Note: Please note that some inputs have been given by our team in order to make the topic more relevant to UPSC

1. WHY TRIBAL PEOPLE DIE YOUNG

Topics covered from the syllabus: GS-2: Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes; mechanisms, laws, institutions and Bodies constituted for the protection and betterment of these vulnerable sections. GS-2: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

Prelims Focus Twin Cyclones: It is a system of two simultaneous cyclones, which develop on either side of the Equator, and are formed by the interaction of wind and monsoon systems. Recently, twin cyclones were seen developing in the form of Cyclone Asani and Cyclone Karim. Similarly, Cyclones Fani and Lorna developed as twin cyclones in April 2019. Twin Cyclones develop due to Rossby waves. Rossby Waves are massive ocean surges, which develop due to the effect of Earth’s rotation.

Context: Relative geographical isolation, lack of modern healthcare facilities and multiple other factors have taken a toll on tribal health profile, making it one of the worst social groups in terms of health indicators.

Health Issues among Tribals

• Tribes of India: Tribes of India account for 8.6% of the total population. The tribal population of the country majorly resides in geographically-isolated hilly and forest areas. In fact, 60% of the forest cover in the country is inhabited by the tribal people. At the same time, tribal habitations are dispersed over large areas, resulting in a low density of population.
• Fertility Rate: Total Fertility Rate (TFR) of Scheduled Tribes is 3.2%, which is well above the replacement rate. However, a few exceptions are seen in the form of negative population growth rate, which has been seen in Particularly Vulnerable Tribal Groups (PVTGs) inhabiting Andaman and Nicobar Islands.
• Life expectancy: Life expectancy is defined as the average number of years a person is expected to live. The life expectancy of Scheduled Tribes has generally been the lowest among all social groups in the country. According to the Union Ministry of Tribal Affairs, as compared to the life expectancy of 67 years for the rest of India, the tribal population has a life expectancy of hardly 63.9 years.

• Reasons for Lesser Life Expectancy: Some experts attribute this to genetic diseases like Sickle cell anaemia and Thalassemia, which are prevalent among tribal population. It is to be noted that the life expectancy of tribal women is more than tribal men.

• Modern diseases: Due to land alienation, displacement, prevalence of poverty and the resultant indebtedness, tribal women are forced into prostitution. This has led to an increasing caseload of Sexually Transmitted Diseases (STDs) including AIDS.

• Non communicable Diseases like Hypertension: One out of every four tribal adults suffers from hypertension. As per the experts, the cases of hypertension have increased significantly with the increasing consumption of tobacco and alcohol, and prevalence of a sedentary lifestyle among tribals. 
• Drug addiction and Mental illness: Globally, tribals are known to be easy prey to addictive substances like drugs. Further, increasing instances of land alienation and displacement among tribal people have exposed them to several existential threats and resultant mental stress.

• Communicable diseases: As stated above, the tribal communities constitute only about 8.6% of the national population. However, they account for about 30% of all cases of malaria and almost 50% of the mortality associated with malaria. Similarly, the cases of pulmonary Tuberculosis in tribal communities is significantly higher than rest of the country, viz. 703 in tribal population as compared to 256 per 100,000 in the rest of India.
• Nutritional diseases: As per the 5th National Family Health Survey conducted during 2019-21, there is high prevalence of cases of malnutrition, including stunting, underweight and wasting among tribal children. In fact, only 30% of children and, 25% of pregnant and lactating women consumed an adequate diet in terms of protein, energy and calories, as per the National Nutrition Monitoring Bureau (under the National Institute of Nutrition).

Causes of Low Health Profile

• Geographical isolation: The tribal areas are located in remote geographical areas. Difficult natural conditions, arising due to difficult geographical terrain and large distance from mainstream areas lead to accidents, snake and animal bites, and violence in conflict situations. The geographical isolation also leads to low level of social-economic determinants, covering aspects like education, income, housing, connectivity, water and sanitation, poor quality and inappropriate health care services etc.

