Honoring Cultural Sensibilities: Reworking Current Models of Public Health Education in Kerala, India

Roshan S. Nair


In July 2014, a three week immersive internship was completed, a primary purpose of which was to raise awareness and to provide education on alcohol and tobacco use for tribal adults and children of rural Kerala, India. To achieve this goal, alcohol and tobacco use awareness classes were conducted under the supervision of a group of health administrators and healthcare workers at eleven primary and secondary schools and at several free rural medical camps and medical clinics. Each of these sites provided numerous opportunities for interaction with the Adivasi or indigenous communities of the region, one of which was the Paniya tribe. Despite government-authorized anti-alcohol and tobacco abuse awareness campaigns in Kerala, there continues to be a dramatic rise of substance abuse. This increase in abuse raises the question as to why such programs are ineffective.

Based on an evaluation of the internship experience, along with research on the problems perceived while participating in the fieldwork, this paper maintains that the ineffectiveness of these programs derives from their individualistic emphasis, one which is incongruent with the collectivistic moral framework of the Paniya tribe. The individualistic tones of the current government-authorized public health campaigns target the agent (i.e. the smoker or the drinker). Contrastingly, the collectivistic values and concerns characteristic of and voiced by the Paniyas focus on the social effects of substance abuse. This distinction, in conjunction with the fieldwork and research, suggests that in order for substance abuse education to be effective in Kerala, it must be reworked in a manner which honors the virtues and values of the existing collectivistic culture, for instance by presenting the effects of substance abuse within the context of the family and society.


Collectivism; Individualism; Alcoholism; Substance Abuse; Public Health; Morality; Indigenous Peoples

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