OUR STUDENTS AND OUR EDUCATION, BOTH NEED TO CHANGE

 

The Annual Status of Education Report (ASER) 2024, released in early 2025, showed learning recovery in states like Uttar Pradesh and Bihar, a decline in government school enrolment from pandemic highs, and increased smartphone ownership among rural children. While learning outcomes are improving, a significant portion of children still face challenges with foundational literacy and numeracy, and a majority of teenagers use smartphones primarily for social media rather than education. 

 

Now here lies the problem - education is all that remains after we have forgotten every bookish lesson taught in schools. But, when chalk was replaced by click, and distant education was formalised as the new normal, if student found stupid social media reels more interesting than the teaching material, the purpose of laptop and smartphone got defeated. Instead of a teaching aid it became a distraction. 

 

So, when we come across students who are oblivious of the world around them and things which we club under 'general knowledge' like names of capitals of states and countries, important people and events from history, names of chief ministers, prime minister and president, are not on their finger tips, then you know there is a problem. What is their logic - why remember when you can Google? But is this education on Google crutches truly enough?

 

There is an entire generation of graduates and would be graduates who have stopped thinking. Consequently, they are unable to understand, analyse and communicate. The malady started with the calculator, which made multiplication tables redundant. The smartphone has now made the book redundant and today the source of knowledge is in the unfiltered Internet. The attention span of our students is less than that of a goldfish, and so reading a book is simply not in fashion anymore. The AI is only going to make it worse and take away the minimum originality that remains with individual students. Chetan Bhagat very poignantly says 'if some students drink at the fountains of knowledge, most are just doing gargle.'

 

Education is an instrument by which we align our tomorrows with our yesterdays and todays. This is a giant experiment in time - we use the present to distil the wisdom of the past, so as to prepare ourselves for the future. As the future changes rapidly it produces enormous strain on our education pattern as it has to change with changing times. Yet, education remains the most sluggish moving sector in our country, crippled on either sides - afraid to take newer steps to the future and forgetting to reap benefits from the past. Knowledge today is not just coming from books and teachers but from various other sources - Internet, YouTube, social media and AI. It is today curiosity driven and no more institutional and agenda driven. The students needs to take the responsibility of enriching themselves in the best way, from the best source, in the best time, but are our students mature enough to understand this challenge?

 

Simply knowing facts about a subject and reproducing them successfully in an examination is no more enough. The subject needs thorough understanding and knowledge from other sources needs to be sifted through, perhaps with a mentor / teacher to become a master of the subject. Education today is expected to teach students how to learn better, think more critically and how to use knowledge more meaningfully, and not merely pass an examination. This pie chart made by Dr. Jenifer Summers sums it all up beautifully:

 

As if this was not enough the idea that education is a one time 15 years slog and what we learn during this period will serve us a lifetime, no more holds true today. Students have to constantly upskill and supplement their pool of knowledge to keep pace with the changing technology. Education is a lifelong process today. Knowledge moves quickly and obsolescence sets in fast. Education is freeing itself from purely utilitarian perspective, and is being embraced for its own sake, rather than only a means of landing a job.

 

We perhaps produce more students than food grains but employers will tell you that most of them are unemployable. Rote learning and mass copying have given them a degree but no skills, physical or mental. They all want to get quickly rich, but have no idea how! There is a frightening level of incompetence amongst these graduates, both urban and rural, and no amount of skill development programmes and industry internship will work, if their brain has outsourced the job of thinking to the internet and now AI.

 

Make no mistake, our top students who are qualifying from IITs, IIMs, AIIMSs are the best in the world, but they comprise a miniscule minority, and they are unfortunately our best exports which historically have worked to make America great! We are left with the students in the middle of the curve, and their overindulgence in meaningless social media has made them unintelligent and unemployable. 

