The rise of Tapusa Singh

I always wanted a 'good' pet name since the time I was very young. A short-form for my long name is just ‘Sha’ which doesn’t make sense or ‘Shaw’ which doesn’t sound right or Punjabi enough either. So what should my pet name be? Once my Czech friend mispronounced my name as ‘Shweti’, and she continues to call me that. Another lawyer friend calls me ‘Shruti’ as that’s what she heard when I introduced myself to her at a restaurant that played loud music, over dinner.

My dad lovingly calls me ‘dabbi-ka-putti-kau’  since ever. This long pet name has no meaning in my reckoning and doesn’t match my official name either. He still calls me ‘dabbi’  though, despite my age because to him, I still am his baby… anyway. Some of my teachers call me ‘Shaaa weta’  as I hurry through JNU corridors just because they are perfectionists and want to pronounce my name the way it is spelt.

Many times, the sounds emanating from my name or inspired by my name slightly ache my ears but I do respond to them because I believe I still am socialized to be convent-school-polite. For one, it’s difficult to completely unlearn everything they teach you at school and secondly, I think it is the intention that counts. So if anyone calls me anything, respectfully, or lovingly, think I can make peace with that.

In a recent you-update-me-I-update-you conversation with my Mumbai-based friend, I naughtily named her ‘Billo Rani’ from the hit Bipasha Basu number because in my understanding, men of our batch still drool over her. It happens to them involuntarily, just the way our vital organs work i.e. without asking. Think my calling her that did boost her ego :), but guess what she ended up naming me in return - Tapusa Singh! She claims profound logic behind the new name. My other Mumbai friend thinks the same too. Think it’s a Mumbai thing rather than what both these women see in me. Let me contextualize my own pet-naming ceremony a little bit :).

After the wedding got over last month, for some of us from the over-enthusiastic, self-proclaimed organizing committee, the exhilaration didn't die down much after we had ordered Thai Chicken in Red Curry dish from Yo!China, immediately after savoring shaadi ke ladoo that had already started going bad. Gluttony is a feeling that can overwhelm the strongest minds at any point if one is not alert.

At that point last month, different types of foods in more-than-adequate quantities ended up getting mish-mashed in my poor stomach. Being used to digesting simple vegetarian food for a long time, my stomach couldn’t tolerate the gastronomic torture unleashed upon it, quicker than it could literally digest.

In retrospect, I do realise that the shaadi-food was only a trigger to regular over-consumption of rice (I am primarily a wheat-eater) and too much caffeine intake through tea, coffee, chocolates and my favorite choco-chip hide-and-seek biscuits since few months. This condition was worsened by unprecedented lethargy leading to a discontinuation of physical exercise, including the gym and morning walks around the JNU ring road.

Pic from ny.eater.com

The pill-for-everything allopathic doctor gave me strong medicines that made me vomit anyway, or feel dizzy and worthless during most of the day. Besides acid reflux (liquid from stomach leaking back into food pipe) and heartburn, what I additionally got were terrible skin rashes every time I took bath. A gentle soul advised me to apply coconut oil which continues to work well for me. My allopathic doctor however handed me cetrizine tablets to cure the medicine reaction. Still have those tablets in my bag in case some day I am not able to tolerate skin irritation in exasperation.

After visiting two allopathic doctors over two weeks who diagnosed my state differently but gave me one common advice about the kind of food to eat, I decided to quit all pills and start a healing-by-food diet. But after having water-porridge cooked over hostel heater for so many weeks, with often tea in between, I realised there is something more wrong than what I was able to comprehend. The skin irritation and eruptions continued all through.

Bless my friend who told me about ‘Kottakkal Arya Vaidya Sala’ last week. Once there, the doctor consoled me and prescribed me herbal medicine for fourteen days. She diagnosed my condition as ‘aggravated pitta dosha’ that is the imbalance of fire element in the body, which is basically an imbalance of the digestive energies.

According to her, due to prolonged intake of spicy/oily/heavy food or even over-eating, I got excessive heat/pitta in the body, even though it is winter-time. Usually, pitta-dosha occurs during summer months. The one good thing I learnt from this experience was that there are cooling food items like cucumber, cauliflower, beans, peas, sweet apples, coconut, cool badam milk etc. that I should prefer to eat anyway since I do have an intense pitta personality. It is from a description of this pitta personality that my Mumbai friend thought of the name ‘Tapusa Singh’ for me.

