India: Inequalities of health, Dalit Solidarity’s health advocacy strategies

The caste system is a major indicator of health outcomes and requires interventions to change these social structures.6 While caste system is no longer practised in urban areas of India, it still persists in rural India.6 The inherent caste-related inequality continues to dominate reality in Indian society despite the secular, socialistic and democratic principles enshrined in the constitution demand of equality of outcomes.6 Caste system is a social construct and there is hardly any genetic difference among castes.6 The caste system is just a social concept without any genetic concept.6 These social constructs have a stranglehold on human though, perpetuating prejudice and propagating unjust societal structures.6

The National Family Health Survey-III (2005-2006) highlights the caste differentials in relation to health status.6 The lower castes have reduced access to maternal and child healthcare, together with evident reduced levels of antenatal care, complete vaccination coverage and institutional deliveries. There is higher mortality in under-five children among the lower classes.6 The problems in accessing healthcare were higher among lower castes.6 Stunting, wasting, underweight and anaemia in children and adults are higher among the lower castes.6

Dalits continue to face social discrimination and exclusion and are targets of communal violence. It is common for upper castes to assault, rape and murder the Dalits (the untouchables).6 However, these crimes are not investigated and the upper castes are not punished by authorities, despite laws and protection provided by the India government.6

There is a connection between health and human rights. The abuse of human rights can have serious health consequences.6 However, protecting human rights will reduce vulnerability to ill-health by providing freedom from discrimination, rights to health, education and housing.6 The World Health Organisation strongly encourage for a human rights-based approach strategy to address human rights issues and overcome the persistence of discrimination.6

The Dalit Solidarity is an organisation to provide India’s Dalits with the equipments they need to improve their quality of life.1 Thousands of Dalits now have access to quality health care and hundreds of children are provided with opportunities to attend good schools, from elementary through graduate school.1 The Dalit Solidarity advocates tirelessly on behalf of India’s Dalits, to address the discrimination issue of the caste system and untouchables and standing strong for one of the world’s most oppressed populations.1

St. Mary’s Medical camps provide affordable and quality care directly to the rural villagers in Villupuram District.2 St. Mary is a 10 bed health centre, equipped with pharmacy and laboratory facilities.2 There is a physician, two nurses, a pharmacist and laboratory technician.2 Dalit Solidarity provides quality health care for over 1500 patients each month and also operates a First Responder Program to provide first aid in the villages.2

First Responders provide the only available emergency care in the villages.3 There is virtually no emergency transportation service in rural India.3 Patients have to travel by ox cart or be carried by family and friends to the nearest emergency centre.3 First Responders Program provides limited onsite emergency care and stabilise patients until they can be transported to a medical facility.3

Dalit Solidarity has a community health program which focuses on improving the health of rural Indian men, women and children.4 This program provides comprehensive healthcare for rural villagers in Villupuram District. Community health program provides preventative healthcare which is generally not known in rural India.4 Early detection and prevention system is a diagnostic computer software system which allows early detection of diseases among rural populations and provides patients with probable diagnosis and recommendations to physicians, necessity for laboratory testing or appropriate home treatment.4

Dalit Solidarity provides opportunities for quality education.5 The Dalit leadership academy bridge program is a boarding program which provides qualified Dalit youths with one year of intensive training in academics, communications and leadership skills to allow them to succeed secondary school.5 The scholarship program provides more than 200 students with scholarships to attend the academic institution of their choice.5 Community college program provides qualified high school graduates with training opportunities in a variety of fields such as nursing, preschool education, tailoring, computers and automotive mechanics.5

Overall, there are many social determinants contributing to the health of Indians such as cultural factors which affect socioeconomic factors. Strategies and advocacy principles are taken by organisations such as Dalit Solidarity to improve the health of Dalits and provide them equal opportunities and education to succeed in life.


  1. Dalit Solidarity (UN). What we do [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from:
  2. Dalit Solidarity (UN). St. Mary’s Health Care Center [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from:
  3. Dalit Solidarity (UN). First Responders Programme [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from:
  4. Dalit Solidarity (UN). First Responders Programme [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from:
  5. Dalit Solidarity (UN). Education [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from:
  6. The Hindu (India). Caste and inequalities in health [Internet]. The Hindu (India); 2009 [cited 2014 Apr 8]. Available from:

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