Special Article
Practices of Healing in Tribal Gujarat
David Hardiman, Gauri Raje
Healthcare for the tribal population of Gujarat is highly
inadequate, with people being systematically exploited
by both legitimate doctors and quacks. Alternative
forms of treatment continue to flourish, whether by
traditional healers or by Christian faith healers. Three
modes of healing – the biomedical, the traditional and
Christian faith healing – are examined in this paper. Each
can be seen to cater for particular needs, and so long as
present socio-economic conditions remain as they are
in the tribal regions, and the public healthcare system
exists as it does, it seems unlikely that there will be any
significant change.
David Hardiman (D.Hardiman@warwick.ac.uk) is with the department
of history, University of Warwick, UK. Gauri Raje is with the Centre for
the History of Medicine, University of Warwick, UK.
Economic & Political Weekly EPW march 1, 2008
B
etween 2004 and 2007, we carried out research on the
medical care and various other forms of healing that have
been and are practised in the tribal areas of Gujarat. The
main questions posed were as follows: How have indigenous
systems of healing changed over time, and what is their role
today? What was the impact of the Protestant medical missionar-
ies who provided the bulk of biomedical care for the tribal people
from the 1880s to the 1950s? How did Indian nationalists and
then – after 1947 – the Indian government seek to meet the health
needs of the tribal people? How did non-governmental doctors in
tribal areas – both self-employed and employed by non-govern-
mental organisations (NGOs) and Hindu organisations – respond
to these needs? What are the causes and implications of the
upsurge over the past three decades of Christian faith healing?
The research was carried out by a historian (Hardiman) and
an anthropologist (Raje). Hardiman focused on the period up to
1980, using archival, printed and oral sources, and he also
explored the issue of more recent Christian faith healing, while
Raje concentrated on the contemporary situation, living for an
extended period in the area, observing the situation and carry-
ing out interviews. The findings are summarised in the
following pages.
In India as a whole, the tribal peoples today make up about 8
per cent of the total of population of over one billion, while in
Gujarat they make up almost 15 per cent of the population of 51
million. They belong to a range of kinship-based communities
associated with interior regions that are often hilly and with poor
soil. Before independence in 1947, Indian princes ruled most of
the tribal belt of what is now Gujarat state, though there were
pockets of British rule, mainly in the southern Gujarat tribal belt
(Surat and Valsad districts), and the area that is now Dahod
district in north-eastern Gujarat. During the colonial period, the
tribal people were excluded from large tracts of their homelands,
which were reserved for government-controlled forests. Although
this policy was implemented most strongly in British-ruled areas,
it was extended gradually to the princely states also. After
independence, many were displaced through large-scale irriga-
tion and other development projects. As a result of these
processes, many are unable now to make a living from the
low-grade land they retain, and have to work as migrant labourers
outside their own region, for example, as seasonal agricultural
labourers and on construction sites in the towns and more
prosperous rural areas. Their general condition is characterised by
poverty, social exclusion, susceptibility to exploitation and poor
health. They are, however, an important element within the
modern Indian political system, as since independence in 1947,
their vote has been decisive in a significant number of
43
Special Article
parliamentary and state assembly seats. In Gujarat, for example,
the tribal vote is crucial in 33 out of a total of 181 state assembly
seats (18.23 per cent), which in a tight election may be enough to
determine the result. For this and other reasons, different factions
of the dominant classes have a strong interest in extending their
hege­mony over the tribal peoples, and health and healing
provides one means towards this end.
1 Tribal Health and Healing in the Past
Evidence from early missionary reports was evaluated, and it was
found that in the past the tribal people of western India suffered
from a wide range of diseases and maladies such as malaria,
tuberculosis, smallpox, pneumonia, dysentery, worm infestation,
eye infection and various skin complaints. There was a devastat-
ing epidemic of cholera during a severe famine in 1900, and many
died from influenza in 1918. This undermines the argument put
forward by some historians that tribal people were in the past
protected from many diseases by their isolation. The missionary
evidence revealed that their hills and forests failed to safeguard
them in this respect, no doubt because there was considerable
ongoing communication and trade between the plains regions
and the hilly areas of western India.
Left to their own devices, the tribal peoples sought to cure such
diseases and disorders in a range of ways. If a disease persisted
for more than a day or two, the tribal people generally sought a
cure from a ‘bhagat’, or ritual specialist. The bhagats had particu-
lar skills in the use of various herb, root, tree or animal products
in healing, and they would perform rites as they both extracted
the plant from the forest and administered it to a patient. Thus,
even a herbal preparation was seen not merely as a “natural”
medicine for an illness located in the physical world, but a remedy
that possessed numinous qualities that might be endowed with
benign power through ritual. This duality was seen in other
forms of treatment, such as cauterisation of the site of pain,
applied with a red-hot iron. The rationale for this practice was
that it drove away the malign spirit that was causing the problem,
as such spirits feared fire. Exorcism, also carried out by bhagats,
performed the same function. It was assumed that invisible forces
or spirits pervaded the world, affecting the lives of the living.
These forces were Janus-faced, being both benign and malign in
differing proportions.
