Q7(a) · UPSC Civil Services Mains 2024 · Anthropology GS 2 · 20 marks · 2 min read

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Critically examine existing paradigms of holistic health for the marginalized sections of society drawing inferences from COVID-19 pandemic.

Topic: Evolution of the Indian Culture and Civilization. Syllabus: 1.1 Evolution of the Indian Culture and Civilization—Prehistoric (Palaeolithic, Mesolithic, Neolithic and Neolithic-Chalcolithic), Protohistoric (Indus Civilization). Pre-Harappan, Harappan and post-Harappan cultures. Contributions of the tribal cultures to Indian civilization. Same official PYQ from year-wise 2024 and Evolution of the Indian Culture and Civilization.

Revision summary

Holistic health means body, household, ecology and inequality together. Paradigms include hospitals, Alma-Ata primary care, AYUSH/ethnomedicine, and rights-based social determinants. COVID-19 exposed migrant invisibility, weak tribal PHCs, vaccine distrust and nutrition shock. Vertical hospital care without food and housing failed the poor. Assemble PHC, PDS, FRA livelihoods and non-discriminatory biomedical care; do not stop at a wellness slogan.

Model answer

Introduction

Holistic health treats illness as body, household, ecology and inequality together. For marginalised sections — ST, SC, slum, migrant, PVTG — no single clinic model is enough. COVID-19 made that visible when the virus followed crowding, transport and distrust rather than a random medical map.

Body

Existing paradigms

Biomedical hospital care saves acute lives (oxygen, ICU) but is distant from hamlets and costly. During COVID-19, tertiary hospitals filled while tribal PHCs lacked oxygen and staff. Alma-Ata primary health care (1978) and India’s NRHM/NHM, ASHA and anganwadi are the public-health paradigm: prevention, immunisation, nutrition. They work when the worker is local and paid; they failed when migrants were invisible on lists.

AYUSH and tribal medicine are living systems (Elwin noted local healing; ethnomedicine is a syllabus topic). They can support care and meaning; they cannot replace oxygen. A holistic paradigm includes them without abandoning epidemiology.

Rights and structural paradigms (Xaxa, social determinants: land, food, water, caste clinic discrimination) say TB and stunting are political. WHO social determinants and Amartya Sen’s capability talk belong here. ICDS, PDS, POSHAN, PM-JANMAN are this paradigm in scheme form.

Community and PESA Gram Sabha health would make the hamlet the unit: quarantine decided with consent, MFP cash as nutrition, local language information. This was rare in 2020.

Inferences from COVID-19

  • Migrant Adivasi and OBC workers walked home when industry shut: livelihood is health. Quarantine centres that ignored food taboos and menstrual needs failed. Vaccine uptake lagged where rumours met a history of coercive camps; trust is a clinical resource. Excess death in the poor was a class and crowding fact. Forest villages sometimes had fewer early cases (distance) then worse second-wave outcomes (no beds). Sickle-cell and TB co-morbidity in tribal belts were under-managed.

Holistic talk that only adds a yoga module to a corporate hospital is not holistic. Holistic health for the marginalised is PHC plus food plus FRA income plus non-discriminatory wards plus epidemic information in Ho, Santali, Gondi, Kui. COVID-19 showed that vertical disease control without social protection collapses.

Critical close

Do not romanticise “tribal immunity” or blame “superstition” as the main death cause. The paradigm that survived the pandemic is primary care + social determinants + respectful biomedical surge. Anthropology’s job is to keep the household and the hamlet in the protocol.

Flow diagram

flowchart TD
  B[Biomedical surge] --> H[Holistic health]
  P[PHC nutrition PDS] --> H
  S[Land FRA no stigma] --> H
  C[COVID migrants] --> G[Gap in assembly]

Conclusion

Holistic health for the marginalised joins clinic, food, land and trust. COVID-19 proved that hospital modernity without migrant housing and hamlet PHCs is not holistic. Existing schemes name the parts; the pandemic showed they were not assembled.

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