 

Internet is not the only culprit. The father/mother and son/daughter interaction at home, across the dining table is replaced by dinner in front of the TV. When and how are parents doing the serious business of parenting? Why have the grandparents, if they are staying together, not reading stories from epics like Ramayana, Mahabharata and Panchatantra? When we were children we had an image of Ayodhya and Lanka, which we were made to imagine. The image of Abhimanyu inside the Chakravhieu or Ghatotkatch on the battlefield was not created by Sri B.R. Chopra for me but my grandmother. Why are these interactions suddenly out of fashion?

 

Without these interactions, a young mind is not introduced to our culture and to our civilization. That empty space gets filled by Cartoon Network, Disney and Nicklodean and the McDonald and Pizza Hut come as sponsors on their piggyback. This upbringing makes children intellectually stagnant and the seeds of under-achievement are sown right in childhood. There is no inspiration, no focus, and no desire to conquer the world, excel in life, and march towards a meaningful existence. This is a very serious lacuna that has crept into our future generation.

 

India will not become Vikasit Bharat with the improvement of its inanimate infrastructures like smart cities, smart roads and smart cars. We need smart people too, with ability to think critically, act decisively, and construct a better future for themselves and for our country. Education should lead and not follow the scientific advances. It should equip our students for the future and not keep them chained to the past. It must be the domain of outstanding creativity, outrageous ambitions and not merely a slave of habit. For Bharat to become vikasit tomorrow, her youth has to become vikasit today.

 

GREET WITH A KISS – CUSTOMS AROUND THE WORLD

 

Kissing as a greeting is not popular among Indians. We stick to our Namaskar or Namaste with folded hands and only amongst friends do we extend our hand out to shake someone's hand. A jhappi or embrace is for very intimate friends and Modi ji's gesture of greeting foreign dignitaries but a pappi is reserved only for children and lovers in romantic situations.

 

A greeting kiss however, was fairly popular on either side of the Atlantic. Its demise was falsely predicted during the coronavirus pandemic, but this cultural habit is too ingrained in Europe to be abandoned, so be prepared to proffer a cheek – but leave your lips for more adventurous occasions.

The cheek kiss is more art than science. For world travelers, a basic understanding of how it works is essential, for if you make the wrong move and you risk offending the other person. Unlike a simple handshake or hug, circumstances that warrant the cheek kiss differ by culture, and the logistics are equally as varied: In Spain, one kiss on each cheek is common; in some parts of Afghanistan, it’s customary to kiss up to eight times.

Cheek-kissing is common across much of Europe and has made inroads into places formerly keen only on handshakes, such as Britain and Germany. In those countries, however, a single kiss is the limit and, with its overtones of Frenchified culture, usually only practiced among the middle and upper classes. Who Europeans kiss, as well as when and how many times, can depend on many things: their family relationship, length of acquaintance, type of social occasion and level of formality.

Europeans don’t just kiss in greeting. A cheek kiss may also be congratulatory or respectful and is also often expected again on departure, even among people who’ve been chatting for only a few minutes. However, a few simple rules should help you navigate this cheeky culture. You shouldn’t kiss anyone on the first meeting, or in a business context. Kissing implies some level of familiarity, though often a second or third meeting is enough to qualify you on social occasions.

If you’re a man, you should always wait for a woman to initiate the kiss – offer a hand or nod instead. The norm is male-female and female-female kissing. Male-male kissing is less widespread, though common in southern Italy, southern France, Spain and some parts of the Balkans. Male-male kissing also has a ceremonial purpose – you might see European male presidents and monarchs kissing at summits – or is confined to men within the family, or old friends who haven’t met for a considerable time.

Don’t attempt a literal kiss by planting your lips on someone’s cheek. Lean forward and merely brush cheeks – especially if wearing lipstick – while making a faint kissing sound. Place your hands lightly on the other person’s arms or shoulders. Don’t be stiff or awkward. The Eskimo Kiss is an intimate greeting where people press their noses together, observed among the Inuit people in the Arctic regions.

