trial sewage. Thousands of industrial plants
don't treat their wastes, which often contain
toxic synthetics and heavy metals. They
are simply pumped out into canals and rivers
or into lakes, which are used even for drink­
ing water purposes in developing countries.

Pesticides used by farmers also get mixed
up in water, both running water and ground
water, causing problems later on. Though
fish may develop resistance to survive in the
polluted rivers and lakes, all the same they will
contain significant quantities of toxic chemi­
cals.
Beware of chlorinated water

To purify the water for drinking purposes,
the authorities use chlorine to kill the disease
spreading virus and bacteria. Chlorination
has been a standard operating procedure in
the water treatment performance. But the
chlorine used as a disinfectant combines with
organic wastes in drinking water to form ex­
tremely dangerous compounds called trihalomethanes (THMs). One of these compounds
in chloroform, a known carcinogen. Others
include brominated compounds that appa­
rently are formed by the interaction of chlorine,
the organic chemicals and bromide.
What is the effect of this pollution on hu­
man health ? The research studies in the USA
have indicated that pollution contaminants in
water are linked with an increase in the cancer
rate. In late 1980, the US Council on Environ­
mental Quality published a new study, accord­
ing to which, chemically contaminated drink­
ing water has been linked to increased risk
of cancer.

The Chief of the Clinical Epidemiology
Branch of the National Cancer Institute, Dr.
Robert Miller, has said, "It iS clear that the
contamination of water has shrunk the size
of new born babies, starved others for oxygen,
pustulated the skin for years in persons of all
5

ages, caused bones to ache with every step,
and addled the brains of new borns, children
and adults. With this array of adverse effects
of the integrity of the human organism, is
there really any need to invoke the spectre
of cancer to achieve clean water?"

use there. Unless there is a total ban by all
the countries at the UN level for the manu­
facture and use of these hazardous chemicals,
the multinationals will continue to produce
these dangerous chemicals and export them
to unsuspecting nations.

Granular Activated Carbon (GAC) filters
are available as an alternative to chlorination.
GAC filters are the best known method for
removing organic pollutants in water. The
filters are extensively used already in European
cities, including Zurich, Cologne and Amster­
dam. About 40 American cities use them to
improve lhe taste and odour of water but none
to filter out dangerous chemicals. The rea­
son is the opposition by vested interests in
the American Industry.

It is high time we took stock of the situa­
tion and banned the manufacture of all hazar­
dous and dangerous chemicals in the country,
however profitable it may be. Secondly, we
should also thoroughly check all the factories
which are manufacturing the chemicals, even
the essential and harmless ones, to ensure
that all safety regulations are strictly followed.
Thirdly, no chemical factory should be allow­
ed to be constructed within a stipulated safe
distance of the populated areas. Care should
be taken to fix the distance, taking into consi­
deration the future expansion of cities and
towns. Fourthly, all workers should be given
full protection from dangerous exposure to
toxic chemicals.

In India, we are still using chlorine to purify
water, blissfully ignorant of the controversies
going on about the danger of drinking such
water. It is high time the authorities look
into this, and stop using chlorine to purify
water and to find an alternative like GAC
filter.
Despite all the grim evidence, the produc­
tion of hazardous substances and their reck­
less use continue to increase. The results
of steady global pollution in this generation
are an epidemic of cancer and increased rates
of heart and respiratory diseases. The cal­
lousness of some of the advanced countries
is also responsible for the pollution by hazar­
dous chemicals. For example, pesticide like
DDT, aldrin, dialdrin, chlordane and heptachlore are banned in the USA, but these are
being freely exported to other countries for

6

If enough precautions had been taken, the
Bhopal disaster could have been averted. At
least, we should resolve now, to see that the
Bhopal-type disaster is not repeated anywhere
in future.
Courtesy SOCIAL WELFARE

An epidemic of cancer and an increase
in the rates of heart and respiratory
diseases is the price mankind pays
for runaway industrialisation.

Medical Service

Correcting Genetic Defects During Pregnancy
—John Newell

A research team at London's King's Col­
lege Hospital believes it will soon be able to
diagnose and correct—during early preg­
nancy-genetic defects currently regarded as
incurable.

cells, as in sickle cell anaemia or thalassaemia
or for skin or liver defects caused by genetic
abnormalities.
Treated Before Births

The centre has been named the Harris
Birthright Research Centre after London busi­
nessman Philip Harris, who provided the funds
to establish and develop medical research
there. The centre's director is obstetrician
Charles Rodeck, and he and his team hope to
start within three or four years treating forms
of thalassaemia and sickle cell anaemia (both
hereditary anomalies) before birth by using
grafts of bone marrow. Monkeys are to be
used later this year, in collaboration with
Professor L. Brent of St. Mary's Hospital,
London, to test the techniques that will be
needed. If the tests are successful, there
should be no problem in applying them to
humans, since all these techniques have al­
ready been used in man for other purposes.

Physical abnormalities spotted by the foeto­
scope can sometimes be treated before birth.
Examples are blockages in the urethra,
the
outflow tract from the bladder.
Its continued blockage can cause permanent
damage to the kidneys. But if the condition
is spotted early, a catheter can be inserted in
to the womb to drain off foetal urine. Rhe­
sus disease, in which the foetal blood group
is incompatible with that of the mother, can
readily be diagnosed from a blood sample.
Jt can then be treated in the foetus, using in
reverse the same equipment as that used to
take a foetal blood sample, to deliver a comp­
lete blood transfusion of a group compatible
with that of the mother.

King's College Hospital has for years had
a reputation for its expertise in foetal medicine,
with pregnant women being referred from all
over the world. In the last few months alone
patients have come there from Australia, the
United States of America, West Germany,
France, the Netherlands, Italy, Greece and
Scandinavia. The team led the development
of the use of ultrasound to detect serious
abnormalities before birth.

In recent *years, Mr. Rodeck's team has
developed a technique for diagnosing genetic
defects at a very early stage of pregnancy—as
early as eight weeks after conception. This
technique, called chorion biopsy, involves
taking a biopsy or sample of tissue from the
chorion, one of the membranes surrounding
the foetus, with a fine metal tube guided by
ultrasound.

It has pioneered the use of the foetoscope,
a telescope that is inserted into the uterus to
examine the developing foetus from ail ankles,
while other tubes attached to it can be used
to take blood samples or skin or liver biopsies.
These can then be scanned for defective blood
March 1985

Genes in cells in the biopsy are then com­
pared directly with a reference library of the
same genes from normal, healthy tissue and
any genetic defects are revealed. Ther­
apeutic abortion can then be offered for de­
fects that would lead to fatal abnormalities in
the new born infant.
7

Bone Marrow Donor

Now the King's College Hospital team
hopes to take its work a stage further by not
only diagnosing but actually treating and
curing these conditions before birth. A
chorion biopsy would be performed on a
foetus at known risk of either sickle cell anae­
mia or thalassaemia. If analysis shows the
genetic defect suspected is present then a
suitable bone marrow donor will be foundprobably a close relative.
Bone marrow will be taken from the donor
(a simple, already widely used procedure)
and treated by a new technique to remove the
T-cells from it. The bone marrow T-cells
are responsible for the graft versus host reac­
tion, in which bone marrow grafts develop an
immune response against their new host.

Using a technique developed at London's
University College and Royal Free hospitals
as well as in other centres, T-cells can now be
selectively removed from bone marrow that is
to be used for grafting. This is done by mixing
the bone marrow with monocloha antibodies
made againt T-cells that have been linked
chemically to the toxin ricin. The antibodies
direct the ricin to destroy T-cells without
damaging the rest of the bone marrow.

The Same Technique

Bone marrow.treated in this way will then
be injected into the blood circulation of the
foetus, using exactly the same technique as
that used for treating rhesus disease. But
the procedure will be simpler because only
a small quantity of marrow is needed. Ex­
periments show that the marrow naturally
finds its way to, and settles in, the bone marrow
of its new host. Because chorion biopsy
can be carried out so early, it will be possible

8

to transfuse the bone marrow into the foetus
well before the 18th week of pregnancy.
Eighteen weeks is thought to be the time
at which the foetus first develops the ability
to recognise and reject foreign tissue. It
is therefore reasonable to anticipate that the
foetus will accept the graft, and that this will
cause sufficient healthy, normal red cells to
be formed continually, not only during preg­
nancy, but throughout Childhood and adult­
hood, providing a lifelong cure for sickle cell
anaemia or thalassaemia.
New Techniques

In this way, several relatively new techni­
ques—foetal blood transfusion, chorion biopsy,
diagnosis of genetic defects directly from DNA
analysis, and detection of T-cells from bone
marrow using monoclonal antibodies—are
needed to treat sickle cell anaemia and thalas­
saemia before birth. Mr. Rodeck hopes it
will be possible to test the whole procedure in
monkeys this year, and to start work on hu­
mans in two or three years time.

