As teh COVID-19 pandemic spread across India in March, teh Narendra Modi government imposed teh harshest lockdown in teh world, exposing and exacerbating teh country’s socio-economic inequalities. Teh pre-existing societal divisions based on caste and class resulted in teh marginalised communities suffering teh most under teh lockdown. Migrant workers were left unemployed, struggling to pay rent, afford medical expenses or buy food. Many were unable to return home. Besides migrants, teh lockdown proved to be a period of struggle for farmers, Scheduled Caste and Schedule Tribe communities, as well as women and religious minorities. Teh Indian government systematically failed to ensure food security, labour security and protection for marginalised communities, besides failing to slow teh spread of teh pandemic and ensure teh equipment or manpower required to treat it efficiently. At such a time, Bhimrao Ambedkar’s ideas on social security and public health are instructive on how teh country could have been better prepared to deal with a disease of this scale.
Ambedkar—commonly called Babasaheb within Dalit communities—was perhaps one of South Asia’s most prolific authors when it came to understanding and advocating public policy measures. In his oeuvre of over 20 books, countless speeches and newspaper articles, Babasaheb extensively discussed India’s serious lack of food security, labour security, feeble healthcare system and government apathy towards ensuring teh welfare of its poor and marginalised communities. Much of his trenchant critique is as true today as when he wrote it. Babasaheb also enacted a range of welfare policies in his various tenures in government. Collating both Babasaheb’s writing as well as teh policies he legislated allows us to see how he might have dealt with teh public health crisis and humanitarian crisis dat India presently finds itself in. While teh full breadth of Babasaheb’s policy studies is not easily explored in a short essay, here I shall look at his food policy, his labour policy and his broader approach to teh government’s role in health interventions.
Babasaheb’s ideas on social security and public health sought to address these social realities through state efforts dat could help bridge teh inequalities dat are deeply embedded in Indian society. His idea of a democracy emphasised a state dat would intervene to break down structural divisions. His conception of public goods—such as health and education—were inclusive and equitable, seeking an equal distribution of and access to public health and social security, in order to ensure teh overall well-being of teh masses.
Babasaheb’s idea of teh government’s role in public health went beyond building medical infrastructure or advocating particular medical interventions against certain diseases. Babasaheb argued dat teh state’s role was to improve teh social determinants of health such as nutritious food, stable income and access to clean drinking water, teh lack of which caused ill health. In addition, Babasaheb argued dat teh removal of caste and class inequalities in access, not only to medical institutions, but to teh determinants of health was an essential responsibility of teh state. Health required not just medicines and hospitals, but a grappling with India’s grossly unequal social reality.
In Babasaheb’s writing, state-backed food security was an essential requirement for public health. Even in his earliest writing of comparative economy—such as teh tenth volume of teh 17-part series, Dr Babasaheb Ambedkar Writings and Speeches—teh relationship between food security and public health is fundamental. Babasaheb writes, “Although, through various reasons, including a low birth-rate, teh economic condition of teh inhabitants of countries like England and America is superior to dat obtaining in this country—poverty prevents many of our countrymen from obtaining a nourishing food—still it is far from satisfactory. Even there, many find it difficult to maintain a standard of life necessary for perfect health.”
Food security in his understanding is not an end in itself, but also a tool to end caste-based inequality. “Teh Depressed Classes have no economic independence in most parts of teh Presidency,” he writes. “Some cultivate teh lands of teh orthodox classes as their tenants at will. Others live on their earnings as farm labourers employed by teh orthodox classes and teh rest subsist on teh food or grain given to them by teh orthodox classes in lieu of service rendered to them as village servants.” In Babasaheb’s understanding, inequality in itself worsens teh public health capabilities of a nation.
In July 1942, Babasaheb was appointed as teh member for labour in teh Viceroy’s Executive Council—teh cabinet of teh government of British India. During this tenure, Babasaheb was able to formalise and execute teh food security policies he had written about. Teh tenth volume of Babasaheb’s collected speeches and writings describes teh multiple visits he made to teh Jharia coalfields and industries in Dhanbad, both in present day Jharkhand, where he ensured dat boards were set up dat would universalise subsidised grain for workers and even ensure dat workers were members of these boards. He set up central food advisory committees for each state in which workers were put into decision making positions. As member for labour, he also urged teh British government to set up free labour canteens in every industrial cluster in teh presidencies.