 

The Origins

In his new book One Kiss or Two: In Search of the Perfect Greeting, career diplomat Andy Scott speculates on the origins of the cheek-kissing tradition: “In his Epistle to the Romans, St. Paul instructed followers to ‘salute one another with a holy kiss.’ And so the ‘holy kiss’ became a common greeting among early Christians and a central part of Catholic ceremony.”

Over time, it’s possible that the biblical lip-to-lip salutation evolved into a kiss on the cheek, which would explain why the kiss greeting is popular in many densely Catholic countries. While the practice is also commonplace in parts of the Middle East and Asia, it’s ubiquitous in Latin America and continental Europe

Scott traces the kiss back to a peasant custom that was adopted by elites once lower classes began migrating into cities, suggesting that travelers are more likely to encounter kiss greetings in rural towns and villages than their metropolitan counterparts.

 

Hand Kissing

This gesture is a sign of courtesy and respect, though it is now rare and primarily reserved for formal or traditional settings. In some parts of Hungary and Romania, greeting someone, particularly an elder or woman, involves a verbal greeting that implies a kiss on the hand. The verbal expression "I kiss your hand" is used, which is a sign of respect and blessing. This gesture is a sign of courtesy and respect, though it is now rare and primarily reserved for formal or traditional settings. 

 

How many kisses?

A single kiss on each cheek is common in southern European countries such as Spain, Italy, Greece and Romania, while in the Low Countries (Belgium, Netherlandsand Luxembourg, Benelux, lower than sea level), Switzerland and certain regions of the Balkans you should go for three on alternating cheeks. France is most famous for its cheek kissing, with the number of kisses varying between one and four depending on the region: three in Burgundy and an exasperating four in Normandy and the Loire Valley, for example. You won’t go wrong if you stick to two, the norm in Paris.

Which side to start on has yet to be codified by the European Union, but you’ll be OK most of the time if you start with the right cheek. A notable exception is Italy, where the left is favoured.  No need to stress. Most people overlook the faux pas of foreigners, and the worst that will happen is that you go in for the lean only to be rejected with an out-thrust hand.

When it comes to the number of kisses here’s the common count for a sampling of other countries:

• One Kiss: Colombia, Argentina, Chile, Peru, the Philippines. In Spain to, one kiss on each cheek is common
• Two Kisses: Spain, Italy, Greece, Germany, Hungary, Romania, Croatia, Bosnia, Brazil (though, like France, the number can differ by region), and some Middle Eastern countries (though not between opposite sexes)
• Three Kisses: Belgium, Slovenia, Macedonia, Montenegro, Serbia, the Netherlands, Switzerland, Egypt, and Russia (where it’s accompanied by a bear hug)
• The maximum: in some parts of Afghanistan, it’s customary to kiss up to eight times.

 

The Continental Variation

If I have to give you a continental diift of the kissing pattern, then you will find it truly mind boggling:

Europe:

• France: Known as faire la bise, the number of kisses varies regionally. Parisians typically exchange two kisses, but in other areas, it can be three or four. In most of the country, people start with the right cheek, but in the south and southeast, the custom is to start with the left.
• Netherlands and Belgium: Three alternating kisses on the cheeks, starting with the right, are common among family and friends. Men typically reserve this for women and shake hands with other men.
• Italy: In much of Italy, people give two kisses, but customs can vary. While men often kiss female relatives and friends, it is also common for men to kiss other men, especially relatives or close friends.
• Russia: The traditional greeting among friends and relatives is three kisses on alternating cheeks, often accompanied by a bear hug.
• Spain: The standard greeting is two kisses on alternating cheeks, starting with the right. The gender of the kisser often doesn't matter as long as they are family or very close friends.
• Greece: Two kisses are common among friends and family, with regional variations. In some areas, men kiss other men, while in others, it is uncommon.
• United Kingdom: Kissing on the cheek is less common than in continental Europe, but a single kiss on one cheek is sometimes shared between friends. Hugs and handshakes are more frequent.

• Hungary: Kissing a person's hand is a traditional verbal greeting for elders and in rural communities.
• Poland: Kissing a woman's hand was historically a common gesture of respect, though it is considered largely obsolete today.