If all goes well, the work could then be
extended to treat and cure several other com­
mon and at present mainly incurable condi­
tions caused by genetic defects such as cystic
fibrosis, Tay-Sachs disease, phenyl-ketonuria
and Hurler's syndrome.
The procedure adopted to treat the foetus
should be much quicker, simpler and cheaper
than giving bone marrow grafts to adult pa­
tients because there is no need to destory the
patient's own bone marrow to prevent re­
jection of the graft.
—Courtesy : THE NURSING JOURNAL OF
INDIA

Medical Service

Healthy Youth: Our Best Resource
by Dr. Halfdan Mahler*

Kicking up dust on a make-shift football
pitch in a Brazil village; running races through
the Kenya bush; wrestling in a Bangkok
tournament; or breaking world records in the
Olympic games: young people's sporting
achievements testify that theirs is the age of
peak physical fitness.

More than three-quarters of those between
15 and 24 live in the developing world, and
that proportion will probably reach 84 per cent
by the year 2000. Thus the challenge, is
greatest there. A major trend is for young­
sters to leave the countryside and migrate to
the city in hope of a better life. This erodes
the traditional structure of the rural family
In 1985, International Youth Year, the world and replaces it with the stressful, lifestyle of
will harvest not only its biggest, but also per­ marginal populations living in urban slums.
haps its best crop of young people in history. Young migrants are forced to face the chal­
Today's young people are the healthiest age. lenges of city life without tTie training or skills
group and are better educated than ever be­ that they need. The unemployed in many
fore. Having survived the vulnerability of parts of the world include a very high per­
childhood years, they are intrinsically healthy centage of young people—many of them illite­
and, over the last two decades, school en­ rate, most of them unskilled and inexperienced.
rolment has nearly doubled in the develop­ The dice are already heavily loaded against
ing world, though they are mainly boys on the them.
school benches.

With better access to the world's store of
knowledge, young people are able to grasp
and use new ideas. . In many countries there
are young faces that are starting at the flick­
ering green computer screens, young fingers
that are moving like lightning over the key­
boards, or creating new circuitry that will
itself create new computers.
The potential of youth, if it is to be properly
tapped, requires understanding and support.
Youth is a very special time with special chal­
lenges. This is the period when the body
changes from that of a child to that of an adult.
It is an age characterized by impatience as
well as curiosity, and by a strong desire to
leave childhood behind and play an indepen­
dent* role.

If age is characterized by caution, youth is
characterized by a love of risk-taking. Such
impulses can be guided to take positive formssport, outdoor adventure, social experimentsrather than towards the negative habits of
cigarette smoking, abuse of alcohol or depen­
dence on other drugs. Society must also take
into account the elements inherent in the spirit
of youth, including the urge to seek self-identity
and to find an outlet for one's love for others.
The young have a large role to play in health
care: they themselves are m.ost aware of their
own health problems; they maintain an open
mind and represent the group best able to
appreciate the basic tenets of primary health
care, beginning with the responsibility of car­
ing for themselves.

•Director General of the WHO

March 1985

9

Studies have shown that a majority of
youngsters want to help others and want to
assume responsibility. A good place to start
may be with national community programmes
that demonstrate how to keep fit and achieve
a healthy lifestyle.

towards health for all, every community should
take stock of its youthful resource and nur­
ture it for all its promise. The joyous and ex­
plosive energy of youth and its natural curio­
sity are there to be exploited to build a better
world.

On World Health Day 1985, in the drive

Courtesy WO R L D H EA LTH

from

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Masticating trouble leads to: Indigestion,
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10

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Medical Service

Primary Health Care: A Volunteer’s Experience
—by Lisa Cabrera

This young' UN Volunteer was at first
thought too young to train and supervise
village girls in Sri Lanka in Primary Health
Care. At times she wanted to quit. But inthe end she proved her worth and felt she
never wanted to leave.

Why do we make hospitals a starting point
in identifying and meeting patients' needs?
Why not the community itself, where people
live?
The world is fast recognising not only that
acute-care hospitals are the most expensive
part of its health care system, but also that
such hospitals are not always the most appro­
priate places for the care and treatment of
many health problems. Hospital wards are
commonly overcrowded with patients—many
of them admitted with preventable conditions
that could be more efficiently and effectively
handled if more primary health care services
were available. Millions of dollars have been
spent on medical advancement in the treat­
ment of disease, yet still we wonder why there
is not overall improvement in the health of
the people. Are people used to seeking medi­
cal assistance and taking medication just be­
cause of doctors' orders ? Or do they believe
that Western medicine can, like magic, re­
lieve all health problems? Perhaps, as David
Wener tells us, "if you can use what is best in
modern medicine, together with what is best
in traditional healing, the combination may be
better than either one alone."
Primary Health Care is a major concern of
organizations seeking to involve young people
in health care programmes. The United Na­

March 1985

tions Volunteers' project of support to Domes­
tic Development Services (DDS) and youth
organizations in Asia and the Pacific com­
prises a considerable number of primary
and rural health care activities. When I
decided to join the UN Volunteers family, I
had one goal—to offer my services to the .
people. To help those needing care regard­
less of the artificial barriers erected by men,
is one of life's greatest fulfilments.

The day 1 left the Philippines for Sri Lanka—
in September 1982—was a thrilling one for
me, travelling alone, far from my parents—
a thing I had never done before. When I
arrived in Colombo I received a thorough
briefing about the Sarvodaya Shramadana
Movement, my host volunteer organisation,
from another UN Volunteer. She described
for me the health programme of Sarvodaya,
a non-profit, non-governmental DDS orga­
nization striving to promote the awakening of
the individual, the family, the town and the
nation to the need to develop self-reliant
citizens for the betterment of the country.

I was assigned to the District of Anuradhapura to supervise and provide additional train­
ing in primary health care for village girls from
the Districts of Vavuniya and Anuradhapura.
Ten village health care centres are currently
being managed by these volunteers, who serve
as a link between the villagers and medical
personnel in the town. In the beginning I
had a hard time adjusting to Sri Lankan cus­
toms and traditions: . For a while, my host
organization lacked confidence in me, be­
lieving me to be too young to tackle the work
at hand
I worked overtime just to prove
that first impressions need not be lasting.
1T

There were times when I wanted to quit-to
resign. Yet what held me was the knowledge
that I was a representative., in effect of my
own country, and that I had to face the chal­
lenges that appeared. And once I had settl­
ed down and was fluent in Sinhala, I felt I
never wanted to leave.

A community survey, made by a group of
health volunteers in 1981 -82, had revealed
that remote villages were not only deprived
of dispensaries, but also were not reached by
government services. Malnutrition prevail­
ed among children and adults because of
poverty and ignorance of basic health care,
and water-borne diseases were common
throughout the district of Anuradhapura.

Wide-ranging programme

As a result of the survey, we volunteers
proposed a project to establish first aid clinics,
to build latrines, to initiate a poultry-raising
project, and to conduct health education clas­
ses. UNICEF lent assistance. We ran cli­
nics in five villages. We provided assistance
and training in first aid care, malaria eradica­
tion, infant weighing programmes, soya bean
cooking demonstrations, oral rehydration the­
rapy, immunization campaign?, family plann­
ing, nutrition,, deworming campaigns, com­
munity organization, prenatal and postnatal
examinations, latrine construction, home gar­
dening, and hospital referral. A monthly re­
port of these activities was submitted to the
Sarvodaya district centre, and I conducted
regular visits to monitor the programme. To
supplement the latrine construction project,
we ran health education classes on the dis­
posal of waste products and on hygiene. By
the end of December 1982, 150 latrines had
been completed. Early in 1983, we arranged
a health training programme.
Another project proposal was designed to
develop similar health activities in five more
remote villages. Newly opened first aid
March 1985

clinics were financed by the special UN
Volunteers/DDS Fund, as were a series of
five new poultry-raising units, one in each
village. The purpose of the poultry units
was to generate additional income to support
the health volunteers and the first aid clinics.
It was also an attempt to improve the econo­
mic status of the health workers and thus to
strengthen their initiative in managing the
clinics.

