COVID‐19 and India's vulnerable indigenous populations

In response to the coronavirus pandemic, several countries have imposed curfews, quarantines, and lockdowns to restrict the spread of the infection among people. India had initiated a nationwide lockdown to combat the pandemic starting from the last week of March until the end of May 2020. But, the lockdown had continued subsequently in several red zones across parts of the country for few months. However, scientists have criticized the government’s abrupt lockdown since it prevented people from preparing for the worst aftermath. Besides, the curfews have blocked millions of impoverished migrant workers from leaving cities to return to their homes in distant rural villages. As a result, the destitute workers have endured enormous hardship and outright discrimination desolately leading to their added physical and mental distress, pain, suffering, and death. Most of the victims of the lockdown have belonged to the economically distressed lower social classes of the Indian caste hierarchy. This article outlines their sufferings triggered by the long drawn-out lockdown episode.

To corroborate the Editors' 1 appeal for Indigenous Peoples' right to self-determination as fundamental to ensure their health, we wish to draw attention to the dire situation faced by Indigenous populations in the Amazon, and mainly in Brazil. Since the conquest of the region by the Europeans, the history of the Amazon has been marked by epidemics that ravaged native populations. These calamities, recent or old, have left an indelible mark in the memory of communities: several Amerindian groups have been completely wiped out by exogenous diseases like measles and smallpox; others have barely surv­ived, with mortality rates sometimes exceeding 98% (ie, worse than medieval plague and Spanish flu). 2 The arrival of the COVID-19 epidemic in Indigenous territories therefore revives painful memories and well justified fears. Indigenous communities are not vulnerable in themselves; they have been made fragile by the legacy and persistence of colonial practices. In the Amazon, the COVID-19 pandemic has encountered a failing public health system. Worse still, in some communities, the transmission of severe acute respiratory syndrome coronavirus 2 has started with health professionals infected and not tested before leaving for isolated localities. Today, according to the Brazil's Indigenous People Articulation, more than 27 000 Indigenous people have been infected with COVID-19, of which 806 have died from the disease (situation as of Sept 15, 2020), giving a mortality rate of 3%. This pan­demic already affects 146 different Indigenous groups across the country. 3 On Aug 5, 2020, the Supreme Federal Court recognised the failure of the government of President Bolsonaro to deal with the effects of the epidemic on Indigenous communities. 3 The latter was ordered to put in place an emergency plan for the benefit of the Indigenous populations, as well as to adopt the necessary measures to remove invaders from their territories (illegal miners and loggers are not only vectors of diseases, but also cause environmental destruction, in particular through mercury pollution). 4 Faced with inaction from the Brazilian Government, some nations, such as the Paiter Suruí and Parque Indigena do Xingu peoples, have placed themselves in voluntary isolation since March, 2020. Only two solutions exist to ensure the survival of Indigenous peoples in the wake of this COVID-19 crisis. First, build public health policies in partnership with Indigenous peoples, and which are respectful of local perspectives on diseases and their treatments. And second, respect the right to self-determination recognised by the 2007 UN Declaration on the Rights of Indigenous Peoples. In the absence of these solutions, we will watch these Indigenous peoples die from afar. © 2020 NurPhoto/Getty Images 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Health parameters of tribal population had always been a concern for India's march towards Millennium development Goals (MDG's). Tribal population contributes 8.6% of total population, in spite of efforts and commitment of Government of India towards MGD, India lagged far behind from achieving and optimal health of tribal population will be a concern for achieving Sustainable development Goals SDG's also. Some of the common health problems of the tribal population face are deficiency of essential components in diet like energy malnutrition, protein calorie malnutrition and micronutrient deficiencies. Goiter, Gastrointestinal disorders, particularly dysentery and parasitic infections are very common. High prevalence of genetic disorders like sickle cell anemia and others are endemic in few tribes of India. Tribal Health is further compounded issues by social issues like excessive consumption of alcohol, poor access to contraceptive, substance abuse and gender based violence. Besides other reasons, like poor budget allocation, difficult to reach, poor access to health care facility, severe shortage of qualified health workers and workforce led to poor governance of health sector in tribal areas. Present view point reflects on the issues of inadequacy of doctors in tribal area and suggests possible solutions.