Law and Christian Witness
The Legacy of Health and Caregiving Institutions
John Amalraj K
Published in ‘Christian Manager’ Feb-Mar 2019
An unbelieving Greek
writer Lucian who lived in the second century (120-200 AD) wrote that ‘It is incredible to see the fervour with
which the people of that religion
help each other in their wants. They spare nothing. Their first legislator (Jesus)
has put it in to their heads that they are brethren’. What a beautiful
description of the Christians by an unbeliever. Tertullian, one of the early Church
fathers, during the same period writes, ‘It
is our care for the helpless, our practice of loving kindness that brands us in
the eyes of many of our opponents. Look (they say) how they love one another, look
how they are prepared to die for one another’. This is our faith legacy.
Matthew records that when Jesus saw a large crowd, He was moved with compassion
– the people were harassed, distressed, helpless and dispirited like sheep without
a shepherd (Mt 14:13-21). Moved with compassion, He preached and taught, fed the
hungry, healed the blind, lepers, raised the dead and cast out demons. Jesus broke
the religious mould and traditions in the Jewish society by reaching out to the
outcasts – doing good and healing all who
were under the power of the devil. (Acts 10:38)
Luke describing the community life of the early Christian believers says,
there were no needy persons among them
(4:34). The early Christian believers made a special effort to care for those who
fell through the cracks of society — widows and orphans. In the patriarchal society
of Rome, women without husbands were often forced into poverty. The apostles were
engrossed into the ministry of caring for the widows although it triggered a crisis
which the leadership handled well to institute the ministry of deacons into the
church (Acts 6). In Joppa, there was a disciple named Tabitha (Dorcas
in Greek); she was always doing good and helping the poor. Peter raised her back
to life so that she could continue the ministry of compassion to the needy (9:36-42).
This ministry was built on the scriptural foundations of God’s concern for
the poor, the stranger, and others whom society had forgotten or simply ignored.
Movement
Vs Institutions
The compassionate ministry of Jesus and that of the disciples flourished
outside the existing Jewish religious institutions. It was a movement not an institution.
It was after more than three centuries that institutions came into being. Institutions often fail in its purpose or decline in its impact over the
years. Movements continue to grow beyond institutions. Our loyalty ultimately should
be to the call of God than merely to institutions. Institutions do not always
accomplish God’s plan. It is the people of God who use institutions as an instrument
to accomplish God’s greater purposes. The promise of a new heaven and a new earth
helps us to diminish our unnecessary concern for creating and maintaining existing
institutions and organisations just for the sake of it. Rather, our priority should
be to focus on building strong faith communities within institutional structures
and not the other way round. This will enable us to continue our ministry with or
without an institutional structure.
Impact of Christian Institutions
in India
It is a well known
fact that Christian institutions in the field of education, health care, community
care and social welfare have significantly contributed to the building of the nation
as we see it today. Indian political leaders from the time of Independence have
openly acknowledged with gratitude the contribution of the Indian Christian community
through its institutions. The origin of Christian institutions in India has a legacy
that goes back to the times of the western missionaries.
RL Rawat, in his History of Indian Education, suggests
that India will forever be indebted to the missionaries for the production of textbooks,
dictionaries, and grammar books, and for their zealous pursuit of educational advancement.
The Jesuits followed by the protestant missionaries like Ziegenbalg, Carey, Swartz,
Wilson and Alexander Duff established formal schools for Indian boys. Later, schools
for girls were opened by the wives of missionaries and hundreds of single women
missionaries across the country. Soon post secondary higher education institutions
were founded, including universities run by the governments. These educational institutions
played an important role in producing Indian leadership for the Independence movement
and eventually for post-independence governance. Christian teachers have set a high
standard of discipline that is valued by the society. Today, Christian educational
institutions still attract students from all faith.
Health care is another field where institutions were
set up by missionaries around the country. Institutions from primary health care
clinics to advanced medical care and education were first established by Christian
missionaries. Ida Scudder who founded roadside clinics went on to establish two
institutions – Christian Medical College and Hospitals – that continue to excel
in health care. Church of South India, Church of North India, Methodist Church of
India and other major denominations now manage many hospitals across the country.
Emmanuel Hospital Association with a network of 20 hospitals and 42 community development
projects in North and Central India serves in remote rural areas giving health care
for the poor and marginalised. Christian Medical Association of India networks more
than 350 mission hospitals across the country along with 12000 health care professionals.
