The socio economic health status of Dalit community in Tiruvannamalai district, especially at Kilpennathur block, which has around 30% Dalit population. They are socially neglected; isolated and majorities are the illiterates. Most of their children are the first generation learners. Dalit people do not have the required skill to earn their livelihood. Most of them are the landless labourers, marginal and small farmers, depending on small quantity of lands for dry land cultivation. As their income is less, the purchasing power is also less. Men’s little earning comes out of less than 100 days of employment in the unorganized sector is going for their liquor expenses and the women who earns the marginal sum is taking care of their family. The women are not allowed for decision making and considered them not equal to men in the male dominated society. Women and children are victimized at home in the name of poverty, ill health and illiteracy. The female children are anemic and it leads to the life cycle of adolescents’ girls, pregnant women, lactative mothers and even at old age.
In the context of Globalization, privatization, public health is neglected. The primary health centres of Government are becoming inactive due to the non availability of Medical Doctor and medicine. They are allowed to start the private practice. They have started private practice in their own residence at PHC Doctor’s quarters and they concentrate more on their private practice than the public service. Malnutrition, vitamin A deficiency, lack of primary health care are the basic health problems. Every 5 out of 10 deliveries are conducted at home by untrained women. Infant mortality and maternal mortality is under reported.
HIV/AIDS is another fastly spreading communicable diseases due to the inflow of people from various sides on full moon day and the increasing number of commercial sex workers at lodges, restaurants and at guest houses.
Non availability of suitable employment for the Dalits due to the lack of skill and lack of agriculture employment due to the frequent monsoon failure, inherited debt, and the increased cost of living due to galloping inflation (now inflation of 12.5% is more than the national growth of 7.5%). Around 50% of Dalit children become school drop outs and unable to go for skill training or at job. Child labour is another issue due to poverty. The women, farmers, youth, children, men and other unorganized occupational groups are not organized for their own development.
The health condition of women and children among Dalit is very poor. The infant mortality rate and the maternal mortality rate among Dalit women is at least 50% higher than the non-dalits. The same rate is even reflected among Dalits in child labour and school drop outs. Around 80% of the adolescent girls and around 60% of the pregnant and lactative mothers are anemic, caused by iron deficiency. The life style diseases like tuberculosis, diabetes, hypertension, HIV/AIDS and the reproductive child health is a greater concern among the rural poor now. 25% of the members in the age group of 25 – 45 are diabetic patients. This is caused by alcoholism. The national average of young widows in India is 5%, where as it is 7.2% in Tamil Nadu. This was because of the early death of men due to alcoholism. The number of pre-marital sex among Dalit women was increased from 10% to 20% during last few years and they were not following the safe sexual practices.
The Dalit children and the children from the very poor families are becoming the bread winners to the broken and below poverty line families. There is lack of awareness about the transmission process of HIV/AIDS, tuberculosis and veneral disease (Sexually Transmitted Diseases STD). Malnutrition is another problem due to wrong beliefs and social restrictions about the selected food items. For example, the pregnant women were not allowed to take fruits like Pappaya, plantain and food items like egg, fish, Brinjal and greens. The superstitious beliefs exists in the intake of food. The minimum required weight increase of 10 kg during the full period of pregnancy is not achieved due to the social fear of over size of babies during delivery. Because of this, more than 50% babies have a birth weight of less than 2.5 kg. In take of seasonal vegetables and fruits do not exist with most of the poor women in our project area. This is due to lack of awareness.
Health rights of women is another area of concern. The four areas of concerns are as follows: