Better Citizenship and Disciplining in Schools

When visiting schools and interacting with teachers, one of the questions that keep coming is regarding disciplining of students inside the school. Looking at the need for disciplining of students (whatever the reason might be) and the aims of education especially in the creation of a better citizens, one of the question that arises is: Does disciplining (a strict one) will create a better citizens out of the students by conforming them all to a desired ways?  

One of my views is that, strict disciplining will lead to conformation, which the parents also expected the teacher to do out of their children, will lead to a better citizen who would cast their vote every election, follow traffic rules, and conform to the law everywhere without ever questioning.  

On the other hand, the creative children that we want to raise are taught to be a free thinker, questions everything, and act accordingly.  Free thinker will not blindly follow the rule, free thinker will have the audacity to question the rule...

One of my experiences is that people who are more highly educated and more aware of their rights are more likely to not cast their vote on election days with the excuse that there is little or no choices, or that they break and then questions the law itself.  

Another way to view is that we can say such people are contributing to the nation building though their criticism and actions, which are not always desirable. But then again we can argue that, each rules and laws are enforced only after a proper, if not thorough, thought with a certain goal of common good.

But in the end, we have to have trust on our children and hope that they will, through their free thinking, think of the common and greater good, and contribute to the nation building through their free will.

Reflections on John Holt's How Children Learn (Book)

In the introduction to his book, John Holt wrote that his book can be summed up in two words – Trust Children.  In other words, he’s saying leave the child on their own and s/he will learn on their own.  This is indeed a very simple yet difficult option before any caring and concerned parents.

Leave the child alone to learn? Most parents would ask that sarcastically, but what most parents never asked was how a child learn their language, or to differentiate they variety of dogs (in term of colours, size, breeds, etc.) from one category of just ‘dogs’ to a category of ‘different coloured dogs’, to a category based on the size of dogs, and category of breeds of dogs.  They all are dogs, but they are different, and the child still come to learn and categorize that all these animals of different size, different colours, different looks, and different shapes, no matter, they all belong to the category of dogs.  Whereas, something that is similar to a dog, like a cat, are not called a dog by the child.  We never taught the child how to read our face and facial expression, yet they know when we are angry or happy. The child learns to categorize all these animals on their own, they learn to read our faces, and if they can do all that complex and even abstract thing, all we need to do is trust them to learn on their own as well.

Leaving the child alone to learn is difficult for parents to do because to trust children, parents must trust themselves first, and most parents grew-up to believe that they are not trustworthy.  Since such perception, or lack of confidence become so ingrained in the parents, they are bound not to trust their children.  What parents need to do is break this long downward cycle of fear and distrust, and trust their children the way they were never trusted.

Children have this capacity to learn in the most natural and powerful way, and they know how to use their mind in a special way.  Their way of learning fits their condition, their capacity and physical abilities.  But parents, being concerned that their children are different, and not aware that they had been messed up, will try to school and teach them to use their way of thinking in such a manner that they will end up like their parents.  The child knows how to make sense of their world, but in school setting, we want them and try to teach them to make sense in a way that makes sense to the adult. When we try to teach our children to think and make sense of the world the way we do, we are interfering with their natural way of making sense, and this make the child believes that they are not worthy, making them scared and discouraged.

A school should not change the way the child make sense of the world, but instead, the child should be encouraged to utilize the environment provided in the school to use and enhance their natural abilities to make sense of the world in a much more effective way.

For a Special Friend

---for a special friend (you know who you are ;)

I surely can’t remember when it all started,
But surely now I’m shattered!
Surely it must be my birthday,
the day you started saying to me, hey!

But it doesn't really matter anyway,
For I’ll never forget that special day
But I’d rather remember you forever,
For all that you bring, mostly laughter
‘coz I can always be my silly self
When you are always there to help
And around you I can always be weird and crazy
‘coz you are weirder and crazier than me
And together we can always make the world go hazy!

Oh it doesn't matter by the way,
For I’ll never forget them anyway,
But I’d rather remember you,
for all the silly things that we did,
Like the endless phone-call talking nonsense?
Making silly plan which we thankfully never carried out,
And the stupid plan that are all sell-out?
Those were the greatest day!

Oh that doesn't really matter now,
For I’ll never forget them anyhow.
But I’d rather remember you
for that baritone voice of yours
That sent a ghostly chill down the spine
Like watching a horror movie,
And make a freak out of me!

But it seems everything matter now,
For I will never forget any of them now
And I would always remember
How you make the world so colourful
Even when its only black and white!
You are the best friend one could ever ask for
'Coz you are always there, always there!

