27 Issues of Health among Indian Tribes

Vineet Verma

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Table of Content

 

Introduction

General Profile of Tribal India

Anthropological concerns in study of Tribal’s Health

Health status of a Indian Tribal

  • Health and Its Correlates
  • Health Culture
  • Child Bearing and Maternal Mortality
  • The Infant Mortality Rate (IMR)
  • Tribal Households
  • Life Expectancy
  • Genetic Disorders
  • Sexually Transmitted Diseases (STDs)

Health Problems

  • Deprived of Basic Nutrition, Sanitation, Health
  • Strategies for Tribal Development in Tribal’s Areas

Forest Ecology and Women’s Health

Post Independence Transformation of Tribal’s Society

Summary

 

Learning Objective

  • To able to define an exclusive social and structural account of the Tribal health in India.
  • An attempt to classify the course of historical development, academic, and Anthropological importance in terms Health of Tribal studies.
  • To be able to define the immense significance of health in the tribal development and role of health care administration.
  • To able to define the process of examining source integrated approach to the study of Tribal communities
  • To able to trace the effect of social structure and organization on health of tribal population in India

    Introduction

 

India is known to be a vast country with scanty population in the prehistoric age. During this period there were small groups of people scattered throughout the country in different spots. The Tribal culture blooms in the isolated highlands and forests of India. The tribal’s are an integral part of the Indian population. Their isolated ecology, economy, society, religious beliefs are long association with the Indian society. India is one of the few nations of tribal concentration and is also said to have the largest tribal population.

 

The widespread poverty, illiteracy, malnutrition, absence of safe drinking water and sanitary living conditions, poor maternal and child health services and ineffective coverage of national health and nutritional services have been traced out in several studies as possible contributing factors to dismal health conditions prevailing among the tribal population in India.

 

General Profile of Tribal India

 

Tribal peoples form a major segment of the world population. They are found all over the world. They are called by different names such as “primitive, ‘tribal,’ ‘indigenous,’ ‘aboriginal,’ ‘native,’ and so on. India has a large number of tribal people. India is home to one of the largest number of tribes in the world. Although there are 537 tribal communities in India, only 258 communities have been notified as tribes. STs as a category of India’s population, constituting 8 percent of her’ total population (Census, 2001), is “varied in terms of socio-economic and political development (Sharma, 2007). Tribes in India are not a homogeneous group as their culture and values are distinct from each other. The states of Maharashtra and Orissa share the largest number of tribes in India. There is high variation in the spatial distribution of tribes in India. Almost 82 percent of the tribes live in western and central states where only 11 percent of them are located in southern states. Regarding the growth rate of tribal population, it is obvious that the number of tribe has been growing over the years although the rate of growth of tribe population has been less than that of the general population.

 

On the basis of racial features, Guha, B.S. (1935) considers that the tribal population of India belongs to three races namely the Proto-Australoids, the Mongoloids and the Negritos.

 

Literacy among the tribals is very low (25.9 per cent) and especially so among the tribal females (14.5 per cent). The level of education among the most of the scheduled tribes is upto primary level. The lowest level of literacy among females was found in Rajasthan (4.1 per cent).

 

Sex-ratio (females per thousand males) reflects the status of socio-cultural, maternal and child health care programmes existing in the population, the sex ratio of the tribal population was 972 females per thousand males against 927 for the total population. The highest sex ratio for scheduled tribes among various States has been reported from Orissa (1002) and the lowest from Goa (889).

 

Anthropological concerns in study of Tribal’s health

 

The study of tribal’s, health has been one of the oldest of anthropological concerns. Anthropologists and development planners take cognizance of the tribal tradition and way of life lest the overwhelming non tribal culture swamps their pristine, grass root culture. In fact, the genesis of anthropology can be traced to the attempts, made by European colonists, travellers, explorers, and missionaries to understand and describe the ways of life of the native people they found in Africa, Asia, Australia and the rest of the world. Tribal health studies is though not an exclusive task of anthropologists alone, as any developmental work should be done through multidisciplinary, approach nevertheless, anthropology play greater role in this context is also equally true. Of all the social sciences anthropology has the distinction of having field work tradition. Rigorous training in the field enables anthropologists to be more familiar with the tribal health and effect of rural environment than others. An anthropologist collects data maximum through participant observation method i.e. by living among the natives for a long span times. Thus an anthropologist does certainly have more experience of tribal life; he is better position not only to understand tribal or rural position but also suggest solution for them.