The bhagats were important figures in tribal society.1 Besides
diagnosing and treating individual and collective illnesses, they
also performed priestly rites on significant days of the calendar
for household and village guardian spirits. They were in all cases
male, as women were seen to be ritually polluting. In demeanour
and appearance, they resembled any other tribal person. They
understood their work as a form of devotion to their deities,
describing it as their ‘bhakti’ (devotion). In this way, they believed
that they were divinely granted their skills and power. There
could be several ways in which a person started out on the route
to becoming a bhagat – through dreams of particular deities, or
the possessions of a person by specific deities of healing, death
and divination. They subsequently had to serve an apprentice-
ship under an existing bhagat, honing their knowledge of plants
and forms of treatment. In tribal western India, any male could
44
potentially acquire such skills. It was expected that they practise
their craft in an ethically circumscribed and disciplined way,
which involved periodic fasting, abstention from sex and
alcohol, and a general avoidance of any conspicuous accumu­
lation of wealth.
Although the bhagats were highly respected and had consider-
able influence and power within their own societies, colonial
officials, missionaries and the western-educated Indian elites
were invariably unsympathetic towards them and their healing
practices, which they characterised as being based on superstition
and a wrong understanding of disease and disease causation. The
missionaries, indeed, depicted them “witchdoctors” or “wizards”,
and often described them as their most difficult opponents.
2 European and American Protestant Missionaries
The first missions to focus specifically on the tribals of Gujarat
began work in the last two decades of the 19th century and first
decade of the 20th century. The relevant missions were all Protes-
tant – there were no Roman Catholic missions working in these
tribal tracts until the 1960s. The Protestants were mostly British
and American. They found that they could win sympathy and
converts through medical work, and they therefore invested
much energy and finance in establishing dispensaries and hospi-
tals. They were the first people to provide biomedical care for the
tribals – a healing system known to the latter as “English”
(‘angreji’) or “foreign” (‘vilayati’) medicine (‘dawa’). In many
cases, the missionaries lacked any formal medical qualifications,
and travelled around the tribal villages providing basic remedies,
such as quinine for malaria, the cleaning and dressing of wounds,
and eye drops. In this way, they often managed to gain an ear for
their preaching. It was in this way, for example, that the Ameri-
can missionaries Amos and Flora Ross managed to gain a hold in
the tribal villages around Vyara in South Gujarat in 1906.2 Despite
being medically unqualified, they became known as “doctors”,
and they quickly built up a flourishing medical practice.3
In a few cases, missions were able to employ foreign doctors
who established and ran hospitals that provided a much wider
range of treatment, including surgery. Such doctors generally
enjoyed a high reputation, which was based in part on their skill
and in part on their religious identity. The fact that they prayed
over patients when they provided cures or before they carried out
surgery was particularly appreciated as a mark of their devotion
to their own deity. In this, they were in accord with tribal notions
of what constituted a legitimate healer. The main problem was
that such clinical facilities were expensive to set up and run, and
it was also often hard to obtain qualified doctors from the west.
The Church Missionary Society hospital at Lusadiya, for example,
was for many years run by nurses who could not provide any
surgery, and only fairly rudimentary care, as no volunteer doctors
could be found in Britain.
It was found that the medical work of the missionaries also
gave rise to complex local politics, with, in some cases, the
bhagats seeking to defend their power by opposing the medical
work of missions. On the whole, we found that the bhagats did
not oppose the missionaries when they provided everyday
remedies for a range of minor complaints, or even cured infectious
March 1, 2008 EPW Economic & Political Weekly

diseases. However, in the case of a chronic malady for which the
medicine of the missionaries was often less effective or took
much longer to work, the bhagats generally believed that the cure
lay in propitiation or exorcism, and that failure to act might
expose their wider society to danger from malign forces. In such
cases, the bhagats placed intense community pressure on the
afflicted person, normally forcing them to undergo the relevant
rites. In the case of a non-Christian tribal person, there was little
that the missionaries could do against this; but if a convert was
involved, intense and fractious battles often ensured between the
missionaries and the tribal healers. These were examined, using
rich material from the mission records.4 These struggles were
most intense during the first three decades of the 20th century;
thereafter, missionaries adopted a more relaxed approach,
with a belief that the tribal people would be won over in time to
“scientific” remedies through a process of education. As it was,
they were unable to sustain any such medical education
themselves, as in most cases, the mission hospitals were closed
and the medical missionaries left India in the two decades after
Indian independence.5
3 Nationalists
By the early years of the 20th century a more westernised middle
class was emerging in India that was taking advantage of
bio­medical treatment. Members of this class were trained in
medical schools to practise biomedicine. Many were critical of
the use that missionaries made of medicine to gain a foothold in
the tribal areas. Nationalists went to work in the tribal areas from
around 1918 onwards, carrying out social work of various sorts
with the aim of winning popular support for their cause. In some
cases, this involved handing out medicine, as during the severe
influenza epidemic in the tribal belt of south Gujarat in 1918.6 We
found, nonetheless, that health initiatives of this sort did not
become a major feature of subsequent nationalist work in tribal
Gujarat. The main emphasis for the Gandhian nationalists was
on education, with schools and hostels being established for
tribal children. They taught basic sanitary principles. Many such
nationalists, following Gandhi himself, had a sceptical attitude
towards biomedicine, favouring naturopathy.7 Another problem
in this respect was that Gandhian nationalists were before 1947
almost entirely excluded from the extensive tribal areas under
princely rule, so that they had no chance to carry out any sort of
social work there. However, even after they were able to enter
these tracts after 1947, no medical work was carried out in the early
years. It was only from the 1970s onwards that younger medically-
qualified people associated with the Gandhian Sarvodaya movement
began to provide biomedical care in certain tribal areas, and they
have carried out some excellent work in certain pockets.