The poultry units are being managed by
youngsters previously trained by a UN Vo­
lunteer working with Sri Lanka's National
Youth Service Council (NYSC). Each poul­
try unit consists of 25 chickens, and half of
the feed used comes from food available lo­
cally. In mid-1983, latrine construction be­
gan in these villages also and another 75
latrines were constructed in Anuradhapura
District, with assistance from UNICEF. There
were additional activities in the fields of nu­
trition, and malaria and leprosy control.
In launching any project, it is very impor­
tant to start discussing with the people in­
volved their- day-to-day concerns. During
one village meeting on the planning of a lat­
rine project, a half-drunk man stood up from
the crowd and commented, "I don't give a
damn whether or not we have latrines. What
bothers me is where to look for money to feed
my children—six boys and six girls."
The villager's scepticism reminded us com­
munity health workers how important it is
not only to launch community development
activities, but also to show concern, to pro­
vide an opportunity for the people involved
to voice their problems and worries, and to
discuss with them possible solutions. True
social change is heavily dependent on the
self-confidence and participation of the people
involved. About four out of six cases at the
district health centre are "self-limiting", in
other words, they can be handled without
medical treatment. Nevertheless, such pa­

13

tients do need friendly advice and under­
standing support.
Assisted by the Sarvodaya Movement, we
also conducted a three-month training prog­
ramme for village youngsters. The prog­
ramme consisted of one and a half months of
theoretical lectures and one and a half months
of hospital and field work. An effort was
made to develop in young people a volunteer
spirit and a sense of mission in channeling
health care services to the people. The youth
trainees took their practical training at Anuradhapura General Hospital, at Lanka Nursing
Homes, and at the Ayurvedic Hospital, where
patients are treated with herbal medicines.

All primary health care volunteers worked
hand-in-hand with government health perso­
nnel. We also organized and operated re­
fugee camps in Vavuniya and Mullaitivu Dis­
tricts, where refugees from the recent civil
disturbances received assistance.

Gradually, the local inhabitants come to
realise that the maintenance of good health
and the prevention of disease by all means
available is more effective and economical
in the long run than treating people after they
have become ill.
Courtesy : WORLD HEALTH

UN VOLUNTEERS
Since it first started its operation in 1971, the United Nations Volunteers
programme has responded to developing countries' needs for qualified manpower
by providing several thousand technically skilled young men and women to work
within a wide range of development activities. In doing so, UNV has become
the United Nations' foremost supplier of middle-level and upper-level "operational"
experts—specialists who work closely with their counterpart personnel and help
>to train them. Some 1,000 UN Volunteers are now in the field, working in more
than 90 countries and representing more than 50 professional categories.

The programme is currently in need of qualified motivated candidates to
serve in developing nations in all fields, including health care. For further infor­
mation write to: UN Volunteers, Palais des Nations, CH-1211 Geneva 10, Swit­
zerland.

14

Medical Service

A Sensible Approach to Asthma
Asthma is a trying ailment and a common
one. It is no respector of age, sex or country.
Thanks to medical advances, doctors are
better able to treat this malady that can take
all the joy out of living.

Asthma, doctors tell us, is most often the
result of an allergy-seventy five per cent of all
asthma cases are caused by a concrete subs­
tance, something you touch, smell or eat.
House dust and fur can do it. Feathers in
pillows, particles from wool, and chemicals
such as bleaches and dyes may disturb you.
A man may be bothered by his wife's face
powder, a woman may suffer an attack when
she bakes because of sensitivity of wheat
flour. A frequent cause asthma in children is
allergy, to eggs, wheat, and milk.
One man noticed that his bouts of cough­
ing and choking always started on Sunday.
Investigation showed he read the rotogavure
section of the weekly paper every Sunday
afternoon. On a hunch, the family doctor
banned the picture paper. The attacks dis­
appeared.

If you are unlucky enough to suffer an as­
thma attack, what actually happens? Your
chest tightens, and you have s struggle for
breath. Air has trouble entering the lungs,
but more when trying to escape, and as a
result expiration is prolonged and accompani­
ed by a strained wheezing sound. You obtain
some slight relief when sitting up. Many
sufferers are forced to sleep this way.
Cure is not simple. To lessen immediate
distress, the physician has certain medications
at his command. The actual cure may re­
quire months of patient study, when your
doctor turns Sherlock Holmes, tracking down
every possible clue. He inquires about your
family backgrounds, for asthma can be passed
from parents to children (if you are a sufferer,

March 1985

your children are not necessarily doomed).
He goes back to your first wheeze, and through
questions learns how long an attack lasts
and its severity. He wants to know all about
your job, the furnishings in your home, the
food you eat, your favourite sports, all to find
out the cause of your attacks.
Treatment is a slow, uncertain process.
Your doctor may prescribe a basic diet, then
add items until the food causing the trouble
is pinned down. He may give simple skin
tests, often a dozen at a time. He injects
drops of various extracts-pollen, foods,
other substances-into the skin or places them
on skin scratches. If you are sensitive to the
substances being tested, itching red welts
appear. If the allergy is found, you must
rearrange your life so that you avoid the offend­
ing substance. If animal dander is the cause,
your pet dachshund will have to be boarded
with relatives and horse-back riding become
only a memory. Should it happen that the
troublemaker cannot be avoided your doctor
may give you a series of inoculations to build
up your immunity.

Some medical men believe that allergies
have their basis in psychoneuroses, and stu­
dies indicate that asthma may in some cases
be a state of mind-a symptom, not a disease
at all. Inner conflicts or emotional stress can
cause severe attacks. Today's physician
treats the person as well as the disease.
There is still much to be learned, but re­
volutionary cures may be on the way. One
sociologist points out that psychosomatic
medicine promises to find the reason why
executives suffer ulcers and old maids get
asthma. Study has proven that youngsters
neglected by their parents tend to become
asthmatic.
(Contd. to Page 23)

15

Time and You: Ten Tips on How Best to Use Your Time
—by David Gunston

which we can give free rein to other
parts of our natures our competitivenss, our relation to physical acti­
vity, our need to let off steam, become
playful jovial beings.

Broadly speaking, we are all given the same,
allocation of time. The question then. How
best can we use it? is one we must ail ans­
wer. Here are some suggestions:
1.

Take time to think; It is the source of
power. Nobody has achieved, any­
thing without thought, often long and
hard thought, yet all too often we see
people acting thoughtlessly, refusing
to think things through beforehand.

4.

Take time to dream. It is the highway
to the stars. No life should be so
full of care and the need to earn a
living and fulfil responsibilities that
dreaming has no part in it. Man has
always been a dreamer: that's why
he doesn't live in caves or mud huts
any more. Fulfil that side of your­
self, standing, and you will be all the
better and happier for.it. The only
danger comes when dreaming takes
the place of real life.

5.

Take time to laugh. It is the music
of the soul. For all the advances of
modern science, laughter is still the
best medicine for everybody. A good
laugh is unique in that it benefits us
physically {enriching heart and lungs
with extra oxygen, stimulating the
whole nervous system) and emotio­
nally. Laughter
cuts things (and
people) down to size, shrinks prob­
lems, unites us all.

6.

Take time to be friendly. It is the road
to happiness. We are not here to see
through one another, but to see bne
another through, as one wag said.
And it is very true. No person is an
island, or would really want to be
Friendliness is never wasted, never
an investment bringing only loss. The
realizatipn of this
fact becomes
stronger as one grows older.

A life that never devotes plenty of
time to thinking—about the mystery of
life itself, its meaning and purpose;
great issues, great wonders, great
lives-—is not really a life at al|, but a
mere existence.

2.

3.

Take time to work. It is the* price of
success. There is luck, occasionally,
and for some, but one can never rely
on mere luck. There are no real Short
cuts to success. It comes only
through work and effort, as the life
of any successful person will confirm.
It is worth remembering, too, that
work plus thought and planning is in
the longrun worth much more than
work plus luck and hopefulness.

Take time to play. It is the secret of
youth. All work and no play, however,
not only makes Jack a dull boy, but
also means he misses out on so much
of the best that life has to offer. The
old thing is that people who think
and plan and work hard are the very
ones who manage to play hard as
well. Play can and should be an
important part of daily life, not just an
antidote to work, but the area in

(ContcL to Page 29)
March 1985

17

Conserve Your Vital Force
Self-control is one solution to stress factors that deplete vita! energy.

by Armand T.