And how can I forget you,
when it is so easy to fall in love with you,
for I never had to try, to pretend to be someone,
for I never had to hide, when you know me better than me!
And I hope that you know, when you lived in my heart
and know all that is in my heart, that you are the only one living in my heart!

THE TEACHERS’ PERSPECTIVE: FROM A THEORETICAL POINT OF VIEW

It might be wrong to make theoretical assumptions without a proper research, but we can definitely argue about the level of seriousness of the teachers regarding the in-service teachers’ training.  And I think we can safely argue that at least half of the teachers are not serious about the training; and I think, we all can make certain valid assumptions on why the teachers are not serious.  A few arguments could be made that (a) the teachers had attended such training for so many times without any visible or observable benefits, (b) the frequency of the training made them took it for granted, (c) based on their previous experience, they have no or very less expectation from the current training, etc. 

There are two concepts from psychology that can help explain the above behaviours/perception of the teachers, and understanding those concepts will also help us in understanding what we can do. The two concepts are (i) self-efficacy (Bandura, 1977, 2004) and (ii) learned helplessness (Peterson & Seligman, 1993; Fogle,1978).

Psychologist Albert Bandura has defined self-efficacy as one's belief in one's ability to succeed in specific situations. One's sense of self-efficacy can play a major role in how one approaches goals, tasks, and challenges. So, how do our teachers see themselves, their performance and effectiveness, and the challenges they faced every day in the form of their students whose learning need to be facilitated in such a way that we can fulfil the aims of our education?  The aims of education is not only about moving from one grade to another, and then find a job.  Education has a much broader objectives such as those value laden qualitative concept like justice, liberty, equality, democracy, good citizenship, etc. which are practically impossible to be achieved.  Unless one understand that we are not going to achieve those goals overnight, and we can only work towards the achievement of such aims, one is bound to doubt our capabilities in the process.  Besides, the teachers’ effectiveness is measured through observable results inside the class-room, and if the students are not learning or progressing as expected, the teachers are going to doubt their own ability to help the students learn.   

The other concept, Martin Seligman's concept of Learned Helplessness says that people who had tried and failed many times before have an attitude of hopelessness and passivity towards everything, including their jobs, based on their past experience. Such people will fail to respond even when there are opportunities available to them to improve.  Such people have seen and experienced many things, and their attitude is based on their personal experience.  Many teachers started out their teaching careers with high hopes and many interesting teaching methods and/or passion.  They started with much enthusiasm and inspiration, trying to improve our education system.  But in the first few years of their careers, they have seen and experienced an inflexible and unresponsive system, an unappreciative colleague and seniors, etc. and as such, they gradually lost their enthusiasm and inspiration, and become a part of the system that they wanted to change so much.  They tired and made many attempts and efforts to change or help the system, but their efforts were not appreciated or not even acknowledge, and thus ultimately they are forced to give up. Their passivity is learned and thus real, and you have to ‘move a mountain’ to earn their trust and be able to inspire them again.

In both the situation mentioned above, the solutions psychologists gave are very simple, though it is difficult to achieve.  People who have self-efficacy issue must be made to realize that self-belief and self-confidence come from our understanding of our own capabilities and capacities.  Teachers need to be encouraged and motivated from time to time, not just financially, but also verbally; and ISTT is one good opportunity for us to encourage and motivate the teachers, and take full advantage of the opportunity. 

Regarding those teachers with an issue of ‘learned helplessness’ must be assured that they have our full support in their desire to provide quality education, and bring change.  The only thing we can do for them to put their belief back in what they have already given up is to build trust and let them see our seriousness and commitment towards our goals.

And one precautionary note is that, we should try to avoid directly criticizing and belittling the work being done by the teachers during the training, doing so will serve none of us any good.

Lamka: In Search of a Hero

(Please read through the article before you pass your judgement!)

When a slut and a street punk (pardon the language) were made a hero and a rallying point for different and warring tribes to come together, it said something, something big, isn’t it? It said something about the need of an inspiring leadership behind whom we can rally; it said something about our feeling of solidarity/brotherhood among the tribes despite our petty differences; but more than anything, it said something about the system (government), isn’t it?

Consider the following situation: 

Case 1: An ‘Eimi’ girl had an outdoor sex with a ‘meitei’ and you saw them.  What will you think of the girl? The patriot in you might call her a ‘slut’ or wonder if she’s a prostitute, and the civilized you will obviously say ‘it’s none of your business’!  So, what are the chances of the girl becoming a hero?

Case 2: A young man with a punk hair-cut went to the police-station for a case which he had no connection with, and dare to challenge the police, vandalized public properties and disturb the peace there.  What will you call him, a real punk? So, what are the chances of the boy becoming a hero?

