Socio-cultural Processes and Livelihood Patterns at Tirurangadi - CDS

mostly retained in area because of the demand from the local people. A local Vaidyar was
a social figure who knew the generic and the social profile of the patient. Similarly the
resources of the medical practitioner may be limited, but he knew his patient. As the
doctors and other agencies began to build larger hospitals, this relationship between the
health practitioner and the people was lost, and was replaced by the formal doctor-patient
relationship. This is seen in the attitude of the people towards a particular hospital where
the leading doctor was manhandled by the people for prescribing wrong medicine. The
Government Health centers are no better, as many centers lack doctors, and even if they
are available, they are not part of the society.
There are other accessories to education and health which did not exist earlier. One is the
Integrated Child Development Service (ICDS) and other Indian Population Project (IPP)
All the Anganwadis in the area are under the ICDS project. The Anganwadis are mostly
located near the colonies and other heavily inhabited areas, and almost all of them work
under extremely unsatisfactory conditions. Most of the Anganwadis are in sheds with
mud-floors, and children do not have adequate space to play. Ayas often do not have
space to cook the food for the children and feed them. There is a teacher and aya in each
Anganwadi, and majority of the teachers and ayas live nearby, or are from nearby
villages. Despite these obvious handicaps, most of the Anganwadis have about 20-30
children, and some even more. Anganwadi workers, apart from their normal
responsibilities are also used for several surveys and other forms of enumeration, which
means that they are directly linked with the local people in various ways, and some of
them also manage to get considerable local support for running of the Anganwadis. This
local support naturally is not elite support, and hence the resources they are able to
manage remains meagre. IPP project works along with the health centers and rural
dispensaries and is meant to inculcate reproductive literacy among the people. How far