• Inaccessibility of Health Services: Remoteness of habitations and dispersed population also makes it difficult for the health services to reach in time. This is one of the prime causes of uneven access to healthcare services for the Tribals.

• Unavailability of Food items: Long term changes can be seen in the agricultural practices of tribals. For e.g., due to changing climate and market trends, tribals prefer hybrid varieties of rice and pulses to nutritional native foods. Similarly, consumption of meat has declined in the tribal populations, leading to the deficiency of adequate proteins in the diet.
• Disruption of traditional farming: Due to forest regulations and a ban on shifting agriculture, the tribals are dependent on PDS and market system for their food. Similarly, they have adopted modern farming practices, which include the use of pesticides and fertilizers. Therefore, their dietary preferences have changed due to contact with non-tribals.

• Change in Dietary Preferences: At the same time, the constituents of diet have changed from traditionally healthy options like home-grown pearl millets, sorghum, herbs, fruits and vegetables to modern food commodities like wheat, rice, pulses and seasonal vegetables.

• Lack of Physical Activity: As stated above, tribal populations have adopted some of the ways of non-tribal people. It includes buying grains and groceries of daily use from the market, instead of preparing them at home. This has led to lack of physical activity among the Tribals, affecting their fitness levels.
• Prevalence of Poverty: It is well documented that the tribal groups constitute one of the poorest social groups in the country. This makes many of them dependent on Public Distribution System (PDS) for food grains. The issue with this dependency is that it disrupts the traditional food preference of Tribals in favor of wheat and rice, leading to health-related deficiencies.
• Endogamy and inbreeding: Tribal populations are majorly confined to a small geographical region. Since they have been living for generations in a closed knit community, there is a high prevalence of inbreeding and endogamy. This leads to a large number of genetic disorders like Sickle cell anemia in the tribals.
• Belief in Supernatural powers for treatment: The tribals have their own system of beliefs. They distrust outsiders and are dependent on the traditional systems for health treatment. At the same time, professionals from outside are unwilling to serve in tribal areas, leading to a shortage of manpower and health care professionals in the tribal areas.
• Lack of Financial resources: According to experts, there is a lack of adequate allocation of financial resources for tribal health needs in most of the states. It is further complicated by a lack of transparent accounting of the actual expenditure and the lack of availability of data, monitoring and evaluation of the government schemes.

Way Forward

• Improvement in Indicators: As per the Researchers of Harvard University, the indicators of life expectancy for Tribals in India have shown an improvement over time. For e.g., life expectancy of ST women at birth was 57 years in 1997-2000, which rose to 68 years in 2013-16. During the same period, life expectancy for ST males increased from 54.5 years to 62.4 years.

• Gains in Child Health: Similarly, the indicators of child health have shown a marginal improvement from 58% (in 1998-99) to 56% (in 2007-08) for stunting, from 23% to 22% for wasting and 57% to 52%in case of underweight children in the age group of 1-5 years. The need of the hour is to extend the gains to other Health indicators like Nutrition and Child health.

• Access to Modern Healthcare: There is a need for further expansion of modern healthcare system in tribal areas. This includes Mobile clinics and telemedicine facilities for remote tribal areas. At the same time, preventive approaches like immunization and regular health camps should be conducted in such areas for better access to healthcare services.
• Capacity Building: There is a need to train the healthcare functionaries so that they consider social and cultural background of tribes and act accordingly in times of need. Building trust with the tribals will go a long way in securing their cooperation in multiple areas including healthcare. Similarly, local men providing healthcare facilities to tribes (like Vaidyas) need to be trained in advanced diagnostic techniques and modern medicine.
• Collective approach: Due to their wide experience, Non-governmental organizations (NGOs) have established a relationship based on trust with tribals. The government needs to capitalize on this relationship and NGOs, Government organization and tribal leaders need to work in coherence in order to improve the health profile in tribal areas.

