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Genderlog @genderlogindia
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I touched briefly on caste and healthcare earlier but the problem extends far beyond simply access to medical services.
Vani Kant Borooah used data from the national sample survey (NSS) to study 6 different groups - adivasis (56% Hindu and 33% Christian); Dalits (93% Hindu); non-Muslim OBC; Muslim OBC; Muslim upper caste; and non-Muslim upper classes,- and found disparities in life expectancy.
Upper caste non Muslims on average live up to 17 years longer than other groups (Chart 1). Even when adjusted for income and socioeconomic factors there is still a 10 year difference between upper and lower caste groups (Chart 3). ST have the lowest average age at death-43 years.
Aside from the evident caste discrimination, many SC migrate for work, and then are unable to register for government benefit schemes like ration, aaganwadis, health initiatives like TB treatment programme, perinatal care, etc without ID and address proof.
ST like the Bhils, uprooted from their lands and forced into a cycle of poverty, cannot afford healthcare - the medical aid itself, as well as the traveling to and fro, the financial cost of missing work - and rely on faith healers instead.

atimes.com/article/with-s…
Many have restricted access to vaccination, clean water, sanitation, and nutrition leaving them vulnerable to infectious diseases, including diarrhoeal diseases (3rd leading cause of death) and TB (6th leading cause of death).

thehindu.com/opinion/lead/C…
Manual scavenging has been covered on this account before but I'd like to briefly highlight some of the terrible effects on their health.

(Moment of tweets by a previous curator on manual scavenging and caste and gender discrimination)
twitter.com/i/moments/9217…
From the Hidden Apartheid (2007) report by the UN Committee on the Elimination of Racial Discrimination - bit.ly/2zlCMLR

In addition they are often denied treatment at public health centres, charged fees for services that should be free, given substandard care.
An estimated 1.2 million SC, 95% of whom are women, are trapped in manual scavenging. It was legally abolished in 1993 (TWENTY FIVE YEARS AGO) but the law is rarely enforced.

Report by Rashtriya Garima Abhiyan and International Dalit Solidarity Network
idsn.org/wp-content/upl…
While patients are ill treated on basis of caste, doctors too face discrimination. Federal investigations were conducted into complaints of harassment and abuse of SC/ST students at AIIMS, not just from other students, but also professors.

bbc.co.uk/news/world-asi…
More than 90% of SC/ST students at AIIMS, the country's leading medical school, say they are humiliated by examiners, didn't receive support from their teachers, were asked about their caste background, were not given marks fairly, and their papers not evaluated properly.
Only 13.5% and 4% of the total students in higher education belong to SC, ST respectively, while only 7% and 2% of professors in universities are SC and ST respectively.
The Death of Merit (2011) is about the suicide of a final year MBBS student at AIIMS.
Doctors report facing caste discrimination from all sides - patients, colleagues, universities, and hospital authorities, as well as in other spheres of life like housing.

hindustantimes.com/india-news/whe…

thenewsminute.com/article/theres…

timesofindia.indiatimes.com/city/ahmedabad…

newindianexpress.com/states/tamil-n…
This year India ranked 145th out of 195 countries in terms of quality and accessibility of healthcare. It would be impossible to improve health care without a integrated approach involving social realities of caste and class across the country.

roundtableindia.co.in/index.php?opti…
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I was especially conscious of using gender neutral language here because so often medical discourse completely invalidates people outside the allo cis hetero normative assumption. It has also lead to some alarming blind spots in research today.
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I wonder a lot about why people avoid going to the doctor (including doctors themselves) or ignore health problems for so long.
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