Table 3 Obliteration of caste differences

Quote 1: “Marginalised communities, see actually if we think about Kerala, if you ask about such communities, definitely tribals. In tribal areas, they are still remaining as a marginalised section. One of the main reasons for it is our infrastructural changes, one they are living in very remote areas. Then one other reason is that their traditional culture is very difficult to be changed. So, there are definitely these challenges in tribal areas. Otherwise, I don’t think there is any marginalised section within the general community. I haven’t seen from my experience, of course, other than the tribal areas. One more thing is when it comes to immunisation, of course definitely there are certain religious settlements. In such areas, we still have many unimmunised children. In their issue also we haven’t been able to make a change. Other than these, we do not have any issues in Kerala” (Directorate of Health Service 3)

Quote 2: “When we speak about marginalised groups, commonly used criteria are geographical or social dimensions, or those who are marginalised within the social pyramid. And above all the lower income groups, or tribals in hilly areas. Tribal groups are marginalised at many levels, be it availability or accessibility of services. Then similarly we have urban slums or people who live in slum like situations as Kerala does not have any typical slums that one may expect, or coastal communities also. Then there are groups whom we never used to talk until a few years back, that is migrant labourers, they are also marginalised…. the reasons for urban slums are multiple obviously. One, a common reason for the formation of slums are normally economic, basically unemployed people who come from rural areas or people who come to urban towns as workers of big development activities. Once they complete their work, they tend to remain in urban areas somehow resulting in slums. So, there is a broader socio-political and economic reason behind it and that is a dimension of marginalisation” (Directorate of Health Service 6)

Quote 3: “Yes, there are vulnerable sections in our state, where there are gaps in our primary care services. Specifically, in our Adivasi areas or more within tribal areas. Because the primary challenge is the hard-to-reach dimension. By hard-to-reach, I mean areas that are difficult for people to reach physically. All other areas have been encroached upon by people and have been converted as plantation areas and Adivasis are being pushed to the peripheries. So, the main groups are aadivasis, SCST (Scheduled Caste Scheduled Tribe) groups are also present in such areas” (Directorate of Health Service 5)