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The Ten-Rupee Doctor Who Sparked a Health Revolution in Kerala’s Tribal Highlands

Dr. V. Narayanan’s Swami Vivekananda Medical Mission Hospital in Agali — known locally as the 10-rupee hospital — stands as one of the most remarkable community health transformations in modern Kerala

Dipin Damodharan

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Image credit: Dipin Damodharan/ Edpublica

The road to Attappadi coils through steep cliffs and dense forests, revealing slivers of green and shadows of mountains that appear to move with each turn. For years, headlines from this tribal hotspot in Kerala’s Palakkad district were heartbreakingly similar: child malnutrition, maternal deaths, anaemia, and a healthcare system fractured beyond recognition.

We were travelling from Kochi not to revisit that trauma, but to meet the man whose quiet, steady efforts helped change it.

When Dr. V. Narayanan arrived in 2002, Attappadi’s healthcare landscape was desolate. A few primary health centres existed in name, but medicines were scarce, staff irregular, transport unreliable, and trust nearly non-existent. Many Adivasi (tribal) families walked hours for simple ailments. Women delivering babies often did so without skilled care.

“In those early days,” he recalls, “you wouldn’t even see a bike on the road. Healthcare wasn’t inadequate — it was absent.”

But absence was precisely what he had come to confront.

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The roots of his journey stretch back to his teenage years. “I was in Class 12,” he says. “It’s an age when you question everything. I began reading Vivekananda deeply. His call to serve the poor, to work in backward areas — that stayed with me.”

Medicine wasn’t his ambition. Rural development was. But his family persuaded him to study MBBS, believing it would broaden his capacity for service. It did — but only because he refused to choose the conventional path.

After completing a postgraduate programme in child health, he didn’t apply for a job. He headed straight to Attappadi — without doubts, without second thoughts. “This wasn’t a career decision,” he says. “It was a life decision.”

His first “clinic” was a mobile medical unit borrowed from the Vivekananda Medical Mission in Wayanad. Every evening he visited a different hamlet, listening to people speak about water scarcity, hunger, infections, unemployment, fear, distrust — and neglect that had accumulated over generations.

Slowly, he became a familiar figure in the valley. Mothers insisted he be the first to hold their new-borns. Elders began greeting him as one of their own.

A belonging was forming — one that medicine alone cannot create.

In 2003, as patients multiplied beyond what the mobile clinic could handle, he opened a small outpatient centre in Agali. By 2006, after raising 22 lakh rupees from well-wishers and small donors, the Swami Vivekananda Medical Mission Hospital opened its doors with 10 beds, two consulting rooms, and a lab.

Its defining principle was radical: Adivasi patients would be charged only ten rupees. Always.

Administrators warned him it was economically unviable. But the doctor had seen families pushed into debt by even minor medical expenses.

“The hospital must belong to them,” he says. “Cost should never decide who lives and who dies.”

People came. Trust deepened. And trust became infrastructure.

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A patient visited in the hospital says, “Here, we feel like human beings. Not cases. Not numbers. Narayanan doctor listens to us like we are his family. That is why we come.”

Another woman added softly: “When we step inside this hospital, we feel safe. There is no fear here.”

For communities long accustomed to humiliation and exploitation in medical spaces, this emotional safety mattered as much as treatment.

A Global Gap Mirrored in a Valley

Attappadi’s early struggles are not isolated. Across India, Adivasi (tribal) communities face some of the poorest health indicators — high maternal mortality, anaemia, malnutrition, tuberculosis, and limited access to skilled care.

Globally, too, Indigenous communities — from the Māori of New Zealand to Native American nations and Aboriginal groups in Australia — experience higher infant and maternal mortality, limited access to hospitals, distrust due to historic exclusion, lower life expectancy, and underfunded primary care

A 2021 UN report states that Indigenous peoples worldwide are nearly twice as likely to lack basic healthcare access. What was happening in Attappadi was part of a wider pattern — the world’s margins suffering the world’s worst health outcomes.

Dr. Narayanan stepped directly into that gap.

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Healing Required More Than Hospitals

Over time, he realised medical treatment alone could not fix Attappadi’s pain.

