News How inequality affects healthcare In a country where caste often matters and women can be discounted, it would be naïve to think that inequality and prejudice would not also influence healthcare. India is one of the world’s most populous countries with one of the fastest growing economies but there are still many forms of prejudice applying to class, caste and gender. This can affect healthcare and the treatment a person receives. Many individuals suffering with diseases like leprosy are being left behind as a result. Women are often unable to access treatment because their families do not think they need it, or they are hidden away for fear of prejudice. Often women are unable to marry, cannot find work and can be divorced by their husbands if they have leprosy. This is why many cases go undetected or are detected at a later stage when life-changing disabilities have already set in. Caste is another factor that can influence a person’s access to healthcare. While the caste system was officially abolished in India in 1947, it’s been harder to dispel in society with many claiming there is still inequality dependent on skin colour and heritage. Those considered to be from a better social background have access to better quality healthcare and often have more income to pay for private treatment. This may mean earlier detection of illnesses such as leprosy. However, inequality exists in private healthcare practices too. Some doctors refuse to treat leprosy patients regardless of caste or wealth because they associate the disease with a curse or, despite being doctors, are afraid of catching leprosy. Those attending government hospitals will receive basic treatment because there is an obligation on staff to treat everyone. This however, does not stop personal prejudices as many nurses are thought to treat leprosy patients worse than others. They can leave leprosy patients in dirty sheets for weeks or abandon them for longer periods of time because they too fear contracting the disease. We are working to tackle inequality by raising awareness of leprosy and the multi-drug therapy so that the prejudice surrounding the disease can be dispelled. We also have many female community champions working in remote areas to help identify the women who may not have yet been diagnosed. However, if India as a whole saw less inequality among gender, caste and class, the level and access to healthcare could improve, not just among those with leprosy but for all patients. This could be coming as the economy continues to grow. With the growth many believe there will be a redistribution of wealth and that could mean less inequality which could affect the way individuals are treated for the better.