Category Archives: India

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

http://dlgriffiths.files.wordpress.com/2012/09/001_dalit-lives.jpg
http://dlgriffiths.files.wordpress.com/2012/09/001_dalit-lives.jpg

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

 

communitycaretrust.com
communitycaretrust.com

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.

References

  1. Dalit Solidarity (UN). What we do [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from: http://www.dalitsolidarity.org/what-we-do.html
  2. Dalit Solidarity (UN). St. Mary’s Health Care Center [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from: http://www.dalitsolidarity.org/health-care/st-marys-health-center.html
  3. Dalit Solidarity (UN). First Responders Programme [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from: http://www.dalitsolidarity.org/health-care/first-responders.html
  4. Dalit Solidarity (UN). First Responders Programme [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from: http://www.dalitsolidarity.org/health-care/community-health.html
  5. Dalit Solidarity (UN). Education [Internet]. Dalit Solidarity (UN) [cited 2014 Apr 8]. Available from: http://www.dalitsolidarity.org/education.htm
  6. The Hindu (India). Caste and inequalities in health [Internet]. The Hindu (India); 2009 [cited 2014 Apr 8]. Available from: http://www.thehindu.com/opinion/lead/caste-and-inequalities-in-health/article7075.ece
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The Destiny of Indian People; to be Cursed or Blessed

Just imagine, all of your career opportunities, healthcare options, social status and marriageable partners have all been predetermined from your birth. This is the essence of the caste system which has existed in India for thousands of years.1 It is a social hierarchy system which epitomizes the inequitable distribution of power, money and resources such that higher classes benefit from those beneath them.2 Any hope of ascending through this social ladder was nearly zero.1 The life of a newborn Indian was either blessed with opportunity or cursed with lifelong, unvalued servitude without hope of ever rising to greatness.

So firstly what is the caste system and what are the hierarchies? The image below summarizes:

India caste

Obtained from: https://sites.google.com/a/wdsdvt.net/india—titan-team-2013/history-i/caste-system/how-the-caste-system-is-broken-down

There are 4 official classes of the caste system listed in social standing3

  1. Brahmans            –             The priests, teachers and judges who understood dharma (spiritual laws that govern the world)
  2. Kshatriyas          –             Rulers and warriors
  3. Vaishyas              –             Traders/businessmen and skilled farmers
  4. Shudras               –             Predominantly unskilled workers
  5. Dalits                    –            “untouchables” their work includes toilet cleaning, human/animal body and garbage removal. The jobs the other classes refuse to stain their hands with.

There are strict social rules for how each class should behave within their own caste and with people of other castes.1 The most horrendous rules regarding the untouchables (Dalits). As the name suggests, they are not to be touched by people of other castes as they’re seen as lower class humans. They are not allowed to drink from the same wells as the other castes and paradoxically subject to sexual abuse despite their title ‘untouchables’.4

Intercaste marriage was largely forbidden, forcing classes to stay within their own group.3 The system benefited those at the top of the pyramid while severely disadvantaging the lower classes. The employment, healthcare, study and even religious opportunities are much greater for those of higher classes compared to those of lower classes.1 For example, a Dalit (lowest rank) is usually forbidden to enter a temple as their presence is thought to corrupt the sanctity of the place.1

Mahatma Ghandhi worked hard to end the discrimination against the ‘untouchables’ bestowing upon them the title of harijan which translates to blessed believing they were blessed by their suffering.1 The Indian government had also fought against this social injustice and in 1950, made it illegal to discriminate based on classes.1 The government has given opportunities for education and even reserved positions in political cabinets for all classes including Dalits. There has been increasing hope for Dalits to become successful especially with the election of the tenth president in India, K. R. Narayanan who was a Dalit reigning from 1997-2002.1

Ghandhi

Image obtained from: http://www.caravanmagazine.in/journeys/gandhis-last-stand

However, while the laws are present, caste discrimination has persisted through the 21st century being especially prevalent in rural communities.2 The vast majority of Dalits are still under oppression where they are denied access to lands, abused by police and higher castes, forced to work in appalling conditions and discriminated against.4 The government seldom acknowledge complaints about violations of the law regarding Dalits and therefore forces them to endure the oppression.4 There have been Dalit resistances both violent and non-violent which usually end in more suffering to Dalits.4
Life and society is changing in India but there is still a strong underlying discrimination between caste classes. The problem is likely to persist in the future but with knowledge and understanding, this system can change so that no one is oppressed from their birth and lack opportunities to succeed in life. Social equality should be the ideal we all work for.

 

References

  1. Dowling M. The Caste System at mrdowling.com 2014 [cited 2014 4 April]. Available from: http://www.mrdowling.com/612-caste.html.
  2. Dalmia S. The Tragic Truth About India’s Caste System 2012 [cited 2014 April 3]. Available from: http://reason.com/archives/2012/01/24/the-tragic-truth-about-indias-caste-syst.
  3. Mtholyoke. History of the Caste System in India 2010 [cited 2014 April 5]. Available from: http://www.mtholyoke.edu/~epandit/page2.html.
  4. Watch HR. Broken People – Caste Violence Against India’s Untouchables 1999. Available from: http://www.hrw.org/reports/1999/india/index.htm#TopOfPage.