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Denis Giles

21 June 2015

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By Almas Shamim

My father is one of those people who are doctors without going to a medical college. And if he needs specialist advice, there is always the pharmacy shop round the corner! The said pharmacy shop is THE most favourite of all old-timers living in the vicinity of the G.B. Pant Hospital. Since I might err while recounting others’ relations with the said pharmacy shop, I shall stick to surmising my own father’s relation with it.

So, the moment my abbu (as I call my father) realizes that the machinery of his body is not running as smoothly as he deems fit, he sets out to diagnose himself; the diagnoses, depending on the range of symptoms, usually varying from the very obvious “thanda lagna”, to “nas chadhna”, “naabh sarakna” and the very elusive “hook lagna”. Now, I’ve tried hard to find any shift in abbu’s belly button or the hook in our house which is to blame for so many episodes of illness, but to no avail. In any case, after the ritual blaming my mother for giving abbu a glass of milk or banana or brinjal or any-food-under-the-sun that could have been the reason for his illness, he ventures out to get some maalish, some pulling and pushing and some “jhaadna” from other old-timers, the numbers of whom are, sadly, dwindling systematically in our basti. And IF these time tested remedies fail to work on abbu’s body, off he goes to his specialist friend at the pharmacy shop and brings back allopathic medicines which are, nine times out of ten, the antibiotic Amoxicillin. Yes, irrespective of the symptoms, irrespective of the ‘diagnosis’ and irrespective of the nature of the illness, my abbu buys and consumes Amox. AND it does cure him! *rolling eyes*

Yes, there have been other instances as well, where my family has linked a super-duper expensive brand of a medicine that treats acidity, to a pain in my mother’s arm and gone to the extent of ordering this anti-acidity tablet from Chennai; or where abbu has been told to take a certain liver tonic since my abbu is such a chronic – no, not alcoholic- such a chronic ‘smoker’ and the organ smoking would most seriously effect is the liver! (Should be lungs)

But, the rampant use of Amox (or any other antibiotic) is a whole new ball game. Antibiotics, as we know, are used to treat infections- to kill or stop the growth of microorganisms called bacteria. There are also anti-virals against viral infections and anti-fungals to be used against fungal infections. These medicines should be taken at the correct dose and in the prescribed frequency (two times, three times a day etc) for the complete effect. Improper consumption may actually have only half the effect of the medicine- so the microorganisms will be modified but may not die! These modified microorganisms may (and research shows, HAVE) become RESISTANT to further action by the antibiotics, meaning, the patient may take the correct dose of medicines at the correct time for the correct number of days, but still, the medicines will fail to act on the microorganisms. These resistant organisms are then transmitted from one person to another person, who will have acquired an infection which is ALREADY RESISTANT to its usual medicine. This chain of spread leads to a problematic situation where most of the antibiotics available in the market FAIL TO TREAT most of the infections circulating in the population. The medicines, however, continue to cause their usual side effects. This problem is added on to by the fact that not many new antibiotics are being developed. And the few that may be developed may be too expensive for people to afford.

It, thus, becomes very important for us to be careful with the way we consume our antimicrobials. Whether we were prescribed the correct medicine or not is, obviously, not within our control, but, a little query at the time of getting a prescription from a ‘doctor’ would tell us which one, from the list of medicines, is an antibiotic. We could then also confirm with our doctor if it is really needed and if yes, we must follow prescription advice to the dot. Repeated failure of an antibiotic regimen could mean that we are already resistant to it. Rather than hopping around from one antibiotic to another we could request our doctor for a ‘drug sensitivity testing’ which will help the doctor get a rough idea of which antibiotic to prescribe.

Meanwhile, in my home, there are standing orders for my mummy to seize all Amox tablets lying around and abbu is requested to have a ‘dialogue’ with me before blindly embarking on regimens prescribed by his favourite-est pharmacy shop! 

Almas Shamim is a public health specialist with a great interest in sexual and reproductive health and rights, and feminism among Muslim women. She currently works for an international humanitarian aid organization in New Delhi and can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it.

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Denis Giles

10 June 2015

Hits: 2013

Isn't it an irony that parents spend Rs 1000 per month for education of a child in a private school, while government spends Rs 2000 per month on a child in a government school. The disintegration of education system in the Islands is directly proportional to the increase in investment in pay and perks, infrastructure, facilities, equipments and accessories. Is it systemic failure or lack of a system itself?

By Zubair Ahmed

An analysis of the three press meets by the heads of Electricity, Education and APWD would suffice to get a feel about our idea of development or achievements. When we talk about achievements, its more about quantity than quality in every sector.