Christian mission hospitals are still the first choice for the poor masses. Christian
doctors, nurses and other paramedics have become role models in the health care
sector.
Caregiving institutions like orphanages, homes, rehabilitation
centres is another field where Christian missionaries have pioneered. The Dohnavur
Fellowship instituted by Amy Carmichael to run an orphanage in Tamil Nadu and a
home for the abandoned, orphaned girls and widows in Maharashtra by Pandita
Ramabai, have few comparisons. The Sharp Memorial School for the Blind in Dehradun
is a pioneer along with the Schools for the deaf and dumb in many other parts of
the country. Sanatoriums for those suffering with tuberculosis, leprosy and their
rehabilitation are another area where Christian missionaries have pioneered to set
up institutions. Missionaries of Charities founded by Mother Teresa has left an
impression on the Indian mind for showing the compassion of Christ to orphans and
the dying persons on the streets of Kolkata. Today, caregiving institutions have
gone beyond to rescuing and rehabilitating commercial sex workers, caring for victims
of AIDS, polio, substance abuse, and others diseases. The compassion that is shown
by Christians has broken the age-old religious superstitions that discriminated
and exploited the voiceless population who often suffer in silent.
Social reform has been another major area where Christian
missionaries laboured hard specially with regard to abolishing of the practice of
Sati, temple prostitution and the upliftment of the untouchables, dalits and tribals.
Institutions in the form of mission compounds were set up exclusively to rehabilitate
the abused women and men. Although there were successes in enacting laws for such
social reforms – the battle on the deep-rooted caste system is yet to be won. Today
advocacy for abolishing child labour, bonded labour, human trafficking and controlling
corruption and environmental concerns, etc., are led by many individual Christians
and few mission agencies and institutions.
Mandatory Registrations for
Institutions
All schools, colleges,
vocational training centres, orphanages, rehabilitation centres, homes, clinics
and hospitals have to seek appropriate registrations. There are several authorities
such as the State Education Board, Central Board of Secondary Education (CBSE),
Council for Indian School Certificate Examinations (CISCE), All India Council for
Technical Education (AICTE), University Grants Commission (UGC), the Bar Council
of India (BCI), the Distance Education Council (DEC), the Dental Council of India
(DCI), the Indian Nursing Council (INC), the Medical Council of India (MCI), the
National Council for Teacher Education (NCTE), the Pharmacy Council of India (PCI),
Ministry of Health & Family Welfare (Clinical Establishment – Registration and
Regulation Act, 1910), Ministry of Women and Child Development for all Child Care institutions and adoption
units (Juvenile Justice Act 2016), Child Welfare Committees, Social Welfare
Departments, Rehabilitation Council of India (RCI), Shops and Establishments Acts,
etc. A society registration or a trust registration alone is not sufficient. If
an institution is run without registration, the government is obliged to take action.
There are now mandatory inspections and registration renewals for all institutions.
All registrations require basic infrastructure in
terms of buildings, furniture, equipments and professionally trained staff. For
example, setting up of a hospital, clinic, diagnostic centre, etc., requires land,
building, furniture, medical equipments and instruments, computers and above all
certified medical professionals. Every department in a hospital needs to adhere
to various government regulations and obtain certifications. If one wants to set
up a rehabilitation home, orphanage, half way home for substance abuse victims,
rescue centres for human trafficking victims, etc., they all require licenses and
certifications under various laws and multiple government departments. The risk
of running unregistered ‘clinic or home’
may cause the government to take criminal action under the various laws. Medical
camps organised in rural areas also require permission from appropriate authorities.
Governance
The challenge of governance in Christian institutions
is beginning to affect our witness in the society. Many historical educational institutions
especially in large cities have become ‘elite’
institutions that generate money for the affiliating church denominations or other
institutions. They have lost their original vision of providing education for the
poor. At the same time, due to inadequate governance, health care institutions and
other caregiving institutions suffer from lack of finances to maintain their basic
services to the community around them.
