Sisters of Kasagod write on indefinite fast by the Endosulphan victims

Third Letter From Endosulfan Victims

By Sisters Of Kasargod

30 March, 2013

Dear Friends

This is the third letter that we are writing to you in the past month.We know that many of you got together in your areas in support of our struggle for justice and life, wrote letters, signed memorandums and thought and prayed for us. At this important juncture in our life, we need all of you with us as we are attempting to get back to Life.

So much has happened in the past few days. The indefinite fast and strike in support of the Endosulfan victims by the Endosulfan Victims Janakekya Munnani (EPJM) crossed a month the other day. Fortunately, the discussions by the Government about our fate which took place on March 25th in Trivandrum yielded some positive results that led to the withdrawal of the fast. But we understand that we have to remain alert and our representatives and each one of us have to be on the guard, demanding and insistent. We cannot let the authorities and Government relax in any way and we have to be acutely aware of where all the offers made can be thwarted.
As you know we had submitted a detailed memorandum to the Government on 21st March when we were called for discussion. The major issues in focus were :

1.To review the decision to give aid and help for just 5 years by the Government
2.To include all deserving people in the list which is now incomplete
3. Implement all the recommendations of the National Human Rights Commission
4.Constitute a Tribunal for Compensation and Identification of the Real culprits
5.The debt load of the affected people be taken by the Government
6. To design a scientific rehabilitation program for the affected region
7To remove and detoxify the endosulfan reserves still remaining in the godowns.

The answers given to us by the Government are the following:
1To appoint a Committee to examine the question of a Tribunal to provide compensation for the victims, taking into consideration the liability of the pesticide companies also.

2. Setting up a 3 member Committee ( Kasargod District Collector, Joint Registrar of Cooperatives, Kasargod, and Special Officer in charge of Remediation of Endodulfan victims) to study the demand of waiver of bank loans by victims or their families.

3 Renewal and addition of list of beneficiaries identified by the National Human Rights Commission through new medical camps and examination by an expert team of doctors. In this the number of persons with cancer would be included making the list a total of 2295. The examining of the persons to know if they fulfilled the criteria for compensation recommended by NHRC would not exempt others from receiving the State Government assistance, the number being 5500.

4.The order that indicated that victims would get an assistance for only 5 years would be cancelled. The compensation amount of Rs 5 lakh each to the next of kin of dead victims ( 600 persons paid so far) would be reached to the remaining 134 once the succession certificates are produced.

5.The victims are now getting free rations, free treatment and a monthly pension which would be enhanced from Rs 400- Rs 700 a month.

6.To the newly added list of fresh victims identified as Endosulfan affected last year ( 1318) a fresh medical examination would be conducted by a team of doctors soon.

7. The 11 panchayats identified as Endosulfan affected will be reviewed and more Panchayats and areas outside this will be included where there has been impact of the pesticide.

8. 12 more hospitals will be added to the list of hospitals in Mangalore, Manipal and other parts of Kerala where victims can get free medical care.

9.The Social Welfare Department would pay an additional amount of Rs 1500 per month as compensation to the staff of seven Buds school caring for the mentally challenged children in the region. Ambulances will be provided in all the 11 panchayats.

Though it is a relief that the Government has considered the gamut of issues and concerns of us living in the affected area with our poisoned bodies, we are anxious about the implementation part, the delays and loopholes, the snags and pitfalls.

We request each one of you to stay alert and follow up in your own capacity each of the above promises. We need to build up all pressure so that we can avail of all assistance possible.We want to get out of the victim mode and reinstate a semblance of normalcy in our our children start smiling, walking, holding and feeling human inspite of all their challenges and incapacities.

In anticipation
Sisters of Kasargod
March 28th, 2013

Anitha.S ( in conversation with the people of Kasargod.
For details contact : Ambalathara Kunhikrishnan: 08547654654.
M.A.Rahman : 09048576384.
For updates in English contact Amruth : 09400930968


Kerala: 3 year old gangraped is fighting for her life #Vaw #WTFnews



Vidya Iyengar Updated: Thursday, March 7, 2013, 12:31

Thiruvananthapuram, March 7: Even as the government claims to be working on enhancing security for girls and women, a 3 year old girl who was kidnapped and gangraped is battling for life at a local hospital. The girl was found abandoned near the Thrikandiyur following a search launched by the police.

The girl was first admitted to the Tirur District Hospital and later shifted to the Kozhikode Medical College Hospital (KMCH). According to Kozhikode Medical College Hospital (KMCH) deputy superintendent J C Cheriyan, the condition of the girl is improving. According to doctors who have performed two surgeries on her, she will take months together to recover.

The abandoned child was found on Tuesday morning. “She had high fever and was found with ants crawling all over her body,” eye-witnesses said. The girl’s mother who is a rag-picker is in a state of shock. On Monday night, when she went to sleep her daughter was beside her but when she woke up on Tuesday morning the girl was missing.

Although the child was admitted with severe injuries, she is now out of danger. She is currently under observation in the ICU. The medical examination has confirmed it was a rape. The girl has suffered a number of internal injuries. 16 men have been detained for questioning in connection with the rape.

According to district police chief K Sethuraman in the coming day more people will be questioned. “Police will ensure that the culprits behind the incident are nabbed,” additional director general of police N Shanker Reddy said. He visted Tirur and held a meeting with the invetigation team.

The Kerala Women’s Commission Chairperson KC Rosakutty visited the girl and her mother at the hospital and said that that all would be given to the child who would be under their protection. OneIndia News

Read more at:


#India – Ethics of immunisation services in Kerala and Tamil Nadu #healthcare

This  article is published  in BMJ  in the context of increasing immunisation resistance in Kerala and Tamil Nadu. The article trace part of the reason to special campaign approaches in vaccination. We wanted to convey the importance of understanding and recognising ‘agency’ of individuals, families and communities. Unfortunately, this is an often neglected aspect in the authoritarian public health world.
The interactions of ethical notions and moral values of immediate stakeholders of immunisation services in two Indian states: a qualitative study

The interactions of ethical notions and moral values of immediate stakeholders of immunisation services in two Indian states: a qualitative study

  1. Joe Varghese1,2,
  2. V Raman Kutty2,
  3. Mala Ramanathan2

+Author Affiliations

  1. 1Centre for Chronic Disease Control, New Delhi, India

  2. 2Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, Kerala, India
  1. Correspondence toDr Joe Varghese;
  • Published 1 March 2013


Objectives This study examines the existing norms regarding immunisation within the communities and the ethical notions that govern the actions of different health professionals and their collective synergistic or conflicting effects on the governance of the programme.