 

Health status of a Indian Tribal

 

Health and Its Correlates

 

Health is a pre-requisite for human development and is essentially concerned with the well being of common man. The UNDP Human Development Index (HDI) comprises three components i.e. health, education and income generating capacity. Health is a function, not only of medical care, but also of the overall integrated development of society – cultural, economic, educational, social and political. The health status of a society is intimately related to its value system, philosophical and cultural traditions, and social, economic and political organisation. Each of these aspects has a deep influence on health, which in turn influences all these aspects. Hence, it is not possible to raise the health status and quality of life of people unless such efforts are integrated with the wider effort to bring about overall transformation of a society. Health development can be integrated with the larger programme of overall development in such a manner that the two become mutually self-supporting. Good health and good society go together. This is possible only when supportive services such as nutrition and improvements in the environment and in education reach a higher level.

 

Health Culture

The culture of community determines the health behaviour of the community in general and individual members in particular. The health behaviour of the individual is closely linked to the way he or she perceives various health problems; what they actually mean to him or her, on the one hand, and on the other his or her access to various relevant institutions.7 The holistic concept of health culture provides a valuable framework for analysing the work of anthropologists in health fields. However, a very few studies are available in this direction, especially among the tribal population.

 

Child Bearing and Maternal Mortality

Child bearing imposes additional health needs and problems on women – physically, psychologically and socially. Maternal mortality was reported to be high among various tribal groups but no exact data could be collected. The chief causes of maternal mortality were found to be unhygienic and primitive practices for parturition.

 

For example, it was observed that among Kutia Khondhs the delivery was conducted by the mother herself in a half squatting position holding a rope tied down from the roof of the hut. This helped her in applying pressure to deliver the child. In complicated labour, obviously it might lead to maternal as well as child mortality. Similar crude birth practices were found to exist in other tribal groups like Kharias, Gonds, Santals, Kutia Khondhs of Orissa, Santals, Jaunsaris, Kharias, etc.).

 

Expectant mothers to a large extent are not inoculated against tetanus. From the inception of pregnancy to its termination, no 65 specific nutritious diet is consumed by women. On the other hand, some pregnant tribal women, (that is, Dudh Kharias, Santals) reduced their food intake because of simple fear of recurrent vomitting and also to ensure that the baby may remain small and the delivery may be easier. The consumption of iron, calcium and vitamins during pregnancy is poor. The habit of taking alcohol during pregnancy has been found to be usual in tribal women and almost all of them are observed to continue their regular activities including hard labour during advanced pregnancy. More than 90 per cent of deliveries are conducted at home attended by elderly ladies of the household. No specific precautions are observed at the time of conducting deliveries which resulted in an increased susceptibility to various infections. Services of paramedical staff are secured only in difficult labour cases.

 

As far as child care is concerned, both rural and tribal illiterate mothers are observed to breast -feed their babies. But, most of them adopt harmful practices like discarding of colostrum, giving prelacteal feeds, delayed initiation of breast-feeding and delayed introduction of complementary feeds. Vaccination and immunization of Infants and children have been inadequate among tribal groups. In addition, extremes of magico-religious beliefs and taboos tend to aggravate the problems.

 

The Infant Mortality Rate (IMR)

The tribal population has much lower IMR as compared to the scheduled castes but moderately higher than the other population.

 

Tribal Households

About half of the population of Andhra Pradesh, Madhya Pradesh, Bihar and Orissa enter their dwelling units by bending or crawling only. In Gujarat, Rajasthan and Maharashtra about a quarter of the population has such dwelling units. Most of these houses lack adequate ventilation or natural lighting.

 

Life Expectancy

The expectation of life is the average number of years remaining to be lived by those surviving to that age.