4 Government-Provided Healthcare
Before Indian independence the colonial state and princely rulers
provided almost no biomedical facilities for tribal regions. The
government of independent India sought to rectify this situation
after 1947 through a programme of state-provided biomedical
treatment in a network of primary health centres (PHCs). Jeffrey
has argued that in India, in general PHCs were chronically
Economic & Political Weekly EPW March 1, 2008
Special Article
under-funded and failed to provide adequate care for the mass of
the Indian people [Jeffrey 1988]. A study of one PHC in a tribal
area on the border between Maharashtra and Gujarat found that
the system was operating to good effect, with a diligent local
staff, but it was probable that this situation was the exception
rather than the rule [Kamat 1995]. Other studies have found that
PHCs provide a very poor level of care in most tribal areas
[Ashtekar and Druv 2001]. There is absenteeism by staff, or, when
they are present, they treat tribals with an attitude of superiority
and contempt. High fees may be extracted for treatment, even
though this contravenes government rules. Another set of
questions relate to the medical and semi-medical campaigns
carried out by the state, such as vaccination and inoculation
programmes, and family planning drives that involve mainly
female sterilisation and male vasectomy. In general, these
“campaigns” have a reputation for poor planning and inappropri-
ate and insensitive implementation, none of which builds confi-
dence in government-provided biomedicine.
In our research, we found that many of these criticisms of
government-provided healthcare applied also to the tribal areas
of Gujarat. In a case study of the Dangs district, we found that
those employed at the understaffed government-run Ahwa Civil
Hospital tended to lack interest in their work. It was common for
the hospital to be staffed for stretches only by nurses, and no
doctors. There was also very little medicine available at its
pharmacy. There were six PHCs and numerous sub-centres in this
district; as well as field level paramedical staff who were respon-
sible for administering preventive health services, maternity
services and providing a limited amount of curative medicine.
One of the greatest points of popular mistrust of the public health
system was found to be its provision of free healthcare, which,
while availed of, is also widely regarded as being of low quality.
There is a popular belief that if healthcare is available free of
charge, the doctor lacks accountability, and the quality of medical
advice and of medicine accordingly suffers. This is why private
doctors are generally preferred to government ones. Indeed,
many of these government health workers take advantage of
their position to run private practices that make use of the
government infrastructure. In the process, governmental health-
care languishes.
While we were carrying out our fieldwork in the Dangs district,
the government was pouring a lot of the resources and energy of
its health infrastructure into a polio eradication campaign. This
campaign was commissioned by the World Health Organisation,
with the aim of total global eradication of the disease, and
government health officials implemented it. The campaign was
conducted with great fanfare, with government jeeps driving
about in clouds of dust, and with banners flying and posters
plastered on walls. Women health workers toured the villages,
recording the names of eligible children. None of this was new to
the villagers, for over the past two years they had grown used to
these strident campaigns. Many knew that the onus was on the
officials to reach the required target, and that they would if
necessary go house-to-house to administer the polio vaccine.
Compliance, in most instances, was not a problem, as most
appreciated the fact that government workers were coming to
45
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their homes for a change. This in itself, becomes a moment of
reversal for the Dangis, who are normally treated in an off-hand
and brusque manner in the health centres. While health workers
complain loudly about the “laziness” of the tribal who will not
even walk to the polio booth in their village, many Dangis
responded by noting that it was the one time that the ‘sarkar’ was
meant to visit their homes, so why should we give up work in the
fields or at home to wait in queues?
A few Dangis, however, refused to accept any vaccination.
These were in almost all cases members of the satipati sect. The
sect stands for the self-assertion of tribal peoples, and
non-cooperation with the Indian state, which is seen to be anti-
tribal [Lal 1983]. Satipati households refuse to take government
employment, buy cheap grain from government ration shops, use
state transport for travel, or make use of government health facil-
ities when ill. They actively refused to comply with the polio
eradication campaign, arguing that its propagation by the state
and its functionaries made it suspect. The health workers tried to
persuade them to comply, arguing for the health benefits of vacci-
nation, but they proved deaf to all such entreaties. There were
rumours current within this sect that the polio vaccination
campaign was in fact a surrogate form of mass sterilisation, or
that it caused acquired immune deficiency syndrome (AIDS). The
former rumour appears to have originated among church groups
in the US during the 1980s, with similar stories being current in
West Bengal in the 1990s [Curtis 1992; Banerjea and Coutinho
2000]. The rumours about AIDS related to reports that the virus
might have contaminated the polio vaccine that was widely
administered in equatorial Africa between 1957 and 1960. This
suggestion was published in a local vernacular daily in 2003-04.
