Why Healthcare Remains a Distant Dream for Adivasis

To reach Bargur, a small village in Tamil Nadu’s Nilgiris district, you must leave the paved road and navigate through muddy paths that lead to a stream. After crossing the stream, a steep climb brings you to the village. I visited this place in early October, and Mari Manday, an Adivasi elder from the Irula community, was mourning the recent loss of his eight-year-old granddaughter. Her sudden death left the family devastated.

Manday shared, “She fell ill with fever, vomiting, and diarrhea. We waited too long to take her to the hospital. Maybe if we had gone earlier, she would have survived.” Tragically, not only did they lose a child, but the family also faced financial constraints that delayed their visit to the hospital located 20 kilometers away.

In this area, transportation costs can reach Rs 700, which is unaffordable for many, especially daily wage earners who make about Rs 200 to Rs 300 per day. Public transport has become unreliable; locals often depend on private vehicles or walk for hours to seek medical help.

Jyothi N, another villager, echoed similar sentiments. “My daughter is also unwell, but the journey to the doctor is too challenging right now,” she said. The steep, slippery paths can be dangerous, especially for those who are already sick. Dr. Ajith JS, a community health expert working with the Gudalur Adivasi Hospital, explained how misleading distances can be in these hilly terrains. Although a primary health center might seem close, obstacles like hills and forests make access difficult.

Manday recalled a time when they had to rush his daughter to a hospital. “We were carrying her on a makeshift stretcher when she went into labor. We couldn’t reach the road in time,” he remembered. This was not an isolated incident; the struggle for healthcare access is a common story among the Adivasi communities.

Efforts to provide healthcare are sporadic. A nurse might visit a neighboring hamlet once a week, but without a set schedule, many people miss her. Occasionally, NGOs send vans to provide medical care, but availability is spotty. Unless someone happens to be near the road, they remain unaware of when help is nearby.

Tamil Nadu is recognized as a leader in healthcare, often ranking high on NITI Aayog’s Health Index. However, the situation is dire in Nilgiris, where the Adivasi population faces unique challenges. These include geographical barriers, social discrimination, and the cultural distance from mainstream healthcare.

Mallika Suresh, a mother from the Kattunayakan tribe, shared her heartbreaking experiences with healthcare. After losing two children shortly after birth, she was warned against having more. When she became pregnant again, Mallika hesitated to visit the hospital, fearing harsh treatment. Eventually, when she did go, her experience was traumatic; she was treated rudely and felt humiliated.

Kamalachi, a social worker from the same community, highlighted other pressing issues. Adivasi women often face pressure to undergo sterilizations, with doctors sometimes failing to communicate the procedures properly. Manday also shared a frustrating episode where he was prescribed medication without fully understanding the diagnosis.

The prevailing issue of malnutrition is alarming. A study conducted by the Association for Health Welfare in the Nilgiris indicated that nearly half of the children surveyed were malnourished. Manday noted that his granddaughter often fell sick due to her poor health.

Many villagers expressed their concern over increased illnesses. They believe their declining health is linked to the changing diet they have faced since they were resettled from their ancestral lands. In 2008, over 800 families were moved out of their homes in Mudumalai Tiger Reserve, disrupting their traditional lifestyles and access to nutritious food. Elderly villagers reminisced about the diverse, healthy foods that were once easily available to them.

“Back then, we had fresh water and an abundance of greens from the forest,” an elder lamented. “Now, we struggle to find proper water and nutrition.” Social workers point out that this displacement has created a heavy dependence on the government’s public distribution system, which offers minimal nutrition and inadequate quantities.

Another significant issue is alcohol addiction, which has surged among Adivasi men since their relocation to the town. “In our old habitat, there was no easy access to alcohol,” Kamalachi explained. “After we were moved, it became a harmful habit.” This has led to numerous problems, including increased rates of suicide, with Adivasi communities facing alarmingly high statistics compared to the national average.

The crux of the problem rests on multiple fronts. Healthcare services are inadequate, and when available, they are often dehumanizing. Dr. Mrudula Rao from the Gudalur Adivasi Hospital emphasizes that many in the community hesitate to seek medical help due to past trauma and stigma.

To bring change, it is essential for healthcare providers to engage sensitively with Adivasi populations. Involving tribal counselors could serve as a bridge between the healthcare system and these communities, fostering trust and encouraging them to seek help when needed.

In conclusion, the healthcare crisis faced by Adivasis in Tamil Nadu is a multifaceted issue compounded by social, economic, and geographical barriers. It is vital for governmental and non-governmental efforts to address these disparities and ensure that the Adivasi communities can access the healthcare they deserve.

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