Conclusion

• Tribal health in India suffers from multiple aspects including a historical prevalence of communicable diseases, maternal and child health problems and malnutrition. On the other hand, it has shown signs of vulnerability to non-communicable diseases including mental stress and addiction. There is a need for inclusive and sustainable steps in order to resolve the health problems in the tribal population of the country.

Practice Question

• Comment on the recent trends in tribal healthcare issues, while highlighting the causes of low health profile of tribal population in India.

UPSC PYQs

• Public health system has limitations in providing universal health coverage. Do you think that the private sector could help in bridging the gap? What other viable alternatives would you suggest? (GS2 - 2015)
• Despite Consistent experience of High growth, India still goes with the lowest indicators of human development. Examine the issues that make balanced and inclusive development elusive.     (GS2 – 2019)

2. War’s Other Collateral

Topics covered from the syllabus: GS-2: Effect of policies and politics of developed and developing countries on India’s interests, Indian diaspora. GS-3: Major crops-cropping patterns in various parts of the country, - different types of irrigation and irrigation systems storage, transport and marketing of agricultural produce and issues and related constraints; e-technology in the aid of farmers.

 

Prelims FACTS Global Food Hubs: These are the areas which constitute major grain producing and exporting regions around the world. There are six global food hubs as enumerated below: US Midwest and Canadian prairies: The region is famous for Corn and Soya production. USA contributes 34% to Corn production, 34% to Soya production and 7% to global Wheat production. Brazil and Argentina: The region is known for soya and corn production. Brazil contributes 30% of global Soya production and 8% of global Corn production. Northwestern Europe: It is known for Wheat production. Black Sea Region: It consists of Ukraine and Southern Russia. The area is known for Wheat production. Northern India: Northern India is known for Wheat and Rice production. Eastern China: Eastern China is known for Wheat and Rice production.

Context: Global food supply chains have suffered due to the Russian invasion of Ukraine, which was started in February 2022. This has further complicated the food security situation which was already reeling under the Covid-induced lockdowns. At the same time, the Russia-Ukraine war has disrupted the global supply chain of energy and critical minerals.

Role of Russia and Ukraine in global food supply chain

• Global Food Hubs: Russia and Ukraine contribute 12 percent of all food exports. They constitute one of the Six Global Food Hubs (see inset) existing around the world. Russia is the world’s largest wheat exporter while Ukraine is sixth largest exporter of wheat. Together they contribute 29 percent of global wheat exports. Therefore, any disruption in supplies from Black Sea Region will impact the Global Food Security.
• Export of other Agricultural Commodities: Russia and Ukraine contribute 19% of maize in exports, and 78% of sunflower oil exports. In fact, as per available data, Russia and Ukraine had 16 million tonnes of maize and 13.5 million tonnes of wheat packed for exports, which could not move out due to the break of war between the two countries.
• Increase in Prices: Due to the Russia-Ukraine war, the world is expected to experience a shortage of between 10 and 43 million tonnes of wheat in 2023. This is equivalent to a calorie intake of approx. 60 to 150 million people. At the same time, this abrupt stoppage of supply is projected to increase the prices of wheat by 40% this year.

Reasons for Disruption in Global Food Supply Chain

• Agricultural Issues: Due to Russian invasion, 20-30% of crops have remained unharvested. At the same time, sowing of new crops could not begin due to shelling and safety issues for farmers. Most of the farmers abandoned their farms and moved to safer areas to protect themselves and their families.
• Fuel Shortage: War effort by Russia has led to an artificial shortage of fuels due to the diversion of fuel supplies towards military use. This has affected the agricultural production in the area as many stages of agriculture demanding the use of heavy machinery could not proceed further.
• Lack of Manpower: Russia, being short on manual labour, depends majorly on agricultural machinery and equipment for agricultural work. However, as stated above, Russia-Ukraine war has created a shortage of fuel for the agricultural machinery. At the same time, the human resources are not available as they have migrated to safer areas fearing for the safety of themselves as well as their loved ones.
• Logistics Issues: Russia has blocked the harbors of Black Sea through warships and sea mines so that no transport ship could move through Black sea. This has affected the Sea Lanes of Communication (SLOCs), rendering them inaccessible for transport ships and crippling the global supply of food grains.
• International sanctions: Western countries have declared sanctions on Russia, condemning it for the ‘unilateral invasion of Ukraine’. However, these sanctions have also wreaked havoc on the Poor nations as the Sanctions have prevented these countries from having any trade relations with Russia.