Like any other department of the Admn, in education too, the number of school buildings, toilets, doors, windows, new recruitments, teaching and non-teaching staff, ayahs, peons and watchmen seems to be the focus. But, the dismal performance of govt schools in the board exams has now compelled the Administration to reflect on reasons behind the debacle.

The Administrator recently expressed concern over low pass percentage both in Class X and XII. Had we achieved 100% pass in Class X, we would have celebrated our success and started comparing it with states in Mainland conveniently overlooking the fact that even 100% is just quantity and not about quality. Will the Directorate tell us the overall average CGPA this year, even in the schools which achieved 100% results? It would be a shocking revelation!

In fact, if the Admn contemplates tweaking the system to make a turnaround, the change should begin from top to bottom. The Directorate needs an academic to run the show instead of a bureaucrat. A bureaucrat can be good in providing resources, but monitoring of academic performance is not their cup of tea. Mismanagement of resources including manpower is quite apparent everywhere. Schools with disproportionate pupil-teacher ratio is abundant in number.

The example of two schools in South Andaman District are glaring. One Govt secondary school at Jirkatang,  affiliated to CBSE, has 16 students on roll with five GTTs, two PSTs one Craft Instructor and one Librarian. Three students appeared for Class X Board examinations out of which two passed and one was placed under EIOP or compartment. The teacher-student ratio is 16:9! One teacher for every 1.5 student!

The CBSE-affiliated secondary school at Mile Tilak has 30 students and 8 teachers including a PET and a Librarian. Five students appeared for Class X examinations and secured 100% pass with an average result of 6.5 CGPA. The teacher-student ratio is 30:8! A teacher for every 3.5 student!

Why not buy a fully-air-conditioned 40-seater coach with home pickup for the children with lunch from a star-hotel and admit them in a premier school at Port Blair? The per capita cost would be less than what is spent on such schools, and a fortune can be saved too.

Isn't it sheer mismanagement or eternal indecisiveness to find a solution? These are not exceptional cases. There are many such examples throughout the territory. There was a school with 16 teachers and 9 students!

There are many schools in South Andaman District where enrolment is very low due to numerous private schools that have come up. But, the sanctioned strength of staff remains same with disproportionate teacher-student ratio. Many teachers can be seen loitering around or sitting around the headmaster gossiping.

In fact, there are approximately 300 surplus teaching staff including GTT and PST in the department, without taking into account those engaged under Sarva Shiksha Abhiyan (SSA). The recent recruitment might have earned a brownie point, but was it need-based? The haphazard placement of teachers throughout the territory exposes the sorry state of affairs in the department. Even the official Pupil Teacher Ratio claimed to be around 15:1 is highly debatable. The no. of students studying in govt schools as projected by the Directorate is 86460, and teachers under the Directorate is 5574 which is also susceptible. In fact, no developed country, even USA can beat the record of Pupil-Teacher Ratio (PTR) in our Islands. It runs in single digit.

A large number of media of instruction also add to the miseries of the department. The same infrastructure and faculty are needed for a small number of students. Schools were provided for small number of students again on demand, without considering the logistics and practical difficulties. Rationalization of medium, as pinpointed by the Administrator, however politically incorrect it might be, needs to be implemented.

To bring quality in education, a robust monitoring system needs to be in place. However, the department is not devoid of saner voices. They do admit that there is no accountability, no proper, timely and effective inspection of schools. Inspection by peers is hardly meaningful unless sustained and evaluated periodically. 

But the question is how inspections can be carried out with the present dispensation? Principals, DEOs, Asst Directors and sometimes Directors are of same scale. The DEO acts as principal in charges of many schools in the absence of regular principals. If the climate is conducive, they may sit in Directorate as Asst Directors and in bad times may be sent back as Principals or DEOs. There is no well-defined hierarchy to bell the cat?

In 2009, the pass percentage of Class X was 57%. Thousands of students were thrown out of education system. Last year, when the results were 97%, instead of celebrating it, we rued the system saying that Class X is no more a benchmark. This year, the results seems to have rationalized. Its a wake up call to take CCE seriously in lower classes itself to prepare them for board exams, especially Class X. Dissection of average marks in different subjects will be a good way to start with to know what we were missing down the line.

Moreover, to get into the bottom of the disintegration, there needs to be a thorough understanding of the CCE pattern, which is often blamed by majority of teachers for poor performance.

Earlier, they rued that students weren't serious due to no-fail policy. Now, when the pass percentage have come down, they blame the CCE pattern itself.

In fact, CCE pattern is widely misconstrued by most of the stakeholders. It prepares the students for life rather than just higher studies. There has been no serious effort among teachers in implementing it in true spirit. Blaming it as paper-work intensive system, the focus is deflected from children failing the purpose itself.