Now consider a situation again:

Case 1: A ‘Sister’ (who would otherwise have been dismissed as a slut for hanging out with some ‘outsider’ if she had not been captured and the video circulated and earn everyone’s sympathies) took up the courage despite her humiliation and shame to challenge her torturer through a system which we know was not functional.  

Case 2: A ‘brother’ (who would otherwise have been scoffed at inside our churches for dressing like a street punk) took the opportunity to express his feelings in an impromptu protest for a ‘sister’ he never met, and got killed in the process.  

And put this two together, and we got Heroes!  

[No, this is not how heroes are usually made!  I don’t want our kids to have the wrong idea and run towards khuga dam to become heroes. To me, heroes are all those women sitting in New Bazaar selling vegetables to run their families; heroes are all those fathers who pulled their rick-shaw all day long to feed their family. And for Manipur, let’s just define heroes as those government employees who do the work they are paid to do!  That’s a good enough definition of a hero for Manipur.]

Now, let’s get back to our subject. 

Regarding our sister, she might be a slut or even a prostitute, who cares?  But the fact that she dared to use the system to challenge the system itself is of hero stuff.  It sounds crazy to use a government system that we all know very well doesn't work at all to get justice which she thinks she deserved.  The simple fact that she dared to challenge and stand up for a justice, no matter how crazy that sounds, is enough reason to be a hero in my eye!

Regarding our brother, I wonder what made him stand in the way of the straying bullet? Was he there by accident or just a curious observer of the situation unfolding at the police station? Was he a miscreant out looking for a cheap thrill or a passionate sympathizer of our sister? His intention, that, I don’t know. But one thing I know is that he dared to raise his voice and use his voice by being there to express himself, and that is enough to make him a hero.  (His death is unfortunate, but you don’t need to get yourself killed to be a hero, just saying!)

One thing that connects these two heroes is a system that doesn’t work. The girl used the system to get justice despite the fact that she know the system doesn’t work, and the boy know that the system doesn’t work so he was there to ensure that the system worked so that the girl will get the justice she deserved. 

If the system has worked, and people trusted the system, the IRB people would have been more civilized and not torture a sister, or if he had got his salary regularly, he might not need to make a side-income. If the system had worked and the girl have faith in the system, she would have immediately protested and demanded justice, and she might not need a social worker to demand justice. If the system had worked, everyone will trust the system and the boy will not need to ensure that it worked.

Also, if we had effective leadership, the common man might not have to ensure the working of the system.  If our tribes have not fought each other over petty issues, the system might show us some respect and function. But that’s not the case now.

We definitely don’t want a street punk who vandalized public property, or a slut who have sex in public to be our heroes.  But we need those two.  We need those two to invoke/provoke the sleeping masses who gave up on the system to come out of their comfort zone and demand the system to function. We need those two so that we can cry wolf, that the system is not functioning, and that justice is not rendered, and that someone might actually hear our cries.   We do need those two heroes….but a heroes with less public sexual history and less rebellious deeds would have been nice!

Random Musing: About Behaviourism and Constructivism

Behaviourist' view of learning (Pavlov, Watson, etc) believed that behaviour can be conditioned, reinforced, etc. which put the teacher in a demi-god position. Also, social learning theorist like Bandura believed that children modelled their behaviour from their social environment.  This put the teacher and any other people in the environment of the child to be a role-model for the child which put the role of the teacher more critical.

But, we now know better through Vygotsky, Chomsky, Piaget, that learning is not one-sided and the child is the centre of learning and that the teacher is not a demi-god or a role-model.

One thing we now know for certain is that the child constructs to learn and not just acquire, model or get reinforced as believed earlier.  However, it gets very complex when we look at the various factors involved in the process of construction of knowledge.

Construction of knowledge, as we know is a process, and that process begins with perception.  The child, in the process of constructing his/her learning, utilizes

his/her innate abilities as can be seen in language acquisition

• Reinforcement of cultural norms and values
• Conditioning of certain practice through social institutions
• Modelling of his or her behaviour through certain role model
• Construction through previous knowledge

Behaviourism, per se, is not a bad theory, nor is it irrelevant.  It is just that it is too limited to explain the learning behaviours.

Personally, my stand-point is that constructivism and behaviourism go hand in hand, especially in the context of India.  For example, cultural norms and values got shoved down our throat –if we want it or not, in various forms and at the end, we have to conform.  This is, in brief, reinforcement and condition at work!  On the other hand, the simple fact that children came to the same, unchanged class-room without getting bored and still find excitement and continue to discover new things to learn is proof that individual constructivism is very much at work!

   

Why Progressive School Works....

