Govt inaction killed 10 lakh tribals of treatable diseases, malnutrition since Aug 2018

Nagpur: Even as the government is going full steam in containing Covid-19 which has claimed over 43,000 across the country, apathy and inaction on the recommendations of an expert committee have killed over 10 lakh tribals in India since August 2018.
The committee led by NGO Search’s founder Dr Abhay Bang, whose studies have shaped health care policies, had said health status and care in tribal areas were poorest in its report submitted on August 9, 2018.
The biggest causes of death include preventable illnesses such as malaria, malnutrition, childhood pneumonia and diarrhoea, neonatal morbidities, tuberculosis, snake bites, alcoholism, suicides and non-communicable diseases such as hypertension, stroke and cancer, which are rising rapidly among tribal people.
Dr Bang warned recently, the arrival of Covid-19 may play havoc because tribal people might be vulnerable due to lack of health care.
In his reminder sent on World Indigenous People’s Day, on August 9, to the Centre, Dr Bang appealed to Union health minister Dr Harsh Vardhan to launch ‘Tribal Health Mission’ for the 11 crore tribals, as per the committee’s recommendations. He also suggested an action plan on tribal health by the health ministry and time-bound implementation.
Ministries of health and tribal affairs had jointly appointed the committee on tribal health under the chairmanship of Dr Bang. After over four years of study, the committee of 12 experts submitted its report on August 9, 2018. Though both ministries welcomed the report and promised action, nothing has been done.
The committee report ‘Tribal Health in India: Bridging the Gap and Roadmap for the Future’ had concluded that tribal people’s health status is worst in India, their health care system has a design mismatch, and it is a ‘low input, low output, low quality and low morale system’.
The committee identified 10 specific health problems in tribal areas and suggested appropriate solutions.
Most importantly, the committee recommended formulation of a tribal health action plan, and annually allocating Rs2,500 per tribal person or total Rs27,500 crore for tribal health, to be spent by the Centre and the states together. The NITI Ayog had also recommended to the health ministry to initiate action on the report.
In 2011, an estimated 1,46,000 tribal children died. The health service delivery in tribal areas is extremely weak, as basic infrastructure and personnel needs have large gaps.
The expert committee recommended some long-term structural measures, some solutions for the specific problems such as malaria or child mortality.
In a press note, Dr Bang said, “Dr Harsh Vardhan, who himself is a doctor, and known for his crusades against polio and tobacco, was probably not aware of this report.”
In response to Dr Bang’s letter, Dr Vardhan has replied, “Sure, due action will be initiated.”
FINDINGS
30-80% doctor posts vacant, absenteeism common, morale low
Low input, low quality, low output and low outcome system
Record keeping and data on tribal health absent
Indices like infant mortality rate and life expectancy not calculated for tribals
Nobody in Centre or states care for these numbers
Indifference to tribal health, not counted, not published, not monitored or evaluated
RECOMMENDATIONS
Launch Tribal Health Action Plan to raise tribal health to state levels by 2027
8.6% of the health budget be spent on tribal health
Tribal Health Council, Tribal Health Directorate and Tribal Health Research Cell at national and state levels
Shift primary health care delivery system towards tribal communities
Facilitate integration of tribal medical system and modern medicine and public health systems
Generate knowledge and data on aspects of tribal health through surveys, epidemiological research, maternal and child death audits and create Tribal Health Index