• Romania: Men may kiss a woman's hand when first introduced

Latin America 

The custom of cheek kissing is widespread and warm throughout Latin America, but the specifics vary by country.

• Argentina and Uruguay: A single cheek kiss is the standard greeting for everyone, including men kissing men. It's often paired with a hug.
• Brazil: Two kisses are common, though this can vary by region. In São Paulo, one kiss may be the norm.
• Colombia, Chile, and Peru: A single kiss on the cheek is standard.
• Ecuador: Women generally greet with a single kiss on the right cheek.
• Mexico: One kiss on the cheek is common between women and between a man and a woman.

Africa and the Middle East

Kissing greetings are common in many parts of the Middle East and North Africa, with rules often defined by religious and cultural customs.

• Kuwait and Oman: The nose kiss is a customary greeting between men.
• Middle East: In general, cheek kissing is common between same-sex friends and relatives. Public kissing between unrelated men and women is often considered inappropriate.
• Lebanon: Close relatives often exchange three kisses—left, right, then left—as a greeting.
• South Africa: Cheek kisses are shared primarily between male and female friends, while handshakes are more formal.
• Iran: Cheek kissing between friends and family is common, but kissing between unrelated individuals of the opposite sex is considered inappropriate in public.

Asia and Oceania 

Physical contact as a greeting is less common in many parts of Asia, while Oceania has a mix of customs, including nose touching.

• The Philippines: The cheek-to-cheek press is a common greeting, particularly among friends and family. It's usually a single press to the right cheek.
• Indonesia: In certain communities, a double-cheek kiss is standard for relatives.
• New Zealand (Maori): The traditional greeting is the hongi, where two people press their noses and foreheads together. The gesture is not a kiss but is highly intimate, representing the sharing of breath.
• East and Southeast Asia: In cultures influenced by Buddhist or Hindu traditions, cheek kissing is often uncommon and can be considered offensive. Public displays of affection are generally discouraged in countries like Japan and Thailand, where bowing is more traditional.

 

How many names?

A kiss, by name, has its charming differences—it's el beso in Spain, beijnhos in Portugal, beijos in Brazil, and beso-beso in the Philippines—but the logistics are fairly straightforward. You start by leaning in and placing right cheek to right cheek, before moving to the left side—and back and forth thereafter if additional pecks are required. The primary exception is Italy, which starts il bacio on the left.

 

What does the rest of your body do?

Don't know what to do with the rest of your body? If you stand at a distance with your arms at your sides, you may come off as aloof or unfriendly. If you're greeting someone you know well, a hug is acceptable. (There's only confusion when you go in for a hug without the kiss, while your partner puckers, and the misread leads to your faces mistakenly mashed together.) But for less familiar relations, you’re best served by gently placing your hands on the other person’s shoulders.

 

Kissing greetings generally signify warmth, familiarity, and affection, though the context and custom surrounding them differ. The number of kisses, the direction of the first kiss, and the gender of those who participate all vary by region and culture. When in doubt follow the lead. It's best to extend a hand first and see what the local does, or follow their lead to avoid awkwardness or offense. 

PLANNING FOR RETIREMENT IS CRUCIAL

 

We professionals, who are self employed in some way or the other, are so busy planning the next strategy to succeed, that we often do not even think of retiring. This is not work, this is our purpose of living, we say, and we keep on toiling passionately. I have to admit that this passion is the best anti-aging medicine ever invented and so to us retirement is an alien word.

But not all senior people are working because they love to do so. They are concerned about the cost of living, which is going up exponentially, and the social security, which is conspicuous by its total absence. An honest taxpayer, who has contributed to the government coffers all his/her life, is not assured of any healthcare benefits and societal support when he/she needs them most in their senior years. Retirement, for them, is a serious decision, which they keep on postponing as long as they can.

Every time someone starts thinking about retirement, the very first instinct is panic – more specifically, money panic. It’s so uncomfortable that many people avoid the topic altogether, but how can that be helpful? They all have the same question in their mind: “How much money do I need in super before I can pull the plug on work?” I think it’s a fun number to contemplate. It’s also the wrong first question.