Our present education system, with all its drawbacks and imperfections, has survived the world wars, drought, famine, disaster, etc. and it will survive in the future as well.  It is resilient, it is easy to start a new one, and it is easy to organize and manage. Still, that doesn’t mean it’s the best.

Whatever progressive education system that are propounded, be it Gandhi’s Nai Talim, Totto Chan’s Tomoe Gakeun, or AS Neill’s Summer Hill schools, they all are context based, and exist within its context only.

For instance, the Summer Hill School has been around for almost a century now, but if it had been a good, practical, economical and sustainable education system, the schools all over the world must have followed its model by now. Instead the Summer Hill School is confined to its original state in rural England surviving because of its prominent supporter.

And Totto Chan’s Tomoe Gakeun was, pardon my language, only for the misfits who failed to fit into the ‘so-called conventional’ educational system.  Of course, I’m saying too much by saying that, but can you imagine having about 1000 Tomoe Gakuen in present day’s Tokyo which is over populated with shortage of space?

And Gandhi’s labour based Nai Talim is for the rural village only, and it failed to survive a simple test of young India’s industrial economy of those days which was a much lesser version of our present day capitalism.  The major problem with Gandhi’s New Education system is not it’s requirement of labour as a base of learning, but because it called for a new and revolutionized society which as we know, is unimaginable.

I'm not insinuating that our present education system is good and the progressive schools are bad or impractical. It is just that the kind of progressive schools we have seen so far are context based, confined to specific area, and were either usually led, not by the system, but by few good people who were fully dedicated to what they do. 

Every now and then, we saw some very excellent Government School, and if you have taken a deeper look at why the school work, most probably you're going to find some dedicated and passionate people responsible for it.  We need that kind of passion among the stake-holders of our education system.

The Progressive schools are progressive because of its founders or proponents' dedication and passion. Like everything else, we need passion, we need dedication, and we need commitment to put meaning to education, and to make something of our education, and to make our education works!  

Terminology I don't like: First Generation Learner

First generation learner???  Seriously, those people never learn before??? Don’t you ever wonder how the child came into being? Out of thin air, or are you saying that the child was born out of some virgin maiden?

The simple fact that the child, who you called a ‘first generation learner’ existed means the parents learned how to make a child, and they also learned how to nurture the child, and obviously, how to survive.  And since we all do whatever we do to survive, it means the parents had achieved something great.  It also means they learned a lot, and that the child is not a first generation learner, but a first generation school goer.

There is a big difference between learning and going to school.  You can learn, live and thrive without going to school, and going to school doesn't necessarily guarantee that you will learn, live and thrive!

So please stop using the term ‘first-generation learner'!  It’s not fair, and it’s against every possible human rights!

The Integration of Work and Education

I had earlier reviewed Marjorie Sykes’s The Story of Nai Talim about Gandhi's idea of education which I dismissed with one word: “romantic”!  I said the idea was romantic because the education system started by Gandhi’s failed to survive the economy of post-independent India which is an infant version of our current overtly commercialized capitalism.  Besides, I thought of the possibility of having such a school in the city and considering the kind of space it required, I thought it was practically impossible. 

Now looking back on my argument, I was too focused on the infrastructure aspect and not on the ideology of education.  If we take a good look, there is an integration of work and education at all level, and it cannot be separated.  The only thing absent is that raising the consciousness that the thing that we do everyday involved as many knowledge as available to use, the only thing is we are not aware of the knowledge we use, and we don’t know how to categorize them.

For example, a farmer integrated many knowledge in his day life.  He knows about the season, the rains, the pattern of cloud, how crops grows, what crops will be good in the type of soil, how to tilt his land and what to do with pest.  In other words, he knows botany, holti-culture, geography, language, applied science, etc. 

What we can do about the integration of work and education in our school is that, we don’t need a field where they can grow crops, or rear cattle, all we need is a room where we can store all sorts of things and give the freedom to children to do whatever they want to do with it.  For e.g. in the book “To the principal with love”, the author mentioned that we can collect old and used cycles and cycles part and store them in one room, children should be free to bring their own cycle and repair it, or build a new one from the parts that are available.  They should be allowed to tinkle with it, play with it.  We can do the same for computer parts for those of our children who want to be a computer/ hardware engineer, old (but clean) clothes for those of our children who want to be a designer.

What is Worth Teaching?

In ancient India and Greece, teachers were revered as a guru or a master, and most importantly, they were fully empowered.  The teacher decided, based on his understanding of the student, what to be taught, when and how or what not to be taught, withheld, or even refused. But the situation was different in those days.  Education was only for a select few –mostly children from the noble family and the rich got education, and the aim of education was basically for moral development and the pursuit of pure knowledge.

