This book explores how social discrimination in South Asia contributes to health disparities and impedes well-being. Specifically, it addresses how marginalization shapes health outcomes, both under normal circumstances and specifically during the COVID-19 pandemic. Coming from diverse backgrounds and representing different academic disciplines, the authors have contributed a range of chapters drawing from quantitative and ethnographic material across South Asia. Chapters address reservation politics, tribal lifeways, Dalit exclusions from governmental institutions, Muslim ghettoization, gendered domestic violence, social determinants of health among migrant workers, and the pandemic fallout across South Asian society, among other subjects. Scholars draw on decades of experience and firsthand ethnographic fieldwork among affected communities. The chapters provide an innovative analysis, often in real time, of the human toll of casteism, classism, patriarchy, and religious intolerance―many set against the spectre of COVID-19. Many authors not only present social critiques but also offer specific policy recommendations. The book is of great interest to social scientists, public health practitioners, and policy advocates interested in addressing systemic inequalities and ensuring that future pandemics are not disproportionately felt by the most vulnerable.
Author(s): Sanghmitra S. Acharya, Stephen Christopher
Series: People, Cultures and Societies: Exploring and Documenting Diversities
Publisher: Springer
Year: 2022
Language: English
Pages: 400
City: Singapore
Foreword
Contents
Editors and Contributors
1 Of Prejudice and Pandemics
Social Discrimination and Well-being
Indian Inequality in a Global Perspective
References
Part I Institutional Exclusions
2 Exceptional Aryans: State Misrecognition of Himachali Dalits
Introduction
Halis and Scheduled Caste Gaddis
Purification Through the Arya Samaj
Chandru’s Arya Problem
Caste Correction Woes
An Institutional Rejoinder
Conclusion
References
3 A World Inside a Pig’s Stomach: Alimentary Knots of Tension Around Nutrition, Autonomy and Nationhood
Introduction
Sixth Schedule, Autonomy and Food Security
Caste Hindu Porcine Discourses
Complexities of Caste and Hindu Nationalism in Assam
‘We are unable to become Hindu’: Alimentary Paths, Nutrition and Nationhood
Medical Discourses About Hygiene and Nutrition
Muddiness, Dirt and Disease: Medical Discourse About Porcine Lives
Climate Change and Nutrition in Riverine Mising Lives
“We do not eat the Mother”: Intimate Human–Animal Relationships
Porcine Industrialization as Disrupting Ancestral Connections
‘We ate pork with herbs that cut its fat’: Co-Produced Lifecycles of Pigs and Herbs
Conclusion
References
4 The Role of Caste Prejudice in Hampering Infection Control Efforts in Government Hospitals
Introduction
Background
Methods
Findings
Unhygienic Practices and Lacking Infection Control
Persistence of Unhygienic Conditions
The Role of Caste Prejudice
Misperception of the Probability of Infection
Lack of Resources
Systemic Negligence and Corruption
Conclusion
References
5 Public and Corporate Health Sector Disparities: Reflections on COVID-19 Experiences in India
Introduction
Development of Health Care Services in India
Three Tier Public Health Care Services
Health Care Spending
Human Resource Vacancies in Public Health Sector
Private and Corporate Health Care Services
Public Subsidies to Corporate Hospitals
Medical Tourism and Misplaced Priorities
Disaster Capitalism: Private Hospitals and Unethical Behaviour
Role of Private and Corporate Sector in Disasters
Good Practices by Some States
Discussion and Recommendations
References
6 Knowledge Accumulation During COVID-19: Increasing Digital Divide and Vulnerability Among Indian Students
Introduction
Digital Divide and Indian Social Inequalities
Government Initiatives and Programmes to Address Digital Divide
Gender and E-learning Accessibility
A Framework to Understand the Digital Divide in India
Methodology
Case Studies of Student Suicides
Analysis of Case Studies
Age
Gender
Economic Status
Occupation of Father
Geographical Location
State of Domicile
Causes of Suicide
Cases of Institutional Negligence
Other Observable Patterns
Discussion
References
7 Segregation of Muslims: A Reflection on Urban Living Environments and Infrastructure Conditions in Hyderabad
Introduction
Segregation as Process and Reality
Reasons for Segregation of Muslims
Methods and Research Questions
Contextualizing Segregation and Muslim Neighbourhoods
Patterns of Discrimination
Muslims, Segregation and Ghettoized Pockets
The Muslim Dilemma and Institutional Exclusions
Poor Water Drainage Facilities and Health Hazards
Amenities Versus Policing
Multiple Exclusions and Muslim Urban Poverty
Economic Deprivations
Life Without Potable Water Sources
Households by Availability of Electricity and Latrines
Size of Households and the Mean Household Size
Apathy of QQUDA
Multiple Deprivations of Urban Muslims
Concluding Observations
References
8 Experiences of and Responses to COVID-19 in a Ho Tribal Village in Jharkhand
