Industry Odisha Bureau, Oct 20: When people lack adequate food, clean water and timely healthcare, illness has deeper roots. A doctor argues medicine must confront them, despite professional risks.
India’s rural health crisis is often framed as a shortage of doctors. That shortage is real and well documented. Yet community medicine physician Dr Parth Sharma argues it tells only half the story. Writing in The Hindu on 19 October, he says prescriptions cannot fix deprivation.
Public health experts call these wider factors social determinants of health. They include income, nutrition, housing, literacy, transport and access to clean water. When people lack adequate food or timely healthcare, illness spreads and deepens. For poor households, one illness can also trigger long-term debt and poverty.
Sharma’s field visits illustrate these links. At a cancer screening camp in rural Assam, he questioned 25 villagers. Their answer was not a disease but a missing road. Without it, bringing water into the village was difficult. Reaching a hospital on time during emergencies was harder still.
In rural Tamil Nadu, an Adivasi hamlet described a different link. Residents said the government moved them to land about 20 kilometres away. They said nothing grows there, leaving them unable to afford daily food. Their account has not been independently verified. Still, it shows how insecure land can undermine nutrition and health.
Sharma defines a good doctor as compassionate, competent and courageous. Such doctors, he argues, ask why patients fell sick in the first place. That question can lead to roads, land, water and public services.
He cites Dr Binayak Sen, a paediatrician and public health specialist. Sen served rural communities in Chhattisgarh. He won the Paul Harrison Award for rural service in 2004. Sen once told The Hindu that “the greatest violence is structural violence”. The term describes harm caused by unequal access to resources and services. In 2010, a court convicted Sen over alleged Naxalite links and sentenced him to life. The Supreme Court granted him bail in April 2011 while his appeal proceeded.
Sharma also highlights Dr Randall Sequeira, a general medicine specialist in Odisha. Sequeira has worked with Adivasi communities on health concerns linked to mining. He has also supported their resistance to mining projects. He was arrested on 16 October and reportedly remains in judicial custody. The specific charges were not detailed in Sharma’s article. An arrest is not proof of guilt, nor of a link to advocacy.
Mining can affect health through dust, water contamination and lost livelihoods. Actual impacts depend on local exposure and scientific evidence. Doctors must obey the law like anyone else. Yet lawful criticism of conditions harming patients should not invite criminal risk. Sharma stresses that clinical care remains vital, and not every doctor must become an activist.
His broader point concerns public policy. Roads, clean water, nutrition schemes and primary health centres all shape outcomes. Better health in rural India needs medicine and the conditions that make it work.