Multiple
Models
There are many approaches to governance. When an institution
is founded – the founders and his or her close associates assume the governance
role along with the management functions. However as the institution grows, a need
for a formal governance structure is realised. There are multiple models of governance
for ‘not for profit’ institutions. Jeremy
Barlow in his blog lists the following: Advisory Boards, Patron Boards, Cooperative
Boards, Management team model and Policy Board. (https://www.boardeffect.com/blog/board-governance-models-a-comprehensive-list/)
Governance boards are formed traditionally as a representative
of major stakeholders like large donors, founding church leadership or other agencies
and those who are involved in the management of the institutions. There is often
a power struggle in the governance of institutions as there is no clarity as to
the role of the board. Many of the institutions are now moving towards the policy
governance model as advocated by John Carver. It has its limitations for a Christian
‘non-profit’ institution as it is likely
to distance the board from the management artificially. The relationship based governance
as advocated by Dr Les Stahlke is a more balanced approach (www.relationshipmodel.com).
Dr Stahlke states that ‘an organisation is
like a tree and a healthy tree bears healthy fruit’. Governance as required
by the Societies Registration Act 1860 and The Indian Trusts Act, 1882 provide very
basic structures to ensure the minimum compliance required under these laws. However,
the Maharashtra Public Trusts Act, 1950, Gujarat Public Trust Act, 1950 and Rajasthan
Public Trust Act, 1959 provide for Charity Commissioners who exercise quasi-judicial
functions to regulate the management of all societies and trusts in their states.
Christian institutions must go beyond what the law requires in terms of governance
and management. A governance manual describing the role, powers and functions of
the Boards and the chief functionary and their relationships must be adopted by
every institution. The vision, mission, values and the expected outcomes of the
institution must also be adopted as part of the manual. These can be reviewed periodically.
The most important part of the governance is to distinguish governance issues from
day to day management issues. A board normally should not interfere with the day
to day affairs, but set policies and boundaries of authorities for the staff to
implement. This will enable best practices in governance of institutions and will
help to maintain the Christian witness in a changing context.
Management
Managing educational, health care and other caregiving
institutions is no longer a simple task. Legal compliances with regard to physical
infrastructure facilities, equipments and the employees have to be followed strictly.
Day to day administration of these institutions takes away a lot of energy and often
compliance deadlines are overlooked. In the long term, these lapses by staff can
land an institution into deep trouble with the registration and licensing authorities.
The penalties and consequences are serious. Management must come up with systems
and periodic audits to ensure all compliances are complied by the institution. Audits
should not be restricted to finances but extend to other facilities, equipments
and employees.
Working
Hours
It is a
typical Indian mindset that working for long hours means that an employee is quite
hard working and has more than 100 percent commitment. The other perspective is
that an employee who regularly sits late in the office does not know to manage time.
The Indian culture of being relational means that during the working hours there
is a lot of conversation that takes place among the staff that are not work related.
In fact there is more socialisation that
happens in the workplace even though it is good in one sense it may not be healthy
for an institution. This affects the productivity as compared to a commercial establishment
like a factory where the supervision and accountability of time is very high. Often
workers are not aware of the vision and mission of the institution. The casual workers
(unskilled manual workers) in an institution often are the ones who do not see their
role in fulfilling the larger vision of the institution. Vision, mission and values
are good motivators across all sections of employees in an institution. The senior
management must take the initiative to communicate and motivate the lower level
staff. Outsourcing some of the
non-critical activities in an institution to contractors following due
diligence and compliance improves productivity.
Care
for the Caregivers
The role of teachers, doctors, nurses, paramedics,
counselors, wardens, matrons and social workers are energy sapping both physically
and emotionally, since they function as the caregivers in an institution. They end
up bearing the primary load of the ‘mission’
of the institution because they understand the vision and are expected to work towards
the same. The other employees who function in a supporting role seldom share the
vision. They end up to work to earn their living and care for their own families.
Those who carry the load eventually are affected by ‘compassion fatigue’ that undermines their performance in the workplace
and also the quality of life in their homes. Ensuring that all employees utilise
the legally mandated weekly off, holidays and paid leaves will go a long way in
preventive care. Organising spiritual retreats, in-house training sessions and prayer
fellowships help to care for needs that may not be voiced.
Sabbath
Rest
Employees in Christian institutions who function as
primary caregivers need a sabbatical leave once every six years. Christian Institutions
often ignore the Sabbath rest mandate because of the compulsion of the ministry
needs. Matthew Sleeth, an emergency room doctor, hospital chief and emergency services
director in the US has authored the book, 24/6 - A Prescription for a Healthier,
Happier Life. He describes our symptoms, clarifies the
signs, diagnoses the illness, and lays out a simple plan for living a healthier,
more God-centred life in a digitally-dazed, always on world. He calls the Church
to recapture the gift of Sabbath as a weekly reminder of the joyful reign of God
in the midst of a broken world. Being a workaholic sounds very spiritual or highly
committed to the task but it mars God’s design for life. Christian institutions
need to heed this call to revive the Sabbath rest to care for the caregivers.