Introduction
Historical Background
Nakahasa: A Placid Reception of an ‘Unseen Pandemic’
Return of Migrants: Longing, Anxiety and Reunion
Narratives from Migrant Workers: The Pandemic and Beyond
Conclusion
References
Part II COVID-19 Disparities
9 Disability, Access to Food and COVID-19: An Intersectional Analysis
Introduction
Disability Through theTimes
Disability and Food Insecurity
Disability and Poverty
Poverty, Malnutrition and Disability
Neoliberalism: Disability and Access to Food
Disability, COVID-19 and Food Insecurity
Conclusion
References
10 Inequality in Access to Healthcare for Persons with Disability During COVID-19: An Illustration from Bangladesh
Introduction
Background
Scope of the Study
Rationale
Methodology
Literature Review
Analysis of Primary Data
Discussions with Key Stakeholders
COVID-19 and the Problem of Women in Accessing Healthcare
Conclusion
References
11 How Do Pandemics Affect Frontline Health Interventions? Insights from the National Tuberculosis Elimination Programme in Bengaluru, India
Introduction
Methods
Limitations
Findings
Balancing Treatment, Work and Family: DOTS Regimens for Female Patients
Challenges of Frontline TB Interventions for Health Workers
Discussion
Pandemic Exacerbation of Tuberculous and Poverty Cycles
Unmet Needs of Patients at Multiple Intersections
Slowing Down of Frontline TB Interventions
Conclusion
References
12 Lone Warriors in the COVID-19 Lockdown: Impediments and Resilience of Women in Allahabad District, India
Introduction
Roadmap
Literature Review
Theoretical Perspective
Research Methodology
Findings
Case Study-1
Case Study-2
Case Study-3
Case Analysis and Discussion
Burden of All Responsibilities of Household and Non-Household Chores
Loss of Purchasing Power Parity and Difficulty Getting Enough Food
Inability to Afford Children’s Fees and Online Education
Inability to Pay Rent and High Indebtedness
Failed Public Health System
Loss of Social Cohesions
Conclusion
Policy Implications
References
13 COVID-19 and Violence Against Women in India
Conceptualizing Violence
Intersectional Determinants of Violence
Pandemic Forms of Exclusion and Impediments Towards Inclusion
COVID-19 and Gender Violence
Complaints
Right to Live with Dignity
Domestic Violence
Lockdown Gendered Violence
Cybercrime Against Women
Statewide Analysis
Impact of Gender Violence
Strategies for Helping Victims of Gender Violence
Discussion
Conclusion
References
Part III Health Inequalities
14 Inequality and Exclusion in Access to HealthCare: Learning from the Pandemic
Introduction: Recognizing an Unequal World
Understanding Inequality as Privilege and Disadvantage
Wealth and Income Inequality
Inequality and Health: The Interconnect
Social Exclusions and the Health Gap
Poverty, Social Exclusion and Ill-Health
Government Efforts to Reduce Health Inequalities
Ensuring Healthy Lives?
Pandemic Lessons for Health Equity
Migrant Workers in the Informal Sector
Cleaners
‘Masaan’ Workers
Terminological Inequalities: ‘Social Distance’ and ‘Infection Safe’
Containment Measures
Nudges and Boosts
Conclusion
References
15 Caste Disparities in Health Care Utilization in India
Introduction
Present Study
Data and Methods
Sampling
Independent Variables
Dependent Variables
Statistical Analysis
Blinder-Oaxaca Decomposition
Results
Decomposition Analysis
Discussion
Conclusion
References
16 Reflections on Gendered Health Inequalities within Households
Introduction
Household as the Fountainhead of Gender Discrimination
Gender Inequality in Health: An Overview
The Study
Methodology
Findings
Receivers’ Perspectives
Deliverers’ Perspectives
Conclusion
References
17 Tea Plantation Workers and the Human Cost of Darjeeling Tea
Introduction
Key Organizational Features of the Tea Industry
From Garden to Cup
Social Realities of Tea Workers
Social Hierarchy
Level of Education
Workers’ Ages
Caste
Wages
Housing
Water and Sanitation
Education and Occupational Mobility
Health Concerns of Workers, Patterns of Provisioning and Utilization
Tea Gardens Through a Gender Lens
The Way Forward
References
18 Socioeconomic Disparities in Access and Utilization of Health Care Services in Nepal
Introduction
Caste and Ethnicity in Nepal
Method and Material
Village Setting
Wellbeing Ranking
Findings
Identity and Well-Being
Utilization of Health Post Services Based on Caste/Ethnicity
The Use of Herbs and Healers
Disparity in Health-Seeking and the Use of Medicine
Discussion
Family and Folk Sector of Health
Policy Rhetoric and Reality
COVID-19 and Inequality
The Use of Herbs During COVID-19 Pandemic
Conclusion
References
19 Social Epidemiology of Chronic Kidney Disease with Uncertain Etiology (CKDu) in Sri Lanka: Persistent Inequalities Among Agricultural Communities in a Dry Zone
Introduction
Setting
Methodology
Socioeconomic Backgrounds of CKDu Patients
CKDu Local Discourses
Economic Impact of CKDu on Affected Communities
Psychosocial Impact of CKDu
Social Impact of CKDu
Impact of CKDu on Livelihood
Impact of CKDu on Patients’ Families
Impact of CKDu on the Community
Healthcare-Seeking Behaviour
State Response
Discussion and Conclusion
References
