daktre/ಡಾಕ್ಟ್ರೇ Profile picture
Dad|Dr|Public Health researcher|birder|half-marathoner|Faculty @iphindia|@India_Alliance Fellow|Editor @HPP_LSHTM @plosgph @WikiJMed|tweets own
9 Aug
Made Gowda from the Solega Adivasi community recalls the global struggle for land of indigenous peoples and the close relationships with nature that many other communities have lost and connects this special relationship to climate change #WorldIndigenousDay
Shares that Covid19 is a real threat to Adivasi as well; adding to a long list of problems that they already face; “let’s protect our language, symbols and our culture”…let’s retain our pride in Adivasi culture he says
Without ಸಂಘಟನೆ and solidarity we are weak; we need to stand up for our interests and take our entire community with us; nit clutch at individual opportunities but look for opportunities that lift communities he says
Read 25 tweets
26 Jul
1/ Thread on landscape level (across administrative boundaries & sectoral jurisdictions) #OneHealth approach could ↑ socio-ecological solutions; our new paper analyses Emerging infectious disease (EID) risk in high altitude mountains/plateaus of Asia
link.springer.com/article/10.100…
2/ 75% of EIDs are zoonotic i.e, transmitted to us from animals: SARS, COVID19, HIV/AIDS, Avian Flu, Plague etc. they've always had pandemic potential, but increase in frequency linked to globalisation & increasing anthropogenic resource extraction & macroeconomic demands;
3/ In a supplementary file, estimates of human fatalities from known pandemics are tabulated (with links to sources); see for eg estimates from plague & Spanish Flu static-content.springer.com/esm/art%3A10.1…
Read 29 tweets
10 Jul
1/ Thread on our paper reporting unfair accumulation of malnutrition in particular intersectional social gps & geographies in India; we id 4 clusters of dts (hotspots); instead of separately for stunting, wasting & underweight, we use CIAF; > comprehensive Image
2/ Paper co-authored with @SabujosephK & @yogishcb & Sangeetha Joice; equityhealthj.biomedcentral.com/articles/10.11…
3/ High stunting (>46 m children) & wasting (>25 m) in India; 5th highest prevalence of u-weight & 3rd highest prevalence of wasting; unfair patterning of child malnutrition by caste, sex, religion, location and socio-economic position already well characterised;
Read 61 tweets
27 Jun
1/ Thread on High Level Expert Committee for Prevention & Management of COVID 3rd wave chaired by #DeviShetty & nearly #allmale & clinician led committee with hardly any diverse expertise needed (covered in my earlier thread which fell on deaf ears @BSYBJP @mla_sudhakar);
2/ My view based on my training in medicine & #PublicHealth & what I have learned through several years of #CommunityEngagement & #PrimaryHealthCare in rural Karnataka #Chamarajanagar;
3/ While the original notification was all men, 2 women seem to have been added; the summary of the report is about 30 pages while the "detailed recommendations" are 60 pages; rather poor attempt at summarising IMO
Read 38 tweets
9 Jun
1/ #Vaccination #Adivasi #COVID thread; day begins with an orientation meeting to #Solega #Adivasi leadership on #vaccination at a hamlet; we address doubts and misconceptions; leaders criticise the stereotype of #Tribal Community as being hesitant and "running away";
2/ ask that officials & NGOs engage meaningfully and respectfully with their leadership at multiple levels; refuse the idea that they are ALL hesitant which often prevails among "others"; they explain what is the best way of engaging #Adivasi communities
3/ They offer to identify #COVID volunteers in each podu (hamlet); volunteers can be oriented in small groups & shall help with obtaining proper consent and participation of their elders;
Read 11 tweets
8 Jun
1/ Shared few insights emerging from community-based #COVID care that some communities have begun in #Adivasi populations in #Chamarajanagar with support from #ZillaPanchayat in live video interaction with #Karnataka #GramPanchayats thanks to @gokRDPR
2/ #COVID19 care needs to be rational & #evidence-based but also respectful & dignified; these are not aspects we have done well with in our #HealthSystem & hence need special attention;
3/ Dignified & respectful care requires an awareness of diverse socio-economic & cultural contexts at individual, household, neighbourhood & societal levels; we haven't substantively engaged with (#caste #gender #disability #sexuality #privacy )-aware care at systemic level
Read 7 tweets
4 Jun
#COVIDSecondWave care requires local #CommunityEngagement for it to be meaningful, respectful and dignified; at one of #chamarajanagar #solega #adivasi settlements yesterday was a humbling experience learning together with the people how to organise care in a culturally safe way
A remote forest settlement; sudden spurt of cases; testing hesitancy and immediate referral to far away #covidcare centres driving anxiety for testing and failing trust in ASHAs; #Panchayat president on location, NGOs, health workers, tribal welfare officers on site
Hours of respectful dialogue follows; various modalities discussed; an amazingly enthusiastic #Panchayat president convenes impromptu consultation at local tribal residential school; CEO and Zilla panchayat admin patiently listen to local proposals
Read 8 tweets
2 Jun
1/ Joining some wonderful people from what I am seeing as a diverse group of researchers at the #EditorialBoard of @PLOSGPH; journal has given itself the tall order of “addresses inequities in public health and makes impactful research accessible to all… (1/n) #Threads
2/ In words of @paimadhu "the journal will amplify the voices of underrepresented and historically excluded communities and prioritize equity, diversity, and inclusion at all levels"; I am highly skeptical of this,
3/ yet I am thrilled that a #PublicHealth journal would give itself such a vision; #Knowledge #Science #Evidence all reproduce the same kind of social hierarchies that drive unfair accumulation of resources in our society
Read 12 tweets
31 May
Thread on #GramPanchayat task force chaired by #Rangamma frm #Soliga #Adivasi community #brhills #Chamarajanagar; praise for #HealthWorkers but frustration at lack of “higher officials” coming to GPs; @readingkafka @iphindia
PHC MO and other doctors address the gathering about the last one month experience of #Chamarajanagar and how situation is slowly improving; need to address hesitancy towards testing and vaccine; also not to become complacent about dropping numbers
PHC Dr frm #Gumballi patiently heard & clarified how these are stressful times for all #HealthWorkers; members demand at least one visit a month from #taluka officials; patient listening of complaints is an important function even if they are not immediately resolved;
Read 8 tweets
27 May
Will we EVER learn about #PublicHealth?