"Awful" is our common expression when­
ever we see something precious being wast­
ed or lost. Take the case of a tanker that has
collided with another ship, and all its crude oil
gets spilled out into the sea. Or someone who
has neglected to put off those big neon
lights and they keep on shining brightly even
at daytime.
One noontime I parked my car somewhere
in Baclaran. When I stepped out, absent­
mindedly took the key from the ignition without
turning it off. I did not hear the muffled sound of
a running engine. For one hour my car conti­
nued on "idling," burning its gas for nothing,
while my friends and I were enjoying our lunch
together in a nearby restaurant.

Yes, we shake our, heads whenever we
have lost or wasted something valuable. But
within us there is a more precious energy which
we often waste and abuse. This has to be
conserved and used wisely.
A capital energy for each human being.
After forming man out of dust, the Creator
"breathed into his.nostrils the breath of life;
and man become a living being." In Hebrew,
what God breathed into man is called as ruach
which means "spirit." In Greek it is pneuma.
This life-giving principle is a divine energy
given during conception to every human be­
ing. It is this vital force that enables man to
live through this world of sin and suffering,
to experience delight and satisfaction, and to
function as a "living soul." Through such
power man is able to adapt himself to his
environment no matter how stressful it may be.

18

Fabella

In the late 1800's Ellen White wrote "God
endowed man with so great vital force that
he has withstood the accumulation of disease
brought upon the race in consequence of
perverted habits, and has continued for six
thousand years. This fact of itself is enough
to evidence to us the strength and electrical
energy that God gave to man at his creation.
It took more than two thousand years of crime
and indulgence of base passions to bring bo­
dily disease upon the race to any great extent.
If Adam at his creation, had not been endowed
with twenty times as much vital, force as.men
now have, the race, with their present habits
of living in violation of natural law, would
have become extinct".
From our conception, each of us received
from our parents certain amount of life-giving
energy. Such amount is fixed but enough to
last for a lifetime. However, one's span of
life may be cut short by the early exhaustion
of the God-given reserves. Ordinarily, "as
for the days of our life, they if we recklessly
exhaust our vital force, we shall some­
times be losers. Contain seventy years, or
if due to strength, eighty years."

As expressed by Ellen White: "God has
endowed us with a certain amount of vital
force. He has also formed us with organs
suited to maintain the various functions of
life, and He designs that these organs shall
work together in harmony. If we carefully,
preserve the life, force, and keep the delicate
mechanism of the body in order, the result is
health; but if the vital force is too rapidly ex­
hausted, the nervous system borrows power

Medical Service

for present use from its resources of strength,
and when one organ is injured, all are affect­
ed."

"Those who make great exertions to ac­
complish just so much work in a given time,"
Ellen White explains, "and continue to labour
when their judgement tells them they should
rest, are never gainers. They are living on
borrowed capital. They are expending the
vital force which they will need at future
time........... God has provided us with consti­
tutional force, which will be needed at different
periods of our lives. If we recklessly exhaust
this force by continual over-tazation we
shall sometimes be losers'.
Dr. Hans Selye, a world's authority on stress,
calls this vital force as adaption energy. Based
on his animal experiments and medical obser­
vation, Dr. Selye concludes "that at birth each
individual inherits a certain amount of adap­
tation energy; the magnitude is determined
by one's genetic background. One can draw
upon this capital thriftily for a long but mono­
tonous, uneventful existence, or spend it
lavishly in the course of a stressful, intense,
but more colourful and exciting life."

Adaptation energy is like a special kind of
bank account which you can use by with­
drawals but cannot increase by deposits. Your
only control over this most precious fortune is
the rate at which you make withdrawals.

After exposing ourselves to very stressful
activities, can a rest not restore us to where we
were before? "No," said Dr. Selye. "Ex­
periments on animals have clearly shown that
each exposure leaves an indelible scar, in
that it uses up reserves of adaptability which
cannot be replaced."

Adaptation energy is not merely caloric
energy which comes from the food we eat.
Just as any inanimate machine gradually wears
out, even if it has enough fuel, so does the
human machine sooner or later become the
victim of constant wear and tear.

March 1985

Hans selye made a distinction between
superficial and deep adaptation energy.
"Superficial adaptation energy is immediately
available upon demand, like money in a bank
account that is readily accessible by writing
out a check. On the other hand, deep adap­
tation energy is stored away safely as a re­
serve, just as part of our inherited fortune may
be invested in stock and bonds, which must
first be sold to replenish our checking account,
thus furnishing another supply of immediately
usable cash. Still, after a lifetime of constant
expenditure, even our last investments will be
eventually exhausted if we only spend and
never earn."
This process, otherwise known as "general
adaptation syndrome" (G.A.S.) is the body's
way of responding to any demand which calls
for readjustment or adaptation in order to main­
tain normalcy. However, it puts the body
under stress. It comes in three stages, namely:

(a)

the alarm reaction,

(b)

the stage of resistance, and

(c)

the stage of exhaustion.

After the initial alarm reaction, the body
becomes adapted and begins to resist, the
length of the resistance period depending upon
the body's inate adaptability, and the intensity
of the stressor. Yet, eventually, exhaustion
ensues.
Hans Selye stated that only, the most severe
stress leads rapidly to the stage of exhaustion
and death. Most of the physical and mental
stressors which act during a limited period
produce changes corresponding only to the
first and second stage of the G.A.S.: at first,
these stressors may upset and alarm us, but
then we get used to them. Everybody goes
through the first two stages many, many times;
otherwise, we could never become adapted to
perform all activities and face all demands.
19

It is only when the whole organism is ex­
hausted and hopelessly encumbered by the
accumulated chemical wastes of life that one
enters into the terminal stage of exhaustion
of the G.A.S. This happens in senility at the
end of a normal life span, or through the ac­
celerated aging caused by excessive stress.
Only when all our adaptability is used up will
irreversible general exhaustion and death
follow.

Stress Factors contributing to the Deple­
tion of Vital Energy
Dr. Selye listed various stress factors in­
volved in using up a person's adaptation or
vital force. Among these are: mechanical
(i.e. accidents,) psychological, (i.e. worry and
fear), chemical, (i.e. drugs), bacterial, (i.e.
disease), and physiological, (i.e. defects).

A side from what Hans Selye mentioned,
Ellen White pointed out other specific elements
that contribute to the depletion of vital energy.
She said: "Whatever disturbs the circulation
of the electric currents in the nervous system
lessens the strength of the vital powers, and
the result is a deadening of the sensibilities
of the mind."
In this statement of truth, the electric cur­
rents that circulate through the nerves are
equated with the vital powers which give us
strength. Thus if the circulation of these cur­
rents is disturbed, having sort of a short cir­
cuit, the strength of the vital energy is lessened
which in turn leads to a "dimming" of the
mental faculties. What are the elements that
disturb the circulation of the electrical energy
of the body?

Tobacco. "Those who acquire the unna­
tural appetite for tobacco, do this at the ex­
pense of health. They are destroying nervous
energy, lessening vital force, and sacrificing
mental strength." Such effects are brought
about by nicotine, tar, carbon monoxide and
20

other noxious elements. Hence smokers are
highly prone to suffer from various cancers,
heart disease and other ailements.

Liquor. "The use of liquor or tobacco
destroys the sensitive nerves of the brain, and
benumbs the sensibilities. "This is due to
alchohol which affects primarily the higher
faculties of the brain and other organs of the
body especially the liver.
Drugs. "Drugs always have a tendency to
break down vital forces." Physicians there­
fore must be discreet in their prescription of
drugs; much more so, those who engage in
selfmedication.
Tea. "The use of tea spurs up nature by
stimulation to perform unwanted^ - unnatural
action and -thereby lessens her power to per­
form, and her * powers give out long before
Heaven designed they should." .

Coffee. "It temporarily excites the mind. . . .
but the after effect is......... exhaustion, pros­
tration paralysis of the mental, moral, and
physical powers. The mind becomes enervat­
ed, and unless through determind effort the
habit is overcome, the activity of the brain
is permanently lessened." Both tea and coffee
contain caffeine which produces such effects
both in the mind and body of the drinker.
Overeating. "The brain nerve energy is
benumbed and almost paralyzed by overeat­
ing." Furthermore, - "continual
overeating
uses up the vital forces, and deprives the brain
of power to do its works."

Irregular eating. "The digestive organs,
like a mill which is continually kept running,
become enfeebled. Vital force is called from
the brain to aid the stomach in its overwork,
and thus the mental powers are weakened."
By eating between meals or excessively during
mean time, you intend to store more caloric
energy but at the expense of your stored
Medical Service

adaptation energy.
Nothing.