Along the way, two major changes occurred. Firstly, education was opened to the general public, and secondly, the government took over the responsibilities of educating the public. These two factors are critical and become indispensable when considering the future of education.

When education is opened to all, we need to set aims and objectives so that we know what kind of future we create for our students, we need to plan and develop appropriate mechanism for teaching and imparting those knowledge we selected as worth teaching, and most importantly, we needed to decide how best to teach an entire population, and that too, at the least minimum budget level. But the major question is: who are the ‘we’?  

The entrance of the government in education system can be viewed from two aspect; the government is possibly the only institution capable of educating the whole masses in term of reach (every corner of the country), financial power, and Authority (respect demanded) to provide education. On the other hand, the government is made up of people who are not necessarily qualified, with their own ideological beliefs and objectives that influence their world views. Now what, if the government want the education system to reflects its ideological beliefs? And, what kind of society does the government want to constitute through its education system?

‘What is worth teaching?’ may sounds like a fairly simple question, but it hides many complexities.  Education is a crucial social good, a definite avenue for developing individuals and society, and thus the world.  And as such, it is crucial that decisions related to education must somehow be determined by larger social will, factoring in social, economic and cultural concerns.  

To factor in the social will, there is no better representative than the government.  But can we trust the government to decide what is being taught at our school? We can try trusting the government and take comfort in the assumption that the government chooses the most sensible and qualified of people who are charged with the job of selecting and deciding what is to be taught, and hope that they do what they are supposed to do, and that they did a good job!

We must also assume that these sensible people selected by the government has no vested interest, and most importantly, we definitely must assume that the government has no vested interest of its own in the kind of knowledge that is being taught in school. 

The Preamble in the constitution of India has clearly spelled-out what it plan to achieve, that aims, is also the aims that we plan to achieve through education.  It means, the deliberations or decisions regarding what are being taught at our school are not deliberate, but methodical and selective, and validly drawn from the accumulated body of knowledge that humanity has with us.

As teachers, teacher educators or anyone connected with education we rarely get to reflect or understand our work in schools and classrooms within the context of the bigger historical, socio-political setting of the country. It never seems to be part of the training and induction process for the Indian teachers, or educators.

What is worth teaching in school, what is worth learning for our children, and what sort of activities must be considered as worthy, etc. are a crucial issue for any educational system and institution.  These questions has been asked for ages now, and it will continue to be asked, which is a positive sign, because if we ever stop asking these questions, we will never know what kind of future we are creating through what we taught to our children, and thus, the future of our world.

[This is an extract from my review of Krishna Kumar's Book "What is Worth Teaching?"]

ROLE OF SOCIAL WORK IN CANCER PREVENTION AND CANCER CARE

 

Cancer is, to a large extent, avoidable. Many types of cancers are preventable. Others can be detected early in their development, treated and cured. Even with late stage cancer, the pain can be reduced, the progression of the cancer slowed, and patients and their families helped to cope.

The profession of social work has great strength in tools and techniques especially in the areas of community mobilization and in providing psychosocial support that the medical profession doesn’t have. Some other example of the strength of social work will include social action and mass mobilization; understanding of community’s dynamics and eliciting community participation; social welfare linkage and management; counselling, group work and community work for educational purpose and psycho-social support, etc. The tools of social action especially mass motivation, mobilization and participation of the community will be very effective at the preventive level of cancer.

In the Curative level, social work can provide supportive roles to the doctors and patients by providing psychosocial and emotional support which is today, widely accepted as a critical component of medical treatment. It can provide motivational, educational and therapeutic counselling to the cancer patients; it can links patients with necessary resources like funding and treatment aids from the governmental sector as well as non-governmental sectors, etc.

At the rehabilitation level, there is even a greater role for social work by taking care of the palliative unit. At the palliative level, taking care of the psycho-emotional needs is critical not just for the cancer patients but also for their families for any eventualities.

The Government of India under its National Cancer Control Programmes (NCCP) followed four principal approaches in controlling cancer in India. This paper will also follow that approach in exploring the possible roles of the profession of Social Work in Cancer Care and Prevention, with one more heading added, i.e. Policy level.  

1. Prevention
2. Early Detection
3. Diagnosis and Treatment
4. Palliative Care
5. Policy Level

1. PREVENTIVE LEVEL

Prevention should be the key element in any disease control programme. Prevention means eliminating or minimizing exposure to the causes of cancer, and includes reducing individual susceptibility to the effect of such causes. This approach offers the greatest public health potential and the most cost effective long-term method of cancer control.

Cancer prevention at the individual and community level, social worker can take a leading role by ensuring community participation in taking preventive actions, awareness generation at all level from school, neighbourhood, to community.

