Department of Dermatology, Sree Gokulam Medical College, Thiruvananthapuram, Kerala, India.
Department of Community Medicine, Sree Gokulam Medical College, Thiruvananthapuram, Kerala, India.
Int J Equity Health. 2024 Aug 26;23(1):172. doi: 10.1186/s12939-024-02237-w.
Kerala has a history of achievements in health through acting on the distal social determinants, but certain communities like tribals were pushed back from the stream of social development and health achievements. Subsequently, the lifestyle and the poor living conditions of tribes make them more prone to several diseases including skin diseases. However, neither the burden nor the situation of the same in the tribal population in several parts including Kerala is seldom assessed.
The lack of awareness about the symptoms, complications, and management options as a part of the social backwardness has led to the concentration of certain diseases like Leprosy among the tribal community. In addition, the tribal population is under the threat of infectious diseases of public health significance like Leishmaniasis (CL). The tribal population owing to ignorance neglects the skin lesions or uses their local remedies. Tribes might have been using many local remedies for their issues, but the emerging skin diseases may not be amenable to local remedies and often impose significant public health concerns. Developing and maintaining an effectively functioning health system in these difficult-to-reach terrains is also a challenge. The pattern of skin diseases among tribals residing in environmentally sensitive localities is an indicator for the need for more social, economic and geospatial inclusion. Skin lesions of the tribal population should be kept under active surveillance activities through the integrated health information platform (IHIP) and it should follow a vigilant public health response if there are clusterings. A dedicated evidence-based system should be developed to diagnose and treat skin diseases of tribal people residing away from the availability of specialist care using local resources and community-level workers.
The rampant skin diseases among tribals are the product of their unacceptable socio-economic status and living conditions. It could only improve through interventions focusing on social determinants of health. Improvements in the living conditions of tribals are sustainable long-term solutions, but such solutions should be coupled with medium-term and short-term strategies.
喀拉拉邦在通过解决远端社会决定因素来促进健康方面有着卓越的成就，但某些群体，如部落居民，却被社会发展和健康成就的洪流所排斥。因此，部落的生活方式和恶劣的生活条件使他们更容易患上多种疾病，包括皮肤病。然而，包括喀拉拉邦在内的多个地区的部落人口的负担和情况却很少被评估。
由于社会落后，部落居民对症状、并发症和管理选择缺乏认识，导致某些疾病，如麻风病，在部落社区中集中出现。此外，部落人口受到公共卫生意义上的传染病，如利什曼病（CL）的威胁。由于无知，部落居民忽视了皮肤损伤或使用当地的补救措施。部落可能一直在使用许多当地的补救措施来解决问题，但新兴的皮肤病可能不适用于当地的补救措施，而且往往会引起重大的公共卫生问题。在这些难以到达的地区建立和维持一个有效运作的卫生系统也是一个挑战。居住在环境敏感地区的部落居民的皮肤病模式是需要更多社会、经济和地理空间包容的指标。应通过综合健康信息平台（IHIP）对部落人口的皮肤损伤进行积极监测，并在出现聚集时采取警惕的公共卫生应对措施。应开发一种专门的基于证据的系统，利用当地资源和社区一级的工作人员，为居住在无法获得专科护理的部落人群诊断和治疗皮肤病。
部落居民中猖獗的皮肤病是他们不可接受的社会经济地位和生活条件的产物。只有通过关注健康的社会决定因素的干预措施，才能改善这种状况。改善部落居民的生活条件是可持续的长期解决方案，但这种解决方案应与中期和短期战略相结合。
