"From Neglect to Empowerment: PAD’s Rights-Based Health Interventions for Adivasi Communities"

People’s Action for Development (PAD) has prioritized health equity for Adivasi tea garden workers in Assam since its inception. This commitment stems from PAD’s leadership—comprising the first generation of educated Adivasis—who recognize the historical marginalization and systemic neglect faced by their community. Much like the riverine Chor-Chapori minorities, tea garden workers exhibit some of the lowest human development indicators in Assam, particularly in maternal and child health.
Assam continues to report one of India’s highest maternal mortality ratios (MMR) and infant mortality rates (IMR). NFHS-5 data places the state’s IMR at 31.9 per 1,000 live births, yet this figure conceals the acute disparities within tea garden populations. Studies across districts like Sonitpur, Tinsukia, and Dibrugarh reveal that tea garden women face elevated risks due to early marriage, high fertility, anemia, unsafe water, and prolonged physical labor during pregnancy. Institutional delivery rates remain low, and uptake of schemes like Janani Suraksha Yojana and Mamata is hindered by cultural barriers, poor awareness, and logistical constraints.
PAD’s health strategy is rooted in collaborative, rights-based programming that addresses both immediate medical needs and long-term systemic gaps. Key initiatives include:
1. Health Camps with Assam Medical Trust (New Zealand)
PAD has partnered with the Assam Medical Trust (AMT), led by Dr. Harry Mc—a neurologist with over a decade of service in Assam. Annual health camps are conducted in collaboration with district health departments, offering free consultations, medicines, and referrals to tertiary care. A post-COVID camp held on 18 November 2022 treated over 250 patients, with a team including Dr. Amanda Mc (New Zealand), Dr. Ajay Peter Topno (NML), and Dr. Sermili Rini Singnapi (LMC). AMT also sponsors Adivasi children’s education and supports referred patients financially for advanced treatment.
2. Maternal and Child Health through ActionAid India (LRP Project)
PAD’s partnership with ActionAid India under the Local Rights Programme (LRP) focuses on reducing maternal and infant mortality by addressing malnutrition and anemia. The initiative promotes Mothers’ Groups and Adolescent Girls’ Clubs, which serve as platforms for health education, nutritional awareness, and early intervention. These community structures have proven effective in identifying high-risk pregnancies, encouraging antenatal care, and fostering peer-led advocacy.
PAD’s health interventions are not isolated efforts—they are embedded within a broader vision of empowerment through education, livelihoods, and cultural identity. By integrating grassroots mobilization with institutional partnerships, PAD continues to challenge the structural determinants of poor health and advocate for inclusive, accountable healthcare systems.
For donors and policymakers, PAD’s model offers a replicable framework for addressing health inequities in labor-intensive, marginalized communities—grounded in lived experience, participatory design, and strategic collaboration.