Franke R W, Chasin B H
Department of Anthropology, Montclair State College, NJ 07043.
Int J Health Serv. 1992;22(1):139-56. doi: 10.2190/HMXD-PNQF-2X2L-C8TR.
Kerala State in southwestern India has achieved some of the third world's best rates of life expectancy, literacy, and infant mortality, despite one of the lowest per capita incomes. Especially notable is the nearly equal distribution of development benefits to urban, rural, male, female, high-caste, and low-caste sections of the populations. An even population distribution, a cosmopolitan trading history, and the development of militant worker and small farmer organizations led by dedicated activists provide the main explanations for Kerala's achievements. Land reform has redistributed wealth and political power from a rich elite to small holders and landless laborers. Public food distribution at controlled prices, large-scale public health actions, accessible medical facilities, and widespread literacy combine with and reinforce each other to maintain and expand Kerala's achievements. Serious unemployment threatens the Kerala experiment, but Kerala nonetheless offers important lessons to development planners, policymakers, and third world activists.
印度西南部的喀拉拉邦尽管人均收入处于世界最低水平之列,却取得了一些第三世界国家中预期寿命、识字率和婴儿死亡率方面的最佳比率。特别值得注意的是,发展福利在城市、农村、男性、女性、高种姓和低种姓人群中近乎平等地分配。人口分布均匀、国际化的贸易历史以及由热忱的活动家领导的激进工人和小农户组织的发展,是喀拉拉邦取得成就的主要原因。土地改革将财富和政治权力从富裕精英阶层重新分配给小土地所有者和无地劳动者。以受控价格进行的公共食品分配、大规模的公共卫生行动、可及的医疗设施以及广泛的识字教育相互结合并相互强化,以维持和扩大喀拉拉邦的成就。严重的失业问题威胁着喀拉拉邦的这一试验,但喀拉拉邦仍然为发展规划者、政策制定者和第三世界的活动家提供了重要的经验教训。