The local health authorities forced a retraction from the newspa-
per, but by then, the damage had already been done. Many
members of the satipati sect keep copies of this article in their
homes, and produce it to justify their refusal to be vaccinated.
This is all illustrative of the manner in which global debates on
health and medicines are interpreted, translated and come to
have specific meanings in local settings.
5 Private Biomedical Doctors
There are now numerous people who practise as “doctors” in the
tribal regions, only a minority of whom have full biomedical
qualifications. What they share is a prestigious title – that of
“doctors” – that gives them an entry into tribal villages. A range
of these “doctors” were interviewed, some with legitimate
medical qualification, some with qualifications that were inappro-
priate for the practice of biomedicine (such as an ayurvedic or
homeopathic degree), and some with no qualifications whatso-
ever. Some of those with legitimate medical qualifications were
themselves tribal people, and they tended to be very rooted in
their community, and knew how to relate to their fellow-tribals
well. The other “doctors” presented themselves in a very differ-
ent way. They generally claimed to be able to provide “fast-
working” cures for a range of illnesses. Some maintain clinics in
villages, while others live an itinerant life, practising on roadside
at village markets or peddling their services through the differ-
ent villages. They were addressed locally with an honorific ‘Dr’
46
before their name, being distinguished in this way from other
local healers, most notably the bhagats. While they have not
displaced such diviners and exorcists, they exist alongside them
providing an additional service for all those who choose to avail
of it. Because of their limited training they tend to focus on a
rather narrow range of treatments. In particular, they give injec-
tions and administer glucose drips – treatments much in demand,
even when not medically appropriate.
When biomedical facilities of any sort are available – and in
many cases they are not – tribal people will use them. It is, for
example, widely believed that certain problems, such as fever
and headache, yield well to biomedical drugs and injections.
These are often described as ‘angrezi bimari’ or “English
illnesses”. Nonetheless, while taking the “English medicine” from
“doctors” – who may be qualified or unqualified – tribals will still
consult their own ritual specialists so that the efficacy of the
biomedical cure is enhanced with charms, ‘mantras’ and
exorcism. Although it was found that some educated tribals had a
better grasp of biomedical principles, the majority, including
many educated tribals, continue to understand disease in this
dual manner.
One particularly notable belief that has developed in the tribal
areas is that the strongest and most certain cure for many
complaints is through an injection, as it provides a particularly
“fast” remedy. Injections are thus demanded, even when not
appropriate. This appears to have been a post-1940 development.
When the mission doctor Margaret Johnson set up a health insur-
ance scheme at Lusadiya in north-east Gujarat in 1946, injections
were considered too expensive and exceptional a remedy to be
covered by it – those who wanted one had to pay extra.
None­theless, she also reported at this time that injections were
becoming increasingly popular.8 By the late 1950s, she was
reporting that villagers were commonly demanding “an injection
and medicine” in the first instance. There was a strong belief that
all that was required was a single injection.9 This had no clinical
base, for biomedical practice requires that in most cases antibiot-
ics and most other drugs be administered as a course of treat-
ment – alone they might bring a seeming improvement, but fail to
provide any long-term cure. Despite this, the belief in the power
of the single injection soon spread to even the most out-of-the-
way places. One doctor who volunteered his services within the
Gandhian Sarvodaya movement was surprised to discover when
he began his medical work in a remote tribal tract in south
Gujarat in the mid-1960s that people who had almost no previous
contact with biomedical doctors demanded “an injection” from
him, regardless of his diagnosis. He tried his best to educate his
patients as to when injections were necessary, and when they
were not, and how they should be administered.10 He was unable
to make many inroads into shaking this belief: an NGO doctor
who today operates a regular travelling clinic in this area told us
in an interview that the demand for injections is almost universal
among the tribal people.11 Anyone who can give an injection is
now a potential “doctor”. More recently, glucose drips have
become increasingly popular, as again it is believed they provide
fast-acting fortification and strength. A fertile ground has thus
been created for flourishing practices in tribal areas by quacks
March 1, 2008 EPW Economic & Political Weekly

wielding syringes and bags of glucose. Because of this demand,
drugs – in particular, analgesics and antibiotics – are adminis-
tered through an injection rather than in tablet form, at inevita-
bly much greater cost to the patient.
In recent years, there has been a marked increase in dubiously
qualified “doctors” practising in this way in the tribal villages of
Gujarat. In general, they rely on extensive social and political
networking to secure local faith in their skills. As a career, it
provides potential social status, and also good earnings, though
it is inherently unstable. Their limited medical skills may be
exposed when wrong diagnosis, inappropriate prescriptions or
dosages, and possible allergies cause disastrous side effects,
leading to a loss of reputation and sudden end to a career. We saw
some such “doctors” breaking into a cold sweat when a patient
suffered pain through a wrongfully administered injection or
other form of treatment. They are also vulnerable to periodic
directives by the district health bureaucracy against the
mal­practices of private doctors, which may lead to them having
to curtail their practice, for a time at least. In some cases they
maintain their influence over patients by giving them loans at
high rates of interest (up to 50 per cent). For the patients, this is
on a par with familiar modes of transaction with local shopkeep-
ers or the economically and politically powerful people of their
villages. Such “doctors” thus establish themselves in a patron-
client relationship with their patients.