Design We used descriptive and analytical qualitative methods as it suited the research question.

Setting The data were collected from areas under 16 primary health centres in Kerala and Tamil Nadu identified through a three-step sampling process.

Participants This involved in-depth interviews with stakeholders including providers, beneficiaries and other stakeholders, focus group discussions with mothers of under-five children and participant and non-participant observations of vaccination-related activities.

Results Unlike most other ethical analyses that look at the ethics of vaccination policies, the interactions of normative principles and notions are analysed in this article. Moral obligation of parents towards their children, beneficence of healthcare providers and the utilitarian aspirations of the state are the key normative principles involved. Our analysis points to the interplay of both synergy and conflict in ethical notions and moral values in the context of immunisation services. Paternalistic interventions like special immunisation campaigns against polio and Japanese encephalitis are a case in point: they generate conflict at the normative level and create mistrust.

Conclusions Analysis of vaccination policies and programmes needs to go beyond factors that assess monetary benefits or herd immunity. Understanding the interactions of normative notions that shape the social organisation of the providers and the users of vaccination is important in creating a sustainable environment for the programme.

Article summary

Article focus

  • Ethical analysis includes not only ethical rationale but also the exploration of interactions of ethical and moral notions.

  • The article examines the interactions of ethical notions of the health professionals and moral values governing parental actions and their collective effect on governance of childhood immunisation programmes.

  • The study hypothesises that the vaccination policies and programmes that do not take into consideration the need for equilibrium of normative notions that motivate the actions of immediate stakeholders can be detrimental to its implementation.

Key messages

  • Analysis of vaccination policies and programmes needs to go beyond factors that assess monetary benefits or public safety.

  • The interactions at the normative level play a significant role in sustaining the acceptability and compliance to vaccinations at the community level. The moral obligation of parents towards their children, beneficence of healthcare providers and the utilitarian aspirations of the state are the key normative principles involved in immunisation.

  • Overly aggressive vaccination programmes based on utilitarian notions can conflict with other dominant normative notions that motivate the actions of healthcare providers and parents.

Strength and limitations of this study

  • An analysis of interactions at the normative level of the providers and the users of vaccination gives new insights for developing sustainable vaccination programmes.

  • Generalisability of findings to other contexts where the immunisation programme faces challenges, including resistance, should be verified through further studies.


Normative principles, explicit and implicit, operate within a social system and guide the delivery of public health interventions such as vaccination. They influence not just policy decisions and programme implementation, but they also shape the decision making of medical practitioners and community behaviours.1 ,2 For an intervention like immunisation, it is important to understand how the ethical principles that influence policies or behaviours of health professionals interact with the moral values that operate at the level of parents whose decisions ultimately facilitate paediatric vaccinations. This understanding is expected to provide valuable information for designing policies and programmes related to immunisation.

Most ethical deliberations on public health revolve around providing a framework for capturing the appropriateness of measures used in interventions and policies.3–6 The ethical deliberations in vaccination have highlighted the utilitarian orientation of public health professionals against the healthcare worker’s value of client beneficence.7–9 This paper examines the interactions of the ethical notions of the health professionals and the moral values governing parental actions and their collective effect on governance of the paediatric immunisation programmes. This analysis is part of a larger study to understand relatively recent decreasing immunisation coverage in two states of India, Kerala and Tamil Nadu, which have otherwise reached a fairly high level of coverage compared to most of the states in the past (figure 1).10

Figure 1

Immunisation coverage in Kerala and Tamil Nadu.

In this paper, we use this concept of ‘ethical notions’ instead of ethical principles as we refer to values that are acquired collectively from an understanding of what is right and wrong based on the healthcare and public health practitioner’s professional training and the professional code of ethics that is adopted for practice by health professionals. Moral values are the norms defined and accepted by a larger section of the society. Both ethical notions and moral values are normative principles that guide the decision making of immediate stakeholders.

In India, vaccines have been widely used since the early 1900s and several collective vaccination programmes were periodically introduced nationally and regionally as part of various disease control programmes. The Expanded Programme of Immunisation was started in 1978, though it was limited mainly to urban areas. The Universal Immunisation Programme (UIP) against basic vaccine preventable diseases was introduced in the year 1985 with a mandate to progressively cover the entire country. The programme is implemented through the government’s three-tier health institutions with the active support of a vast network of field workers. The private healthcare providers also complement the immunisation programme. Even after two decades of implementation, the progress of the UIP has not been very encouraging in most parts of the country. Although UIP has contributed to improvement in ensuring the availability of vaccines and maintenance of cold chain requirement, the system is considered to be failing to deliver in many states in terms of coverage.

The states of Kerala and Tamil Nadu have a tradition of state intervention in health which ensures an adequate basic administrative system for implementing immunisation programmes. The state of Kerala is known for its remarkable health achievements in the public health discourse. Public investment in health has been traditionally high compared to many other states.11–12 Similarly, the improvement in population health status of Tamil Nadu in recent decades has been attributed to increased public expenditure in health and a relatively well-functioning public health administrative system.13–15 The increased presence of private sector in healthcare is indicative of the acceptability of private providers in both the states.14 ,16

Another important factor to be considered in the context of immunisation is the influence of reduction in fertility rates in both states. With the decreasing family size, children have assumed a special place in these societies and the child-centredness of these societies has been noted.17 ,18 Immunisation programmes in these two states have recently faced new challenges. Media reports of sporadic and organised forms of resistance against immunisation exist. Special vaccination programmes for polio eradication and targeted campaign against Japanese encephalitis have been the special focus of widespread resistance against immunisation in Kerala.19 ,20 Polio eradication campaigns included additional doses of oral polio vaccines given to all children under 5 years of age on at least two occasions every year. The vaccination campaign against Japanese encephalitis in the previous year had targeted schoolchildren in Alappuzha district. These programmes are organised by the government public health machinery with significant political commitment and resources. There are extensive planning and preparations for the execution of the programme, which involve a number of government departments other than the health department. The dates of the programme are announced well in advance in the review meetings and special instructions are issued to all peripheral institutions. Local-level health department staff hold several rounds of planning meetings with other government departments, local self-government officials, local non-governmental organisations and schools well ahead of the programme in order to identify and access potential non-compliers with regard to the special immunisation drive.