With a little bit of tweaking here and there, its one system, which gives sufficient emphasis on overall development of the child. It is observed that there has been a drop in the capability of writing among the children due to irrational mark allocation in different tools in formative assessments in lower classes, which can be easily overcome by following a rational system giving an extra edge for pen-paper test, preparing the students for summative assessments. Problem Solving Assessment (PSA) introduced by CBSE a couple of years back seems to be far beyond the comprehension of our teachers.

There has been wide discussion of inclusion of soft skills in school curriculum, but how many teachers in our Islands have ever seen the well-researched Life Skill manuals prepared by CBSE? Do they use it in schools? How many periods are earmarked for the same? Instead of blaming the system and looking out for solutions, there is a serious need to get acquainted with the materials provided by CBSE as well as NCERT, and implement it in true sense.

The state of evidences of assessment by government schools will tell another sordid tale of affairs how much they are concerned about the students. If the Administration is serious about improving the quality of education in the govt run schools, they need to check the quality of evidences of assessment of each school. To make CCE work, periodic internal assessment of evidences need to be carried out.

A one time quality assessment test at two levels can help in getting a clear picture about the ground reality.  To assess the quality of language and mathematics up to Class V and Maths and Science upto Class VIII would help in assessing the teachers, schools as well as students. Necessary inputs and outputs from the review can help in taking remedial measures.

On making the teachers responsive and accountable, the Secretary recently made a remark about carrot and stick approach. Only reward and punishment can bring meaningful change in the system. Transfers are very lucrative in the department. A lot of political as well as bureaucratic pressures are exerted on the Directorate to accommodate the ‘well connected’ teachers in the headquarters. Others manage on medical ground; true or false. Yet others come up with excuses of ailing old parents, and close relatives; some actual, some cooked up to stay in South Andaman Main Island, not even Neil, Havelock and Little Andaman. If the warning from Secretary-cum-Director that non-performers will be shown the door makes an impact, well and good. Moreover, there are no incentives for performers, who gradually feel let down by the Directorate.

While the private schools with minimal infrastructure and manpower delivers, the over pampered government schools with experienced teachers and quality infrastructure fails miserably. The govt spends around Rs 20 crores on just salary of teachers, and per head expenditure on a child comes to more than Rs 40,000/- but the output is dismal. The irony is that when a parent spends Rs 1000/- per month for education in a private school, government spends Rs 2000/- per month on a child in government school. 

Sixth Pay Commission brought a windfall for the government teachers beyond their wildest dream. But in terms of output, there is hardly anything to write home about. The teaching fraternity instead of discussing the debacle in board exams would be more keener to discuss threadbare about Seventh Pay Commission and its nitty-gritty.

Its a fact that educated parents including govt teachers admit their children in private schools despite knowing that the teachers are not experienced and are not paid at par with those in govt service, but they are confident that the schools will deliver.

Its an enigma why govt schools in outer Islands, where there are no private schools too fail to perform. The enrolment is not bad. The community as stakeholders too needs to give a thought about it. 

If ten percent of the time teachers spent on gossiping about their pay scale, DA and pay band is utilized to discuss about education and their students, the Administrator wouldn't have to worry about the declining quality of education in the Islands.

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Denis Giles

14 June 2015

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By Almas Shamim

Some of us may have read the brief news about an abandoned child being found somewhere around Foreshore Road a few days ago. The news piece received its share of comments in social media but the striking thing about the comments was that apart from those commending the boys who had tried to protect the child from the rain, a major share of the comments assumed that the mother of the child is to blame. In fact, the news piece itself judged it to be an abandonment act by an ‘unmarried mother’ (prima facie!). Now, it’s only natural that news of an abandoned child wrenches most hearts. It definitely should be treated as a crime and the perpetrator punished. But, amidst all the emotions and knee-jerk shaming of the said “unmarried mother” are we looking away from a few pertinent questions that the situation raises?

To begin with, we all assume that the abandonment was by the “mother” and the mother was “unmarried”. It could well be true, but the very fact that we assume so is a proof of our skewed thinking. The child could have been abandoned by anyone, for all we know, but the blame has to naturally fall on the woman since it is she who was born with the uterus! Assuming that indeed it was the mother who had abandoned the child, we are faced with some serious questions. What could have led a woman to do it. Was she forced into it? Why, in a country like India, where abortion of a foetus upto a certain number of weeks is legal, did the woman NOT seek abortion?

Probably, the woman was plain wicked- she just loved the idea of giving birth to a child and then abandoning it. This is what most comments sounded like. But, I shall try to leave you with a few other probabilities and hopefully it will make us think about the bigger picture and help us find solutions which are more than just blaming the woman. So, well…

Probably, she was too young a child to understand pregnancy or, for that matter, sexual abuse. By the time the family realized the child is pregnant, it was too late for abortion medically.