6 Traditional Healers Today
With biomedical facilities remaining so poor in most tribal areas,
and with a continuing belief in supernatural causation for many
maladies, the bhagats continue to command a large tribal clien-
tele. We found that many bhagats had an impression that in
recent decades their practice had been compromised and that
they were losing their healing power because of the destruction
of the forest and the medicinal plants that were found there. One
older and more respected bhagat who had been practising for
nearly 50 years told us it was becoming increasingly hard to find
plants in the forest, as it was being destroyed. Due to this, bhagats
were becoming secretive about places where plants could still be
found. Another problem was that the forest department now
placed a high value on medicinal plants, and was trying to stop
bhagats extracting them.12 This bhagat also voiced a common
concern that many of his colleagues were developing an increas-
ingly commercial attitude, and that they were exploiting the
people for their own gain.13
Some bhagats had however managed to adapt to the times
with panache. One such person was Mangubhai Bhagat of Shiva­
rimal village in the Dangs. A large billboard at his house
proclaimed that he was a “bhagat vaidyaraj” who could cure
cancer, blood pressure, paralysis, diabetes, kidney stones, and
sickle cell anaemia (vernacularised to “sicker”). While the claim
to these cures was not uncommon among the other more “tradi-
tional” bhagats that we had met, it was the conscious and strident
advertising of the healers’ skills that was new. His particular
novelty was however a ‘sauna’ bath (steam bath) that he claimed
he had used to cure cases of cancer, paralysis and sickle cell
anaemia. He charged his patients a fixed rate of Rs 60 per half
Economic & Political Weekly EPW March 1, 2008
Special Article
hour to use the ‘sauna’, while having no fixed rates for divination
sessions, as is usual among bhagats.14 He has become a contro-
versial figure among other bhagats, as they feel that his practice
has become overcommercialised. He has certainly earned very
good money – enough to be the only Dangi to own a Scorpio – one
of the most expensive Humvee-type cars in the Indian consumer
market. He was critical of the more traditional bhagats, who he
claimed had failed to move with the times. They were unable, he
said, to cope with many new, imported maladies, such as diabe-
tes, a complaint previously unknown in the region. Despite this,
he still believed that disease and misfortune could be caused by
witchcraft, and stated that he, like other bhagats, was able to
divine cases of witchcraft. He held that tribal peoples were more
prone to witchcraft than non-tribal people, simply because there
were more persons in tribal areas with the knowledge and where-
withal to carry out witchcraft practices. We, therefore, observed
that Mangubhai not only attempted to incorporate elements of
mainstream biomedical classification of diseases and their
causes, but went further to highlight areas of illness that
bio­medicine was unable to take cognisance of.
Other “modernising” bhagats were adopting a variety of strat-
egies to adapt to the times. One had given up all forms of divina-
tion and exorcism, and focused entirely on providing herbal
remedies. He describes himself now as an ayurvedic doctor. The
Shivarimal bhagat made no such claim to be a “doctor”. Signifi-
cantly, he made a distinction between the divinatory and
non-divinatory aspects of his practice, but did not deny that the
core of his practice rather than just his training fell within the
realms of bhakti. In that sense, unlike the bhagats who had begun
to call themselves “doctors”, Mangubhai continued to call himself
a bhagat. However, there were definite selective processes operat-
ing wherein certain features of his learning and practice were
foregrounded at the cost of others.
Today, with biomedicine under increasing attack, traditional
modes of treatment are attracting a new interest, including those
of the tribal healers. Development programmes often call for an
increasing awareness of the tribal heritage of healing. Increas-
ingly, official health agencies are emphasising the importance of
getting local practitioners on their side so that they can imple-
ment their medical programmes more effectively. The state has
started to run training programmes and workshop for bhagats.
The bhagats have also been encouraged to establish associations
of traditional healers so as to legitimise their practice. Most
bhagats, however, suspect such programmes as being a cover for
attempts by the authorities to wheedle knowledge of medicinal
plants from them for exploitation by outsiders. Because of this,
little has come of such initiatives.
Some of the more significant and popular of the private
“doctors” are now strong rivals to the bhagats, offering medicinal
cures that claim to heal faster and with fewer restrictions on
dietary and lifestyle restrictions. The private biomedical
“doctors”, for their part, have learnt to relate to their patients in
an informal way similar to the bhagats. Most of these “doctors”
refrain from overtly criticising the indigenous healers, and never
dissuade their patients from seeking advice and divination
sessions from them. As one such “doctor” explained: “Divination
47
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practices are a matter of belief for the patient, and if it helps them
cope with the illness or gives them hope in getting well, what is
the harm?”. However, they do not hesitate to criticise the more
severely ill patients who did not approach their clinics first on
falling ill. They also criticise the bhagats in various subtle ways
when providing treatment.
