26 NOVEMBER 2018
Leave them alone
Calls to take action against the Sentinelese for a tragic death are dangerously misguided
The death of a young American man at the hands of the inhabitants of North Sentinel Island in the Andaman and Nicobar Islands has led to dangerous lines of debate. Some have called for the Sentinelese to be convicted and punished and others have urged that they be integrated into modern society. Both these demands are misguided, and can only result in the extinction of a people. John Chau’s killing was a tragedy but his attempt to make contact with the Sentinelese, who he seemed to know something about, was foolhardy and dangerous, not only to himself but to them. There is a reason why no one — whether missionary, scholar, adventurer, U.S. citizen or Indian — is allowed to venture near North Sentinel Island without permission, which is given only in the rarest of circumstances and with meticulous precautions in place to ensure that the Sentinelese are not disturbed. Having lived in isolation in an island in the Bay of Bengal for thousands of years, the Sentinelese have no immunity or resistance to even the commonest of infections. Various degrees of protection are in place for the indigenous people of A&N Islands, but it is complete in the case of the Sentinelese. The administration enforces “an ‘eyes-on and hands-off’ policy to ensure that no poachers enter the island”. A protocol of circumnavigation of the island is in place, and the buffer maintained around the island is enforced under various laws. The Sentinelese are perhaps the most reclusive community in the world today. Their language is so far understood by no other group and they have traditionally guarded their island fiercely, attacking most intruders with spears and arrows. Arrows were fired even at a government aircraft that flew over the island after the 2004 Tsunami.
Chau knowingly broke the law, as did those who took him to the waters off North Sentinel Island. Seven persons, including five fishermen, have been arrested for facilitating this misadventure. To call for an investigation on the island, however, is to fail to see its historical and administrative uniqueness. At the heart of the issue is the survival of the Sentinelese. According to the 2011 Census, their population was just 15 — though anthropologists like T.N. Pandit, who made contact with them in the 1960s, put the figure at 80-90. This degree of ignorance about the Sentinelese often sparks an Orientalist public discourse, instead of understanding the dangers of trying to physically overpower them. Chau’s death is a cautionary incident — for the danger of adventurism, and for the administration to step up oversight. But it is also an occasion for the country to embrace its human heritage in all its diversity, and to empathetically try to see the world from the eyes of its most vulnerable inhabitants.
Ahead on malaria
Odisha shows the way in bringing down the incidence of new cases
India has suffered from a major burden of malaria for decades, with high levels of morbidity and death. But the declining trend of the scourge shows that sustained public health action can achieve good results. The World Malaria Report 2018 of the World Health Organisation notes that India’s record offers great promise in the quest to cut the number of new cases and deaths globally by at least 40% by 2020, and to end the epidemic by 2030. A lot of that optimism has to do with the progress made by Odisha, one of the most endemic States. Investments made there in recruiting accredited social health workers and large-scale distribution of insecticide-treated bednets, together with strategies to encourage health-seeking behaviour, seem to have paid off. The WHO report highlights a sharp drop in the number of cases in the State. The reduction in cases by half in 2017 compared to the same study period in 2016 appears to reinforce research findings: malaria cases in Odisha have been coming down steadily since 2003, with a marked reduction since 2008, attributed to greater political and administrative commitment. This positive trend should encourage authorities not just in Odisha, but in the northeastern States and elsewhere too to cut the transmission of the disease further. Importantly, the reduction in the number of cases should not produce complacency and lead to a reduction in deployment of health workers and funding cuts to programme components. Where allocations have been reduced, they should be reversed. It should be pointed out that even in 2017, the Union Health and Family Welfare Ministry put the number of malaria cases in Odisha at 3,52,140.
One issue that requires monitoring in India is resistance to combination therapy using artemisinin. Recent reports indicate that some patients in West Bengal became resistant to the treatment protocol used for the falciparum parasite, which causes debilitating cerebral malaria and leads to a high number of deaths. The phenomenon requires close monitoring — although the WHO said in a recent assessment that the treatment policy was changed to another efficacious set of combination drugs in some northeastern States, after statistically significant treatment failure rates were found in 2012. Eliminating malaria requires an integrated approach, and this should involve Chhattisgarh, Jharkhand and West Bengal, which have a higher burden of the disease. Odisha’s experience with using public health education as a tool and reaching out to remote populations with advice needs to be replicated. Given that emerging resistance to treatment has been reported in Myanmar, among other countries in this belt, there is a need for a coordinated approach to rid southern Asia of malaria.