The state of Kerala has seen organised forms of resistance spearheaded by some practitioners of alternate systems of medicine including homoeopaths and naturopaths especially in the northern districts. In the state of Tamil Nadu, a false propaganda of death of a child aired through a news channel in the previous year’s special vaccination drive against polio had caused widespread anguish among parents and resulted in violence in some locations. Deaths related to immunisation have been reported in both states in the recent past with an associated negative image, sometimes leading to a temporary stoppage of the programme.21


The study employed a descriptive and analytical qualitative method for data collection as it suited the research question. This included a review of the relevant literature and documents as well as a field-based study of implementation of the immunisation programme. The field study employed a range of qualitative methods and specific comments on each of the methods are detailed in table 1. These included multisite participant and non-participant observations, focus group discussions (FGDs) and interviews.

Table 1

Methods of data collection used in Kerala and Tamil Nadu, 2009–2010

Sampling of study areas

A three-step sampling process was used to select 16 primary health centre (PHC) areas as study sites for maximum variability of regions with successful implementation of immunisation programmes in terms of coverage. Each PHC covers a population of about 30 000. On the basis of immunisation coverage, the districts in each state were categorised into three groups and two districts in each state were selected randomly, one from a better performing category (Alappuzha in Kerala and Dindigul in Tamil Nadu with an immunisation coverage of 90.2% and 87.5%, respectively) and another from a poorly performing category (Kozhikode in Kerala with 65% and Theni in Tamil Nadu with 72.1%). The immunisation coverage was assessed based on a percentage of fully immunised children in the 12–23 month age group as per the District Level Health Service survey.22 Average population in a district in Kerala and Tamil Nadu was 2 384 834 and 2 254 342, respectively. In each of these four districts, one better performing block and one poorly performing block (one block consists of 100 000 people) in terms of immunisation service coverage were identified with the help of district-level managers. In each block, two PHCs were identified for detailed study. One PHC in the block was selected based on an assessment of difficult geographic terrain and significant presence of poor and marginalised communities, and the second one randomly. One private facility used for immunisation services within each of the eight study blocks was selected randomly for observation of the immunisation services and interviewing the practitioners.

Data collection

Non-participant observations focused on immunisation sessions at health facilities, outreach immunisation sessions and review meetings of field staff in charge of the immunisation programme. All participant observations were made at the time when the researcher made house visits along with the health field staff or community health worker for mobilising beneficiaries for the upcoming immunisation session. During each of the visits, the researcher was introduced to households as a public health researcher and was involved in motivating and educating the families on childhood vaccinations. In most of the households visited, the initial communication related to vaccination was provided by the field staff or community health worker and the researcher was asked to clarify it further. In this process, the researcher had to shift between the role of an expert and researcher. All observations were made by JV. At the time of the observation rough notes were made, and at the end of the day, a full record was prepared by appropriately commenting on each of these activities as per the observation.

The respondents of in-depth interviews were immunisation service providers from the public and private sectors, those who facilitate vaccination like community health workers and those who opposed vaccination, all from the study areas. They were identified using the snowball method whereby, at the end of an interview, the respondent’s suggestion was asked about other important stakeholders for identifying the next respondent. Key informants were identified based on their expertise of immunisation service as a past or present state or district-level immunisation programme implementer or researcher in either or both of the states. Two of them were primarily researchers of immunisation services with expertise on the functioning of immunisation services in these two states.

FGDs with mothers were held in anganwadi centres (government-run free preschool and nutrition centre) belonging to the study areas. The number of participants in the FGDs varied from 7 to 10. The mothers included in the FGDs had children below 5 years of age who attended the anganwadi centre. They were identified and invited to participate by the teacher of an anganwadi centre. FGDs involving female field staff of the study PHCs were held in the PHC building after the weekly immunisation session. Leading questions were asked of the respondents of the interviews and participants of FGDs and they were encouraged to narrate their responses in detail. Clarifications were sought on specific points emerging from their narratives. All the interviews and FGDs were conducted in the local languages and recorded with the permission of the respondents.

Data collection was undertaken over 6 months during late 2009 and 2010 by JV who has oral communication skills in both languages. The additional help of a person familiar with the FGD process was taken in organising FGDs and for note-taking in Tamil Nadu. Only five FGDs with the female field staff of PHC could be organised as the staff found it inconvenient to sit in groups after the immunisation session. The recordings were simultaneously transcribed and translated into English by the JV within a few days of the interview. JV and VRK decided on the required number of in-depth interviews and FGDs by periodically assessing the saturation of the information by reviewing the transcripts.

Data management and analysis

The template approach, which is described as one of the four approaches to qualitative analysis by Crabtree and Miller,23 was used for data analysis. This method uses a template or analytical guide that derives from a theory or research tradition. As the analysis had to reconcile varying perceptions of different stakeholders across the same set of issues, the template approach, otherwise called deductive coding, was used. Sufficient attention was paid to negative case analysis during data collection and analysis for validation. Weft QDA, a software for qualitative data analysis, was used for arranging the text according to codes and managing the codes in the interpretive phase. The quotes of the study are included in the results as illustrations of themes emerging from the analysis of the data.

The study protocol was reviewed for ethical and technical clearance by the Institutional Review Board, where the JV was affiliated as a research student. Many parents approached JV during data collection for his opinion on the need for vaccination of their children. As suggested by the Institutional Review Board, the researcher had taken the initiative to clarify the vaccination-related doubts of parents who were interacted with and also reassured the need for vaccination. Official permission for data collection was taken from state-level health officials as well as from district-level officials, and participation in the study was made voluntary by ensuring informed consent from all participants.


The ethical analysis using the qualitative data shows that there are implicit ethical notions and moral values involved in the delivery of immunisation services. Identifying them makes it possible for use to understand the varying rationales involved in decision making regarding immunisation of children.