“Pregnant women worked until delivery because they had no choice,” he says. “Many ate barely one meal a day. How can a baby survive that?”

He conducted a participatory rural appraisal across several hamlets — and what he saw changed everything. Malnutrition was linked to income instability. Illnesses persisted because basic hygiene wasn’t possible. Women were dying because poverty didn’t allow rest.

“It felt like pouring water into a pot full of holes,” he says. “We had to strengthen the pot — not just keep pouring.”

The hospital expanded into a movement that worked on, restoring nutrition, improving sanitation, supporting livelihoods, strengthening housing, reviving agriculture, education, and building self-reliance.

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Village health workers — trained women and men from each hamlet — became ambassadors of preventive care. From an initial 40, tthe network has grown to nearly 130 health workers across Attappadi.

Education too became central. The Mission school today teaches 600+ children, and the valley now has young people pursuing medicine, nursing, and engineering — an unimaginable shift a decade ago.

Growing, But Never Losing Its Soul

The hospital today has 50 beds, 12 full-time doctors, and over 80 staff. Across the Mission’s programmes, more than 200 people work toward one idea: dignity. Nearly 70% of all patients remain Adivasi (tribal).

The next dream: a 100-bed hospital. Construction for new OP wings and a skill development centre has already begun.

CSR funding keeps the institution afloat, but the ten-rupee fee remains untouched.

“It will never change,” he says. “This hospital exists because of them. It must always belong to them.”

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A Revolution Fuelled by Belonging

When asked what sustains him, Dr. Narayanan doesn’t speak of recognition. Instead, he points to his staff — many of whom left better-paying jobs to join the Mission.

“They believe in this work more than anything I’ve done,” he says. “I’m just one person. They are the movement.”

Two decades after he arrived here, the Ten-Rupee Doctor still walks through the corridors of his hospital with the same simplicity and calm that first won the valley’s trust.

In the world of global public health — dominated by budgets, systems, and crises — Attappadi offers a different narrative: that change is possible when a community finds a place where it is seen, heard, and treated as human.

Sometimes, revolutions don’t begin with policy. They begin with one person who refuses to turn away.

Dipin is the Co-founder and Editor-in-Chief of EdPublica. A journalist and editor with over 15 years of experience leading and co-founding both print and digital media outlets, he has written extensively on education, politics, and culture. His work has appeared in global publications such as The Huffington Post, The Himalayan Times, DailyO, Education Insider, and others.

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Climate

Could Global Warming Make Greenland, Norway and Sweden Much Colder?

A Nordic Council report warns that global warming could make Norway colder if the Atlantic ocean circulation collapses, triggering severe climate impacts.

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Could Global Warming Make Greenland, Norway and Sweden Much Colder? Nordic Report Says Yes
A new Nordic report warns global warming could drive parts of northern Europe into far colder conditions if a major Atlantic ocean current collapses. Hamnøy, Norway. Image credit: Petr Slováček/Pexels.

Global warming is usually associated with rising temperatures—but a new Nordic report warns it could drive parts of northern Europe into far colder conditions if a major Atlantic ocean current collapses.

Greenland, Norway and Sweden could experience significantly colder climates as the planet warms, according to a new report by the Nordic Council of Ministers that examines the risks linked to a possible collapse of the Atlantic Meridional Overturning Circulation (AMOC).

The report, A Nordic Perspective on AMOC Tipping, brings together the latest scientific evidence on how global warming is slowing the AMOC—one of the world’s largest ocean circulation systems, responsible for transporting heat from the tropics to the North Atlantic. While a full collapse is considered unlikely, the authors warn that it remains possible even at relatively low levels of global warming, with potentially disruptive consequences for northern countries.

The Reversal

If the circulation were to weaken rapidly or cross a tipping point, the report notes, northern Europe could cool sharply even as the rest of the world continues to warm. Such a reversal would have wide-ranging effects on food production, energy systems, infrastructure, and livelihoods across the Nordic region.

“The AMOC is a key part of the climate system for the Nordic region. While the future of the AMOC is uncertain, the potential for a rapid weakening or collapse is a risk we need to take seriously,” said Aleksi Nummelin, Research Professor at the Finnish Meteorological Institute, in a media statement. “This report brings together current scientific knowledge and highlights practical actions for mitigation, monitoring and preparedness.”