In Punjabi, the word ‘tapusi’ means a jump/movement from one place to another. The time I was conversing with my friend, I was walking up and down the house after lunch, making up for the lack of exercise in my life. The moment I called her ‘Billo Rani’ in some context she reverted back by calling me ‘Tapusa Singh’ in another.

Love for movement due to pitta dosha or not, most of my friends seem to agree with my new pet name. Happy that I finally have a ‘good' and meaningful pet name luckily suggested by a really thoughtful academic. Glad I am not called Golo, Pinky, Baby, Guddi, Bubli, Bittu, Babbu, Babbi or Gudia. Have nothing against these names. Just that with any of those names, I’d have to work harder to get taken seriously.

Coping with death, somewhat

This was a dark Diwali for us as we lost our grand-mom this October. Agreed death is a part of life for anything that breathes, but still, we all hope to evade death ourselves and pray no one we know succumbs to the inevitable (how ironical). We know it will eventually come by but the subject of death escapes most of our daily materialistic conversations. We spend not even a minute to deliberate upon it unless someone leaves us for good and we’re forced to face 'the ultimate truth' indirectly.

This year, I have been to the crematorium (shamshaan bhoomi) thrice. Once to mourn death of a young feminist due to marry her childhood sweetheart, who guided me during a Dalit-women-based project at Jagori. She passed away in painful circumstances, locked up in a bathroom in a house abroad where she was staying alone at that time. She didn’t get any medical attention in crucial hours after slipping in the bathroom. Even her doctor parents couldn’t revive her because too much had been damaged before medical help finally arrived. I particularly remember her because she really 'tolerated' me a lot at a time when I was going through an identity crisis of sorts, i.e. immediately after MA. That had some kind of a role to play in who I became subsequently or am still becoming. Blessings in her direction!

Next to bid adieu was my nani, a 90-years-old lady, who went through transition in her son’s arms while chanting ‘ram ram’. Apparently that has relevance during moments of experiencing death and takes the dying person to more advanced forms of being in the next life, as some choose to believe. As long as the transition is peaceful, I feel people are free to believe what they like.

Remember nani as this forever smiling person, who laughed with me in innocence, some call it senility, during her last years, even though she could barely hear or remember anything from the decades of an active past life. Fortunately, she seemed to recognise me as someone known and thankfully as someone who appeared to be funny. All she could see were my facial expressions so I am sure I over-dramatised for her benefit. Had a nagging feeling that I 'had to' amuse her to make her happy, like her state of happiness was also my responsibility.

Can only hope that the innumerable impromptu laughter episodes with her, like the gibberish proposed by Osho, took away at least part of her extreme loneliness after 60 years of companionship with nanu ended recently. As for why I do it, I believe I am largely at peace with the truth of being alone anyway, so can conjure up peals of laughter of varied intensities on just about any occasion with people of any kind. Makes me look over-enthusiastic sometimes, but I am fine with that. "Farewell nanima... lots of warm loving hugs for you, always!”...

Then it was the turn of my single friend’s younger brother who was working in a corporate office down south. Everything seemed perfectly fine until he hung himself after which all hell broke loose for the family. My friend, who has already lost her father much earlier, is the only daughter, obviously is in a state of shock and doesn’t know from where to start making sense of a life that has gone totally berserk. After meeting her at the shamshaam bhoomi, I didn't have courage to go to uthala and terwi because I didn't want to put words where they don't work, so I chose the convenience of praying from a distance. However, feel like calling her today.

I don’t know exactly why I began writing about death if I had to write something after a gap of so many months. There is a lot more that happened during this time period. For instance, besides going to crematoriums and philosophising about life and death, including my own, I was also working on my PhD research area - well-being of trafficked and subsequently rescued children. Also there was a short visit to Gujarat to study pastoral lifestyles there as part of continuing contractual work. This was interspersed with news of two close friends opting for court marriage, thinking about what to gift them. Humm...