7 Non-Governmental Organisations
Continuing in the tradition established by the missionaries, many
non-governmental organisations are now involved in health
projects of one sort or another in tribal areas. Some are purely
secular, but a growing number have religious and political affilia-
tions. We found that they are faced with a variety of local
problems, and that they adopt many different approaches to
healing. Some adhere strictly to biomedicine; others are more
eclectic in their approach. Much depends on the particular
ideological leanings of each group. Some are much more
successful than others. In certain cases dedicated work by
committed doctors has achieved admirable results in particular
localities. It is not evident, however, that such models can be
duplicated on a wider basis, given the severe lack of such
dedicated medical workers in India in general. Also, what
happens when the committed doctors who run such projects
retire or depart the scene?
Some NGO health workers spoke about the problem of provid-
ing healthcare in areas in which a large number of poor tribal
people migrate out of the area on a seasonal basis, only returning
to their villages during the monsoon. Most NGOs and other health
projects are village-based, which means that migrants have no
access to such facilities for most of the year. Being considered
“non-residents” in the plains regions where they work, they are
unable to access effective healthcare there. The migrant work
camps are also very unhealthy and insanitary places, with no
protection from mosquitoes, and corresponding high rates of
malaria, including the potentially lethal falciparum variety of the
disease. The harsh working conditions also undermine the health
of migrants, and they are often unable to sustain many seasons of
such work.
We also found that the government has been depending
increasingly on NGOs to carry out fundamental health work in
India. In this, the Indian government is merely following wider
directives laid down by bodies such as the World Bank and World
Trade Organisation that have an ideological commitment to
decreasing governmental welfare programmes. Funds are being
increasingly channelled into the NGO sector. This allows for the
proliferation of many sub-standard, or even bogus NGOs. It also
absolves the government of responsibility for healthcare. The
NGOs may lack the appropriate qualifications and facilities for the
tasks they take on, and they are also not accountable to the
electorate. Although it is clear that government health projects
are often mistrusted – for good reason – it is clear that NGOs can
never be an adequate substitute for systematic health schemes
implemented by the state.
One important development in recent years has been the
growth of NGO groups that are sponsored and financed by Hindu
religious organisations. The very influential Swaminarayan sect
48
has, for example, been reaching out to tribal people in a concerted
way in recent years. For example, one of its sadhus, P P Swamy,
was sent to the Dangs district in 1998 to start work amongst the
tribal people there. He established an NGO project that soon
attracted government funding. He is involved in health activities,
including an HIV awareness project. Various organisations
connected with what is known as the Sangh parivar have also
become active in tribal areas. One such organisation is the
Vanvasi Kalyan Parishad (vKP), first founded in 1952 and which
now claims to have active units in 20,000 villages in 276 districts
of India that have tribal populations. It seeks, according to its
website, “to wean the vanvasi (tribal) away from the evil influ-
ences of foreign missionaries, anti-social, and anti-national
forces”. As the missionaries found a century before, philanthropic
activities provide a point of entry into tribal villages. ‘Dharma
raksha samitis’ (religious protection committees) are formed,
which organise religious discourses and song-worship sessions.
Their members are given calendars adorned with Hindu deities
and they are encouraged to celebrate Hindu festivals that are
unfamiliar to tribals [Baviskar 2005]. This organisation is active
in certain tribal areas of Gujarat. Although it focuses mainly on
educational work, it also runs medical clinics and mobile medical
vans.15 We observed one mobile service run by the VKP in the
Dangs. It began operating in 2001, and initially provided a relia-
ble service. In recent years, however, its visits have become infre-
quent and unpredictable. The biomedicine that is dispensed is
very limited, and seems to consist mainly of injections. In this
respect, it resembles the sort of inappropriate medical care
provided by quack “doctors”. It hands out unreligious propaganda
to the people who come for treatment, and patients are required
to bow before the god Rama prior to being treated. On the whole,
the people of the Dangs have no faith in these clinics, as they see
that they have an ulterior purpose. The VKP workers talk openly
of using healthcare to counter the Christians, and this seems to
be almost their only rationale. Even the Rashtriya Swayamsevak
Sangh (RSS) president in Navsari was dismissive of the medical
work of the Sangh parivar, stating in a conversation with us that
it was not a major element of their tribal work. More important,
he said, is the more purely religious side to their activities. On the
whole, therefore, the NGO health work of Hindu fundamentalist
organisations is less important than we initially supposed it
might be.
8 Christian Faith Healing
By the 1960s it had become clear that medical missionaries had
to a large extent failed to provide a distinctively Christian
approach towards healing the sick. Their approach was rooted in
a scientific medical practice that might have evolved in Christian
lands, but had soon freed itself from that connection as it spread
throughout the world in the 19th and 20th centuries and became
a largely secular practice. In tribal Gujarat, their medical work
had won much sympathy, but it had failed to bring about any
large-scale conversions to Christianity. In 1961, there were a total
of about 10,500 Christians in the tribal areas of Gujarat in which
the Protestant missionaries had been most active, representing
about 11.5 per cent of all Christians in Gujarat as a whole (the
March 1, 2008 EPW Economic & Political Weekly

large majority of Gujarati Christians were from a dalit background
and were concentrated in central Gujarat). The total tribal
population of Gujarat in 1961 was 2,064,522, so that only about
0.51 per cent were Christians. It was in this context that new
missionary initiatives were inaugurated, with greater success.
