Panamaram:  Despite the terrible track record in previous seasons, efforts  to tackle rain-related diseases and other miseries that routinely plague the tribal hamlets continue to be ignored even with another season of more than average rains waiting just days away. Lack of basic hygiene and vulnerability to contagious diseases has cast a pall of gloom over the impoverished hamlets which had seen deaths due to cholera last season.   

Unhygienic living conditions and lack of basic facilities have contributed massively to diseases and death, more so because patients chose to stay indoors till the situation worsens and critical care infrastructure are lacking.

Each season scars the hamlets with diseases. Last season it was cholera that claimed four lives in Karimam Colony at Pulpally and Kinattingal Colony at Vellamunda. The maternal and infant mortality rates have also shot up.

The tribes, alienated from their traditional food habits and nature friendly life, have been falling victims to diseases more than ever. The malaria resistance exhibited by the tribes, with 1:3 average casualty rate compared to others, has vanished. Anemia is common. Tribes like Paniyas, who have been listed in the Risk category by the Government, are suffering the most due to lack of toilets and proper housing facilities. 

Diseases like cancer, tuberculosis and 'beedi disease', caused by excessive use of nicotine products, are also common among the tribes. Lack of information on avoiding the occurrence and containing the disease has worsened the spread, mostly among family members. In most cases they approach hospitals at advanced stages affecting the chances of recovery.

It is a common occurrence for the tribal volunteers and the palliative care workers to get to know the matter too late for any meaningful intervention. The general apathy towards medication is also a serious concern. The patients who are sometimes taken to the hospitals by civil society groups or by the health authorities show immense refusal to stay there for treatment.

The incidence of mental diseases is also on the rise with even children showing disturbed mental status. The patients have to approach the Kuthiravattom Mental Hospital or the Kozhikode Medical College for treatment as there are no local facilities. It is also common to see the patients being abandoned in these hospitals with many of them meeting a lonely and painful end.

The first dedicated tribal hospital in the state was established in 1981 at Nallurnaattil near Mananthavadi. The tribal hospital seldom functioned and the department finally handed it over to the health department in 2008. There are Panchayats with more than 50 people who are mentally disturbed. The trouble is that the patients refuse to stay in the hospitals citing cost of the caretakers despite free medicines and other facilities. 

A study conducted by IIM across 251 houses in Thirunelli threw up disturbing results with regard to mortality rates among tribes. Forty nine deaths were reported from these houses, 33 men and 16 women, of which 12 were suicides.

The agricultural crisis in the district also affected the tribes negatively as many were solely dependent on this for income. Several of them took to brewing illicit liquor in their homes or converted their homes into supply centers. Even though they get picked up in the excise raids, they are mostly excused citing their conditions.