Utilitarian ‘notions’ of public health authorities

Strong utilitarian notions prevail among the government public health authorities at the state and district levels and guide the vaccination programmes. This considers the best ultimate outcome for the society. It supports mandating vaccinations for all.Vaccination should be mandatory. What is wrong with it? After all it is for the benefit of the society. If some do not agree, all of us will be affectedA district official (male), Theni

The utilitarian focus runs through all levels of the government’s health department and shapes the way the institutional mechanisms are structured for functioning. Its explicit outcome is the ‘thrust on coverage’ which is translated as targets for staff. The staff of the government public health service department placed at different levels of the hierarchy are expected to ensure coverage. This is evaluated against the targets fixed in the beginning of the programme. The transactions at the departmental monthly review meetings at various levels reveal how targets and their assessments form key activities in such programme reviews.There are very strict (annual) targets … By September if we did not reach 50 to 60%, we will be made to stand in the review meetings and explain. Excuses will not be of any helpFieldworker (female), Alappuzha district, Kerala

The overwhelming emphasis on coverage results in the use of coercive means to achieve targets. It restricts the options for refusal to undergo immunisation or for postponement of immunisation available to beneficiaries. This is especially so with the special vaccination campaigns introduced for the control or elimination of diseases such as Japanese encephalitis or polio. In Alappuzha district which had a targeted immunisation campaign against Japanese encephalitis, focusing school students in the previous year had openly debated the issue of consent of parents.We were told (by the district authorities) that the consent of parents was not required. Truly speaking there is no need for consent of parents. But schools were objecting. Teachers were not willing. They said “if we give, parents will question us. But, if we wait for the consent of parents, nothing would happen”. Taking parents’ consent is a wrong strategyA fieldworker (female), Alappuzha

Similar feelings have been expressed by a district-level officer (male) who was in charge of the special immunisation campaign against Japanese encephalitis in Alappuzha district.This is a state programme, no need to take consent of parents, if we take consent of parents, nothing is going to happen, programme will be a failureA district-level official (male), Alappuzha

Most of the public health workers who participated in FGDs believed that parental consent was a wrong strategy especially for special vaccination programmes. Even those who supported parental consent for vaccination wanted it for avoiding conflict and for the smooth running of the programme.

For many health department officials of the immunisation programme, targets are imperative to state-led governance of a public function. The emphasis on coverage is also applied to various levels of hierarchy in the department. If district coverage is less, DMO (district-level health authority) will be questioned at the state meeting and he will in turn raise it in the district meeting, then it goes down to each level—observed a district-level officer (male) from Kozhikode district.

In the FGDs, field staff described how any delay in vaccination among children is attributed to ‘lack in strictness’ in implementation. The utilitarian orientation is visible in the extensive planning and preparations for the execution of the special vaccination programme, such as vaccination programmes against Japanese encephalitis and polio, which involves coordination across various government departments. The dates of the programme are announced well in advance in the review meetings and special instructions are issued to institutions at all levels. Public health department staff hold several rounds of planning meetings with other government departments, local self-government officials, local non-governmental organisations and schools well ahead of the programme in order to estimate and identify beneficiaries and access potential non-compliers with regard to the special immunisation drive.

The special immunisation day is followed up with mop-up rounds where volunteers and vaccinators make house-to-house visits to vaccinate dropouts. These preparations contribute to creating a sense of urgency. An expert on immunisation policy and implementation described it using the following words:Polio campaign is like a war. Logistics and tactics are adapted like in a war. The word strategy, the word logistics or tactics are all taken from war. Logistics are about how armaments and supplies are reached the battlefield, tactics is about how you fight in a locality, it is more about how you design your war tactics

The utilitarian approach of the public health authorities results in making the vaccination programmes coercive and such efforts throw up conflicts with the caregivers of children. For example, a targeted campaign against Japanese encephalitis in Alappuzha district, Kerala was resisted by the school authorities as the public health workers sought to abrogate the need for parental consent. Some schools called a meeting of office bearers of the parent teachers association (PTA) and the PTA decision was taken as consent. Some other schools sent a note to parents through children asking for their approval.People saw this as a test dose. They thought government is experimenting on their children. JE vaccination was used for the first time; they had doubts … Many had raised a lot of questions to us; why this vaccine; why only on us?Medical officer (male), Alappuzha district

Even when special campaigns receive a high priority from the public health department, resistance from beneficiaries is found to be widespread in Kerala. ‘my child was given all vaccine injections when she was small. Even my 15-year-old daughter was given all injections. We did not understand why they were giving it again in the school. My husband said no when she told us about this. My daughter did not go to school on that day.’, explained a parent who refused a school-based vaccination programme against Japanese encephalitis. In resistant areas, attempts to reach out to unvaccinated children through house-to-house vaccination drives occasionally result in heated arguments between health workers and family members. Most field workers from Kerala who participated in the study shared their experiences of similar incidents.

Beneficence to patients

The ethical principle of beneficence that marks the immunisation function is also part of the professional relationship of healthcare delivery. Within the professional relationship, the expectation is that the caregiver will act in the best interests of the patients. This notion is visible in the thrust received for vaccination against mumps, measles and rubella (MMR vaccine). This vaccine does not form part of the UIP in the study states, but doctors, both in the public and private sectors, recommend it to children. Many older children in Alappuzha district in Kerala and both the study districts in Tamil Nadu had been prescribed MMR vaccines by doctors in the public and private sectors. While many practitioners prescribe MMR vaccine in the interest of their clients, the state public health authorities delayed its introduction in the routine schedule mainly due to cost considerations.

Beneficiaries’ expectations from caregivers are also rooted in the belief that health workers act in the interest of their patients. This has been an accepted notion in society which submits itself to the decision of the caregiver to a large extent. Most mothers who were part of the FGDs agreed that the doctors would act in the best interests of their children, even though some have raised doubts about the potential conflict of interest arising out of financial incentives to doctors.

Parents even accept the paternalistic behaviour by medical caregivers as they see this as an exercise of beneficence. This is reflected in their tolerance of rebukes from medical care providers for not holding the infant the right way or for delays in approaching the system for vaccinating their wards.If a mother comes late for vaccination by two or three months and if we question her, I am sure she would definitely cry. This happens in my clinic.A paediatrician (male), Theni

Here, paternalism takes the form of a belief among the caregivers that clients should accept decisions made in their best interests by caregivers. Therefore, negotiations and discussions with parents on the choice of vaccines and vaccination decisions are perceived as unnecessary in clinical settings. Often, the only verbal exchanges are a set of prevaccination inquiries and postvaccination instructions.

Several private medical practitioners across Kerala opposed the repeated rounds of polio campaign and advised their clients against vaccination as they thought it unnecessary for children in Kerala. For them, repeated doses of oral polio vaccines can only enhance herd immunity and not individual immunity, which was already covered under the UIP. Most of the private practitioners interviewed as part of the study in Kerala raised doubts about the rationale of repeated doses of oral polio vaccine to children.We are often approached by parents whenever a vaccine campaign is announced. Patients always ask their own doctors. If they are not sure of vaccination, they will advice against it.A paediatrician (male) working in a private hospital in Kozhikode

The state public authorities have failed to engage or convince them. Many parents who did not vaccinate their children during special campaigns, but had taken the routine vaccination, trace their decision to a doctor who advised against it. However, it should be noted that all the private medical practitioners from Tamil Nadu who were interviewed supported the special campaign for polio. Many of them referred to the decision taken in a meeting of the professional association of paediatricians in the state which supported the polio vaccination campaign.