Probably, some family member himself was the perpetrator of the abuse, and didn’t want his act of sexual abuse to be leaked.

Or probably the family of the child, or even a grown up girl, was just too afraid of the stigma associated with an “unmarried mother” that it was decided to rather deliver the baby at home and abandon it THAN approach a medical facility for abortion.

Probably, it wasn’t an “unmarried mother” at all. Probably it was a married woman who conceived and very late into the pregnancy, her husband died and she was left with no source of income to feed another child.

Probably, the woman’s husband disowned the child- suspecting the child to have been fathered by another man- whether or not true, and demanded that the child be abandoned.

 The more we think, the more situations we can come up with, especially if we change the context and move it away from Port Blair. These probabilities raise questions of safety, social security, sex education, trust and stigma. What have we done to address any of these?

These are questions we must ask ourselves.

Abandoning the child was a crime but avoiding these major questions could be no less of a crime. When we blame women (and women alone) blindly for abandonment of children, we are, in a way, saying that the position of women is either so high in society that she is powerful to do as she pleases, or it is so low that she should bear the brunt of decisions taken by more people than just her! 

Almas Shamim is a public health specialist with a great interest in sexual and reproductive health and rights, and feminism among Muslim women. She currently works for an international humanitarian aid organization in New Delhi and can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it.

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Denis Giles

08 June 2015

Hits: 1895

Our Sore Expectations

By Almas Shamim

“Ye to haalat hai G.B.Pant ke doctor log ka!” my friend fumed, seemingly exasperated by the unsatisfactory prescription for her runny nose. One does not go to a doctor only to be told to take paracetamol and cetirizine! Obviously, a doctor is supposed to do much more- or should I say- ‘prescribe much more’?

Indeed, there are many instances when requisite medicines are missed, but the example quoted above is nothing more than a beacon of danger, to put it in the mildest way. Let me remind you that my friend had presented herself only with a ‘runny nose’. She had no other symptoms or signs, whatsoever. So her expectation, which she so eloquently spelled, of being prescribed some more medicines, was unfounded. These expectations form a major factor in forcing many doctors to adopt the unethical practice of prescribing unnecessary medicines. And one of the most abused categories of medicines is that of antibiotics. It is not uncommon to see patients diagnosed with a ‘viral fever’ prescribed some or the other antibiotic, even though the doctors know well enough that the antibiotic cannot treat the ‘viral fever’ in itself, but only help cure the accompanying bacterial infections, if any. Many doctors prescribe these medicines only to avoid the situation mentioned above as an example- of the patient complaining about NOT been given more medicines. A private sector doctor may be scared that an unsatisfied patient might not come back to his/her clinic the next time (meaning a lost chance of earning money!) and so the doctor prescribes a list of vitamin and mineral tablets, syrups for indigestion, a randomly thrown in antibiotic and maybe a few more- so that when the patient leaves the clinic, s/he not only has a lighter pocket (having spent at the pharmacy which is so often attached to private clinics) but also a feeling of gratitude and satisfaction towards the doctor. A government sector doctor might not be bound by the money factor in his prescriptions- probably that is why govt. sector prescriptions have been found, through research, to be less irrelevant than prescriptions by private doctors- but s/he still depends on patients for building up trust of the public on the health system of the state. In short, all doctors are influenced, in some way, by the NEED for more medicines among their patients.

Such unnecessarily prescribed medicines have a lot of serious outcomes on the patient and the state. For one, we might be consuming a tablet that will NOT improve our health any further, simply because our body never needed it in the first place; but these medicines will continue to bring about their side effects on our bodies. Secondly, sometimes these medicines might not be available at the government pharmacy and could burn a hole in our pockets when we try to buy them from ‘outside’. Thirdly, and this is quite an irony, the unnecessary use of some medicines among some patients may translate to the unavailability of the same medicines for other patients who might ACTUALLY need them. And lastly, the unnecessary use of antibiotics may lead to resistance to these antibiotics and they may NOT be effective on us in the future (while continuing to cause their side effects).

So, while it is undoubtedly true that no doctor should prescribe medicines unreasonably, it should be interesting to see how, sometimes at least, WE and our sore expectations shape our doctors’ prescriptions. It will be a good practice to try and ask our doctors the purpose of each of the drugs on our list and also confirm from our doctors if all the pills are really necessary. While the doctor may not go back and change the prescription instantly, and you may also not be able to judge if the medicines are really necessary or not, it DOES help to bring to your doctors’ knowledge that the patients are AWARE and unnecessary prescriptions are NO LONGER NEEDED and WILL NOT BE ACCEPTED anymore. 

Almas Shamim is a public health specialist with a great interest in sexual and reproductive health and rights, and feminism among Muslim women. She currently works for an international humanitarian aid organization in New Delhi and can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it.