During the 1960s, the Roman Catholic Church began for the first
time to open up missions in the tribal belt in Gujarat. They estab-
lished dispensaries staffed by nuns, rather than full-fledged
hospitals. The focus was on providing basic primary biomedical
healthcare that was largely free to patients. The nuns also toured
the villages treating people and giving out medicine.16 To a large
extent, this work followed the same pattern as that of earlier
Protestant denominations, the difference being that the Roman
Catholics had the funds and personnel – in particular nuns who
were often from south India – to make an impact at a time
when the older Protestant missions were winding down their
health activities.
The other initiative, which was to have the greater success,
was by some Indian Christians from Tamil Nadu, working
through an evangelical denomination called the Friend’s Mission-
ary Prayer Band (FMPb). Arriving in the 1970s, they soon began to
win converts on a significant scale, largely through faith healing
of the sort that had been developed elsewhere by the Pentecostal
churches. A belief became widespread that those who had
converted enjoyed better health and a new prosperity, and soon
large numbers were coming forward [Dasan 2000]. Ebenezer
Dasan, a Tamil priest of the FMPb who worked for many years as
a missionary in the Dangs, described its work as providing a
“power encounter” with Christ, in which Christ healed the adivasi
converts, expelled evil spirits that were blighting their lives,
reformed their morals and ethics, broke the hold of the bhagats,
and allowed them to stand up to the shopkeepers who exploited
them (ibid p 162). Whereas, the older Protestant denominations
had deployed biomedicine so as to gain a sympathetic audience
for their preaching in tribal villages – rather than as an active
tool for mass conversion – the FMPB sought primarily to heal
through prayer so as to reveal the compelling spiritual power of
Christ. Stories of conversions through such means lay at the heart
of their proselytising work. Once they were converted, Christians
generally stopped going to the traditional bhagats for treatment.
Nonetheless, when biomedical treatment was needed, the pastors
did not discourage them from seeing doctors.
The other important Christian mission in tribal Gujarat was
that of the Pentecostalists, who are known locally as the “Halle-
luiahs”, due to their frequent repetition of this refrain in their
worship. They began to have an impact in the 1980s, slightly later
than the FMPB. By the 1990s they were holding monster rallies,
with up to 50,000 tribals coming each day. This attracted the
attention of the Hindu right, with adverse consequences. In 1998,
there was a wave of violence instigated by Hindu fundamental-
ists against Christians in the Dangs, and since then, there have
been no large rallies of that sort.17 Pentecostalist are wary of
being questioned by researchers – understandably, given this
history – which makes investigation of their work difficult.
Nonetheless, we managed to meet some of them and attend their
meetings for worship in the Dangs in 2005 that incorporated
Economic & Political Weekly EPW March 1, 2008
Special Article
healing testimonies (‘sakshi’). Although outsiders, who were
mainly missionaries from south India, brought the Pentecostal
church to tribal Gujarat, it is now largely run and financed by the
tribal peoples themselves. They stress that they became Chris-
tians entirely of their own free will, implicitly countering the
criticism of the Hindu right that poor tribals are duped into
converting through the allure of foreign funds. Conversion was
seen as providing a means to transform their lives for the better,
in which they abandoned the old wild ways of traditional tribal
life, and became sober, hard-working and god-fearing. They had,
clearly, entered into a bargain with god – if they gave him their
faith, he must in turn give them benefits. God had accepted
these terms by bestowing on them good health and
pros­p erity. There is a strong emphasis on the healing of all
maladies and sicknesses through the power of faith alone. They
consider that malign forces cause ill-health, and that these forces
can be countered through prayer and faith. The belief in evil
forces clearly accords with existing tribal perceptions, though the
remedy for Christians is no longer divination and exorcism by a
bhagat, but prayer to god. Because of their strong beliefs in this
respect, they do not, as a rule, provide any support for healthcare
activities. There is a sharp contrast here with the older Protestant
denominations, the Catholics, and even the FMPB, which has
in recent years supported initiatives in providing biomedical
healthcare. In tribal Gujarat, however, Pentecostalists for
the most part continue to adopt a fundamentalist approach
– the use of biomedicine is seen as a sign of moral failure, to be
avoided as much as possible.
9 Conclusion
Before the coming of the missionaries, power conflicts over
health and healing were largely internal to tribal communities,
often revolving around accusations of witchcraft. The bhagats
exercise considerable power in this respect, as they were consid-
ered to have the ability to discover witches through divination.
The missionaries, after they arrived, believed that the bhagats
would soon be discredited when the tribal people realised the
superiority of their scientific medicine. As it was, the tribal people
continued to believe that evil spirits, divine displeasure, or witch-
craft caused many maladies, and they continued to utilise the
services of the bhagats.
Official biomedicine, as provided in government clinics in the
years after independence, made no serious inroads into the tradi-
tional forms of healing, due to the low quality of what was
provided and frequent staff absenteeism. The government
presence was felt more in spasmodic health campaigns. Although
the existing literature suggests that these could at times be highly
oppressive, especially when they involved family planning, our
research found that the recent polio vaccination programme
saw, if anything, power shift to the side of the tribal people, as
government officials had to cajole them into compliance due to
their need to reach bureaucratic targets. Even then, some refused
vaccination, deploying a number of rumours about the vaccine
that had gained international currency. In this case, a global
system of communication provided a new rationale for tribal
self-assertion.