• The most useful prevention strategy is reduction in tobacco consumption (all forms). Currently about 50% of cancers in men and 20% of cancers in women are related to tobacco use. Social workers can take a leading role in spreading the health implication of tobacco, helping people deal with tobacco addiction, and rehabilitation of tobacco farmers and those whose livelihoods depended on tobacco in one form or the other by helping and generating alternative source of livelihood;
• The social workers can ensure in involving all levels of the population in the educational process regarding cancer. The contents of cancer education should focus on, tobacco control, physical activity and avoidance of obesity, healthy dietary practices, reducing occupational and environmental occupational exposures, reducing alcohol use, immunization against hepatitis B virus, safe sexual practices to avoid human papilloma virus infection.
• Campaigning for a healthy lifestyle, which includes eating plenty of fruits and vegetables, avoidance of alcohol and adequate physical activity, is protective for many of the non-communicable diseases including cardiovascular disease and diabetes, and can be considered as part of the overall health promotion programmes.
• Cancers related to infectious agents such as human papillomavirus and hepatitis B virus can be prevented through vaccination strategies, and social workers can take a leading role in mobilizing the communities.

For the above mentioned prevention measures at the community level, a variety of methods can be employed to educated the community:

• Among School and University student: Conducting drawing and essay competitions, debates, discussions, seminars and street play competitions, etc.
• Among Community organization, Municipal, District and State Health Administration: Organizing Participatory workshops and training sessions.
• In the Mass Media: Participatory programmes on radio and television, descriptive articles in newspapers and magazines,
• Among the General population: Conducting exhibitions and public lectures, conducting street level awareness drive, focus group discussion with community members, health camp, etc.

2. EARLY DETECTION OF CANCER

Early detection of cancer is critical in combating cancer mortality rate. In India, almost 60 – 70 % of cancer patients are detected at advanced stage which reduced the chances of recovery and raise the cancer mortality rate. 

Cancer Screening is the application of a relatively simple and inexpensive test to asymptomatic subjects to classify them as being likely or unlikely to have cancer. A screening test in itself will not prevent cancer; it needs to be followed up through a systematic medical approach. Still, this is a relative simple measure for early detection of cancer that can be undertaken even by those who have no advance training in medicine but are familiar with medical processes like medical and health social workers with minimal training about the screening process.

• Opportunistic screening or case finding can be done by the Medical Social Welfare Unit in selected pockets of community based on the populations’ likelihood of getting cancer (this can be determined by many criteria like life-style, community living in industrial areas, or in a waste disposal or waste treatment areas, community whose livelihood are related to radiation or tobacco industry, etc.). This will help not only in early detection but also in increasing the awareness level of the community.
• Clinical breast examination can be made feasible for women above the age of 40 years, which can be carried out by general practitioners besides community mobilizers like Social Workers. Also there are some simple breast self-examination techniques for women which social workers can teach to groups of women in the communities.
• Cancers in accessible parts of the body like the oral cavity may be detected at an early stage or even in a precancerous stage through simple inspection and examination; medically familiar personnel like medical social workers can be trained for this purpose.
• Self-examination of the oral cavity (MSE) and breast (BSE) can be useful methods and each can be propagated widely as a strategy through simple IEC (Informational, Educational Communication) materials, community meeting, focus group discussion, etc. for the early detection of cancer.

3. DIAGNOSIS AND TREATMENT LEVEL

In the Curative level, social work can provide supportive roles to the doctors by providing psychosocial and emotional support to the patients and their families which is considered as a critical component of medical treatment. It can provide motivational, educational and therapeutic counselling to the cancer patients; it can links patients with necessary resources like funding and treatment aids from the governmental sector as well as non-governmental sectors, etc.

At the diagnosis and treatment level, the roles and functions that a social worker can play in cancer care are:

• Motivation counselling to patients to seek medical help and enabling resources for the treatment and providing proper referral services
• Educational counselling to the cancer patients about their medical status, preparing them for future course of treatment and treatment process and the possible outcomes of the treatments.
• Therapeutic counselling to deal with the psychological stress and trauma that can have severe implication on their already weak physical body;
• If the patients and/or the family are in crisis because of the treatment, crisis intervention has to be undertaken
• Emotional support to the family of the cancer patients, and eliciting the involvement of the family in the treatment process
• Providing the cancer patients with various social welfare resources that will enable and enhance their access to better health care and treatment
• Linkage of cancer patients with governmental and non-governmental welfare resources
• Organizing therapeutic and/or peer support group for cancer patients
• Since cancer patients are under extensive emotional and psychological anxiety and stress, organizing recreational and entertainment for them is important
• A diagnosis of cancer and subsequent treatment can have a significant impact on self-concept, the way in which people perceive or react to themselves. Living with cancer may affect personal self-concept (facts about the self or a person’s self-opinion); social self-concept (perceptions of how one is regarded by others); and self-ideals (perceptions of oneself with respect to how one would like to be). Social worker can provide support and counselling for such patients.