Anyway, apart from 'returning to boyhood' by chopping my locks yet again to the dismay of my family, the other update is that I ended up baking tea brownies for my aunt in her new microwave oven, the recipe of which I want to share here as requested. The preparation time is about 15 minutes while the baking time is just four minutes! You should try this one out if you don't like eggs. I found the recipe on an online cookery blog whose name I just can’t remember. Btw, I do like eggs :).

Eggless banana-flavoured brownies:

Blend together two tbsp. sugar, ripe mashed banana, 1/3rd cup butter and half tin milkmaid, along with two tbsp. crushed nuts (walnuts, cashews, almonds- your choice).

In another container, sift one cup flour, one pinch baking soda, two tbsp. cocoa powder.

Mix both well and transfer contents to a special microwave dish, and let it cook for four minutes, after which leave the cooked batter to cool for some more time before slicing it up and serving with hot tea. I say cooking is therapeutic in the middle of all this, and I am not saying this because I am a woman and I ‘ought to know’ how to cook. I believe it's good to know something about everything, including cooking, so that one doesn't have to completely depend on anyone.

My aunt, who is single and retired as a government school headmistress about ten years ago, was looking after my grandparents before they passed away, one by one. She seemed pleased with the recipe and has booked me for Thai vegetarian cooking in her new gadget for another time. Makes me nervous because I don't know abc of that, not yet. I dislike experimenting with nutritious veggies because I feel they'll go to waste if I burn them or don't cook them well. Anyway, anything to make my aunt feel better, including hopping on one leg if she wants me to :).

The time spent with her seems to be helping us both deal with gaps left in our hearts, with food (!). For me, I think it's more about getting distracted from memories of nani while living alone in that house. Or maybe, it's about learning to live with them.

Glamour Undone

http://www.hardnewsmedia.com/2011/04/3925

With a case in consumer court, a high-end beauty clinic is in the spotlight for irreversible damage caused to the eyesight, psyche and future of a young girl

For those of us who have studied Biology in school and dissected frogs in the laboratory, the following visual analogy might help. Preeti (name changed) had to lie face down on a bench, arms and feet spread out, so that the doctor could perform lumbar (spinal) puncture - a painful procedure involving surgical removal of excessive fluid from the spine to relieve the high fluid pressure that was blurring her vision. She screamed in pain but the operation was the only way to save her from going completely blind, thanks to a drug reaction.

In this procedure, a needle was used to extract a maximum of 25ml fluid to relieve her bulged out eye so that it could see better, and to treat severe headaches. This was the last resort after every other medical treatment to diagnose, treat or suppress her intense, intolerable pain had failed.

As was finally diagnosed by the neurophysician treating Preeti, the high fluid pressure was caused by a reaction to the minocycline drug prescribed to her at the high-end Kaya Skin Clinic for treatment of acne, rendering her 80 per cent blind at that time. Sadly, instead of stopping her from having more tablets, clinic staffers ensured she continued having them "to complete the medicine course".

Preeti underwent the spinal tap once and then another procedure - optic nerve fenestration - to save her failing eyesight, but is still left with permanent loss of peripheral (sideways) vision with blurry vision in one eye. She has acquired a hypo-allergic face skin that gets purple and blotchy under the sun, and so she will always have to use a special sunscreen or avoid sun exposure altogether.

It all started when Preeti complained of mild acne as an adolescent, which is a common complaint at that age. Impressed by advertisements, she wanted her pimples to be removed cosmetically and immediately. She could have also chosen a simple, healthy and balanced diet; but that perhaps would have taken much longer to work, compared to the quick-fix options offered by seductive, often brazenly unethical, ads.

"Since the time we contacted the Noida branch of Kaya Skin Clinic for treatment, our daughter has been traumatised. She has not stopped going to hospitals for one reason or another because of the reaction to the medicine they prescribed her," says her father, on condition of anonymity.

Among other things, Preeti was prescribed minox/minocycline 100 mg tablet daily, without any warning about probable side-effects that are well-established in medical literature. The consent form mentioned nothing to that effect either.

When contacted, Kaya representatives did not respond to this reporter's queries about the issue.

"Despite absence of proper legislation, the one thing that beauty clinics shouldn't be allowed to get away with is malpractice like this," says Dr Shehla Agarwal, consultant skin specialist, Mehak Skin Clinic, Delhi, who has hands-on experience of dealing with adolescents, anxious with skin problems.