49
Special Article

The main rivals to the bhagats within the villages today are the
private “doctors”, the majority of whom lack adequate training
and qualifications for the medicine that they practise. They are
able to gain a foothold because their services are in demand for a
particular kind of “fast” cure. They do not set themselves up as
competitors against the bhagats as such, whom they accept have
the ability to cure certain maladies in psychosomatic ways.
Although they maintain something of a patron-client relationship
with their patients, as when they provide loans at high rates of
interest, their position is inherently instable, due to their lack of
qualifications, limited abilities and periodic official clampdowns
on quacks. They have to be sensitive to local opinion, maintain-
ing their position through their personal appeal. Although they
clearly exploit the tribal people, charging high amounts for very
simple and cheap medication, it is not an altogether one-sided
relationship of power.
We found a situation in which three forms of understanding of
disease causation and healing coexist as paradigms that
constantly interact without any displacement of one by another.
These three forms are, first, modern biomedicine as practised by
people who are known popularly as “doctors” – who may work
for the state or be in private practice, and may be fully qualified,
partially qualified, or without any recognised medical training,
second, healing by bhagats and other such traditional healers,
and third, the practice of Christian faith healers. None of the
three has had the power to entirely displace the other, so that
they exist in a situation in which each has to elicit support.
This helps to enhance the power of the patient as against that of
the practitioner. Conventional narratives of medical progress
have maintained that in time – as education and scientific
understanding advances – belief in supernatural causation will
give way to an understanding of disease primarily in physical
terms, requiring an adherence to biomedical forms of healing.
The present research shows that this has not been the case in
tribal Gujarat. Each of these three very different modes of healing
can be seen to cater for particular needs, and so long as present
socio-economic conditions remain as they are in the tribal
regions, and the public healthcare system exists as it does, it
seems unlikely that there will be any significant change in
this respect.

Notes
1 In some parts of tribal Gujarat such people are
known as ‘buvas’; in this paper we shall however
refer to them generically as ‘bhagats’.
2 The Missionary Visitor, Vol 28, No 3, March 1926,
p 69.
3 Annual Report (Church of the Brethren), to
March 31, 1907, pp 10-11.
4 For further details, see Hardiman (2006), pp 137-67.
5 Of a total of eleven Protestant mission hospitals in
Gujarat, six closed between 1956 and 1966 due to
lack of funds, leaving only five remaining. Boyd
(1981), pp 189-90.
6 The severity of this epidemic is described in detail in
Stover (1919), pp 64-74. For nationalist health work
during this epidemic, see Bhatt (1970), pp 320-21.
7 Interview with Prabhodh Joshi in Vyara. He was a
leading Gandhian social worker in the tribal belt of
Surat district and a firm believer in naturopathy.
8 ‘Mrs Johnson Writes’, Church Missionary Society
Report of the Mission to the Bhils for the Year 1946,
Mission Press, Surat 1947, p 16.
9 Report of the Lusadia Mission Hospital and Biladia
Dispensary for the Year 1957, Wesley Press, Mysore
1958, p 8.
10 Interview with Dr Navnit Fozdar, Gora Colony,
Kevadia, Narmada district, December 8, 2004.
11 Interview with Dr Daxa Patel, Dharampur, Navsari
district, December 2, 2004.
12 Ramalyabhagat, Bhendmal, Dangs district, May 2005.
13 This has been observed of traditional healers
elsewhere. Commercialisation is, for example,
said to have brought a loss of confidence in the
‘nyanga’ healers of Mozambique, providing an
opening for Pentecostalist groups [Pfeiffer 2005].
14 Mangubhai, Shivarimal, Dangs district, April 2005.
15 w w w.h i ndu we v.or g / home /s e v a /v a nv a s i /
vanvasi.htm
16 Suria (1990), Interview with Fr Valentine de Souza,
Baroda, December 21, 2002. Fr de Souza was one
of the pioneers of the Catholic mission to the tribals
of Gujarat. He was sent to work at Vyara in 1961.
17 Interview with Valentine de Souza, Baroda,
December 21, 2002.
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Call for Papers
Announcing a Special Issue on ‘Community Organisation in India’ in Community
Development Journal, published by Oxford University Press. The journal provides
an international forum for discussing political, economic and social issues and
covers a wide range of subjects including community action, local and regional
planning, community studies and rural and tribal development.
This special issue critically explores contemporar y debates and
dilemmas, ideological dimensions of community organization and strategic and
practice innovations in India. Those interested in contributing to this Special
Issue should send an Abstract (500 words) and article outline no later than
March 31st, 2008 to our Guest Editor Professor Janki Andharia, Tata Institute
of Social Sciences, Deonar, Mumbai, India, 400 088.
Email: andharia@tiss.edu, jankiandharia@gmail.com

50 March 1, 2008 EPW Economic & Political Weekly