 

Your purpose in retirement doesn’t need to be grand. It just needs to be yours. Most middle class Indians, the salaried class jump straight into talking about retirement benefit funds, pension schemes, assets, and pull out spreadsheets, online calculators and doomsday scenarios, and then delay retiring while they wait for the “perfect” lump-sum number. Others avoid the conversation altogether. In the process, many end up chasing someone else’s idea of what a good retirement should look like, only to discover they’ve waited too long and are suddenly forced out by a round of retrenchments, a health issue or caring responsibilities.

 

But the starting point for a good retirement isn’t about the numbers. It’s personal. It’s about understanding where you are in life and setting a vision for the years you have ahead. Ideally one you can afford, but also one that genuinely reflects how you want to live and what you want to do with your time, health and best years. Ultimately, it walks you through five steps:

Thinking about your goals

Before you even glance at your pension fund and fixed deposits, ask yourself a few prickly questions. What do you want your mornings to feel like? Where will you be living? Who do you want to spend your time with? Are you planning to work part-time, or walk away from paid work completely? Do you want to travel – and if so, where and how often? Will you be doing some voluntary service in a project you are passionate about? Will you study or train for something new?

Then go one layer deeper: what does a genuinely great week look like for you? Not an idealised Facebook and Instagram version of retirement, your real expectations of life. The rhythm of your days matters more than you think once the structure of a hierarchical career stops.

These aren’t fluffy lifestyle questions. They’re the foundation of your goal setting, and this comes before the budgeting process. You simply can’t work out what your future will cost until you know what you want your future to be. And even the smartest financial adviser can’t set those goals for you. Only you can do that part.

Exploring how much is enough

Once you’ve mapped out the life you want, then you can start working out what it might cost. And this is where people often discover something surprising: their number is usually far more achievable than they feared.

The amount you need in retirement isn’t a single magic figure. It depends on four things:

1. the lifestyle you’ve just described
2. the income you actually need each year
3. how much comes from your remaining income sourses – pension, interests on fixed deposits and debentures, rentals etc.
4. your health, longevity expectations and family responsibilities.

Most seniors will draw their retirement income from a combination of pension, part-time work, investments, and savings. That means the big lump-sum question matters far less than people think. Health support from the government like Aayushman Bharat, Jan Aushadhi Kendra are also making retirement more affordable.

So the real question isn’t “What lump sum do I need?” It’s whether you understand how the systems of retirement work, how the layers of income you could have interact, and how to put them to work for you. True, government policies will change over time, but the fact that we will only go stronger economically as a nation is no more a subject of debate. So, for seniors, tomorrow is certainly rosier than yesterday.

Run the numbers – then get some help

If you’ve never run your own “retirement income” calculation before, this is the moment to start. You can do it yourself by listing your assets and liabilities or you can take the help of your chartered accountant or even a wealth manager for a small fee. I have in the past, written a blog on wealth management and you can read it by clicking: https://surajitbrainwaves.blogspot.com/2024/11/wealth-management-and-inheritance.html

Your pension fund can give you a projection either through their app or their guidance team. You can plug some numbers into a simple calculator. And then take a breath and think about what kind of advice you might need. If your needs are simple, this level of guidance might be enough. If they’re more complex, you may need comprehensive advice. Your mutual funds need a revisit, and if they are predominantly equity in nature, that type of risk is not good for your senior years and you have to change them to ‘balance funds’, which invest more in debt instead of all our equities. An overhaul your entire investment strategy at this juncture is mandatory.