"The consumer has to be more vigilant and should not get swayed by big media advertisements. They should ensure that people they go to for beauty treatment have the right qualification and are registered under the Medical Council Act," says Dr Shishu Bhushan Singh, a cosmetic surgeon at Dr Rekha Suman's Laser Cosmetic Surgery and Skin Clinic in Delhi.

Not only that, every clinic should maintain proper documentation of treatment they are giving. They should provide consumers with elaborate consent forms that clearly spell out the side-effects of medicines prescribed by their qualified doctors.

Doctors argue that people should understand how 'selling beauty' is big business because establishing and running such clinics in cities is not an easy job. Hence, demanding full information about the products and services they offer is the consumer's prerogative. Plus, none of the practitioners can claim to have magic wands for quick, short-cut, yet healthy treatments, as is misleadingly claimed in ads promoting beauty products and services endorsed by celebrities.

"Inexperienced medical graduates (fresh degree holders) should not be allowed to deal with patients in beauty clinics as the knowledge required to monitor the side-effects of medicines comes only with time," argues Dr Agarwal. "In many such clinics, there is this trend of different people dealing with the same patient each time s/he visits the clinic, thus breaking continuity in effective monitoring of the treatment."

"Yes, provision of services should be done ethically. The service provider should have full knowledge of the treatment s/he is giving. Another important factor is the quality of chemical products used during beauty treatments to avoid such chemical reactions. Today, every product in the market has a cheaper duplicate, from milk to garam masala. So when anyone goes for beauty treatment, s/he should also enquire about the quality of products used because beauty clinics commonly don't use original, good quality products so as to maximise their profit," says Karan, a senior make-up artist working with the Hindi film industry.

"Whatever the legislative weaknesses with regard to the beauty and cosmetic industry in our country, the fact remains that due to constant bombardment of the so-called ideal beauty images, especially targeting women, they have developed an inferiority complex and deep-seated insecurities about who they are and how they look," says Dr Rippon Sippy, a Delhi-based clinical psychologist. "I mean what is wrong with having acne sometimes? If you let it be, it goes away on its own."

In the contemporary anorexia-driven beauty business in metros and urban India, there is a constant comparison between bodily 'imperfections' vis-à-vis the artificial perfection of models and celebrities. Secretly or openly, the desire to possess a perfect skin, body, features, has been stimulated. Even youngsters, especially girls in their teens, face immense peer pressure, and suffer deep anxieties and insecurities. Like perhaps Preeti did.

Given that a section of women has more money to spare - it empowers but also creates an ironic decrease in self-worth - it is not surprising that many use products and services to alter their looks, points out Jessy K Philip, a sociology teacher at Delhi University. "In cities, fitting the beauty stereotype is something women are more obsessed with than in a village in Kerala, for instance, where women are also valued as workers."

As Naomi Wolf suggests in her book The Beauty Myth, why does this stereotypical notion of beauty - light coloured, fair, flawless, acne-less, hairless, smooth, young, tight skin and an hour-glass anorexic, almost famished, body shape - exclude women's inner qualities, integrity, resilience, achievements and talents? Why are educated, working women expected to conform to the mythical, antiseptic, market-driven, commercial body image, as if their acquired knowledge and professional skills are not enough?

"In my profession, if your face is not acne-free and your body weighs more than a prescribed standard, you'll be soon on your way out. This does cause stress, but it is part of our job to appear that way," says former air hostess Sanjam Jasuja.

Producer-anchor of a TV channel, Kajal Sharma, feels that for someone who appears on the TV screen every day, it becomes mandatory to constantly work towards a fair, smooth skin, wear make-up, have hair of a certain length, flaunt a certain kind of figure and look 'beautiful'. Just being intelligent and efficient is not enough.

Altering one's looks for 'job security' is one aspect of the problem women face, but changing one's appearance to feel valued as a person in relationships seems far more depressing. "One of the reasons why my marriage didn't work out was because I couldn't live up to the beauty norms prescribed in Punjabi families, which is different from what we learnt in Marathi culture. I remember growing up comfortably, like a tomboy, but today I use every product I must to make me look and feel feminine, and worthy of love," says Shruti (name changed), a JNU student in Delhi.