 

Genetic Disorders

Genetic disorders especially sickle cell disease and G-6-PD have been found to occur in high frequency among various tribal groups and scheduled caste population. The sickle cell disease has been found in most of districts of Central, Western and Southern India. The prevalence is especially high among the tribes and scheduled castes of Madhya Pradesh, Maharashtra, Tamil Nadu, Orissa, Assam (more than 15 per cent) specially in hyperendemic malarial zones. Prevalence rate upto 40 per cent of sickle cell trait has been reported in some tribes i.e. Adiyan, Irula, Paniyan, Gonds.

 

Sexually Transmitted Diseases (STDs)

Sexually transmitted diseases (STDs) are most prevalent disease in the tribal areas. VDRL was found to be positive in most of the cases of polyandrous Jaunsaris of Chakrata, Dehradun.

 

Health Problems

The health problems need special attention in the context of tribal communities of India. Available research studies point out that the tribal population has distinctive health problems which are mainly governed by their habitat, difficult terrains and ecologically variable niches. The health, nutrition and medico-genetic problems of diverse tribal groups have been found to be unique and present a formidable challenge for which appropriate solutions have to be found out by planning and evolving relevant research studies.

 

Insanitary conditions, ignorance, lack of personal hygiene and health education are the main factors responsible for their ill health. Some primitive tribal communities are facing extinction like the Onges, Jarwas and Shompens of Andaman and Nicobar Islands.

 

Some of the problems as indicated by investigations include

  • Endemic diseases like malaria,. introduced from outside or otherwise like tuberculosis, influenza, dysentery, high infant mortality and malnutrition,
  • Venereal diseases, induced abortion, inbreeding, addiction to opium, custom of eating tubers of DIOSCERA (may cause sterility as they contain substances used in oral contraception), and
  • Disturbed sex ratio leading to shortage of women. Urgent studies are, therefore, required on different primitive tribal groups of India which are small in size. The health and nutrition problems of the vast tribal population of India are as varied as the tribal groups themselves who present a bewildering diversity and variety in their socio-economic, socio-cultural and ecological settings.

   Nutritional anaemia is a major problem for women in India and more so in the rural and tribal belt. This is particularly serious in view of the fact that both rural and tribal women have heavy workload and anaemia has profound effect on psychological and physical health. Anaemia lowers resistance to fatigue, affects working capacity under conditions of stress and increases susceptibility to other diseases. Maternal malnutrition is quite common among the tribal women especially those who have many pregnancies too colsely spaced. Tribal diets are generally grossly deficient in calcium, vitamin A, vitamin C, riboflavin and animal protein.

 

Deprived of Basic Nutrition, Sanitation, Health

 

Tribal are the life line of India but poverty has plagued the lives of Tribal’s folk. The unequal distribution of assets such as land along with failure in crops due to erratic rainfall and floods are causes of poverty in the country side. Lack of skills and education along with distress migration has been other causes of poverty. Poverty has its effects on overall Tribal development. They are deprived of basic human necessity of nutrition, sanitation, health.

  • The anti -poverty and development programmes has not percolated to the real beneficiary.
  • The problem of disguised labour is prevalent in agriculture.
  • Lack of other employment avenues due lack of requisite skills and technical education.
  • Irrigational facilities are not available in major areas. Dependence on rainfall and groundwater extraction has cause a detrimental effect on agricultural practices
  • Low agricultural poverty due to dependence on traditional methods of farming techniques.
  • Poor quality of livestock.
  • Poor quality of education and lack of skill development.
  • Absence of dynamic community leadership.
  • Presence of liquor and unwanted expansive social spending on rituals, customs etc.

   Union and state governments have made efforts to raise the level of tribal living at par with the other citizens; aimed at inhabitants, have taken special care to protect and preserve the tribal culture. In tribal area, where the tribal economy revolves around forests and forest based produce, the forestry based programmes have to be devised as to be in consonance with the socioeconomic fabric tribal culture and ethos. Economic development of tribal population, without cultural oppression or giving offence to their heritage or ethos will remain a challenging task for years to come.

 

Strategies for Tribal Development in Tribal’s Areas

  • The formal credit institution should be properly strengthened.
  • Poverty alleviation programmes should be properly targeted so the benefits reach the needy ones.
  • Focus should be given on integrated approach of human development by focussing on health, nutrition, sanitation and skill development.
  • Creating social awareness to arrest increasing debt growth among the poor.
  • Financial literacy must be propagated and banking facilities must be introduced with right earnest.
  • Diversifying farming activities to animal husbandry, poultry, fishing and dairy farming.
  • Steps should be taken to empower women by skill training, education, handicraft, financial training so that they can be part of the developmental process.