What do you gain then?

Sugar. '"Sugar clogs the system. It hin­
ders the working of the living machine."
Moreover, anything that hinders the active
motion of the living machinery, affects the
brain very directly. Sugar, when largely used,
is more injurious than meat." This comes by
eating ice-cream, cakes and other desserts
as well as candies and soft drinks.

Flesh foods. "He permitted long-lived
race to eat animal food to.shorten their sinful
lives. Soon after the flood the race began to
rapidly decrease in size, and in length of
years."
"As a general thing, the Lord did not pro­
vide His people with flesh meat in the desert,
because He knew that the use of this diet
would create disease and insubordination.
In order to modify the disposition, and bring
the higher powers of the mind into active ex­
ercise, He removed from them the flesh of
dead animals.
"The moral evils of a flesh diet are not less
marked than are the physical ills. Flesh food
is injurious to health and whatever affects the
body has a corresponding effect on the mind
and the soul."

Lack of exercise. "Those who are engaged
in constant mental labour, whether in studying
or preaching, need rest and change. The ear­
nest student is constantly taxing the brain, too
often while neglecting physical exercise; and
as the result the bodily powers are enfeebled,
and mental effort is restricted." Many of them
have suffered from severe mental taxation,
unrelieved by physical exercise. The result is
a deterioration of their powers and tendency
to shirk responsibilities." A balanced activity
of mind and body promotes a smooth and
harmonious circulation not only of the blood,
but also of the electrical currents around the
system. Strength is evenly distributed. Ho­
meostasis is maintained.
March 1985

Condiments and spices. "Under the head
of stimulants and narcotics is classed a great
variety of articles that, altogether, used as
food or drink, irritate the stomach, poison the
blood, and excite the nerves. Their use is a
positive evil."
"Spices at first irritate the coating of the
stomach, but finally destroy the natural sensi­
tiveness of this delicate membrane. The blood
becomes fevered, the animal propensities are
aroused, while the moral and intellectual
powers are weakened, and become servants
to the baser passions."

Self-abuse (masturbation). "The body is
enervated, the brain weakened. The material
deposited there to nourish the system is squan­
dered. The drain upon the system is great.
The fine nerves of the brain, being excited to
unnatural action, become benumbed and in a
measure paralyzed."
In view of its thrilling effect, this habit is
reinforced until it becomes a vicious cycle and
the person gets hooked into it. Considering
the waste of so much energy, masturbation is
truly self-destructive.

Sexual excess. "Sexual excess will effec­
tually destroy a love for devotional exercises.
will take from the brain the substance needed
to nourish the system and will most effectively
exhaust the vitality. There is no difference
between excessive sexual intercourse by a
couple and masturbation of one person, except
that the former is covered by a cloak of mar­
riage. Both are committed in the name of
lust, and the effect on the nervous system is
the same.
Ill-chosen reading. "The memory is great­
ly injured by ill-chosen reading, which has a
tendency to unbalance the reasoning powers
and to create nervousness, weariness of the
brain, and prostration of the entire system."
This is especially true when one feasts on por­
nographic literature as well as on fiction, ro­

21

mance, "detective” stories or materials that
are lewd and full of fantasy.
Guilt. "Guilt and sorrow.... crush the
life forces.”

Doubt and grief. "The assurance of God's
approval will promote physical health. It
fortifies the soul against doubt, perplexity,
and excessive grief, that so often sap the vital
forces and induce nervous diseases of the most
debilitating and distressing character.
Worry. "The continual worry, is wearing
out the life forces.”

Anger. "Every one of these exhibitions of
wrath weakness the nervous system."
All of these feelings and emotions-guilt gnd
sorrow, doubt and grief, worry and enxiety
aqd anger cause short circuit of electricity in
the nervous system. Consequently, much
energy is withdrawn from the internal bank
and is spent needlessly. What a waste

This means that we abstain totally from
taking tobacco and liquor, tea and coffee,
condiments and spices as well as from in­
dulging in masturbation and iliicit/excess sex.
Overeating and eating between meals are
avoided, likewise the eating of flesh food.
Sugar and other articles of food are used judi­
ciously.

The key to such practice is selfcontrol.

Conform to natural laws and remedies.
The human system is governed by laws of
nature. Breaking these laws leads to a short
circuit of the electrical energy which in turn
lessens the vital force and makes the human
system vulnerable to illness. To prevent such
consequences, the laws of nature must be
obeyed.

Nature has true remedies which, if applied,
enhance our health and healing. Ellen White
cited eight natural remedies;

1.

Pure air;

2.

Sunlight;

How to conserve the Vital Energy

3.

Abstemiousness;

Minimize stress. Since adaptation energy
is vital to cope with the daily stress of life, it is
logical that the latter be minimized and pro­
perly managed. Severe stress leads to the
stage of exhaustion when the body can no
longer tolerate and has already used up its
adaptability.

4.

Rest;

5.

Exercise;

This calls for a restructuring of the stress­
ful situation and of stressprone personality.
9

Practise temperance. I n view of the abovementioned stress factors that contribute to
the depletion of the vital energy, one solution
to conserve this precious treasure is to prac­
tice temperance. According to Ellen White,
"True temperance teaches us to abstain en­
tirely from that which is injurious, and to use
judiciously only healthful and nutritious ar­
ticles of food”.
22

6. Proper diet-vegetables, nuts, grains and
fruits;
7.

Use of water;

8.

Trust in divine power.

Develop and maintain emotional stasis.
Emotional stasis is defined as "the ability to
meet a wide variety of life situations, the bad
with the good, with emotions like equanimity,
resignation, courage, determination, cheer­
fulness, and pleasantness.

Dr. John Schindler pointed out that the
physiologic effects of the good emotions are
just as great in the right directions as the effects
of the bad emotions are in the wrong directions.
Good emotions have two general effects. First,
Medical Service

they replace the bad emotions which were
producing stress effects; and secondly, they
produce their own pituitary effect which is an
optional balance of endocrine function.

endowment of physical, mental and spiritual
power."

As stated by Ellen White: "Courage, hope,
faith, sympathy, love promote health and pro­
long life. A contented mind, a cheerful spirit,
is health to the body and strength to the soul".

Channel your energy to worthwhile activities.
To avoid wasting of the precious power, it
has to be channelled to and utilized for worth­
while, activities. Plan out what you can do
for the day and in the near future. Aside from
your regular activities and responsibilities at
home and in your place at work, think of a
project through which you can put your crea­
tivity and actualize yourself.

Take hold of an outside power. Though
man is endowed at birth a certain amount of
power that would last for a lifetime, he can
still avail himself of a tremendous power above
and outside himself. "But you shall receive
power when the Holy Spirit has come upon
you." said Jesus. By taking hold of the
divine power through the Holy Spirit, much
can be accomplished. And man's innate vital
power is conserved.
"There is no limit to the usefulness of one
who, putting self aside, makes room for the
working of the Holy Spirit upon his heart and
lives a life wholly consecrated to God. All
who consecrate body, soul and spirit to His
service will be constantly receiving a new

God offers His power to you-full and free.
Take it by faith.

Above all, make use of that God given
power to reach out for others and share some­
thing with them. You can make someone's
life happier and this world a better place to
live in.

Remember, the vital force that you have is
just enough for your life time. You live and
pass this way but once. Use that vital force
wisely.
E.G. White was a prolific writer on health
and moral subjects.
"Courtesy : THE HERALD OF HEALTH"

(Contd. from Page 15)
When a new baby brother appeared in the
Reddi household, five-your-old Lakshmi came
down with an asthma attack. Routine food
and skin tests met with failure, j When the
family physician suggested that a dented ego
might be behind Lakshmi's illness, her parents
were sceptical but eager to cooperate. They
set out to assure their first-born that she had
lost none of their love. In a short time Laksh­
mi's health returned to normal.
The child whose mother is a perfectionist,
demanding adult standards from him, may,
fall victim to asthma. Such a child is under
constant mental strain, and the body breaks
down at its weakest point-in this case the res­
piratory system.

Attacks have been traced to early childhood
fears. One woman who as a child had been

accidentally looked in a closet developed her
first attack of asthma on a crowded elevator.
Hippocrates' warning that the asthmatic
must guard against temper is still sound ad­
vice. Even among people with purely allergic
asthma, attacks are more severe during emo­
tional upsets.
Children stand a good chance of being
cured, of growing out of the complaint. For
the adult, medical science offers more hope
today than ever before. And no matter how
many nights you are forced to sit up struggling
for one easy breath asthma alone will not
likely be the death of you.