Financial
Resources
Financial resource is another issue in managing institutions. Legal compliance
to Income Tax Act and Foreign Contribution Regulation Act in a timely manner is
required. Christian institutions are not profit centres. All the institutions come
under charitable status and therefore any excess of income over expenses which in
commercial establishment may be considered as ‘profit’ will be considered as ‘surplus’.
This surplus can be utilised only for the objectives of the institution that benefit
the larger community and not for the benefit of the board members, society members,
trustees or even employees and staff. The ‘surplus’
cannot be donated to other societies or trusts. Financial systems that inculcate
transparency in all transactions, accountability at every level and efficient budget
controls are essential to the survival of an institution. Charges are for services
rendered in the form of fees is an important source of revenue for educational and
health care institutions. However, other caregiving institutions like orphanages,
rescue centres will primarily operate by providing free services. Fundraising for
infrastructures like buildings, furniture and equipment is a necessity to maintain
the service of the institution. We need
to make ends meet and run our institutions efficiently with the income we can
generate through our services without compromising our mission of serving the
poor and marginalized.
Charitable Status
Any institution
created for the advancement of education, promotion of public health, relief of
poverty, etc. regarded as charitable in law is considered as a public charitable
trust whether they are registered as a society, trust or even as a not for profit
company. Though it doesn’t have a definition of its own, public charitable trust
must be created for the benefit of the public. All health care and community care
institutions can register for charitable status under the Income Tax Act through
their registered society or trust provided these are part of the objectives in the
memorandum of association or trust deed.
To look into what laws apply to public charitable
trusts in India, we need to understand what charitable purpose means. Under Section
2(15) of The Income Tax Act expression of, charitable purpose is in an inclusive
manner. Charitable purpose under Section 2(15) of the Income Tax Act includes relief
for the poor, education, medical relief and the advancement of any other object
of general public utility. The aforesaid definition is not exhaustive and therefore,
purpose similar to the purposes mentioned in the aforesaid definition will also
constitute charitable purpose. The charitable activities must be for the benefit
of a community or a section of the community and not for individuals. It is also
important that the constitution of the institution must provide for these activities
in their aims and objectives. Only public religious trusts and societies can claim
exemptions from income tax.
Responding
to Public Opinion
Many years ago, in an interview with Kushwant Singh, RSS Leader MS Golwalkar
said, ‘We have nothing against the Christians
except their methods of gaining converts. When they give medicines to the sick or
bread to the hungry, they should not exploit the situation by propagating their
religion to those people.’ (Khushwant
Singh, Ed., Mala Dayal, Me, The
Jokerman: Enthusiasms, Rants & Obsessions, New Delhi: Aleph Book Company, 2016).
The recent political atmosphere of religious and communal polarisation
has attributed motives to the management of Christian institutions. The mischievous
false allegation that Christian institutions established for charitable activities
are used for ‘conversion’ to Christianity
must be opposed through our continued ‘good
works’ showing God’s compassion.
The Indian context
has seen many changes in the running of institutions. Commercial profit
oriented educational institutions, health care providers and care givers with
huge private investment stand in direct competition to our calling to serve
with compassion. Our unique selling point (USP) is our brand of love and
compassionate service. Christian institutions
serve a greater purpose. It is to show God’s love to the world through our acts
of kindness, deliverance, forgiveness, restoration and healing for those who are
marginalised in the society.
John Amalraj served
as staff with India Missions Association (1993-2005) and Interserve India (2006-2017).
Presently as a mission field Partner of Interserve, he is involved in mobilising
churches for missions, mentoring leaders, enabling strategic thinking and envisioning
Christ’s disciples to witness in the marketplace. John is married to Jessie
who serves as an English Language trainer. They are blessed with two sons, Jason
(26) and Joash (17).
The earlier articles published in Christian Manager
on this series: ‘Law and Christian Witness’ are: “What Is Our Vehicle for Ministry”
- April-May 2018, “Why Must We Pay Taxes?” - June-July 2018, “Why Do We Need Labour
Laws?” - Aug-Sept 2018, “Asserting Our Constitutional Rights” - Oct-Nov 2018, “The
Legacy of Educational Institutions” - Dec ’18-Jan ’19.