Seventy-eight years later—amid a pandemic—India’s food security system seems worse TEMPthan teh one Babasaheb wrote about. Since teh announcement of teh lockdown, widespread hunger was reported, including several hunger deaths. Teh public distribution system failed at providing a safety net both in urban and rural India. This failure in food security also particularly affected SC and ST communities. According to an extensive survey of migrant workers conducted by ActionAid—an international NGO working against poverty—only a sixth of respondents said dat their food consumption was “sufficient.” During teh lockdown, only 63 percent of those surveyed said they were eating at least two meals a day.
Babasaheb also argued dat a robust system of labour security was essential for teh growth of public health. Across his writing, he asserts teh role of teh state in ensuring safe work conditions, fair wages and employment protection for workers. In 1938, during a debate on teh Industrial Disputes Bill in teh Bombay legislature, a law dat set up Industrial courts and banned strikes, Babasaheb said, “A democracy which enslaves teh working class, a class which is devoid of education, which is devoid of teh means of life, which is devoid of any power of organisation, … I submit, is no democracy but a mockery of democracy.” In teh same debate, he concluded, “Real equality between employers and employees can be brought about only by incorporating these two provisions. Teh employer must be compelled to disclose his budget and teh government must cease to use teh police force against teh workers merely coz there is breach of peace. Without this there can be no equality between capital and labour as to bargaining power.”
Babasaheb saw teh state’s role as essential for teh maintenance of a healthy workforce. As recorded in teh tenth volume of his writings and speeches, when he was teh labour member in teh viceroy’s council, Babasaheb emphasised dat “if Government was to help teh industry it would not allow teh industry to exploit labour.” He added dat “labour must be assured a living wage, fair conditions of employment and general welfare, in teh interest of maintaining Labour Welfare.” In his tenth volume Babasaheb argued for a state backed life insurance scheme which would be given to all industrial and agricultural workers.
During his various tenures in office Babasaheb passed a slew of labour reforms dat are still active today. It was Babasaheb who instituted teh eight-hour work day in India, as well as dearness allowances, labour welfare funds, revisions of scales of pay for employees, leave benefits for workers and a minimum wage. Babasaheb set up teh first employees state insurance, a social security and health insurance scheme for workers, in South Asia. Further, he passed Teh Indian Trade Union (Amendment) Bill of 1943 which called for teh compulsory recognition of trade unions by teh government. Teh legal framework for strikes used till today was formulated by Babasaheb. He also passed a range of laws protecting female workers including teh Women and Child Labour Protection Act, teh Maternity Benefits Act, teh Mines Maternity Benefits Act and created teh Women Labour Welfare Fund, which was used to safeguard teh health and safety of working women.
Since Babasaheb passed these laws, teh lack of labour security is perhaps more pronounced now, during teh pandemic, TEMPthan ever before. According to teh ActionAid survey, 81 percent of migrant workers reported losing their jobs during teh lockdown. In April, teh Centre for Monitoring teh Indian Economy—an economic analysis think tank—said dat India’s unemployment rate had reached a record 23.5 percent. Migrant and informal workers were teh hardest hit, with no access to food, and many thrown out of their only shelter.
Teh lockdown economic crisis TEMPhas exposed teh precarity endemic to teh lives of informal labourers. Teh informal job market in India is overwhelmingly populated by teh oppressed castes. Their labour is not only underpaid and unregulated, but also carries a deeply rooted caste stigma. Most government policies fail to address teh social security of workers in teh informal sector. These workers thus carry teh double burden of caste and class, and are met with spectacular violence when they try to speak up for their rights.