3rd wave “expert” committee is nearly-ALL #Pediatricians (to keep Devi Shetty’s non-#evidence-based assertion on #children will be entirely affected), #AllMale #Manel, nearly-all #clinicians headed by #PrivateSector #Cardiologist
I request this committee members:
- Please QUESTION Devi Shetty’s credentials to lead this
- Please hold to account #Manel #AllMale membership
- Please include #RuralHealth #CommunityHealth #PublicHealth
- Expertise is NOT only CLINICAL; also social; include grounded voices
Unfortunately no time & bandwidth; but putting this out there
We need:
- campaign for a DIVERSE expert committee including #Citizen #CommunityEngagement #Dalit #Adivasi voices
- Devi Shetty’s position as Chair is NOT tenable; appoint a #PublicHealth expert in his place
Read 6 tweets
8 Apr
A #thread on our recent paper in @PLOSNTDs examining ecological #evidence-base for #DiseaseControl management practices for #KyasanurForestDisease #AcademicTwitter #Scicomm #OneHealth; paper led by @SarahBurthe from @MonkeyFever_ consortium
#Diseasecontrol strategies originate through endorsements by Governments/academia/authorities; they're often not field-tested robustly; even when they are, evidence is limited to one sector (cf. #OneHealth #Intersectoral approaches);
#publichealth approaches ought to be contextual & their effectiveness ought to be evaluated, yet strategies for disease control often spread through word of mouth and are sometimes untested;
Read 50 tweets
9 Mar
A #thread on #IWD2021 at #brhills at IPH field station in collaboration with the #brhills #Panchayat, Zilla Budakattu Girijana Abhivruddhi Sangha (Sangha; Dt. #Indigenous #Adivasi People’s Welfare Society) & VGKK #THETAProject; Main organisers: Mahadevamma, Susheela & Mahantesh Image
Idea for holding ಮಹಿಳಾ ದಿನಾಚರಣೆ mooted by Mahadevamma who is a #Soliga woman leader and supported by the Sangha; initial discussions with the newly elected #Panchayat members drew support; they didn’t recall a gathering for this purpose before
Rangamma, a newly elected GP member from Seege Betta Podu agrees to preside; all GP members agree to attend and involve as many people from nearby settlements as possible; Muthugada Gadde & Hosa Podu girls throwball clubs formed under THETA intervention too involve themselves
Read 21 tweets
26 Dec 19
A compilation that I #Kant but share. :)

Tweet-quotes from "Grounwork for the Metaphyics of Morals" (1875) #Thread follows:

"Nothing can possibly be conceived in the world, or even out of it, which can be called good, without qualification, except a good will."
"Intelligence, wit, judgement, and the other talents of the mind, however they may be named, or courage, resolution, perseverance, as qualities of temperament, are undoubtedly good and desirable in many respects;" #Kant
"but these gifts of nature may also become extremely bad and mischievous if the will which is to make use of them, and which, therefore, constitutes what is called character, is not good. It is the same with the gifts of fortune." #Kant
Read 53 tweets
3 Nov 19
A thread on some quotes from @gautambhatia88’s “The transformative constitution “In equality jurisprudence, the approach of focusing on the disproportionately exclusionary impact if politics rather than their formal character or motive is known as disparate impact”
“It is based on the premise that inequality and discrimination result not (only) from individual hostile acts, but from structures and institutions.” @gautambhatia88 Only in brackets important & added by me.
An test for entry may be “neutral” but yet exclude by aligning with exclusionary institutions; if an physical entrance test for firefighter includes activities not necessary for fulfilling duties and unintentionally poses #gender-barriers, deserves to be struck down. #NoteToSelf
Read 95 tweets
28 Oct 19
“...people usually gain power through traits and actions that advance interests of others such as #empathy, #collaboration, openness, #fairness...when they start to feel powerful or enjoy position of privilege, those qualities begin to fade....(1)
...The powerful are more likely than other people to engage in rude, selfish and unethical behaviour” #RebeccaSolnit citing #DacherKeltner on his work studying relationship between empathy and power
“If power generates a cushion of obliviousness around it, those of us with power need to counter it. That means, first, treating people with respect, regardless of their status: not taking the invitation to disdain or ignore” #Solnit
Read 26 tweets
19 Sep 19
#TRIBECON begins #Pravara; felicitations to #AbhayBang @SearchGad & #sudarshan #VGKK for their inspiring work on #TribalHealth; @DrLahariya @whoindia among others felicitated
#abhayBang #healthsystem design for tribal communities need to be relooked for #UHC; strategies & schemes must adapt with local social & cultural context; recollects #Brainstorming with @DesirajuKeshav at @SearchGad leading to #ExpertCommittee #tribalhealth @TribalHealthIND
#TRIBECON #AbhayBang notes with happiness increasing interest in #tribalhealth research, yet this continues to be “off the beaten path”; congratulations to #pravara medical college in bringing this together; the proposed #Bandardhara declaration to improve #tribalhealth research
Read 81 tweets