Moral value of parental obligation

Parents’ moral obligation towards their children plays another major role in guiding the immunisation programme and contributes to its sustainability. This value comes out of the parent’s feeling that immunisation is their duty towards children.With small family norm people are ready to take vaccinations against even lesser known diseases. Yes vaccination is seen as norm; just like the need for good nutrition a ‘good’ is also attached to vaccinationAn expert (male), Tamil Nadu

It is widespread in societies which have a good coverage of immunisation. In such areas, vaccines have become a societal norm making it difficult for parents to avoid it. The FGDs with mothers held in areas of high vaccination coverage reiterated that in an environment where all parents vaccinated their children, it was difficult to be a deviant. Healthcare workers use this factor to ensure compliance to vaccination schedules and tend to chide parents saying that parents would be held responsible for their lapses (by their children when they grow older).People are not seeing disease as they were seeing before. Their fear has now gone. They are still taking it because everybody else is taking itA district-level supervisor (male), TheniThey have no fear of diseases. Most people think it is their duty towards their children. Many mothers are in their 20s. As a child, many of them had not received these vaccines. Some of them are daily wage workers, but want to bring up their children in the best possible way. Whatever they missed in their childhood they want to give to their children. They think vaccines are important. They have already made up their mind that vaccination is a mustAn expert (male), Tamil Nadu

Vaccination is one of the fist things that people do as parents for the well-being of their children. Some parents were apologetic that they used government facilities for vaccinations as these are seen as inferior to those offered in private facilities. Acceptance of vaccination as a social norm has been an important driving factor for sustaining the immunisation coverage when the incidence of diseases gradually declines. This also partially explains the high acceptability of optional vaccines.For some people, if they take the child to a private hospital for immunisation, they have a feeling that they have done something great for their child. Even poor are taking injections costing Rs. 500 and more. They have no problem in spendingCommunity health worker (female), Alappuzha

It is important to consider the perception of parents who did not vaccinate their children in the context of widespread propaganda against vaccination programmes in Kozhikode district. Contradictory information on vaccines and the vaccination programme left many parents in a dilemma. The efforts by the field workers to convince the mothers of unvaccinated children only led them into more confusion. One of the mothers interviewed who did not fully vaccinate her child as per the schedule explainsBut the problem is that nobody here is too keen about injections. It is difficult for me to take initiative; I have lot of difficulty which you should understand. I am an educated lady; I have studied up to degree. I am in favour of this. But if I decide alone and take the child for vaccination and after that if the child develops even a cold, all blame will be on me. They will say this was because of the vaccines and I did not listen to them. Last time, after I had taken the child for vaccination, child had developed fever in the night. Then my husband’s family members started scolding me saying I had caused this to the child who was otherwise healthy. After that I did not take the child (for vaccination).


Explicit and implicit values and norms are critical to the implementation of paediatric immunisation programmes as they influence the institutionalisation of programmes. The interactions of values and norms play a significant role in sustaining the acceptability and compliance to vaccinations at the community level.

In regions with good immunisation coverage, the programme has been sustained because of the confluence of several ethical notions involved. This has been possible because the values that influence the actions of parents and the ethical notions of professionals involved in immunisation find a common ground in immunisation-related decisions. Parents’ motivation is driven by the fact that vaccination is seen as a routine and parental obligation towards their children. This consideration is important as it ensures the public health department’s utilitarian goal of adequate protection against vaccine preventable diseases. The other studies which analysed the prevalent values that motivate parents to comply with paediatric vaccination have also highlighted this fact.2 Steefland et al have noted how vital it is for parents to retain a positive perception of the vaccination process if the immunisation programmes need to succeed.24

The role played by general acceptance of the small family norm in Tamil Nadu and Kerala has an influence over the values of parental obligation towards their children.17 ,18 This has facilitated the state’s entry into the domain of family decision making. The state’s goal of universal immunisation has benefited in contexts where state interventions are accepted by parents.

Another important notion that plays a role in sustaining immunisation in regions with good immunisation coverage is beneficence, which is attributed to the healthcare providers. An explicit recognition of beneficence by healthcare workers can have a synergetic effect with values of parental obligation. The government sector in both the study states has acted differently to tap into the importance of parents’ expectation of beneficence from caregivers. Tamil Nadu had made it mandatory for doctors to see each child before vaccination. The decision was taken as a confidence-building measure immediately following an incident of deaths of children after immunisation, which created widespread anguish and derailed the programme.

Ethical notions and moral values can also run into conflict with each other. The ethical principles operate differently in the policy-making process and in service delivery or at the household level. Interventions with a strong utilitarian focus have the potential to undermine parental obligation. In other words, state-led interventions in immunisations are accepted as long as they do not overshadow parental values of welfare for their children. The state’s utilitarian intentions are accepted only when the voluntary nature of the universal programme is ensured. A paternalistic state and public health driven compulsion for vaccinations have the potential to undermine the value of parental obligations, which is one of the driving forces behind paediatric vaccination. ‘…may be because when it is forced, they may think it is for the others benefit not for their benefit’—commented one of the experts on the widespread resistance against special campaign in Kerala.

Many medical practitioners also advised their beneficiaries against repeated intake of oral polio vaccine as the global polio eradication goal did not appeal to them beyond the benefits of their clients. This perspective is important in understanding their support for routine immunisation and general indifference to special campaigns. Such an attitude of medical professionals to the immunisation programme has also been noted by other authors.25 ,26

As the incidence of vaccine preventable diseases declines, it is difficult for the state to motivate individual parents to attain a utilitarian public health goal. This is evident in the way beneficiaries are motivated by the field health workers for special campaigns where the health message is invariably directed at personal benefit. They avoid discussing the objective of global polio eradication with beneficiaries. The public health officials try to tackle the widespread resistance against immunisation by raising the issue of possible return of vaccine preventable diseases. As the fear of diseases no longer explains the acceptability of vaccinations in these societies, it proves to be a weak strategy.


The arguments in this paper are different from the other criticisms of the campaign approach in immunisation for its single-disease focus or its contribution to weakening health systems in the developing world.27 ,28 We emphasise on the need for public health actions to take into consideration the manner in which societies organise themselves to manage public affairs. Ethical analysis is one such aspect that enables us to understand the decision-making process surrounding public health interventions. This analysis should include an exploration of the ethical rationale and the interplay with multiple moral notions.