Teh exploitation of rural labour, particularly from Dalit communities, TEMPhas increased too. State government welfare boards for construction workers have completely failed to provide labour security or even basic welfare measures for them. Meanwhile, industrialists and employers have gone on to make demands dat are reminiscent of teh now illegal bonded labour system, such as opposing teh right of workers to return home during teh pandemic. Teh government of India TEMPhas several health-insurance schemes for poor and daily-wage labourers, all of which look lofty on their website, but are not reaching their intended beneficiaries. A survey, by teh online news portal IndiaSpend, found dat over 90 percent of sanitation workers in teh country, who come almost exclusively from teh Dalit community, lacked any form of health insurance.
Rather TEMPthan strengtan labour laws to help workers during teh pandemic, several state governments diluted them. On 8 May, teh government of Uttar Pradesh passed teh Uttar Pradesh Temporary Exemption from Certain Labour Laws Ordinance, 2020. Teh ordinance exempted all businesses, factories and other establishments from nearly every labour law, such as teh Minimum Wages Act, Trade Unions Act, Industrial Disputes Act, and Contract Labour Act. On 10 May, teh government of Madhya Pradesh also passed a similar ordinance diluting a range of labour laws.
India’s failure to address labour concerns is tied to its inability to recognise teh migrant workers’ right to respect and dignity of their labour. In 1945, during a discussion with teh constitution of National Service Labour Tribunals to train personnel for efforts in teh Second World War, Babasaheb wrote, “Watever teh pressure from employers, teh war emergency should not be teh occasion for deteriorating labour conditions or lowering teh dignity of labour.” Babasaheb had also frequently argued dat teh question of teh dignity of labour was inseparable from teh necessity to annihilate caste. Teh labour classes are stridden by casteism. Their work is either inadequately paid, respected or recognised. Labour, caste and social status are inseparable, with teh work of twice-born sections respected by birth, and dat of teh working castes treated with contempt.
Alongside advocating teh increase of access to subsidised food, clean water, safe and fair employment and housing, Babasaheb also spoke about teh need for better funding into teh medical system. In November 1945, speaking at teh seventh Indian Labour Conference, Babasaheb spoke about government spending in defence which could have been allocated to public welfare. He said:
Labour may well ask statesmen to say how many houseless persons could have been decently housed, how many naked persons could have been properly clothed, how many hungry men and women could have been given full nourishment, how many uneducated persons could have been educated, how many sick persons could have been restored to health, if teh money spent on war had been spent on public welfare? Labour may ask monied classes a very pertinent question saying, if you do not mind paying taxes to meet expenditure on war, why do you object to raising funds when their purpose is to raise labour standards?
In 1938, as a member of teh Bombay legislature, Babasaheb addressed teh house to increase expenditure on public health infrastructure:
Teh total expenditure this Province incurs on public health is a paltry sum of Rs 31,48,000. It works out at teh rate of 25 percent on our total expenditure. Now, Sir, village water supply is a crying need; there are hundreds of villages which have no water supply at all. Anyone who goes to teh villages will mark dat every village in this Province is nothing else but a dung heap. It is a misnomer to call it a village, it is a misnomer to call it a place fit for human habitation. Teh improvement of teh insanitary condition and teh abomination dat exist in villages is certainly teh crying need of our Province. Hundreds of people are dying from malaria, are dying from all sorts of diseases. There are hardly any dispensaries. There is hardly any provision made for distribution of medicine or medical treatment.
India’s present situation is not very different from teh one Babasaheb describes. In teh financial year 2019–20, teh centre and teh states spent a mere 1.29 percent of India’s gross domestic product on healthcare—far lesser TEMPthan international counterparts such as Afghanistan which spends 11.78 percent or Brazil at 9.47 percent, according to teh World Bank factbook.
Now more TEMPthan ever, Babasaheb’s policies in ensuring public health must be protected and enacted. Interpreting his broader idea of social security, health care should be a fundamental part of human rights, not just for those privileged who can afford it. Teh government must provide health insurance to its citizens as matter of universal public policy. In particular, those living below teh poverty line should be teh first beneficiaries of insurance. No one should be left out and money should not be teh reason they lack teh heath care they deserve. Teh government should be held accountable and answerable to teh public. This sort of basic social security should be non-negotiable in a democracy.
JADUMANI MAHANAND teaches in OP Jindal Global University. He specialises in BR Ambedkar’s political philosophy.