 

Set up your retirement account and your drawdown

Once you’ve worked out roughly how much income you’ll need, the next piece of the puzzle is understanding how to turn your scattered funds into a regular income stream. You may not be withdrawing dividends but reinvesting them so far, because you had a regular income source, and you didn’t need the money. Now you do. So this is the time to change your mutual funds to devidend payout modality – yearly, half yearly or quarterly. Similarly, banks can be instructed to renew only the principal amount of your fixed deposits and pay out your interest to your savings account. The idea is to shift your deposits from the accumulation phase into the retirement, or “pension,” phase, where the goal becomes getting a steady, tax-free income while managing risk a little more carefully. The fact that seniors still have to pay tax on the interest their FDs earn is a prickly issue, which needs government’s attention.

This is the moment where planning becomes reality. Drawing a regular sum of money from your thus modified savings is a long-term strategy that influences every part of your retirement. You need to think about how much to withdraw, how often, and how you’ll invest the remaining balance so it continues to grow and support you for decades and all the things you can (or can’t) do with your money.

Spend too quickly, and you risk running down your balance earlier than expected. Spend too slowly, and you risk looking at a pile of money with regrets in your old age. A good retirement investment and drawdown strategy strikes a balance between having confidence and being cautious. It assumes you want your money to last, yes, but also that you want enough freedom to actually live the life you’ve imagined. And if you understand the plan, you’re less likely to panic when markets wobble because you’ll know you’ve planned for this.

Dig in on your sense of purpose

Ultimately, the reason you set up your finances is to give yourself the freedom to spend your time on things you enjoy, care about and feel energised by. These are things you choose, regardless of what they pay. And for many people, that shift can be surprisingly difficult to make.

Our identities are often tied to our work and our ego. Stepping away from a job, a title or a role can leave a space that feels uncomfortable until you consciously refill it. So take the time to reconsider what you value, how you want to contribute and what makes you feel useful and connected is an essential part of the transition. Your purpose doesn’t need to be grand. It just needs to be yours.

So if you’re thinking about retiring, start with the basics. And remember, retirement isn’t a finish line any more. For most Indians, it’s a long, gradual shift into a different way of living and earning. The more prepared you are going in, the easier it is to make good decisions and avoid the traps that catch people who leave it too late. I have a publication in the Indian Journal of Surgery o the retirement planning of a surgeon. You can read it by clicking: Bhattacharya, S., Bhattacharya, K. & Bhattacharya, N. Retirement Planning—Unpleasant but Mandatory for All Aging Surgeons. Indian J Surg (2025). https://doi.org/10.1007/s12262-025-04318-8

 

 

REMEMBERING PROF. D. KUTTY - FIGHT CERVICAL CANCER BY VACCINATION AND EARLY DETECTION

Prof. Kutty, Prof. Meena Mukherjee, Prof. Prabha Mehra, Dr. Kalyani Das, Dr. Chandrawati, Dr. Asha Harish and Dr. Lakshmi Singh taught us Obstetrics and Gynaecology in King George's Medical College, Lucknow. They were all kept very busy because ladies from all over the state and even from Nepal and Bihar would come to Lucknow for treatment as our OBG service had a stellar reputation. Despite being so busy, being surrounded by patients in OPD and in the wards, these ladies were always smiling and their affection for students was matched only by their simplicity. Whether in lectures or in demonstrations or in ward rounds, they were always keen to teach, but I cannot vouch for the fact whether we were keen to study. 

Prof. Kutty was our Head of the Department and a wonderful teacher. She had a soft corner for the poorest of the poor and would go an extra mile to accommodate their surgery even when her O.T, list was over spilling. She would often go to a hospital run by her spiritual Guru Swami Sivananda ji Maharaj in Haridwar to offer her services to the poor and after her retirement she permanently shifted to Haridwar and worked in Shivananda Charitable Hospital with the same zeal and zest with which she worked in K.G.M.C.

Prof. Devaki Kutty was from Kerala and did her graduation from Madras Medical College. Her destiny and our good luck brought her to King George's Medical College in Lucknow where she rose to the position of Head of the Department. Her parents stayed with her and in one of her vacations with her parents to Badrinath and during this trip she came across saint and sage H.H. Sri Swami Sivanandaji Maharaj of Muni-Ki-Reti, Sivananda Ashram, a couple of km further from Rishikesh on the road to Badrinath Dham. She visited the Ashram and knew that this was the place she would be visiting again and again to serve the suffering humanity. Her Gurudev imparted a spiritual impulse to her life and set into activity her latent spirituality. The devotee in her also became a Sadhika. 