A climate paradox

The AMOC plays a central role in maintaining the relatively mild climate of Northern Europe. As global temperatures rise, melting ice from Greenland and increased freshwater input into the North Atlantic are expected to weaken this circulation. According to the report, such changes could reduce heat transport northwards, leading to colder regional conditions—particularly during winter—even under a globally warming climate.

Scientists caution that the impacts would not simply mirror gradual climate change trends. Instead, an AMOC collapse could trigger abrupt and uneven shifts, including expanded sea ice, stronger storms, altered rainfall patterns, and rising sea levels along European coastlines. Some of these impacts would occur regardless of when or how quickly the circulation weakens.

The report also highlights global ripple effects. A slowdown of the AMOC could shift the tropical rain belt southwards, with potentially severe consequences for monsoon-dependent regions such as parts of Africa and South Asia, underscoring that AMOC tipping is not a regional concern alone.

Calls for precaution and preparedness

Given the uncertainty surrounding when—or if—the AMOC might cross a critical threshold, the report urges policymakers to adopt a precautionary approach. It stresses that any additional global warming, and prolonged overshoot of the 1.5°C target, increases the risk of triggering a collapse.

Key recommendations include accelerating emissions reductions, securing long-term funding for ocean observation networks, and developing an early warning system that integrates real-world measurements with climate model simulations. The authors argue that such systems should be embedded directly into policymaking to enable rapid responses.

The report also calls for climate adaptation strategies that account for multiple futures—including scenarios in which parts of Northern Europe cool rather than warm. It emphasises that AMOC collapse should be treated as a real and significant risk, requiring comprehensive risk management frameworks across climate, ocean, and disaster governance.

Science driving policy attention

The findings were developed through the Nordic Tipping Week workshop held in October 2025 in Helsinki and Rovaniemi, bringing together physical oceanographers, climate scientists, and social scientists from across Nordic and international institutions. The initiative was partly motivated by an open letter submitted in 2024 by 44 climate scientists, warning Nordic policymakers that the risks associated with AMOC tipping may have been underestimated.

By consolidating current scientific understanding and translating it into policy-relevant recommendations, the report aims to shift AMOC collapse from a theoretical concern to a concrete risk requiring immediate attention.

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Society

Science Is Talking – Why Aren’t We Hearing?

Why the world still struggles to communicate science, and how researchers, journalists, and
institutions can rebuild a broken chain

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Have you ever listened to an expert discuss their work and felt like they were speaking a completely different language? You’re not alone. Scientific breakthroughs have the power to shape our health, environment, and future, yet they often remain locked behind a wall of jargon and complexity, failing to reach the public or the policymakers who write our laws.

This communication breakdown creates a “broken chain of knowledge,” with crucial information stuck at its source. The path from a scientific discovery to public understanding and sound policy is fraught with obstacles, from the culture inside the lab to systemic barriers in government.

Let us look at the most significant reasons for this disconnect. By understanding the challenges from the perspectives of scientists, journalists, and policymakers, we can begin to see how we might mend the chain and ensure that knowledge flows to where it’s needed most.

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The First Barrier Isn’t a Wall, It’s a Mindset

The communication problem often begins not with external hurdles, but within the culture of science itself. Before a single word is spoken to the public, an internal mindset can prevent scientists from effectively sharing their work. Some researchers operate with what former Indian minister Jairam Ramesh calls a “high pad” mentality, believing their specialized knowledge places them above the need for public engagement.

As Ramesh recently points out at the Science Journalists Conference of India, Ahmedabad University, this attitude is a primary barrier: “Too often I find scientists sitting on a high pad thinking that they have a better knowledge than the rest of the people… they speak in jargon they speak in their own language and they are really appealing to the community and not necessarily to the non-scientific community.”

Dr. Abhijit Majumdar of IIT Bombay acknowledges that scientists are often poor communicators — but he stresses a deeper issue: “Before learning how to communicate, scientists must first appreciate the need to communicate with the general public.” That awareness, he says, is still lacking in many settings. Experts note that this gap persists for two key reasons. The first is mindset: a cultural tendency to work in isolation — an “ivory tower inside their own ego.” The second is Language: after years of specialization, many scientists use technical vocabulary without realizing it’s incomprehensible jargon to outsiders, effectively building a wall where they intend to build a bridge. Overcoming this internal culture is the first step toward unlocking the mutual benefits of communication.

