A Global Perspective: International Social Work Research Among Indigenous Women in Northeast India

Background and Purpose: Situated amidst the Himalayas, Arunachal Pradesh (AP) is the largest state in Northeast India. AP is one of the last reserves of extraordinary biodiversity, which has been preserved by its indigenous communities. Juxtaposed with the environmental richness are a multitude of social, health and economic challenges. National reports indicate literacy levels below the national average, poor life expectancy in remote districts, inadequate access to health services, as well as poor infrastructure. When natural disasters affect such remote regions, it is very difficult for relief aid to reach the people. In conjunction with our community partners at Research Institute of World’s Ancient Traditions, Cultures and Heritage, we explored death and dying beliefs and practices among local women. The intention was that by investigating indigenous people’s health conditions and socio-cultural practices, we, as social workers would enhance our knowledge of relevant health issues and challenges of working with indigenous peoples. Such knowledge can contribute to our cultural and clinical competency with indigenous groups and can inform international research endeavours.

Methods: We conducted six focus groups with 42 female members of the Indu Mishmi tribes whose ages ranged from 22 to 53, with a median age of 32.5 years. Participants were recruited by members of the Women's Empowerment Group in AP, themselves members of the Indu Mishmi tribes. Death and dying beliefs and practices were explored. Kleinman's Explanatory Model of Illness formed the framework and semi-structured guides were developed to facilitate data collection. The focus groups were audio-recorded in the Hindi and Indu Mishmi languages and transcribed into English. Grounded theory and the constant comparison method enabled derivation of relevant themes. 

 Results:  Among these women routine medical visits are nonexistent. Symptoms are treated by the tribal priest, using herbal and local medicines. Family members care for the terminally ill and rely on the tribal priest for healing. The Indu Mishmi tribe members believe that once a person dies his/her soul is transported to another world where they begin another life. Therefore, underground and above-ground burial mounds contain the individuals’ belongings ensuring they will have all they need. Rituals and prayers are performed by the priest to facilitate a "safe journey" and to ensure they will not return to torment family members. These death and dying beliefs and practices play a significant role among the Indu Mishmi tribes given that specialized medical care is limited with the nearest government hospital being seven hours away. Transportation is treacherous during inclement weather increasing travel time to at least 14 hours. Physicians are scarce and unavailable when needed due to the limited resources and difficult topography. Individuals lack a timely diagnosis which often results in untimely deaths. Consequently, the Indu Mishmi tribe is diminishing causing challenges for youth, family structures and the community.

Conclusions and Implications: We have identified critical factors that hinder health access for our targeted community. Future efforts should involve local community leaders, policy makers, youth and similar women to discuss collaborative strategies to proactively and intentionally address the extant barriers.