    Forest Ecology and Women’s Health

 

The forest based, tribal economy in most parts of the world was women-centred. Women made provisions for the basic necessities like food, fuel, medicine, housing material, etc. Because of extensive cutting of trees by vested interests, the distances between the villages and the forest areas had increased, forcing the tribal women to walk longer distances in search of minor forest produce and firewood. In this rapidly changing milieu, tribal women were confronted with an extraordinary workload. Given this additional workload, even women in advanced stages of pregnancy were required to work in the agricultural fields or walk great distances to collect fuel and minor forest produce. To add to the malnutrition and additional workload, there was destruction of traditional herbs through deforestation and the lack of access of the tribal to modern medicine. This along with the increasing ecological imbalance resulted in diseases such as TB, stomach disorders and malaria.

 

Post Independence Transformation of Tribal’s Society

 

The post -independence period has shown a dynamic shift in Tribal’s society. The increase use of agricultural labour, shift in mode of payment from kind to cash and presence of free wage labourers were evident in these Tribal’s areas. The commercialisation of agriculture has brought about a capitalistic mode of production to this sector. The Tribal’s men were used as a mere means of production. As farm sector growth took place the Tribal’s society was integrated to the market economy. The flow of capital led to diversification of business and employment opportunities. The transformation of Tribal’s society began during colonial period but it gain momentum during post – independence period due to intervention of government policies. Development of irrigation, rural infrastructure, input fertilizers; formal credit mechanism through banks and co-operatives for agricultural growth prompted these changes. These policies not only transform the Tribal’s economy but also Tribal’s social system. The transformation of Tribal’s society was regionally imbalanced and varied across India.

 

The impact of globalisation had its impact on social customs and traditions; the westernization of culture has led to erosion of traditional values and customs. The impact of global media has brought about a tectonic shift in the culture and thought process of Indian Tribal’s life. The globalisation process has brought about aspiration changes in the mind of towards Tribal’s people health.

 

Summary

 

Tribals have come a long way. Their situation has been changing. With the facilities available to them, their situation is improving to some extent of health. It remains a great job for the State and Central Government to bring tribes into confidence, educate them, clad them, take health care and arrange for their living by developing skill. The tribal culture of India has undergone changes owing to several factors, such as impact of education introduce by missionaries or Government, development of various communication etc; nevertheless, the greatest impact has been that of industrialization and urbanization. The obvious reason for this has been that the tribal area throughout the country are very rich as for as the mineral and the industrial resources are concerned.

 

In general, however, the tribes in different parts of India passing through an accelerated phase of transformation and equilibrium in the traditional society has definitely been greatly disturbed; a phase of transformation marketing the meeting of the two worlds, traditional and modern, is in the process, it seems the different tribes or sections of a tribe will continue to respond the change differently, and thus the identity and variety of the tribal culture, of course in changed form, will be maintained.

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Know More / Web Resources

 

SUGGESTED READING

  • Dev Nathan, 1997, From Tribe to Caste, Shimla, Indian Institute of Advanced Study.
  • Ghurye, G.S., 1963, The Scheduled Tribe, Popular Book Depot.
  • Mathur, K.S. & Agarwal, B.C., 1974, Tribe Caste and Peasantry, Lucknow, Ethnographic & Folkculture Society.
  • Saraswati, B.N., 1997, ‘Tribes as Caste’ in From Tribe to Caste edited by Dev Nathan, Shimla, Indian Institute of Advanced Study.
  • Beteille, Andre, 1974, Six Essays in Comparative Sociology, Delhi, Oxford University Press
  • Dube, S.C., 1990, Indian Society, New Delhi, National Book Trust
  • Hasnain, Nadeem, 2004, Indian Society and Culture: Continuity and Change, New Delhi, Jawahar Publishers and Distributors
  • Vidyarthi, L.P. & Rai, B.K., 1985, Tribal Cultures of India, New Delhi, Concept Publishing House.

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