"I dress up conservatively and don't wear as much make-up in Delhi as I do when I am at home. This is because with people from the northeast, other stereotypes are associated. If we wear bright lipstick, we are thought of as women who are easily available. So then, this unfriendly city decides how beautiful I can look or how comfortable I can feel while I live here," says another student from JNU.

Celebrated feminist author-filmmaker Jean Kilbourne brings out similar, deeper concerns in her documentary Still Killing Us Softly, which is about beauty images that media propagates through ads. She says that ads sell not just products, but values, images and concepts such as love, sexuality and normalcy, defining who we should continuously aspire to be. Or else, you can feel left behind, incomplete, imperfect and guilty.

So, be it luxury creams or products to prevent aging, remove pregnancy marks, tighten the cleavage, soothe eyebrows, lighten skin colour and increase lip volume, or treatments for acne removal, facial wrinkles (botox) or body hair removal (waxing or laser), removal of 'ugly' fat (liposuction), breast augmentation, hair spa and so on: everything seems legitimate. However, the bitter realism might be different. "I doubt if women are dying to have body-altering treatments as most procedures are not physically comfortable, some involve painful sittings in beauty clinics with medical risks, some require multiple visits and cost a lot of money. Who would want to go through so much inconvenience unless there's some nagging compulsion inside," says Philip.

Uncannily, the UK has reported several cases of women who want 'vagina-cosmetic surgery' because their partners prefer younger-looking vaginas, similar to those advertised in adult magazines and films. This suggests the level of 'self-hate' and 'deep insecurity' women nurture under the guise of being successful, beautiful, rich and happy, argues Wolf.

In her film, Kilbourne also explains the stereotyped images of the 'perfect male'. In the Indian context, celebrities like Shahrukh Khan, Shahid Kapoor, John Abraham and cricketer MS Dhoni have endorsed fairness cream brands for men. In this racist worldview, to be 'fair' is to be handsome, successful and an achiever, with women chasing you.

The crux is that the concept of 'ideal beauty' is fake, fraudulent and false. It is driven by crass commerce with beauty clinics and products claiming to do the 'magical' transformation of the 'ugly' into the 'beautiful'. But when a silly acne-treatment fails and turns into infinite physical and emotional trauma, altering one's life into an abyss of despair, pain and tragedy (like that of Preeti), then it's time for a serious re-think.

From the print issue of Hardnews :

APRIL 2011

Ask the Women! (Story on injectable contraceptives)

http://www.hardnewsmedia.com/2011/01/3802
The introduction of contraceptive Depo Provera in India might spell health disaster for millions of women, especially rural and poor women. And if city women too get hooked, it might also spell an urban disaster.

Shaweta Anand Delhi

Two weeks before her term as Union health secretary ended in November 2010, Kanuru Sujatha Rao suggested to the Drug Technical Advisory Board (DTAB) to introduce Depo Provera (Depot medroxy progesterone acetate/DMPA or Depo) injectable contraceptive in the national Family Welfare Programme (FWP), previously called the Family Planning (read 'sterilise women only') Programme. The only exception to the women-only rule was the time when 'Sanjay Gandhi's totalitarianism' led to forced vasectomy (nasbandi) of men during the notorious Emergency (1975-77), among other widespread atrocities, including press censorship, torture and imprisonment of thousands.

No matter what the FWP is technically called, the government's main intention has been to curb population growth for it holds that as the basic cause of poverty. Thereby it intends to target women, officially or unofficially, especially poor women, in the name of either maternal and child health services or reproductive and child health programmes --- as if women's health, and their life itself, begins and ends strictly between the reproductive period of 15-45 years. Indeed, this uncanny conjecture implies that the only threat to their life and social condition is complication from childbirth.

Somehow, widespread nutritional deficiency, systemic misogyny since birth (high levels of foeticide, infanticide and domestic/work place violence) and lack of education, equal employment opportunities and equal wages, have never qualified to become areas of aggressive government interest or activism, unlike sterilising FWP targets, namely women.

