Reaching out to India's untouchables

Just under the gleam of India's shining economy - which barely skipped a beat even in the world recession - lies the uncomfortable truth that millions still barely survive each day, so deprived are they of nutrition, shelter and healthcare.

Some of these people are rural farmers struggling to eke out an agrarian living in an increasingly industrialised world. Others are slumdwellers in urban hubs like Mumbai. As neglected as these groups often are, there is a slice of the population that is even more ignored - the dalits or 'untouchables', as they used to be known. India's 160 million Dalits make up nearly one-sixth of the country's population, yet you would never guess this from the utter lack of representation in much of Indian society.

In an attempt to make these invisible people visible to the rest of the world, photographer Marcus Perkins is showing a series of portraits of Dalits called Being Untouchable at HOST Gallery in East London, between 18th and 23rd October (the image above is part of the exhibition). The exploitation, injustice, and oppression that the series documents resonate with the plight of vulnerable and marginalised worldwide.

In theory, the Indian government isn't totally turning a blind eye, and has for years made concessions in healthcare and education. But the insidious caste system - still very much present in India, no matter what anyone claims - continues to shun Dalits from society. This means that they are often denied access to public places such as hospitals, schools, and places of worship. Land-owners often refuse to sell to them, and employers find weak excuses not to employ them.

This blatant exclusion inevitably has disastrous results on Dalits' health. According to the Community Health Cell, an Indian civil society organisation, infant mortality rates in Dalits are higher than in non-Dalits. In Dalit communities, 91 babies die per 1000 live births, compared to a national average of 72 per 1000. In Nepal, Dalits have a life expectancy of just 42 compared with (admittedly still appalling) 58 years.

Healthcare experts and human rights activists in India confirm anecdotally that Dalits are discriminated on a daily basis, and local newspapers do report on the issues they face, but Dalits' virtual lack of access to healthcare is largely ignored by the global health community too.

You would be hard pressed to find much in the way of research published in reputable medical journals, and this is partly where the problem lies. Without the weight of evidence to shame governments into action, the healthcare of marginalised communities will always stay neglected.