Tribal Health Initiative: High up in health

Doctor couple Reji George and Lalitha have helped remote tribal villages in Tamil Nadu remain in the best of health.

How a doctor couple, Reji George and Lalitha, have helped remote, far flung tribal villages in Sittlingi Valley in Tamil Nadu remain in the best of health.

The THI hospital at Sittlingi valley.

The THI hospital at Sittlingi valley.

I wonder how I should begin to introduce the work that two doctors are doing in a remote region called the Sittilingi Valley in a far flung corner of Tamil Nadu. This is the fifth draft of an introduction and I am still not satisfied. That is so because what the doctors have managed to do in less than two decades is of the sorts that are retold as inspiring stories in later years. But I try.

Sittilingi is unassuming, just a village like the millions of others that dot the Indian countryside, with its share of problems and flashes of beauty. Dr Regi George and Dr Lalitha Regi are equally unassuming; there is no indication of the struggles of the past years, or the challenges and the successes that abound at Tribal Health Initiative (THI). The couple, from prominent and well-to-do families in Kerala, first worked in Gandhigram, near Dindigul, before they set out to start something of their own.

Post a journey that took Dr Regi across several parts of India in a bid to understand India, her regions and its varied problems, the couple decided to set up at Sittilingi in Dharmapuri district, Tamil Nadu. The valley, surrounded by the Kalrayan and the Sitteri Hill ranges of the Eastern Ghats, takes its name from the biggest of its 21 villages. Those were the years when the doctors would travel once a month to the city of Dharmapuri, 100 kms away, to make their phone calls! The buses stopped at Kottapatti, some 10+ kms away and they almost regularly walked that distance to the hospital.

Community health workers are trained to teach the rest of the village. Pic: Deepa Bhasthi

Community health workers are trained to teach the rest of the village. Pic: Deepa Bhasthi

The ‘malevasis’ (people of the hills), were skeptics and not too friendly either, not at first. PHCs, where they existed, had for long remained unequipped to deal with any complicated case. The nearest hospital was 50 kms away; for surgeries, the tribals had to travel double that distance.

This was nearly 20 years ago and these are the stories I hear. Buses are more frequent now, but can be, and are, cancelled when the rains are heavy. Internet came in just a few years ago. Electricity is erratic and when there is thunder, it still sounds like someone is very angry up there.

But when I first arrive at the ‘hospital’, I am in awe. A bustling hospital housed in beautiful red buildings is not quite what I expected. I have been going there repeatedly after that. The sense of being witness to tremendous change for the good never leaves me.

What started out as an out-patient unit in a thatched hut is today a 24-bed hospital with a fully equipped surgery room and over 20 well trained health workers. In a place inhabited by over 80,000 tribals, where the infant and mother mortality rate was as high as one infant death for every five born, the doctors started THI.

Success is very measurable here

Today, the infant mortality rate, at 20/100 is among the lowest in the entire country. There are no cases of malnutrition and maternal death is almost zero. Along with crucial healthcare, THI now also supports livelihood promotion by way of its craft and organic farming initiatives.

I imagine winning the trust of the tribals must have been the hardest part, they who had never previously seen white tablets or dark tonic bottles. No new program is introduced without meeting with the community leaders and taking a collective decision.

Unique models put to work

One of the most interesting features of the work they do is the health worker and health auxiliary programs. Back in 1996, THI started training local girls as health workers who are now able to diagnose and treat common problems, assist in surgeries, conduct deliveries, and go into villages to provide ante-natal and child care.

Providing healthcare in places where people still balance themselves on thin logs and fragile rope bridges is a challenge. Pic: Deepa Bhasthi

Providing healthcare in places where people still balance themselves on thin logs and fragile rope bridges is a challenge. Pic: Deepa Bhasthi

The health auxiliaries are older women chosen by the community from each village. Some illiterate, some barely educated, these women are trained for a year in basic medical care, hygiene and first aid among others. They then advise the village in cleanliness, care for newborns and new mothers, and provide immediate healthcare. They even turn out to be at the helm of affairs when it came to implementing larger community activities.

The fact that the tribals themselves are so involved in healthcare has ensured increased awareness. Barring the doctors and a couple of administration staff, the rest of THI staff are all local tribals.

I try and go to Sittilingi at least once every two months. The 230 km distance from Bangalore is met by a combination of auto, train and/or bus rides and nearly eight hours. I go there to find my stories. There are plenty.

A typical day begins at about 9am. OP days are thrice a week, and sometimes over 200 out-patients come in on a single day. They come from distant towns; a man even walked 24 kms, took a bus and travelled two hours to get to the hospital! Some bring rice and dal in a cloth bag and sleep the night; their villages are too far to go back to the same day. There is a flurry of activity all day long, people lining up to get medicines, getting their tests done seeing the doctor.

The old age health insurance scheme introduced last year, where older tribals have to pay just Rs 30 for a year, has became as astounding success, with over 500 senior tribals registering for it.

New roads, new challenges

The villagers of the Sittilingi Valley and surrounding areas are so much better off now. The hospital is now trusted as a place that gives quality healthcare. More than ever, girls are being sent to schools. The health workers show by example the need to maintain health habits.

It is mission accomplished at Sittlingi. But not target reached for the doctors.

A few months ago, I accompanied Dr Regi and a team of health workers into the Kalrayan Hills, further up ahead from Sittilingi where the conditions are as bad as they were in the valley in the 1990s. Here are villages that are so remote, you need to walk over 20 kms, one way, to get to the nearest town. There are people who still balance themselves on thin logs and fragile rope bridges to cross dangerous, swollen rivers in the monsoons. Talking of such villages makes the sense of urgency jump up another notch.

In a cool room in the back corner of the hospital, there are regular brain-storming sessions. New models for development are constantly evolving.

Street theatre and its appeal to a rural audience is being used to create awareness of health and other issues of community interest. Collaborations with the state government and institutions like Help Age India help provide better healthcare.

The ride that leads up to the hospital is lush green, with beautiful hills lining the sides of the road. In such a lovely setting, it gets quiet early. The mornings are still fresh and the air crisp. The people are simple, friendly and dare I say, innocent in their ways. In a setting as poetic as this, Dr Regi and Dr Lalitha continue to accomplish one main aim, a line that I have come to love: helping tribals help themselves.

For more details, visit or the Friends of Sittilingi group on Facebook.

Also read:

Sittlingi: Sustaining tribal welfare
Educating the Native


Deepa Bhasthi is a writer and independent journalist based in Bangalore. She blogs at more


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Deepa Bhasthi is a writer and independent journalist based in Bangalore. She blogs at more

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