Immunisation policy decisions need to go beyond the simple rationales of life saved or monetary benefits due to vaccinations29 to enhance vaccine acceptability in societies where resistance to the programmes is developing. We also advocate analysis that transcends mere ‘risk perception’ to assess household behaviour related to paediatric vaccination.30–33 Our analysis identified that the role of the norm ‘vaccination as a parental obligation’ cannot be ignored especially in societies with high coverage and low incidents of vaccine preventable diseases.

Exploration of the operation of the ethical notions and moral values involved enables us to understand the decision-making process surrounding a public health intervention such as immunisation. However, this analysis does not claim that confluence or conflicts of ethical notions and moral values alone explain the resistance or acceptance against collective vaccination programmes. The study also does not explain why most parents accepted vaccination even when some of the parents opposed. We argue that the ethical notions which are professionally created and sustained often result in judgements about how others should conduct themselves and contribute to the complexity of vaccination programmes. The moral values and ethical notions operate not only in the decisions of the governors of the public health interventions but also in that of those who are governed. The study emphasises on the need for public health governance to take into consideration the nature of all the interactions, including those at the normative level at which societies organise themselves. Recognising these values and notions and their interactions with each other should be a key strategy of public health programme planners and implementers. The role played by informal interactions at the level of households or at the clinical settings cannot be ignored. This offers considerable challenges to state-led governance of public health functions.


#India #1billionrising in vain -A woman who thrashed eve-teasers faces police charges #Vaw #WTFnews

One Billion Rising in Vain

A woman who thrashed eve-teasers on V-day faces police charges in Thiruvananthapuram

BY Shahina KK Open Magazine
TAGGED UNDER | women | eve-teasers | Thiruvananthpuram
IN HER DEFENCE: Amrita Mohan believes the police action against her will deter other women from fighting back

IN HER DEFENCE: Amrita Mohan believes the police action against her will deter other women from fighting back

On 14 February, Amrita Mohan, a BA student of All Saints College, attended a One Billion Rising rally in Thiruvananthapuram, a global campaign to end violence against women. Later that night, she was having dinner at a roadside eatery at the venue, Shangumugham beach, with her family and friends. That’s when three men in a vehicle marked ‘Government of Kerala’ started making filthy comments about Amrita and her friend. Amrita ignored them for a while, but when they kept at it, she lost her cool. “There was an argument. There were several men eating at that outlet, but nobody supported us. When my father tried to intervene, one man in the group pushed him. That’s when I lost control,” she says.

What the eve-teasers didn’t know was that Amrita was an expert in martial arts. She first pulled the man on the driver’s seat out of the car and beat him up. When two others tried to attack her, she thrashed them too. By then, the crowd, too, had joined her and somebody called the police.

Amrita’s action was widely hailed by women’s organisations, individuals and the media as an example for other girls. But there has been a twist in the case. Two of three eve-teasers were contract drivers at the Income Tax Department. So, Amrita has now been booked, on directions of the judicial first class magistrate, under Sections 323,325 and 335 and 332 of the IPC for voluntarily causing hurt and deterring a public servant from discharging his ‘lawful duty’. This invites imprisonment for up to seven years and is a non-bailable offence. The eve-teasers have been charged with lighter, bailable offences.

Women’s organisations wonder how harassing women at night could be ‘lawful duty’. “The police are clearly biased. Though Amrita told them that the men were drunk, they were not taken to a hospital for a medical examination,” says Mercy Alexander, director of Saki Women’s Resource Centre in the city.

Amrita is determined to go ahead with her case against the men. “My only concern is that this action against me by the police and court will deter women. They will hesitate to resist when confronted with a similar situation,” she says.

Kerala girl who thrashed men for verbal abuse faces court case #1billionrising #Vaw #WTFnews

PTI | Feb 19, 2013, 10.32 PM IST

THIRUVANANTHAPURAM: A college girl who hit the headlines by kicking and punching those who harassed her at an eatery recently has landed in trouble with the city police registering a case against her based on a local court order.

The courage shown by Amrita, a final year degree student of a city college, has been widely applauded for the way she “handled” her tormentors at a wayside eatery on her way home after participating in “One Billion Rising” programme at Shanghumugham beach on February 14.

After her bold act appeared in the media, she has been showered with phone calls and letters praising the manner in which she handled the situation and a state minister even visited her home to pat the courageous girl.

Following the incident, police registered a case against the two men.

One of the accused, however, filed a private complaint in a local court alleging he had been beaten up by the girl who also blocked his car.

Admitting the complaint, the court on Monday directed the city police to register a case and investigate the incident.

Meanwhile, state women’s commission chairperson KC Rosakutty and leaders of various women outfits criticised the action against Amrita, who is widely seen as a symbol of courage.


A black belt in Karate, Amrita said she would legally fight the case against her.

Call to address concerns of Kudankulam protesters


A chord with the masses:Film director T.K. Rajeevkumar launching the campaign ‘A rupee for Kudankulam’ on the Shanghumughom beach in Thiruvananthapuram on Sunday.— Photo: S. Mahinsha


The concerns of safety, loss of livelihood, and displacement raised by the villagers of Kudankulam are not the isolated concerns of 18,000 fisherfolk. Every individual should see this struggle as the right of another for existence and support it, film-maker T. K. Rajeevkumar said. The agitation against the Kudankulam nuclear plant has crossed 600 days.

Addressing hundreds of people on the Shanghumugham beach on Sunday evening, Mr. Rajeevkumar said the people of Kudankulam only want to convey to the world that none in high places had ever actually explained to them the benefits or disadvantages of building a nuclear plant in their village. They want to tell the world to understand the depth and implications of the concerns they have raised and see it as a concern of humanity and not marginalise it, Mr. Rajeevkumar said.

He was speaking after inaugurating the ‘A Rupee for Kudankulam’ campaign, organised by a State-level action council expressing solidarity with the Kudankulam movement

He said his reaction to the issue was that of a citizen and that of an individual who was apprehensive about what the proximity to a nuclear plant could mean to his world and the safety of people. The government had the responsibility to reassure the people about the concerns they had raised, he said.

Video installation

Mr. Rajeevkumar said a video installation on Kudankulam, explaining the entire anti-nuclear campaign from a human perspective, was being planned, the shooting for which had already commenced. The video installation would travel across the world so that the anti-nuclear voices from an isolated community would be heard across the world, he added.