"Courtesy : THE HERALD OF HEALTH"

4

Some Suggestions to improve Nutrition in these Hard Days
J.D. Pathak

Food, shelter, clothing are basic needs of
men. To this list may be added several items
like medicines, transport, communications and
others.
It is almost impossible for persons of middle
class with fixed income to even maintain
themselves let aside the question of retaining
their former standard of living.
Importance of proper nutrition cannot be
.overstated. Nutritional standards though diffi­
cult, to a certain extent can be maintained if
protective foods are made available at affor­
dable cost. The rest items of food can be
supplemented without much undermining the
nutritive standard.
Considering the common defects of Indian
diets, the main protective foods, are: ’
Proteins

Animal proteins :
Eggs, meats, fish, milk and its preparations
(though non-vegetarian are acceptable to
vegetarians).

Vegetable, proteins:
Pulses, soyabeans, groundnuts.

Minerals
Calcium-milk, cheese: liver, meats, green
leafy veg.

Iodine
Salt from sea, fish.
Vitamins

A — milk, butter, ghee, fish oils, greens.
B — milk, yeast, meats, sprouted pulses.
C — sour fruits, e.g. 'ambla'.

March 1985

To illustrate, any individual getting 500 ml
milk; 25g butter or ghee; or 1 teaspoon fish
liver oil; 50 g green leafy vegetables, alongwith what foods he can procure from market
can still be fairly nourished. If 30% of the
calories can be had from such protective foods,
the rest of the calories may safely be supple­
mented from cheaper items.

Milk powder programme was initiated and
supported by W.H.O. but there were many
flaws in its distribution to right deserving people
In many places this milk powder, gifted by
generous agencies was sold in black market
by unscrupulous agencies. In scarcity of na­
tural milk, 'milk' made from groundnuts or
soyabean is suggested. Their composition
is compared in Table 1.

Some countries made their 'multipurpose
foods' with similar aims. The Indian multi­
purpose food planned to be sold at 15 paise
for 100 grams (by Central Food Research,
Mysore) never saw the light of the day for
some reason. Composition of M.P.F. and
some others is given in Table 2.
As an alternative, cheaper protein foods
like groundnuts, soyabeans, pulses may be
made available at concession. From sprout­
ed pulses and cereals, it is possible to secure
better nutrition without additional cost. Some
of the protein vitamin deficiencies can be cor­
rected if these sprouted items are taken regu­
larly.

Further, by preventing deterioration or loss
of nutrients in preparation of foods, some
improvement in diet can be made withou ad­
ditional cost.

For instance the nutritive value is much re­
duced by :
25

TABLE I

Chemical composition of soyabean and groundnut milks as compared with cow's
milk (Values per 100g)
Nutrients

Soyabean
milk

Groundnut
milk

Cow's milk

Protein (g)
Fat (g)
Carbohydrate (g).
Calcium (g)
Phosphorus (g)
Iron (mg)
Calorific value
Thiamine (mg)
Riboflavin (mg)
Nicotinic acid (mg)

2.4
2.5
3.2
0.08
0.104
1.2
51
0.042
0.04
0.24

3.0
5.2
3.1
0.11
0.102
1.47
71
0.085
0.03
1.11

3.2
4.9
4.6
0.11
0.07
0.2
75
0.045
0.17
0.1

Note : One teaspoonful of shark liver oil or vitamin A and D concentrates should also be used daily along
with soyabean and groundnut milks, to supply vitamins A and D.

TABLE

II

The chemical composition of Indian MPF as compared with that of AmericanJVIPF,
and skimmed milk powder (Values per 100 g)

Nutrients
Protein (g)
Fat (g)
Carbohydrate (g)
Calcium (g)
Pfibsphorus (g)
Iron (mg)
Thiamine (mg)
Nicotimic acid (mg)
Riboflavin (mg)
Vitamin A(I.U.)
Vitamin D (I.U.)
Calorific value

Indian
MPF

American
MPF

Skimmed
milk powder

42.9
8.5 £
35.8
0.665
0.820
5.1
1.3
14.3
3.0
3000
300
387

42.3
7.6
36.9
0.587
0.440
7.0
0.7
7.0
1.2
2940
235
386

35.6
1.0
52.0
1.3
1.03
0.6 0.35
1.1
1.95
40
nil
. 359

.

Ref : Swaminathan and Bhagavan—Our Food, (1969) • p. 68 •* p. 73.

26

Medical Service

(a)

over washing and discarding water in
which foods’ like rice, vegetables are
cooked,

(b)

discarding the outer layers, siftings in
case of flour of wheat, bajra and others.

(c)

over cooking, repeated cooking of
foods and

(d)

in storing cooked foods,

(e)

discarding outer edible layers of vege­
tables, fruits and their seeds,

1.

throwing away useful articles like
groundnut meal after expressing oil,
etc.

Ann Wigmore, Let living food be your
medicine.
Hipprocrates Health Inst,
Boston, U.S.A., 1970.

2.

Gopalan, C., Rama Sastri, B.V. and Bala
Subramanian, S.C., Nutr., Value of
Indian Foods, Nat. Inst. Nutr., I.C.M.R.
Hyderabad (1971).

3.

Pathak, J.D., Nutrition (Poshan Vidya
in Gujarati)- Uni. Book Prod. Board,
Gujarat State, Ahmedabad, 1974.

4.

Rajlaxmi R., Applied Nutrition, 2nd ed.,
Oxf., and I.B.H., Publl Co., Bombay.

5.

Swaminathan M., Essentials of Food
and Nutrition, Ganesh and Co., Mad­
ras, 1974.

ritive value, .e.g. proteins and vitamins. They
now have more than twice the amount of
Vitamin B Complex and C as compared to the
unsprouted forms. Besides, some yet un­
discovered factors and enzymes are said to be
added, whfch also are very essential. This
inexpensive method of improving one's nut­
rition is hence much recommended.

REFERENCES

(f)

(g)

addition of soda, and similar chemi­
cals, which much reduce the nutri­
tive values.

By intelligent application of above facts,
one may still continue to obtain adequate
nutrition, inspite of the rising prices.

Some common cereals and pulses can be
easily sprouted by soaking in water for a
day and keeping them tied up for another day.
Such sprouted grains not only are easier
to digest but the procedure adds to their nut­

March 1985

Courtesy THE BOMBAY HOSPITAL JOURNAL

27

Stress Management
Ms. Veroni Thomas

STRESS is a fact of life. We are under
stress from womb to tomb. Stress is an in­
dividual's physical, mental and emotional reac­
tion to a condition that disturbs normal equili­
brium. Stress is any condition that harms
the body and breaks down or causes death
of few or many cells. Nobody can escape
stress. It is the effect of all the wear and tear
caused by living.
Stress is good and needed for people to
grow to their full potential. So when we talk
of stress management we do not mean elimi­
nating all stress from our life. But how to
cope with our daily quota of stress. Someone
coined a word "incompatibility" to describe
people without much physical illness but find
themselves unable to cope with life situation
anymore and hence transfer their anxiety into
physical symptoms.
When we say a person is under stress we
notice certain signs and symptoms in the in­
dividual. For example:
Stomach upsets (gastro-intestinal upsets)
such as indigestion, nausea, vomiting, diar­
rhoea, constipation, etc.
Tense look, staring eyes, fast or rigid move­
ments, stiff neck, stiff muscles, shaking, sweat­
ing, etc.

Rational thinking is diminished-restless­
ness at all times and often sleeplessness.
Emotional outbreaks are frequent—over­
excitement, crying or shouting for any small
irritations.

Selfishness and self-centredness seems to
be common feature.

Spiritual values diminish gradually.
28

How the body reacts to stress depends on
how the mind reacts to stress. How the mind
reacts to stress depends on how it has learned
to relax. So the relaxed mind is the key to
health, and here comes the stress management.
Man is what his heart is, and whatever he
says or does springs from the heart. There is
a growing recognition that the deepest level
of man's nature or core of his being is beauti­
ful and there dwells the Supreme Power.
Man is made in the image of God. If we can
get in touch with the "Inner Self" or "Still
Point" daily we will have the energy to cope
with situations which cause stress. So the
management of stress can be spelt out as the
following:

SET aside sometime for meditation ordhyans.
TACKLE the emotions properly. Appro­
priate expression of emotions lead to health.

RECOGNIZE the frequency and cause of
stressful situations and its consequence and
be prepared to handle them.

