T. Sundararaman, Daksha Parmar and S. Krithi
We are in the midst of one of the most severe crisesin global public health that the world has ever faced.India is one of the worst affected countries, with the Covid-19 pandemic having devastating impactsboth on the health of the population as well as on the country’s economy. As of November 15, 2020, India’s Covid-19 cases stand at over 88 lakhs and
there are over 1.3 lakh deaths. This unprecedented health crisis is not only having an adverse impact on the health of the population, it has also createda profound negative economic impact. Though all sectors and classes are affected, existing poverty and inequality amplifies the adverse effects on the weaker sections and pushes them further into poverty. The immediate negative impact on the lives of all marginalized sections of the population—migrants, farmers, labourers working in insecure and informal jobs in urban and rural areas—is therefore more severe.
Access to medical services has been severely
affected both for Covid-19 and non-Covid-19 health
problems. Public hospitals have been overwhelmed
with the increased number of Covid-19 cases, resulting in huge shortages of beds for Covid-19 patients as well as exacerbating shortages for all other
patients. Failure to isolate and admit Covid-19 paPublic Health and Health Services
as Global Public Goods T. Sundararaman, Daksha Parmar and S. Krithi
tients in time also leads to enhanced risk of infection for the entire population. (JSA-AIPSN, 2020). This crisis is even more acute for those who are already suffering from critical and lifelong illnesses that require sustained medical check-ups and interventions. This is particularly with reference to life-saving services in case of maternal and child
healthcare, chronic illnesses such as diabetes, hypertension, cancer and dialysis services, where the essential medical services were suspended or cut back across most of the public and private health facilities. The pandemic of Covid-19 knocked at our doors when India was in the third decade of its health sector reforms. Since the nineties, under the reforms, public health policy—as reflected in its implementation—has veered towards restricting public provisioning to only those services which the private sector is unable or unwilling to provide, with an understanding that the majority of health services should be left to the market. This had led to systematic neglect of public health services. But in this moment of a health crisis, this for-profit private health sector, which has grown enormously over the last three decades, was largely missing in action. They either withdrew due to fear of infection or, when they did provide services, charged exorbitant rates and restricted to a limited number of beds and services (Raghavan, Barnagarwala and Ghosh, 2020). Public hospitals and public health
Denied the Right to Have Rights: the Social and Political Exclusion of Circular Labour Migrants in India
By Indrajit Roy
This paper by Indrajit Roy talks about how the social and political exclusion of circular labour migrants in India bars them from fully exercising their basic rights, keeping them from being legitimate citizens of India. There is a general attitude of hostility towards migrant workers, often fostered by powerful politicians, prevailing in India with the workers being labelled as the source of numerous social evils without necessarily finding any evidence. Migrant workers are identified collectively as a ‘floating population’ which, owing to its anonymity, is able to escape consequence for committing heinous crimes. It is against this background that the author conducts ethnographic fieldwork in north Bihar’s Araria district to gain the perspective of the workers, and obtain a better picture of the vulnerabilities they are exposed to.
It is important to acknowledge the role of social and political inclusion in motivating entire populations to migrate. Workers retreat to circular labour migration in the hunt for a life relatively free from social conflict that threatens their very well-being, and one where they may find basic dignity. Migration allows the blurring of lines between previously concrete caste identities, allowing the possibility for a change of status. However, this does not entail that they are liberated from all forms of injustice. Migrant workers, already disproportionately drawn from historically oppressed communities such as Dalits and Adivasis, find their difficulties exacerbated with the low pay they receive, job insecurity and absence of contracts, unrecognised emotional labour, and inhuman working conditions with there being no compensation for working overtime. What makes the nature of their work most precarious is their dependence on employers/contractors for basic amenities, housing, and food provision. Their families are only likely to receive any form of compensation by the State upon their death, and they have no space to articulate their complaints. Policies related to health, education, and labour rights function on the assumption that the beneficiaries live and work in villages where they have been registered. This excludes migrant workers from availing the possible benefits of these policies. Moreover, voting rights are restricted to the places of people’s domicile, not only restricting workers’ capacity to participate in democracy, but also freeing authorities from their duty of supporting the workers.
This state of a “fragmented citizenship” may be overcome by the suggestions made. Migrant workers must be provided legal protection in terms of health and social security. Basic facilities such as financial aid, education, housing and public distribution services must be made accessible for mobile populations as well. These suggestions must be complemented with more ways that could address the political dynamics that underpin their social exclusion.