S. P. Udayakumar, who is spearheading the anti-nuclear protests at Kudankulam plant, addressed the campaign via video conferencing. He said the people of the village were only seeking basic information about the nuclear plant project. But the Centre and the Tamil Nadu government were only concerned about enriching the Russian economy and scuttling the non-violent and democratic agitation being carried out by the villagers.

“Why is the government hell bent on going ahead with the nuclear plant project in such a hasty manner? The Prime Minister says we are approaching the issue emotionally and that we should come forward for a dialogue. But to initiate a dialogue, we need all information about the project – give us details about the site analysis, safety evaluation and emergency preparation and management reports,” Dr. Udayakumar said.

He pointed out that in other States too, proposed nuclear projects had been dropped following people’s opposition. “There is no need for any haste; let us have a national debate on the issue in the next elections,” he said.

He said the agitation will continue and that the people of Kudankulam were determined to fight for their right to live safely in their land till their last breath.


#India-Stories of survival from Kudankulam, Vilappilsala

STAFF REPORTER, Nov 4, 2012, The Hindu

The Young Women’s Christian Association hall (YWCA) here, on Saturday, rang with passionate voices of solidarity and an undaunted spirit of protest as women involved in agitations against the concrete manifestations of ‘development’ in Kudankulam and Vilappilsala gathered for a day of sharing their ‘Stories of Survival.’

With the tagline ‘Kudankulam muthal Vilappilsala verae,’ the programme was led by the Self-Employed Women’s Association (SEWA). Focussing on a woman’s perspective, the programme highlighted the travails of those who lived in the troubled zones.

Support sought

Speakers during the session stressed that women, being the most victimised, needed to pledge support for each other, irrespective of the specific cause. As Sugathakumari, poet, said, “The men may be silent, but the lakhs of women in Kerala need to at least speak against the situation at Kudankulam.”

“The Union government, people’s representatives, business and industrial leaders do not seem to understand what a flawed definition of development they are following. Or they pretend not to,” Ms. Sugathakumari said.

She criticised the responses of political representatives and scientists who have said that the nuclear power plant at Kudankulam will function safely.

“Only God can tell when the system will fail. How can we predict natural catastrophes? There is also such a thing as man-made error. How can we completely rule out the possibility of something like this happening?” she said.

Touching upon various projects in the State itself that threatened the existence of paddy fields, she said even if complete self-sufficiency could not be attained, there must be an attempt to produce essential commodities required by our people.

Jameela Prakasam, MLA, who was present, lauded the strength of the women to carry on their protests. Organisers said that more such meetings, involving various women’s rights and environmental organisations, would be held.

Poster exhibition

A poster exhibition was held as part of the function, along with the screening of a recently released documentary ‘Daughters of the Sea – Voices from Kudankulam.’

The session began with a demonstration led by six women who came from Kudankulam and five, including Vilapilsala panchayat president, Shobana Kumari, from Vilappilsala. Nearly 150 women participated in the march from the YWCA till the Secretariat.

Keywords: YWCAKudankulamVilappilsala


Fishworkers destroyed model of the Kudankulam nuclear power plant

Appeal against nuclear power project

Thiruvananthapuram, September 15, 2012 : THE HINDU

Activists of the Kerala Swathanthra Matsya Thozhilali Federation
destroyed model of the Kudankulam nuclear power plant at a
demonstration in Thiruvananthapuramon

Fish workers’ bodies plan agitation

September 17 to be observed as protest day

Kerala Swathantra Matsya Thozhilali Federation (KSMTF) and the
National Fishworkers Forum (NFF) have urged the State and Union
governments to drop the Kudankulam Nuclear Power Project and set up
wind farms along the coast to generate power.

Addressing reporters here on Thursday, T. Peter, secretary, NFF; P.P.
John, State president, KSMTF; and J.P. John, district president;
questioned the motive of locating the nuclear plant in the densely
populated Kudankulam coast. Highlighting the possibility of a nuclear
accident as the major cause for concern, they feared that the constant
discharge of hot water into the sea from the plant would deplete fish

KSMTF and NFF were embarking on a State-wide agitation from Friday to
express solidarity with the ongoing stir against the project. Fish
workers and their families would take out a march to the Secretariat
here on Friday and stage a dharna. The agitation would be extended to
other districts over the next few days. NFF would observing September
17 as protest day in New Delhi and in coastal States.

KSMTF urged the State government to adopt a stand against nuclear
plants. Mr. John said the oceanarium project in Kochi showcased at the
Emerging Kerala meet would pose a threat to the fisheries sector.

The office-bearers said the Chief Minister’s announcement that the
coastal waters would be opened up for movement of cargo vessels had
led to concern among fishermen who used gillnets along the coast from
Thiruvananthapuram to Kasaragod. Mr. John urged the government to
restrict the movement of cargo vessels beyond the 12-nautical-mile

Kerala a State with a speedily ageing population- issues and concerns #sundayreading

Shades of grey


in Thiruvananthapuram, Front line 


Kerala faces difficult and politically inconvenient policy choices on issues linked to its final-stage demographic transition.


AN ELDERLY WOMAN with her grandson. In Kerala, the continuous decline in the number of births has been accompanied, among other things, by a rapid increase in the number of the elderly. 

IF population trends and hesitant statements by State Ministers are a clue, Kerala is set to face difficult and politically inconvenient policy choices in the near future on issues linked to its final-stage demographic transition, marked by low fertility and mortality rates.

Signs of new dilemmas are already evident in the State. It has one of the lowest population growth rates in India. Its fertility and mortality rates have fallen to very low levels. An average Keralite would live beyond 70 years. All this is leading to a situation making Kerala a State with a speedily ageing population.

At an international seminar on “Emerging Fertility Patterns in India: Causes and Implications” organised recently by the Centre for Development Studies (CDS) in Thiruvananthapuram, participants were calling attention to the “profound demographic transformation” taking place, indeed, all over the world. As a result, more than half the world’s population is now living in countries or regions where birth rates are “at or below the level needed to ensure the replacement of generations” (or 2.1 children per woman, a number known as the “replacement rate of fertility”, which denotes a stable population).

“Nearly one-third of India is witnessing a trend of below replacement level of fertility today [see box]. Our estimate is that by 2021, two-thirds of the districts in India will have below replacement level of fertility,” S. Irudaya Rajan, a professor at the CDS who has been studying demographic and migration issues in Kerala for over two decades, told Frontline.

Within Kerala, one of the first States to reach an advanced stage in demographic transition, the continuous decline in the number of births has been accompanied, among other things, by an increase in the proportion of the working population, the highest unemployment rate among educated youth in India and problems associated with their migration in large numbers in search of job opportunities, and a rapid increase in the number of the elderly within the State.