This highlights the official fixation with birth control through the two-child norm strengthened by advocacy for birth control by women, including by the use of hazardous Depo Provera injectable contraceptive, according to Prof Mohan Rao of the Centre for Social Medicine and Community Health, Jawaharlal Nehru University (JNU), and member of the National Commission on Population. "Other than the Supreme Court upholding the Haryana government's law prohibiting a person from contesting or holding the post of a panch or sarpanch in Panchayati Raj Institutions (PRIs), if s/he has more than two children, there are more state governments like Andhra Pradesh, Madhya Pradesh, Rajasthan, Chhattisgarh and Orissa that also advocate the two-child norm by offering a battery of incentives and disincentives through their population policies," he told Hardnews.

In his note on 'Population policy and the two-child norm', Rao elaborates: "... (desperate to curb population at any cost,state governments are) restricting schooling in government schools to two children; restricting employment in public services to those with two children; linking financial assistance to PRIs for development activities and anti-poverty programmes with performance in family planning; linking assessment of public health staff to performance in family planning and so forth. Indeed, service rules for government employees have been altered in several states making a two-child norm mandatory." This implies that for all the above reasons, primarily a large number of poor women are being coerced to go through sterilisations as permanent contraception.

"The way things happen in our country, the government pressurises thepoor only for population control and therefore contraception. As women, we finally get cornered both by the government and our husbands, untilwe get the (sterilisation) operation done, no matter how physically sick or psychologically weak that makes us feel afterwards," said an old village woman interviewed in Deepa Dhanraj's documentary, Something Like a War.

Most poor women interviewed in this film made 15 years ago, on the subject of coerced family planning, said that pushed by the government's (mostly false) promises of money, some land or foodgrains, it's their husbands who finally decided that they 'need to' get operated. This makes them feeltotally powerless. This is quite the opposite of what promoters of new contraceptive technology claim, including promoters of quarterly injectable hormonal contraceptives like Depo.

Talking of losing control, women (or 'cases', as they were being referred to in the film by 'motivator' health workers and doctors),were brought in, their saris removed, and they were hastily mounted onthe operation table almost upside down for the doctor to easily perform the quick surgery - like an animal is pinned down fortests in a biology lab.

The doctor, while performing operations, simply could not control his boastful monologue, looking straight into the camera, jabbering about having performed 3,50,000 tubectomies (female sterilisations) in the past 12 years, with an efficiency rate of one procedure per minute. "In the interest of the nation," he said, while one of the woman he was "fixing" moaned in excruciating pain and hurled profanities at him.

Women came and women went while the doctor went on about his business of operating upon them most nonchalantly, "like the women were products being rolled out on a conveyor belt, who he is fixing," commented Abha Bhaiya of Jagori, a women's group which played an instrumental role in the making of this documentary. The attitude shows total lack of sensitivity towards women by family members, community workers and doctors. There are many similarities in the experiences of women who went through sterilisations in Dhanraj's film and those who got injectable contraceptive Depo Provera administered in a 'public hospital' setting in Delhi.

This, despite a recommendation against Depo's use in the FWP by the DTAB in 1995 after a Supreme Court direction, even though the injection continues to be available off-the-counter in certain local chemist shops. The 'hospital' had received a stock of injectables directly from Pharmacia and Upjohn, who made the drug before they were taken over by Pfizer, the current manufacturer of Depo.

'UNVEILED REALITIES', A study conducted by Sama - a Delhi-based resource group for women and health - involved recording in-depth experiences of women from a resettlement colony who were administered the injection. Sama also documented how ethically and within medical guidelines was this actually done in a public health set-up.

As in the documentary, this study also showed that men - either the husband/family or the doctor - were basically deciding about women's sexuality and reproduction, including the method and timing of contraception. It makes no difference whether this was 'new-age' -'liberating-the-woman-by-giving-her-another-contraceptive-choice' kindof technology - or a redundant one.

Most women's social identity and status is defined 'because of the father, husband or son' in the Indian context. As a corollary to that, men tend todecide on behalf of a majority of women; hence Depo is not having anyspecial liberating effect on female contraceptive users. In contrast, it is adversely affecting women's bodies and disrupting their lives with anxiety and illness.

On part of the service provider, the crucial issue concerns following ethical and medical safety guidelines, some of which are mentioned in the literature accompanying a Depo pack itself, before administration of the injection. One of the crucial considerations is to ensure 'informed choice' of the recipient before suggesting injectable contraceptives as 'the most effective' contraceptive compared to other methods that might actually suit the potential user better.

