By Dr. Soujanya Rapeti and Dr. Shrikant Kalaskar
Health is not merely a product of medical care; it is shaped by social, economic, and environmental conditions. For the Gutti Koya, a tribal community displaced from Chhattisgarh to Telangana, these factors significantly impact their well-being. Their journey, marked by forced migration, legal invisibility, and systemic neglect, has left them vulnerable to health disparities that demand urgent attention.
Vulnerability of the Gutti Koya Community
Telangana is home to several indigenous communities, including the Gutti Koya, who were displaced due to the ongoing conflict between Naxal insurgents and security forces in Chhattisgarh. Seeking refuge in Bhadradri Kothagudem, they now form a significant part of the tribal population in the region. However, despite escaping violence, their new life presents fresh challenges—legal exclusion, poor healthcare access, lack of educational opportunities, and precarious living conditions.
While working with this community, it is evident that the Gutti Koya community faces severe health inequities. Limited infrastructure, poor sanitation, and malnutrition contribute to widespread health concerns, including infections, malaria, anaemia, joint pain, and pneumonia. Women and children, in particular, bear the brunt of these adversities.
Social Determinants and Their Impact on Health
Health in the Gutti Koya community is closely tied to their social and economic conditions similar to any other underprivileged community. Their main sources of earnings like daily wage labour and seasonal agricultural work, maks it difficult for them to prioritize healthcare. Limited access to education is another major challenge, as children has to walk long distance to attend even a primary school, leading to high dropout rates and limiting future opportunities. Vicious cycle of poverty and poor health continuous in the community.
For Gutti Koya given their strong cultural traditions has strong influence in healthcare choices. Many community members rely on traditional healers and home remedies instead of seeking medical help. Women, in particular, face barriers—hospital visits often require permission from male family members, and home deliveries (births) are predominant even after much advancement of healthcare in the state. This increases the risk of high maternal and infant deaths and health complications.
We have found that the lack of government recognition adds to their vulnerability, preventing them from accessing welfare programs that provide essential health services. As a result, preventable diseases such as malaria, anaemia, pneumonia, skin infections, and respiratory illnesses are widespread, especially among children and the elderly. Poor sanitation and malnutrition further worsen health outcomes, making the community highly susceptible to infections and chronic illnesses.
A Ray of Hope: MMU Interventions
Amid these challenges, there are attempts through NGOs like Indigenous Development Organisation providing basic healthcare services via Mobile Medical Unit (MMU), directly to these remote tribal hamlets. Through persistent community engagement, trust in formal healthcare providers is gradually increasing. More families are now seeking institutional healthcare, though much work remains in undoing long-standing barriers.
The Path Forward: Policy and Community-Led Solutions
There is an urgent need for targeted healthcare strategies, policy reforms, and infrastructure improvements for reaching the unreached. Recognizing their legal status, expanding healthcare outreach programs, encouraging NGO partners and donors, integrating public and private providers for providing services, and integrating culturally sensitive health education can be critical steps toward bridging the health gap. On the other hand, we as a mainstream society can also learn from the marginalised communities on how to service and adopt to given situations and learn some of their best practices may be.