From the mid-1990s, questions were being raised on the economic implications of low fertility and mortality and on how the development achievements of the State could be sustained in the wake of such population trends and in an environment of poor economic growth. Researchers have been saying that the socio-economic implications of the reversal of demographic trends would be far-reaching in a State like Kerala.

A collection of research papers from the CDS titled “Kerala’s Demographic Future: Issues and Policy Options” released at the seminar foresees, among other things, “significant changes in the age structure” in Kerala, including “a decrease in school age population, decrease in proportion of the labour force in about two decades from 2001, decline in young working age population, a doubling of older working age population in two decades ending in 2021 and more unemployment among the older age groups than among the youth in the foreseeable future”.

Unique ageing scenario

A paper on the unique ageing scenario in Kerala estimates that the size of the population in the age group of 60 years and above in the State is expected to increase from 33 lakh in 2001 to 57 lakh in 2021 and to 120 lakh in 2061. By 2061, the proportion of the elderly would constitute 40 per cent of Kerala’s total population. Of this, 6.7 per cent would be in the age group 60-69 years; 23.8 per cent in the age group 70-79 years; and 9.1 per cent in the age group of 80 years and above.

Another study by the State Planning Board, published in 2009 as part of a United Nations Development Programme-Planning Commission project, also makes similar projections, that the number of elderly persons (60+) is set to increase from 3.62 million in 2001 to 8.93 million by 2051, an increase of 166 per cent. The study estimates that the growth rate among the elderly will be the highest during 2011-21 and will decline thereafter to a low of 7.5 per cent during 2041-51.


AN ELDERLY MAN returning home after a day’s work in an agricultural field near Thrissur. The proportion of households in the State that do not have aged persons has been decreasing. 

The CDS studies report that the cost of “dependency burden” of Kerala households will also rise quite rapidly in the future. While the young dependency ratio (defined as the number of persons aged 0-14 per 100 persons in the working age group of 15-59 years) is expected to decline from 41 to 16, the aged dependency ratio (the number of persons above 60 years of age per 100 persons in the working age group of 15 to 59 years) is to increase from 17 to 76 during the period from 2001 to 2061.

Kerala would also have more women than men in the old-age group; also, more aged widows than aged widowers. The proportion of households that do not have aged persons has also been decreasing. Among Kerala’s 14 districts, there are variations in the proportion of the elderly to the total population, with the highest percentage of elderly population (21 per cent) found in Pathanamthitta, followed by Alappuzha, Kottayam, Ernakulam and Thiruvananthapuram.

The older working age population in the State is estimated to double in number in the 20 years from 2001 to 2021, “creating an atmosphere of unemployment more among the older age groups than among the youth in the foreseeable future”.

However, unemployment among Kerala’s young working age population is set to decline in the coming decades, and “educated young workers will be able to virtually pick and choose the jobs they want”, according to the editors of the collection, Irudaya Rajan and K.C. Zachariah, an honorary professor at CDS. They also believe that the reversal of the demographic trends will ease the pressure on Kerala’s education and health care systems and offer opportunities for quality improvement of such services.


It is well known that migration from Kerala to other States in India and abroad had been one of the means by which the State coped with the ill effects of rapid demographic transition in the last 50 years and which helped it realise its human development achievements. Questions are raised on whether migration will continue at such high rates in the future too and contribute to the well-being of Kerala’s economy. Meanwhile, the State is also seeing a new trend of “replacement migration”, an increasing flow of migrant labourers from other States into Kerala.

The authors say that Kerala is now experiencing the secondary effects of migration of its people during the past decades, which are not so beneficial as the primary effects were. They include (a) the creation of educated youth unwilling to take up low-paid or unskilled jobs, and thus leading to a high unemployment rate; (b) the inflow of migrant workers from other States who are willing to accept low wages and poor working conditions and thus make a significant impact on unemployment and wage rates within, and “nullifying some of the potentially positive spin-off effects of emigration”; (c) the divisions caused by the “increasing economic and political clout of the newly rich emigrants”; and (d) rising resentment in Kerala society as a result of unequal opportunities in the emerging migration market.

The recent phenomenon of “replacement migration” is a result of a rapid decline in the number of workers in the young working ages caused by fertility decline to below replacement level, emigration of a large number of young persons to the Gulf and other destinations, and economic improvement in the State economy “which have fostered an aversion to low-paid and unskilled jobs on the part of the youth in the State”.

As a result, “the potential spin-off effects of remittances on employment are benefiting workers outside Kerala more than workers within Kerala”, with much of its remittances being drained off to other States, according to Irudaya Rajan and Zachariah.


PENSIONERS WAIT AT the sub-treasury in Thiruvananthapuram. Nearly 20,000 State government employees retire every year in Kerala. 

Read more here


About 14,000 families depend on manual scavenging in Kerala #indiashining

, TNN | Aug 9, 2012,

KOCHI: The enumerators for the Socio Economic and Caste Census (SECC) 2011 seem to have come up with some curious data.According to them, there are 13,687 families who depend on manual scavenging to eke out a living in Kerala which has won global acclaim for its high levels of social development.Another perplexing finding is that there are 14,947 freed bonded labour families in the state.

Interestingly, even as per the census data of 1982 there were only 51 families who belong to the category of freed bonded labour in the state and all of them are known to have expired, the officials of the Rural Development Department (RDD) told TOI here. The data collection launched in April 11 was over in June. The SECC data also shows that 17,564 families belong to the primitive tribal group in the state and has accorded the status to five tribes, namely Kaadar, Cholanaikkar, Kattunaikkar, Koraka and Kurumba.

According to RDD officials, there could be a maximum of 5,000 families in the state in the group, mainly in Wayanad, Idukki and Kannur.

However, the data collected as part of the SECC indicates that there are about 1,500 families belonging to the group even in Thiruvananthapuram. The RDD officials clarified that some of the enumerators might have committed errors without knowing the criteria to be used for entering into different categories in the census data.

For instance the enumerators may have included the workers engaged in the city cleaning activities in the city areas as manual scavengers, he said.

The entire data collection exercise was paperless, done on hand-held electronic devices. This was expected to reduce data entry errors and enumerator discretion. Also officers at various levels were expected to make sure that there was no misreporting. But RRD officials are surprised that despite all these precautions such errors have crept in.

“We are trying to conduct another round of sample survey to trace how and where the errors have crept in,” the rural development commissioner Nandakumar said.

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