The doctor should ideally feel responsible and accountable to the patient if something goes wrong after taking the shot, and should do whatever is needed to put the woman's health and well being as his first priority, without worrying about discontinuation of the injection. As studies show, in most cases, the doctor takes upon a businessman's role, pushing aside the women's negative experience after using Depo and 'counseling' her to continue with the shot, no matter what be her expressed experience, helplessness, angst or anger.

As for compliance to guidelines, the Sama study reveals that the majority of poor women were suggested only Depo Provera injectable as the contraceptive they can opt for, a majority were not told about the probable short-and long-term side-effects, proving that their informed consent was not taken before administering them the injection, which could seriously jeopardise their future health prospects.

Majority of the respondents in the study were also not screened forall the tests before administering the injection. This includes documenting detailed personal and family medical history, menstrual history, blood pressure and weight, gynaecological examination to rule out pregnancy, and a pap smear test to rule out risk of infections. Majority of women showed contradictions (like history of heart disease or diabetes in the family, migraine, jaundice, hypertension, abnormal pregnancies), but were still given the injection, exposing them to grave danger as the hormonal contraceptive causes changes in the body's metabolism itself.

Not just that, Depo reduces the bone mineral density (BMD) irreversibly that has earned the injectable a black box warning in the past. It is the harshest warning of adverse effects caused by drugs issued by the US Food and Drug Administration. In its latest package insert, Pfizer acknowledges the issue of BMD, and that women who can use other birth control methods should not continue Depo for more than two years!

"As a Physician, I am saying that in the case of long-acting, hormonal contraceptives like Depo, adverse drug reactions - not 'just side effects' as Pfizer would like to put it - are a matter of grave concern. On administration of this injectable, healthy women have faced a disruption of their menstrual cycles, possibility of premature menopause accompanied by anxiety, depression and loss of libido, loss of bone density leading to weak, brittle bones, susceptibility to life-threatening blood clots and an increased possibility of HIV transmission, among other problems. All this can happen to normal, healthy women, who might just desire safe contraception, not sickness -inducing contraception, that will not only increase their suffering but also require additional treatment for disorders they never had earlier," argued Dr C Sathyamala, an epidemiologist. Many of these findings are documented in a research study: 'An epidemiological review of the injectable contraceptive, Depo Provera'.

The collective experiences of women reveal that Depo Provera has been administered to them in a highly unethical way that could endanger their lives. Plus, there is data to show that most women have eventually discontinued the injection due to adverse drug reactions,which service providers brush aside, calling them 'minor side-effects' while trying to cajole women into continuing with the contraceptive to meet population control targets. This has been the experienceof women world over, including in the US!

A related study, Introducing DMPA injectable contraceptives to private medical practitioners in urban Gujarat, by Population Council and others, recommends: "Obstetrics/gynecology specialists may be a more appropriate category of physicians (than generalists or MBBS) for reaching women", to administer the injection and for follow-up care. Indeed, India just does not have that kind of health set-up as yet.

However, after suggesting the inclusion of Depo Provera in FWP, Sujatha Rao had suggested that Accredited Social Health Activists (ASHAs) from the National Rural Health Mission could take up the task of administering the injectable, they being 'gaon ki beti' (daughter of the village) and trusted by villagers. "But the fact is that literacy not being their selection criteria, ASHAs may not be able to read even technical instructions on the Depo package regarding when to administer the injection, probable risks and adverse drug reactions involved, nor do they have much knowledge about a woman's internal bodily functioning like gynaecologists do, to watch out for complications or offer advice in case of ill effects to Depo users. ASHAs cannot do this. It will be like playing with the health of millions of women," said Kalpana Mehta from Saheli, a women's group.

"The injectable is hazardous to the woman and to her progeny irrespective of whether the government can find someone at the village level - trained or not - to persuade women, who trust them, that it is safe. Its use should be banned from the private sector too," urged Dr Sathyamala.

Indeed, its rampant misuse among young girls and women in the US has become an alarming cause of concern within the health sector. And if the trend catches up in 'unaccountable India', with girls and women also picking it up off the counter, without prescription, or corrupt doctors prescribing it, this might mark an epidemic with dangerous consequences. No wonder, the drug is in the midst of a deadly controversy with a dark, depressive narrative hidden behind its public claims.