Impact of Disruption in Food Supplies

• Food Crisis: According to FAO, one of every five calories eaten by people is imported from another country. Around 50 countries depend on Russia-Ukraine for their food supply, particularly for wheat. Due to the interruption in food supplies from Russia and Ukraine, countries like Egypt, Angola and Lebanon are facing double digit inflation in food prices.

• Impact on Poor Countries: Poor countries have suffered disproportionately as they are net importers of food products. As per data, advanced economies spend just 17% of their earnings on Food as compared to Sub-Saharan Africa, which needs to shell out 40% of its earnings on Food.

• Fertilizer Crises: Russia is a major fertilizer supplier, being top most supplier of Nitrogen fertilizers, second in the export of Potassium fertilizers and being third largest exporter of Phosphorus fertilizers. Therefore, due to the disruptions in fertilizer supply, the cost of NPK fertilizers is rising rapidly around the globe. This will further push the food inflation due to increased input costs.
• Energy Crisis: Russia and Ukraine are major suppliers of gas and petroleum. Due to the sanctions and disruption of supply chain, fuel prices have increased around the globe. The increased fuel prices have translated into inflation of other commodities as transportation cost has increased.
• Rise in price of substitutes: Many countries have no option but to substitute commodities like sunflower oil and wheat, which are in short supply, with others such as palm oil and rice. Respectively. This has led to an increase in the prices of the substitutes. The price of Rice has increased by 12% globally.
• Export Restrictions: Countries like Indonesia, Turkey and India have put export restrictions on edible oil, wheat and meat due to uncertainty of supply and their own food security.  Indonesia has stopped palm oil export as its demand has risen as a substitute for sunflower oil.

Way Forward

• Diversification of Supply chains: Five countries viz. China, India, Russia, Brazil and the US control 60% of the global food production. Any disruptions in the supplies of food grains from these countries will cause a shortage of global food supplies across the world. There is a need to decrease this dependency and let the low income countries of Africa and Asia diversify their food imports to ensure food security in emergency situations.
• Diversification of food: Rice, wheat, corn and soy account for 50% of the average daily calorie consumption around the world. Poor countries need to diversify their calorie requirement to locally available alternatives such as coarse grains, corn or other such products.
• Need for Pragmatism: India stopped wheat exports in anticipation of disturbance caused by Russia-Ukraine war to its own food security. It was further exacerbated by the prevalence of heat waves, which have led to fear of lesser wheat production this year. India has also advised countries like UAE to not re-export wheat imported from India to other countries and instead, use it to secure their own food security.

Conclusion

• Global food production is concentrated in a few areas around the world. Recent events have disrupted this global food supply chain. These disruptions have caused food inflation around the globe and threaten the food security of low-income countries. There is a need to take steps to counter such events in the future while ensuring that they do not affect the food supplies in the nations which have strong dependencies on the global food hubs.

Practice Question

• Discuss the impact of Russia-Ukraine war on the global food supplies and their impact on the third world countries. Also, analyze why the poor countries are dependent on the global food hubs despite their favorable geographical location.

UPSC PYQs

• There is a growing divergence in the relationship between poverty and hunger in India. The shrinking of social expenditure by the government is forcing the poor to spend more on Non- Food essential items squeezing their food–budget. Elucidate.                                                                                                                                                     (GS2 -2019)
• Food security bill is expected to eliminate hunger and malnutrition in India. Critically discuss various apprehensions in its effective implementation along with the concerns it has generated in WTO.             (GS3-2013)