Surguja in northern Chhattisgarh is home to a large population of Adivasi and marginalized communities living in remote forest terrains. This region faces a severe and layered health crisis driven by poverty and marginalisation, deep-rooted inaccessibility and poor public health systems.
A. Health Issues
A Triple Burden of Disease
The area struggles with a disproportionately high prevalence of infectious illnesses like severe Tuberculosis, Leprosy, Malaria, and Scrub Typhus. Simultaneously, the incidence of non-communicable diseases (NCDs) such as hypertension, diabetes, stroke, advanced-stage cancers, mental health problems, and sickle cell disease has risen sharply. Compounding both is a severe, unmet burden of undernutrition — affecting not only under 5 children but also adult men and women, , the elderly, and those already sick — which worsen immunity, fuels disease progression, and undermines recovery. This intersection of infectious diseases, lifelong non-communicable conditions, and pervasive malnutrition creates a triple burden of complex comorbidities that overwhelms patients and the health system alike.
Figure 1 — The triple burden: infectious disease, NCDs, and malnutrition converge on the same patients
Late Diagnosis and Avoidable Suffering
Most NCDs are detected at advanced stages, leading to preventable deaths. Palliative care is virtually non-existent; patients with terminal illnesses are frequently sent home with no pain relief, causing immense physical suffering and caregiver burnout. Until recently, even oral morphine was unavailable in the district’s public facilities, as it is only available at UCHC, Nawapara in Ambikapur city due to our efforts.
Economic Vulnerability Despite Schemes
Lifelong NCD treatment and emergency travel push families into making catastrophic out-of-pocket expenditure. Although Ayushman Bharat exists, many households remain “invisible” due to a lack of documentation, digital literacy, and logistical hurdles in claiming benefits.,
Climate Change and Marginalization
Increasing deforestation, mining, and climate shifts disproportionately impact Adivasi communities. They face displacement, loss of livelihood, and heightened exposure to climate-sensitive vector-borne diseases, heat-related illnesses, and human-animal conflict, all while their nutritional security erodes.
Vulnerable Tribal Groups at the Edge
Particularly Vulnerable Tribal Groups (PVTGs) like the Pahadi Korwa and Pando communities bear the heaviest burden of severe malnutrition, and infectious diseases and all diseases made worse by neglect, compounded by social discrimination.ocial discrimination.