Then onwards every year, year after year, she would depart from Lucknow the evening of the very day her annual leave commenced and arrive in Rishikesh the next morning and immediately start her Bhakti and Karma Yoga Seva at the Ashram for 30 days. Her house at Jagat Narayan Road itself became the venue for the spiritual gatherings and Satsang and Bhajans for the devotees. 

 

Four decades ago cervical cancer was a major death risk for women all over the world, mainly because by the time this form of cancer enters its later stages, it has very few obvious outward symptoms. I remember Prof. D. Kutty, teaching us about Cancer Cervix, but the situation is not that gloomy any more. Nowadays it can be detected early with Pap smear tests and education about warning signs, is dropping the death rate of this disease significantly. That is the reason why I am liberally borrowing from the recent literature and augmenting my 45 years old class notes, as almost every aspect of the disease has changed in all these years, and yet it remains the second commonest cancer in women in India at 22.8%, second only to Breast cancer (27%). Every year 60,000 ladies fall victim to Cervical cancer in our country.

Both medical professionals and the female population must learn the warning signs and risk factors associated with cervical cancer, to help prevent this deadly disease from winning.

 

Factors that increase the risk for cervical cancer

1.      HPV - The Human Papilloma Virus is spread through skin contact and considered a virus that can lead to cervical cancer. It can be detected through pap smears or if warts develop. There is a vaccine against it.

2.      Oral contraception - Some of the hormones released through this form of birth control can create an ideal breeding ground for this cancer. The risk increases the longer one takes the pills and doubles after 5 years of consumption.

3.      Diet – There is a higher risk of cervical cancer for overweight women and women whose diets lack essential nutrients.

4.      Chlamydia – Women have been infected with chlamydia in the past or currently infected from it reveal a higher risk for cervical cancer infection.

5.      Pregnancies - Little is known why women who have had 3 or more full-term pregnancies have a higher risk of developing cervical cancer, however, it’s something to be aware of.

6.      Early sexual activity - Having sex at an early age increases your risk of HPV

7.      Early first pregnancy – Women who have a full-term pregnancy before the age of 17 are twice as likely to develop cervical cancer later in life as women who had their first pregnancy after the age of 25.

8.      Increasing number of sexual partners - The greater your number of sexual partners, and the greater your partner's number of sexual partners, the greater your chance of getting HPV

9.      HIV – The human immunodeficiency virus damages the immune system, increasing the risk of HPV infection.

10. Genetics– This is more controversial, however some research presents evidence that the risk is more probable if you have family members who have developed the disease.

11. Smoking - This can double the risk. The by-products of tobacco can damage the DNA of cervix cells, contributing the development of cancer. Smoking can also damage the immune system, creating a weakened system for fighting infections like HPV.

 

The warning sign symptoms

Millions of women continue overlooking symptoms - either due to a significant lack of awareness about cervical cancer and its symptoms, or fear, stigma, and a culture of silence that contributes to delayed screening. These womenare not just from rural area, many of them are youngsters, educated and from urban areas. Unfortunately, the early stages of cervical cancer lack both visual and physical symptoms. In the onset stages these are the typical symptoms:  

1. Leg pain - Some women experience swelling and pain in their legs. This can even be in the early stages. What happens is that the cervix swells, leading to an obstructed blood flow, causing the leg to swell and a feel a painful sensation.  

2. Vaginal discharge – Normally women will have small amounts of clear, odorless discharge. If the amount increases accompanied by an unpleasant smell and an irregular occurrence, this could signify the onset of cervical cancer.  

3. Unexplained vaginal bleeding – This is the most common of all the symptoms. If a woman has vaginal bleeding outside of her period or if she is postmenopausal, this can indicate cervical cancer. If one experiences ongoing bleeding in between menstrual periods or after sexual intercourse, contact your physician.  