ESTABLISH proper interpersonal relation­
ships.
SEEK moderation in all dimensions of life
(a balanced living).

SMILE and this will relax our face and that
of others too.
MAKE facilities for proper exercise, rest
and relaxation.

ACCEPT ourselves as we are and others as
they are with their strengths and limitations.

NURTURE the mind with divine doctrine.
ATTEMPT to modify stressful.situations.

Medical Service

GET in touch with your feelings and ratio­
nalise your emotions and act accordingly.

THANK GOD for our "LIFE". Live for
others. This is the secret of happiness.

ESTABLISH priorities of values.

MODEL your life on a "simple life style".
EVALUATE your life before going to bed
everyday. Ask pardon from God and others
if we have done anything wrong in word or
deed or omitted to do something good.

NOURISH the body with a balanced diet—
preferably vegetarian diet.

(Contd. from Page 17)
7.
Take time to read. It is the founda­
tion of wisdom. No one can acquire
too much wisdom or even too much
knowledge; and reading is the quick­
est and pleasantest way to acquire
both. Books always light a candle
in the mind that goes on burning for
long after, maybe for a whole lifetime;
and a good book once read never
leaves its reader the same as he was
before. He is always a better person
for having read it. Those who never
make time to read, widely and cons­
tantly and deeply, are infinitely the
poorer.
8.

Take time to look around. It is the
short cut to unselfishness. Not only
is there always sure to be someone
worse off or lonelier . than yourself
. who can be helped, the world is based
in every way on variety. So observe
everyone and listen to anyone, even
the seemingly dull or ignorant; they
too have their story and may have
something to offer you in word or
deed. Never be too busy to stand
and stare, to be an interested spec-

March 1985

Reference
Romero Virginia,
Health,

Relaxation is Key to

The Holistic Health Hand Book. Page 372373 Berkeley, California.
Courtesy : THE

NURSING

JOURNAL
INDIA

OF

tator. That way a great deal of value
may be learned.

9.

Take time to relax. It is the key to
long life. Develop and retain always
the ability to "switch off." This
means much more than merely not
taking worries to bed with you; it
means refusing to allow any one as­
pect of life to monopolize all your
time and thought. Ultimately it means
enjoying life to the full, come what
may.

10.

Take time to pray. It is the way. to
heaven. Human beings have always
had a strong sense of awe before the
infinite, of something far bigger than
themselves. Prayer in one form or
another is a basic human need, al­
ways felt, as witness the agnostic
who appeals to "something out there"
when in extremity of danger or con­
cern. By responding freely to this
deepest impulse you will link your­
self to the power of the universe, a
divine power not in ourselves but
favourable to us.

“Courtesy : THE HERALD OF HEALTH"
29

To Kill or not to Kill?
—Mrs. Rosamma Ninan

EUTHANASIA, according to Dorland's
Medical Dictionary, means putting to death
of a person suffering from an incurable
disease. The Universal Webster Dictionary
gives its meaning as killing incurable in
. painlessly. When a person with an incurable
disease embraces death voluntarily with
professional help, it may be defined as
voluntary euthanasia.

modern world.
Under the disguise of
voluntary euthanasia it will be a good oppor­
tunity for a new form of murder to come up.

Is it justifiable to kill a person even if he
wants so? Is the remedy for suffering kill­
ing ? What way can it affect the individual
and society?

Desire to live is great in human being as
long as he is wanted in the society. When
voluntary euthanasia becomes the pattern of
the day one may feel that he is between the
devil and the deep sea. On one side he is
with a keen desire to live; on the other side
he feels that he is looked down upon by the
society as he is-not willing to accept death
because the attitude of the people.who take
trouble to look after him may be such that he
has to linger on like this giving trouble to
others instead of choosing death. This atti­
tude of the society may impress upon the
sick person that he is unwanted and useless.

A disease that falls under 'incurable'
today will not necessarily be the same to­
morrow. For instance tuberculosis was an
incurable disease in the past till the discovery
of antitubercular drugs. Same way many
other diseases had no treatment in the past.
But now only a few diseases are beyond the
control of medicine. I remember a story in
which the main character was affected , by a
fatal. disease. Disappointed, he committed
suicide and a newspaper report was out
the following day of his death. The report
was about an invention of a drug which is
able to cure the disease in question comple­
tely.

In extreme pain due to certain disease, it
is natural for a person to welcome death be­
cause of his inability to suffer. Immediate
relief of pain is more important for him as
compared to death in this kind of situations.
The enactment of a Bill supporting voluntary
euthanasia implies the encouragement to die
instead of facing reality.
Corruption, exploitation and immorality
are gaining their strength more powerfully in
30

Human life has great value in' its true
sense and it is to be respected. Each life is
important in itself, it is not to be destroyed
but to be repaired and maintained till the last
breath.

The functions of medical and nursing
profession is to preserve and promote life,
not to destroy it. Their effort is meant to
improve the gasping patient, they don't stop
their attempt even if all signs of life have
disappeared. Even a gasping patient is a
challenge to them. They work with the hope
of saving each life entrusted to them instead
of looking at them with a pessimistic view.
Euthanasia will only hinder the motivation to
work.hard and to do research.

It is not uncommon that in the beginning
of the treatment the effect of medicine may
not be evident. During this time the patient
who has lost all his hope may choose to die
Medical Service

and the discouragement of the doctor and
the nurse is imaginable.

As the life is ended in the beginning of
any incurable disease man has no chance to
do any study on that case in relation to its
treatment.
*
Insecurity feeling will be another effect of
voluntary euthanasia. Since the provision of
voluntary euthanasia is present one will be
afraid of the same when he is stricken by any
disease, the healing of which is delayed. The
enactment of the Bill may force him to accept

the voluntary death unwillingly as he may
think why*he should give trouble to others.
May times it is not necessary that a dise­
ase is incurable as the diagnosis may be
wrong. Even if the diagnosis is correct a
disease incurable in one system of medicine
need not be incurable in another system. In
some cases Ayurvedic treatment may succeed
where Allopathy has failed and vice versa.

Taking all the above points into considera­
tion should we support or reject voluntary
euthanasia ?

(Courtesy-: The Nursing Journal of India)

PRESS RELEASE

The Community Health Workers Basic Course No. XII will be conducted at the
St.John's Medical College, Bangalore from 5th August 1985 to 31st October 1985.
This is a residential training programme for lay brothers and sisters engaged in (or
those who propose to be engaged in) Rural Health and Development. Two such
basic courses are organised each year. Health Care training is imparted in Preventive,
Promotive and Curative services, at the Department of Community Medicine, St. John's
Medical College Hospital and the Rural Health Centres. Additional Training in First
Aid, Home Nursing and Planning for rural Development Programme, is also imparted.

Those interested, particularly Major Religious Superiors, may please contact The
Principal, St. John's Medical College, Bangalore-560 034.
Sd/Secretary
C.B.C.I. Society for Medical Education
St. John's Medical College

March 1985

31

Medical Ethics Forum
—by Fr. George Lobo, S.J.

Refusing to Eat
Case : A young woman badly handi­
capped by multiple sceloris refused all
food. She was able to chew and swallow
with relative ease; but the deteriorated
condition of her.hands necessitated others'
feeding her. Was her refusal of food
justified by steadily increasing depen­
dency on others for this and other basic
needs, the apparently hopeless prog­
nosis of her condition and her feeling that
life was for her generally lacking in ful­
filment? Would the hospital have been
justified in force-feeding her?

Everyone has the obligation of using ordi­
nary means of preserving life. Simple nou­
rishment is the most basic of all such means.
Those who believe that human life is a gift of
God would more readily agree that there is an
obligation to eat in order to live.
It is true that a patient may not be bound to
take food in vain. Thus a patient who has
only a few short hours to live need not take
food. A patient who cannot retain any food
need not go through a mere ritual 6f eating
if there is no hope that the purpose of eating
will not be at all achieved.

However, where normal intake of food is

32

possible for a given person and will signi­
ficantly prolong life, be it ever so diminished
or ever so emotionally unsatisfactory, then the
patient has ho normal right to refuse food.
It would amount to suicide,* although by
omission.

