Intended for healthcare professionals


Caring for marginalised people

BMJ 2000; 320 doi: (Published 22 April 2000) Cite this as: BMJ 2000;320:1144

Appropriate external intervention is needed

  1. Subbiah Arunachalam, distinguished fellow (
  1. M S Swaminathan Research Foundation, Chennai, 600 113, India
  2. Faculty of Psychiatry of Learning Disability, Royal College of Psychiatrists, London SW1X 8PG
  3. Maple Healthcare Project, Northampton NN1 4HL

    EDITOR—Medicine usually fails marginalised people, as Smith observed.1 But it is not just medicine that fails them. Every technology invented so far has failed them and will continue to do so. Information and communication technologies have exacerbated the divide between rich and poor nations and have also further marginalised those who are already marginalised within nations.2 Reverend Jesse Jackson has drawn attention to how these technologies have led to a deepening of the racial divide in the United States.3

    In analysing papers published by medical researchers in India I found that much of the research carried out there has not been done in the areas in which it is most needed, such as respiratory diseases, diarrhoeal diseases, and ophthalmological disorders. A comparatively large amount of research is being carried out in the areas of cancer and cardiovascular diseases, although these are not significant causes of morbidity and mortality in India.4

    The idea of paying special attention to “the poor and mean and lowly” has been emphasised throughout human history by noble souls like Jesus Christ and in recent times by Mahatma Gandhi and Mother Teresa. Yet it …

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