The conviction of Binayak Sen

Abstract

India has featured heavily in The Lancet already this year. First, an Editorial1The LancetBinayak Sen's conviction: a mockery of justice.Lancet. 2011; 377: 98Scopus (5) Google Scholar condemned Binayak Sen's conviction and then a Series declared that Indian health was in crisis. This letter raises some points overlooked by your coverage.The health of one group, Scheduled Tribes (broadly speaking indigenous people), is significantly worse than that of any other—including Scheduled Castes (untouchables). In 2005–06, the under-5 mortality rate was 74·3 per 1000 for the general population, 88·1 per 1000 for untouchables, and 95·7 per 1000 for tribal people;2International Institute for Population SciencesNational family health survey 3, 2005–06. IIPS, Mumbai2007Google Scholar the proportions of undernourished children were 42·5%, 47·9%, and 54·5%, respectively;2International Institute for Population SciencesNational family health survey 3, 2005–06. IIPS, Mumbai2007Google Scholar and the proportions of women with anaemia 55·3%, 58·3%, and 68·5%, respectively.2International Institute for Population SciencesNational family health survey 3, 2005–06. IIPS, Mumbai2007Google ScholarThis situation can largely be understood in the context of political and economic forces. For the past two centuries, the state has been very active in extracting natural resources from tribal homelands, but more-or-less inactive in providing benevolent functions.3Sundar N Subalterns and sovereigns: an anthropological history of Bastar, 1854–2006. Oxford University Press, Oxford2007Google Scholar The Maoist insurgents expanded their support base in this context, protecting tribal people from the rapacious state and providing basic services.4Planning Commission of IndiaDevelopment challenges in extremist affected areas: report of an expert group. Government of India, New Delhi2008Google ScholarSince 1981, Binayak Sen worked to improve public health in tribal areas, and his activities have encompassed social and political-economic issues.5Doctors in Defence of Dr Binayak SenIndian doctor in jail: the story of Binayak Sen. Promilla, New Delhi2008Google Scholar In 2005, Sen documented the brutality of a counterinsurgent militia that was supported by the state and had strong links to mining corporations.3Sundar N Subalterns and sovereigns: an anthropological history of Bastar, 1854–2006. Oxford University Press, Oxford2007Google Scholar This put him in direct opposition to the neocolonial state, laying the ground for his persecution.These points show that a full understanding of India's health crisis— and Sen's incarceration—must appreciate the political and economic forces that shape the social determinants of health.We declare that we have no conflicts of interest. India has featured heavily in The Lancet already this year. First, an Editorial1The LancetBinayak Sen's conviction: a mockery of justice.Lancet. 2011; 377: 98Scopus (5) Google Scholar condemned Binayak Sen's conviction and then a Series declared that Indian health was in crisis. This letter raises some points overlooked by your coverage. The health of one group, Scheduled Tribes (broadly speaking indigenous people), is significantly worse than that of any other—including Scheduled Castes (untouchables). In 2005–06, the under-5 mortality rate was 74·3 per 1000 for the general population, 88·1 per 1000 for untouchables, and 95·7 per 1000 for tribal people;2International Institute for Population SciencesNational family health survey 3, 2005–06. IIPS, Mumbai2007Google Scholar the proportions of undernourished children were 42·5%, 47·9%, and 54·5%, respectively;2International Institute for Population SciencesNational family health survey 3, 2005–06. IIPS, Mumbai2007Google Scholar and the proportions of women with anaemia 55·3%, 58·3%, and 68·5%, respectively.2International Institute for Population SciencesNational family health survey 3, 2005–06. IIPS, Mumbai2007Google Scholar This situation can largely be understood in the context of political and economic forces. For the past two centuries, the state has been very active in extracting natural resources from tribal homelands, but more-or-less inactive in providing benevolent functions.3Sundar N Subalterns and sovereigns: an anthropological history of Bastar, 1854–2006. Oxford University Press, Oxford2007Google Scholar The Maoist insurgents expanded their support base in this context, protecting tribal people from the rapacious state and providing basic services.4Planning Commission of IndiaDevelopment challenges in extremist affected areas: report of an expert group. Government of India, New Delhi2008Google Scholar Since 1981, Binayak Sen worked to improve public health in tribal areas, and his activities have encompassed social and political-economic issues.5Doctors in Defence of Dr Binayak SenIndian doctor in jail: the story of Binayak Sen. Promilla, New Delhi2008Google Scholar In 2005, Sen documented the brutality of a counterinsurgent militia that was supported by the state and had strong links to mining corporations.3Sundar N Subalterns and sovereigns: an anthropological history of Bastar, 1854–2006. Oxford University Press, Oxford2007Google Scholar This put him in direct opposition to the neocolonial state, laying the ground for his persecution. These points show that a full understanding of India's health crisis— and Sen's incarceration—must appreciate the political and economic forces that shape the social determinants of health. We declare that we have no conflicts of interest.