Society may find it impossible to snatch
from the hand of every would be suicide .the
poison with which he would want to end his
life, or to force-feed every despondent patient
who seeks to starve himself, it has the right
and duty to do, even using force if necessary
as a last resort.
The case is significantly different when
artificial feeding is used as a substitute for
normal eating which is physically no longer.
possible for a particular person. The stroke
victim who can no longer swal.low may not be
morally obliged to submit to a frame of arti­
ficial feeding which he or she finds extremely
painful. A case can be made also for with­
holding or withdrawing artificial feeding from
irreversibly comatose patients. In such a
case when the power connatural to the human
body for the intaking of food has been lost
and the patient or those responsible for him
or her may well judge that the expense of
physical discomfort is out of all proportion to
the benefits in continuing the procedure.

Medical Service

CHAI

NEWS

WHO Meeting Stresses Role of
Traditional Health Practitioners
New Delhi, 12 February : The need to
mobilize and involve traditional health practi­
tioners in primary health care programmes
was stressed at a recently concluded consul­
tation meeting organized by the WHO SouthEast Asia Regional Office.

Well accepted by the communities they
serve, the Traditional Health Practitioners
(THPs) with support from the Ministries of
Health and health professionals, could add
greatly to the momentum of primary health
care (PHC) and accelerate the achievement
of the goal of health for all.

Among other things, the consultation urged
that governments should promote traditional
health practitioners as important providers
of primary health care, especially in the rural
areas and to that end arrange their recognition,
training and utilization through appropriate
supportive legislation. •
It was also recommended that each country
should develop a registry for traditional health
practitioners and traditional birth attendants.
This would serve as an important first step
in obtaining information upon which to develop
policy and take action.
The consultation recommended that neces­
sary support should be made available for
effective public education and information
campaigns, and for the establishment of cli­
nics, pharmacies and training facilities for
traditional practitioners. The need for multi­
disciplinary, action-oriented research was
also stressed.

March 1985

NOTES

The consultation emphasized that an ess­
ential prerequisite for collaboration between
practitioners of the traditional and modern
health systems is understanding of and mutual
respect for each other's system.

Reiterating the vital role of traditional health
practitioners, the consultation urged WHO
to support Member States in mobilizing and
utilizing various categories of THPs with neces­
sary training for PHC. This would help them
to participate more effectively in the imple­
mentation of national strategies for achieving
the Health for All objective.

St. Joseph's Leprosy Hospital,
Tuticorin: Anti-Leprosy Month
Celebrations
This year the anti leprosy month celebra­
tions began from January 10th onwards.till
February 11th closing with a public meeting.
Intensive survey and Health education
programme were conducted at 4 villages be­
longing to Tuticorin subcentre. They were
Mullakadu, Savariarpuram, Pottalkadu and
Muthiapuram, which has become urban area
due to the existence of Spic Nagar. Hence the
se’cond and third surveys were left out, as in
other places of our central area. Most of the
people in these area are immigrants. However
regular clinics are being conducted every
month for the already known cases of leprosy
patients and for those who come otherwise for
treatment.
Total number of persons enumerat­
ed at the above four villages during
the antileprosy drive were
11,147

33

5,591

Talks were given to the public, creating an
awareness on the truth about leprosy.

Old cases

31

On the 30th of January 2 slides on leprosy
were projected in 14 cinema theatres of Tuticorin and our central areas. They would be
screened for 2-3 months.

New cases

13

Total

44

Total number of personal examined
for leprosy lesions were
Total number of leprosy patients
detected were :

Health education programmes were con­
ducted side by side during the survey. Talks
were given to patients, their families and to
the public in groups. About 2000 leaflets were
distributed. All these were done by our staff
in groups with the help of the volunteers from
Spic Nagar Lion's Club.

Essay competitions were held for high
school. Students, of our central area. A total
number of fifty two students took part. The
attempt was good on the whole and fourteen
students were given prizes. Elocution com­
petitions were conducted for school teachers.
It was held in three different schools to faci­
litate the teachers to gather in the nearby school.
The teachers spoke during a small meeting,
in the presence of other teaching staff, stu­
dents and our staff. The total number of tea­
chers who took part were fourteen.
Health education programme was conduct­
ed by our Para Medical workers in groups of
four to six in five villages of our area getting
the involvement of the village administrative
officer and the important persons of the vil­
lages. The programme was as follows :Distribution of leaflets on leprosy

745

Unregistered leprosy patients con­
tacted
.

55

Absentees contacted

123

New leprosy patients detected
34

2

A public meeting was held at Muthiapuram
on the 11th February with the help of the Spic
Nagar Lion's Club members. The Chief Guest
was Dr. V. Thyagarajan, the new D.M.O. of the
District Head Quarters Hospital, Tuticorin and
presided over by Mr. R. Radhakrishnan, Presi­
dent of the Lion's Club Spic Nagar. Rev. Fr.
Tiburtius welcomed the gathering followed by
speeches by the president and the Chief Guest.
Dr. S. Ramesh our Medical Officer gave an
insight to the public about the disease. Prizes
were distributed to the winners of the essay
and elocution competitions.
There was a
great crowd as the site of the meeting was at
the by pass of the main road. The meeting
ended with the screening of the films.
1.

"leprosy not a ,curse".

2.

"leprosy a misunderstood disease"
and

3.

"leprosy control and rehabilitation".

Spirituality
(The following selections are from the 1984
statement of the Association of Major Reli­
gious Superiors of Indonesia. In Indonesia
this group is known as MASRI.)
At our 4th Inter-religious Congress in 1978
we said: "In our relations with other people,
we try to reach a relationship through mutual
dialogue, to build up a family relationship, to
foster a prudent intimacy with families, to
develop solidarity and mutual collaboration
with the surrounding society, particularly
with the common people, the destitute and
the oppressed." .
Medical Service

\Ne have since tried and will continue to
try to make an effort to live a simple life, such
as most Indonesian people do. Would that
the religious were ready to work without
expecting any reward, to serve voluntarily and
honestly all people, particularly the oppressed
and the desolate and to foster a spontaneous
contact with the poor who are forgotten.
Our involvement with the poor will manifest
itself by the choice of religious life-style,
which strives for solidarity with the society
of the poor primarily.

From our experiences and endeavours up
to now, it has become more and more evi­
dent, that religious life, as an expression of
divine love, is being accomplished if we
are willing not only to give, but also to receive.
We should be willing not only to impart or to
apply the riches of our lives, but also to re­
ceive sincerely the riches of those we serve.
Experience indicates that we not only enrich
our neighbours, but that we in turn are also
enriched by them. Thus we not only share
our riches with the poor and needy, but from
them we also receive spiritual riches, such as
"simple" faith in God, willingness to depend on
others, openness, simplicity, sincerity, friend­
liness, endurance and perseverance in suffer­
ing.
The nearness with one's neighbour, especial­
ly the poor, obviously calls for a nearness of
heart too. For our part it means a sensitive­
ness and attention to their lives and needs,
both those expressed and those kept silent.
From the experience of living close by the
poor, valuable spiritual riches have been dis­
covered : not only have we become friends and
a life-support of the poor, but they too
have become the strength and support for our
life and vocation. We therefore have to be
more fully convinced that all the more we
serve the poor and destitute, so much the more
will we be served and enriched by God through
them.

March 1985

Furthermore, on the basis of these experi­
ences, it was also discovered as necessary to
make constant spiritual discernment, so that
our involvement with the poor becomes the
permanent expression of God's redeeming in­
volvement, the expression of God's love, uni­
versal but at the same time preferential. Thus
the involvement*with the poor is not a class­
struggle, but becomes a part of all God's work
which changes the world and all its structures.
If this is the case, then our spiritual discern­
ment has a truly social character. This pre­
supposes the conviction that transformation
of life and its entire social structure, in the dis­
cerning process as well as in its results, can
only be achieved by moving together, in the
spirit of collegiality and cooperation.

It is therefore evident that our efforts to
transform the world through the preferential
option for the poor, demand united action in
the Church, among religious and their con­
gregations, among laity and hierarchy, and of
all people of good will. This unity of action
means that we all together try to secure the
common goal, the promotion of justice. This
also means that we, with all our energy,
spiritual sources and various works, strive for
the promotion of justice, especially with the
poor. This struggle for the promotion of
justice and our preferential pption for the poor,
under the guidance of the thurch, constitutes
the integral expression of our faith.
In conclusion, these new attitudes, which
generate new actions in service to the poor,
will not materialize, if we, for our part, are not
willing to change ourselves, or refuse to form
new patterns of living our religious life and
service.
It is this challenge that urges all of us to­
gether with utmost necessity.

Courtesy: 'Info, on

Human

Development'
35
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MEDICAL SERVICE VOL. 42 No. 3 MARCH-1985.pdf

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