4. PALLIATIVE CARE

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment, and treatment of pain and other problems – physical, psychosocial and spiritual. Palliative care is particularly important in less developed countries where a high proportion of cancer patients are diagnosed in advanced stages when treatment is no longer effective. These patients can be relieved from suffering with relatively low-cost interventions.

The various issues that crop up in palliative care especially in the terminal stages are:

• Physical issues towards the end of life incudes loss of function and curtailment of activity and physical effects to perform activities of daily living, including self-care activities, mobility, physical activities and role activities.
• Psychological issues towards the end of life include fear, distress, anxiety, anger, frustration, disappointment, depression, etc.
• Social issues towards the end of life include disruption social relationships as a result of impaired ability to pursue normal activities and maintenance of social contacts.
• Existential and spiritual issues towards the end of life include confrontation with mortality, the meaning of life, isolation and worth as a person. As patients reached terminal stages, spiritual issues gain importance as determinants of quality of life. Spiritual considerations may also assist the individual to endure present discomforts and, if need be, to face death with courage and dignity.
• Impact of towards-the-end-of-life issues on the family includes general depression, concern about old parents or young children, unclear role and power structures in the family, unclear source of income and means of livelihoods, etc.

The role of the social worker is to help the family and patient deal with the personal and social problems of illness and disability, as well as to provide support during the progression of the disease and the bereavement process if the patient is at the end of life.

• The social worker’s assessment helps define the patient’s and family’s needs from a psychosocial perspective, and helps anticipate problems within the family that may result from dysfunction and financial difficulties, particularly as the family begin planning for the future.
• Social work offer such interventions as referral to needed community services, emotional support (including individual counselling of patients and family members) and bereavement counselling.
• At this stage, social worker can help in finding help and assistance for the patients if there is no one to take care of them, find a nursing home or palliative care unit that can take-care of their personal needs, and helping the family of the patients on how to deal with this physical issues.
• The social worker can help the patients in coping and dealing with the issues of their medical condition, including the possibility of death, ensuring that their personal concern and worries are taken care of as much as possible, and if the need arises, finding spiritual guide and person to interact with the patients.
• The social worker can help the patients in staying in contact with family and friends and other loved ones, explain to the family how he is unable to maintain or reciprocate the relationships, etc.
• Conducting support group for the family, along with therapeutic counselling to cope with the situation.

5. POLICY LEVEL OF CANCER CARE

There are many ways that a social worker can get involved at the Macro level of cancer prevention and cancer care:

• Many types of cancers can be prevented to a large extent through a comprehensive tobacco control programme including education, legislation, and tobacco cessation services.
• Ensuring leadership that create clarity and unity of purpose, and to encourage team building, broad participation, ownership of the process, continuous learning and mutual recognition of efforts made in cancer care.
• Ensuring involvement of stakeholders of all cancer related sectors, and at all levels of the decision-making process, to enable active participation and commitment of key players for the benefit of cancer control programme.
• Creation of partnerships to enhance effectiveness through mutually beneficial relationships, and build upon trust and complementary capacities of partners from different disciplines and sectors.
• Responding to the needs of people at risk of developing cancer or already presenting with the disease, in order to meet their physical, psychosocial and spiritual needs across the full continuum of care.
• Ensuring decision-making based on evidence, social values and efficient and cost effective use of resources that benefit the target population in a sustainable and equitable way.
• Ensuring the application of a systemic approach by implementing a comprehensive programme for cancer with inter-related key components sharing the same goals and integrated with other related programmes and to the health system.
• Seeking continuous improvement, innovation and creativity to maximize performance and to address social and cultural diversity, as well as the needs and challenges presented by a changing environment.

Looking at the prevalent trends in the spread and magnitude of cancer and its non-discriminate penetration of every sections of the society, cancer is already a health concern that needs urgent attention from all sections including policy-makers across the world. According to the World Health Organization, death from cancer and other life-style diseases in the developing world including India is expected to increase 104% worldwide by the year 2020. In India, the total cancer cases alone are likely to go up from 979,786 cases in the year 2010 to 1,148,757 cases in the year 2020.

The profession of Social work, especially medical and health social work must take this opportunity in order to survive and thrive in this fluctuating and complex environment in which it is reduced to a supporting role. Social workers must either accept this challenge to change and re-evaluate the services provided and expand their horizon of works or lose the opportunity to be players in the field of cancer prevention and cancer care.

