In 1993, when a group of young doctors arrived in Sittilingi valley in Tamil Nadu’s Dharmapuri district, healthcare in the tribal region was almost non-existent. Women rarely studied beyond Class 8; many girls dropped out after attaining puberty, infant mortality stood at a staggering 147 per 1,000 live births, and distrust of modern medicine ran deep.
Three decades later, the same valley has become home to one of India’s most remarkable community healthcare models.
The Tribal Health Initiative (THI), which recently received the prestigious Yashraj Bharathi award 2026 for innovation in healthcare, today runs a 35-bed hospital serving nearly one lakh people annually. More than 80 per cent of its staff come from tribal communities themselves. Infant mortality has dropped drastically, maternal deaths were eliminated within a decade, and healthcare has now evolved to include organic farming, women’s enterprises, nutrition programmes and rural medical training.
But the transformation, says Dr Regi M. George, one of the founders of THI, did not begin with medicine, but with trust.
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“It happened over 10 years. It was a very slow process,” George told THE WEEK over a telephonic interview. “The best thing was that we did not counter traditional healing practices. We tried to complement them.”
Instead of dismissing local healers and indigenous practices, the organisation chose to work alongside communities rather than above them. In regions where outsiders were often viewed with suspicion, that approach slowly built credibility.
“In the beginning, sometimes we would bring patients in and suggest something, and families would simply take them away,” George recalled. “But because we were not contradicting their traditional systems, people slowly started trusting us.”
The turning point came when THI realised that sustainable healthcare in rural and tribal India could not rely solely on doctors or hospitals. “Hospitals cannot do this alone,” George said. “Unless you work with communities and empower communities, it will never happen.”
At the time, the region had virtually no trained nurses or healthcare workers. So THI began with the people most excluded from the system, tribal girls.
“Thirty years ago, none of the women here completed schooling,” said George. “There were schools only till the eighth standard, and girls would often stop studying once they got their first period.”
THI began training local girls to assist in healthcare work. Since many lacked formal educational foundations, the training started from scratch with Tamil, English and mathematics before moving into medical instruction.
“We found these girls were excellent,” George said. “They had simply lacked opportunities.” Over time, tribal women became health workers, nurses and the backbone of the healthcare system. Men later joined in pharmacy, laboratory work and administration. The model created employment within the community while also strengthening trust in healthcare institutions.
THI’s community-centred approach soon began yielding dramatic results. Through intensive village-level maternal and child health programmes, local women were trained to identify malnutrition, support antenatal care and monitor vulnerable children.
Infant mortality fell from 147 per 1,000 live births to 60 within a decade. Over the next several years, it dropped further to around 20 and now stands at nearly 8, according to the organisation.
George insists that these gains were not driven primarily by medical technology. “It was basically communities looking after themselves, not doctors,” he said.
By the early 2000s, the organisation began examining the deeper social and economic roots of ill health. That led THI into an entirely new arena, organic farming. The organisation encouraged local farmers to revive traditional millet cultivation instead of shifting entirely to rice. Millets had historically been part of the region’s diet, but were slowly disappearing. THI helped farmers grow indigenous crops organically and then focused heavily on building market access through the Sittilingi Organic Farmers Association.
Once farmers began earning stable incomes from millet cultivation, interest surged. “Two things happened,” George explained. “Money came into people’s pockets, and because they were eating millets again, anaemia and malnutrition almost disappeared.”
The initiative eventually expanded into women-led enterprises and other livelihood programmes aimed at reducing distress migration and strengthening local economies. Healthcare, in Sittilingi, had become inseparable from ecology, food systems and economic dignity.
One of the most significant outcomes was contributing to conversations around the inclusion of millets in Tamil Nadu’s Public Distribution System.
But George is quick to credit the state government for being willing to listen. “That government chose to include grassroots workers in policymaking,” he said. “Many governments don’t do that.”
Concerned by the growing corporatisation of healthcare and the disillusionment many young doctors feel within large hospital systems, the organisation launched a Rural Sensitisation Programme to expose medical students and doctors to rural healthcare realities.
“They joined medicine for big ideals and then suddenly realised this was not what they had signed up for,” he said.
The programme takes participants into villages, tribal homes and rural secondary-care settings to help them understand how healthcare functions outside urban corporate hospitals.
What began as a small initiative has now inspired similar programmes across India. THI also runs a year-long Tribal Fellowship in which young doctors spend time with multiple grassroots organisations across the country, studying different community healthcare models.
For George, the lesson from Sittilingi remains simple, particularly at a time when conversations around healthcare often revolve around infrastructure, insurance and technology.