Youth, Ethnomedicine and The Access Gap: Health Care in Transition Among The Idu Mishimi and Adi Padam of Lower Dibang Valley, Arunachal Pradesh, India

Abstract

Objective: To describe how younger and older members of two tribal communities in north-eastern India use traditional and modern health care, and to assess the health infrastructure available to their villages. Methods: Exploratory qualitative study in four villages of Lower Dibang Valley district, Arunachal Pradesh, India. Open-ended informal interviews were combined with village-level data from the Census of India 2011, state-level Rural Health Statistics 2019–20 and published literature. Results: Younger and older respondents alike preferred modern medical care and kept home-based medicinal plants for minor ailments. Respondents attributed the decline of traditional healing to the non-transmission of knowledge and to the shrinking number of ritual healers. Public facilities were described as poorly equipped and short of staff. No village with census data had a Primary Health Centre within 10 kilometres, and two had no Community Health Centre within 10 kilometres. Across Arunachal Pradesh, the shortfall of specialists in Community Health Centres rose from 124 in 2005 to 226 in 2020. Serious illness usually meant travel to Dibrugarh in Assam or private care, with high out-of-pocket costs. Conclusion: Young people in these villages grow up with modern care as the default, but it is distant, costly and thinly staffed, while the traditional system that once offset this gap is not being passed on. Strengthening peripheral facilities and documenting traditional knowledge with the participation of young people are complementary priorities.