[This is an extract from my Research Paper titled: Exploring the Role of Social Work in Cancer Care and Cancer Prevention submitted to the Dept. of Social Work, Jamia Millia Islamia (New Delhi) and conducted in BRAIRCH of All India Institute of Medical Science (New Delhi) between September 2011 – March 2012 ]

Indian Education System: A Critique

A quick and random critique of the Indian Education System!!!

Structure: Indian education system, just like the executive system is hierarchical in nature. The basic characteristic of education system in India goes in this order: Union Cabinet Level, State Cabinet Level, State Ministerial Level, Secretariat Level, Directorate level, District Level, Block Level, with each level having their’ own sub-level.

SSA emphasized on bottom-up planning using habitation as the base of planning and encourages PRIs and Community to take ownership of school and the educational process -but what is ignored is that the structure of Indian education system is hierarchical and that executive system is never decentralized.  

This has two implication, both innovations and critical voices from the community that can meaningfully feed into existing approaches, programmes, and plans are IGNORED IN BLUEPRINT because the implementation aspect is, and has always been, top-down. Secondly, decision making is delayed as it has to go through many decentralized levels. Simple example is, the community can plan the expansion of school, but without approval from the TOP, it will never be implemented!

Decentralization and Convergence: How exactly is decentralization carried out in India?

The RTE and SSA included decentralized system as in integral part of achieving it goals, emphasizing the role of the PRIs, VECs, SMCs, etc. but as mention earlier, the hierarchical nature of the structure mean that no matter what, the voice of the Central Ministry will always over-power the State Ministry’s, and the State ministry will always have a bigger say that the District level functionaries.  And most often, it is the small functionaries within the structures that do all the works, and with the addition of new programmes, the works of the functionaries increased.  

Besides, the hierarchical nature also makes consultative process very cumbersome, often resulting in ignoring of certain level, and also in delay. Finally, the PRIs got certain responsibility related to the monitoring of the schools in the name of decentralization, but it doesn't got the executive power to take actions, e.g. in dismissing or transferring a teacher who frequently misses school. 

Role Confusion under hierarchy: Who is supposed to do what, and what is being supposed to be done by whom? 

As per SSA requirement, certain aspect of the Education system has been decentralized forming a new structure like the SPO, DPO, BRC/CRC, etc. to realize specific programme objectives however the roles and functions, on certain aspect are not defined. For example, the BRC/CRC has done, and is most appropriate for administrative work rather than academic mentoring as required by the SSA, and regarding the confusing aspect, there are multiple reporting structures like the Block Resource Person is required to report to the Deputy Director of Public Instruction (DDPI)-Administration, the DIET Principal, The Deputy Project Coordinator of SSA, and the Block Education Officer for different aspects of his work.  This resulted in failure to fulfill academic/mentoring responsibilities as they are mostly engaged in administrative responsibilities.

Personnel Policies: Transfer of teachers, allocation of teachers, etc. Who decides and how to decide on which teacher serves on which school?

The absence of proper personnel policies regarding posting and transfer, and the politicization of existing norms like using political forces to put pressure for transfer or to get a posting in a better location, etc. demands for the creation of a statutory committees to authorize and administer such process, besides the committees can also create a public database to monitor transfers after taking into account the kind of teachers the community wanted, and the kind of community the teachers wanted to work in.  

There are also certain specifics requirement under the SSA about the kind of teacher to be posted in certain school, community and area like a tribal teacher who speak the local tribal language, etc, as such having a database monitoring system will make the whole thing, if not smoother, but also much more transparent.

Strengthening Academic Cadre: How academic actually is the structure and personnel policy of our educational institutions?

Firstly, there is a continuous tendency to move into administrative positions from academic positions based on the assumed greater power/authority associated with administrative posts. Secondly, within the education system itself, two people who are in the same grade level, one who is in teaching and the other in administrative have different level of work load with the teacher getting a raw deal –a teaching that demand lots of time and work. Thirdly, Personnel recruited or deputed to SCERT/DIET are not always from academic or teaching background so they have no real experience and understanding of the teaching profession or academic requirements to be able to fully comprehend the sensitivity and intricacies involved in their work like curriculum, module development, assessment methods, etc.

Appraisal Policies of Personnel: When a head teacher got a promotion, what did he become? Or, how and from where should the SCERT and DIET and other educational institutions must recruit new employee?

Since seniority is the mainstay of career progress in the department, there is little opportunity for recognition of performance or individual contributions which result in lace of initiative and innovation. Confidential reports need to be done in consultative process. And the statutory committee proposed above for monitoring personnel policies like transfers and postings, must also do appraisal and reviews based on the confidential reports to make decisions on career advancement.