- The local villages are spread out. The roads are poor and unsafe traffic manners make driving in India dangerous. Children with a disability are not easily transported on a cycle or motorbike. Unlike in the West, the parents of our children have no cars. There is no public transport to our centre. Therefore it is essential that we offer transport with our school-van.
- The tropical climate is extreme. Most of the year it is very hot and there are no rains. The winter monsoon (usually from middle of October to middle of December) can be very heavy. The housing situation in the villages is really bad during this period when roofs are leaking, and the firewood for cooking becomes wet. At any time, but especially in the rainy season, there can be long interruptions of electricity supply.
- Many of the parents have irregular income, often below the poverty line from their work as day laborers, and no health insurance or provision for their old age. The economic changes in India happen extremely fast, but it is mainly the middle class which has profited and the majority of poor people are being left out. The inflation rate is highest for basic goods such as grains and vegetables which affects the poorest people most.
- Disability is a complex problem, not readily accepted in the context of the Indian society. It is difficult for parents to accept that their child might need special care for the rest of its life, especially as most parents have no social security and expect their children to take good care of them when they reach old age.
- A number of our parents from the local villages are illiterate and uneducated. Sometimes they expect miracles from us. For example, they think that their child, who has a severe disability, will be able to walk or talk by doing an exercise only few times or after getting a special injection.
- Many children are undernourished and frequently have intestinal parasites, head lice, skin and other infections. We do a lot of health care and sometimes social care for the whole family in order to support them with the special needs of their child.
- In the local villages there are still marriages between close relatives which often results in genetic disorders of their children.
- It is not easy to find qualified professionals who like to work with the village population. Therefore, we have to train our staff for our own needs and based on our own standard.
- Pediatric specialty centers for diagnostics are slowly developing in India, but not easy to reach or not affordable for our families.