4. Discomfort during urination – This more obvious symptom is described as a tight and concentrating stinging sensation when urinating, although it can feature other discomforting sensations. It’s important to keep track of your urinal patterns. If there are urinary symptoms, it can mean the cancer has spread to nearby tissue and you should consult with a physician for immediate attention.  

5. Irregular urination – Changes in your urinary frequency and appearance can indicate cervical cancer. If you notice more frequent urination, your urine is discolored or with blood, or there are noticeable changes to your regular routine and the development of incontinence (loss of bladder control) you should seek medical input from a professional.  

6. Pelvic pain – Although a fairly routine burden of being a women, if pains and cramps last for long bouts frequently, with pain more intense than regular and outside your menstrual period, this should be looked at by your doctor.

7. Back pain – This is a common symptom that can happen for a number of reasons, however if this is experienced along with a number of the other symptoms on this list, you should go for a medical check-up.  

8. Irregular monthly cycles – Your monthly periods should reach a consistent level with characteristic symptoms after adolescence and if you notice a change in the regular routine, whether in frequency or symptoms, it’s best to contact a physician.  

9. Painful intercourse – Discomfort during sex is called dyspareunia, and this unpleasant side effect can be a sign of cervical cancer. If it’s not cervical cancer it is still commonly linked to a disease and should be tended to by medical professionals.  

10. Loss weight & fatigue – cervical cancer can deplete the number of healthy red blood cells because there will be a higher presence of white blood cells fighting the disease. This results in anemia, which leads to lower energy levels and weight loss. If you suddenly feel tired and lose weight for no reason, it doesn't automatically means you have cervical cancer, but if accompanied by other symptoms on this list it could serve as a warning sign. In either scenario if you have unexplained weight loss and fatigue, talk to your doctor.

 

Types of cervical cancer

Cervical cancer is divided into types based on the type of cell in which the cancer begins. The main types of cervical cancer are:

• Squamous cell carcinoma. This type of cervical cancer begins in thin, flat cells, called squamous cells. The squamous cells line the outer part of the cervix. Most cervical cancers are squamous cell carcinomas.
• Adenocarcinoma. This type of cervical cancer begins in the column-shaped gland cells that line the cervical canal.

Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.

 

Preventative measures

Unfortunately cervical cancer is hard to treat because too often it’s detected too late. The good news is that cervical cancer can be prevented with knowledge and save practices:

1.      Pap smears – These tests are the best way to screen for the disease. Women ages 20 to 30 should have a test every 3 years. From ages 30 to 65 every 3 to 5 years and women over 65 years don’t need screening if they’ve had 3 tests in a row with regular results. This check-up needs to be undertaken despite having no symptoms at all, starting from the age of 30 and continuing at regular intervals.

2.      HPV vaccine – Medical professionals recommend both men and women have this vaccine to prevent the disease that leads to cervical cancer. The vaccine became available in 2006.

3.      Don’t smoke – Even secondhand smoke can increase the risk of contracting cervical cancer.

4.      Protection against STDs – HPV can be deceptively asymptomatic. If you don’t have a firm grasp of your partner’s sexual history, and haven’t been tested together, always use protection.

 

 The history, largely untold, of the development of cervical cytology, of effective screening and its ultimate success in reducing cervical cancer incidence and mortality, and the viral cause of cervical cancer, took place within a complex social background of changing attitudes to women’s health and sexual behaviour. Dr Georges Papanicolaou’s screening method (the Pap smear) started in the US in the 1940s. It was widely used in the UK a decade later and a national programme of cervical screening was established in 1988. The association of sexually transmitted human papillomavirus (HPV) with cervical cancer was less readily accepted. The detection of HPV16 in cervical cancers at the end of the 1970s was aided by the explosion of laboratory, clinical, and public health research on new screening tests and procedures. These made possible the successful development, licensing and use of preventive vaccines against the major oncogenic HPV types, HPV16 and -18.