(a) Critically examine existing paradigms of holistic health for the marginalised sections of society drawing inferences from…

(a) Holistic health paradigms for the marginalised: lessons from COVID-19

Existing paradigms

• Biomedical model: disease is a malfunction of the body, treated by doctors, drugs and hospitals. It has dominated Indian health planning.

Holistic alternatives:

• WHO (1948): health as "complete physical, mental and social well-being".
• Biopsychosocial model (George Engel, 1977).
• Primary health care (Alma-Ata, 1978): community participation and appropriate technology.
• Social determinants of health (WHO Commission, 2008): income, housing, caste, gender and work shape health.
• One Health: links human, animal and environmental health.
• AYUSH and folk medicine: traditional systems that treat the body, mind and environment together.
• Anthropological lenses: medical anthropology adds "structural violence" (Paul Farmer), the social arrangements that make the poor sick, and "syndemics" (Merrill Singer), diseases clustering with poverty and malnutrition. It also distinguishes the patient's illness experience from the doctor's disease category (Arthur Kleinman).

What COVID-19 revealed for the marginalised

• Migrant workers: the lockdown of March 2020 left informal workers without income. About 1.04 crore migrants returned home, often on foot, showing that health depends on livelihood, housing and social security.
• Urban poor: in crowded slums, "social distancing" and handwashing were impossible. Dharavi's "chase the virus" model, with community screening, showed what local action could do.
• Adivasis: remote villages had few testing and ICU facilities, and malnutrition and anaemia were already high. Rumours and distrust led to vaccine hesitancy, which was overcome where local leaders, ASHAs and the use of tribal languages built trust. The Expert Committee on Tribal Health (2018) had already recommended a separate tribal health plan with community participation.
• Dalits, sanitation workers and women: front-line sanitation workers faced high exposure, domestic violence and unpaid care work rose, and caste stigma affected cremation workers.
• Digital exclusion: CoWIN's online registration disadvantaged people without smartphones, until walk-in vaccination was allowed.
• Positive lessons: free grain under PM Garib Kalyan Anna Yojana, cash transfers, Kerala's community kitchens, and ASHA and Anganwadi networks showed the value of social protection and community health workers.

Critical assessment

• Biomedical focus: the response was largely biomedical and security-driven (lockdowns, policing, apps) rather than holistic.
• Weak public health system: spending of roughly 2% of GDP and shortages of doctors in tribal areas left little capacity to cope.
• Tokenistic holism: AYUSH and "immunity boosters" were often promoted without evidence, while mental health, nutrition and livelihood were neglected.
• What true holism needs: community participation, local knowledge, social security and attention to caste, gender and tribal difference. COVID-19 showed that a health system is only as strong as its reach to the most marginalised.

(b) Theories of the origin of caste, their criticism, and caste versus class and race

Theories

Traditional (divine) theory: the four varnas emerged from the body of the cosmic being (Purusha Sukta, Rig Veda) and were justified by karma and dharma.

• Criticism: it explains varna ideology, not the thousands of endogamous jatis.

Racial theory (H. H. Risley, 1901 Census): caste arose from the conquest of dark-skinned natives by fair-skinned "Aryans", and Risley measured the nasal index to rank castes.

• Criticism: Ghurye and later physical anthropologists found no neat racial divisions. Genetics shows ancient mixing of Ancestral North and South Indians, followed by the onset of endogamy about 1,900–4,200 years ago (Moorjani et al., 2013), so caste is a social, not racial, formation.

Occupational theory (J. C. Nesfield; also Ibbetson): castes grew from hereditary occupational guilds, ranked by the purity of their work.

• Criticism: many castes share or change occupations, and it ignores ritual rank.

Ritual and political theories:

• A. M. Hocart linked caste to royal sacrifice, with each caste having a ritual function around the king.
• G. S. Ghurye stressed Brahminical ideas of purity combined with political power.
• J. H. Hutton offered a multi-factor theory with roots in tribal ideas of mana and taboo and in endogamous groups.
• Criticism: these theories are speculative and hard to test.

Structural and critical approaches:

• Louis Dumont: caste as hierarchy based on the purity–impurity opposition.
• Gerald Berreman: caste as institutionalised inequality comparable to race in the American South.
• Dipankar Gupta: caste as a matter of "difference" and multiple, contested hierarchies.
• B. R. Ambedkar: caste as "graded inequality" maintained by endogamy.
• Gail Omvedt: caste as a system of economic and social exploitation.
• Most anthropologists now see caste as having emerged gradually from several factors, and as reshaped by colonial census classification.

Caste, class and race compared

• Caste: status is ascribed at birth and closed through endogamy, commensality rules, hereditary occupation and ideas of purity and pollution. Mobility is collective and slow (Sanskritisation). It is legitimated by religion and custom, and legally addressed through reservations, Article 17 and the SC/ST (Prevention of Atrocities) Act, 1989.
• Class: position in the economy (property, income, occupation). It is relatively open, with individual mobility, and has no rule of endogamy. In India it overlaps with caste, but, as Béteille showed, the two have partly separated.
• Race: a category claimed to rest on inherited physical traits. Biologically, human variation is continuous and races are not discrete, so race is a social construct used to justify hierarchy, as in slavery, apartheid and colonialism. Caste is not identifiable by physical features, though both involve descent-based discrimination, which is why caste was discussed at the UN Durban conference (2001).

(c) The resurgence of ethno-nationalism: an anthropological view

Ethno-nationalism claims that a people defined by shared descent, language, religion or culture should have its own political community: a state, homeland or autonomous territory.

Anthropological lenses

• Primordialism (Edward Shils, Clifford Geertz): ethnic attachments to blood, language and soil feel given and powerful.
• Boundaries (Fredrik Barth, Ethnic Groups and Boundaries, 1969): ethnicity lies in the maintenance of boundaries between "us" and "them", not in the cultural content inside them.
• Modernist and constructivist views: nations are modern creations. Gellner (1983) linked them to industrial society and mass education, Anderson (1983) to "imagined communities" formed through print and the census, and Hobsbawm to "invented traditions".
• Instrumentalism (Paul Brass): elites mobilise ethnic identity to compete for power and resources.
• Globalisation: Arjun Appadurai (Fear of Small Numbers, 2006) argued that globalisation creates uncertainty and anxiety about identity, which fuel majoritarian and minority ethno-nationalism alike.

Why it is resurging

• Economic insecurity and inequality under globalisation, with competition for land, jobs and resources.
• Migration and demographic change, with fears of being "swamped".
• Social media and digital networks, which speed up the spread of identity narratives.
• The decline of class-based politics and the use of history, heritage and census categories in electoral competition.

Examples

India:

• The Naga movement and the Framework Agreement of 2015.
• Statehood and autonomy movements such as Bodoland and Gorkhaland.
• The Assam movement and the National Register of Citizens, whose 2019 list excluded about 19 lakh people.
• The ethnic conflict between Meitei and Kuki-Zo communities in Manipur since May 2023, linked to ST-status demands, land and migration fears.
• "Sons of the soil" and language movements, and tribal demands such as a separate Sarna religion code.

Elsewhere:

• Sinhala and Tamil nationalisms in Sri Lanka.
• Buddhist nationalism and the persecution of the Rohingya in Myanmar.
• Kurdish, Catalan and Scottish movements.
• The ethnic framing of conflicts in the former Yugoslavia and the former Soviet space.

Anthropological insight. Ethnic identities are neither purely ancient nor purely invented. They are built on real cultural materials and memories but are mobilised under specific political and economic conditions. Fieldwork shows how boundaries harden through everyday practices, rumour, violence and state classification. It also shows the counter-trend of shared lives, intermarriage and syncretic traditions that can contain ethno-nationalism.