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It’s Not ‘Dumbing Down,’ It’s a Two-Way Street

A fundamental misunderstanding of science communication is that it’s simply “dumbing down” complex work; in reality, it is a transformative, two-way exchange that can lead to deeper insights for the researchers themselves.

When scientists are challenged to explain their work to non-experts, they must distill complex ideas to their “’observable conceptual’ level.” This act of translation often forces them to see their own work from a new perspective, uncovering fresh insights. As Dr. Majumdar states, the benefits flow in both directions:

“It’s a two-way street, it is beneficial for the sides if we learn how to communicate.”

Furthermore, this process can generate questions from the public that are “much more superior” to those scientists typically receive from their peers, pushing their research in new and unexpected directions.

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A Scientist’s Silence Creates a Vacuum for Misinformation

In our modern digital world, many scientists are hesitant to speak publicly, “scared that one wrong use of the work can be taken out of the context,” potentially leading to professional backlash. While this caution is understandable, it creates a dangerous paradox.

When credible experts stay silent on a complex issue, they create an “information vacuum.” That empty space will not remain empty for long. It is inevitably filled by less informed, less qualified, or even malicious actors eager to become the spokesperson on the topic. The silence of experts, therefore, directly enables the spread of false narratives.

In an era with a “lot of misinformation,” the proactive solution is a strong partnership between cautious, responsible scientists and trusted journalists. This collaboration is the public’s best and most powerful defense against falsehoods.

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The System Itself Is Designed to Fail

Even when individual scientists are willing to engage, they are often crushed by systemic and structural barriers. The larger systems governing science and media are frequently not built to support public communication, a problem that is truly global in scope.

Studies reveal a stark reality. Nearly 46% of academics in one study had never communicated their findings beyond peer circles, with 80% citing a lack of time as a major barrier. A global survey of geoscientists found that while 90% believe they have a moral duty to engage, 87% identified a lack of funding as a key obstacle. This isn’t confined to one region; a study in Zimbabwe found nearly half of academics had never shared their research with public audiences.

In India, this is compounded by institutional support that suffers from “irregular funding” and offers little incentive for sustained engagement. Interestingly, a 2020 Pew Research survey found that 75% of Indians believe government investment in science is worthwhile, suggesting a public appetite for knowledge that the system is failing to meet.

Further straining the system is the inherent conflict between the clashing timelines of science and journalism. Science is slow, careful, and methodical, prioritizing peer review and accuracy. The news cycle is instantaneous and reactive, demanding immediate responses for a public hungry for information. This friction between a scientist’s verification process and a journalist’s deadline puts constant stress on the very relationship needed to bridge the knowledge gap.

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In Policy, There’s a Structural Wall Between Science and Law

Even when science successfully reaches the public, the final link in the chain—influencing policy—is often completely broken. In India, for instance, Jairam Ramesh describes a profound structural disconnect between the nation’s scientific community and its lawmakers.

He explains that Members of Parliament receive their information almost exclusively from “government bodies” and “ministries,” not from the independent scientific institutions that house the country’s experts. This has led to a glaring absence of science-informed debate on some of the most critical issues facing the nation, including:

  • GM crops
  • Nuclear policy
  • The increasing frequency of landslides and earthquakes

Global warming and its impact on agriculture, health, and energy

To fix this, Ramesh proposes that India’s scientific academies must take a more “active role.” Instead of relying on individuals, these institutions should consolidate a “collective view” from the scientific community and present it directly to legislators, providing an authoritative voice that is much harder for policymakers to ignore.

Building the Bridge, Together

Mending the broken “chain of knowledge” is not a simple task, nor is it the responsibility of a single group. It requires a collaborative effort from scientists who see communication as a duty, journalists who build trust and provide context, and institutions that create systems that reward and support public engagement.

Breaking down these barriers is a critical responsibility for any society that wishes to be guided by evidence and shared understanding. By strengthening every link in the chain—from the lab to our laws—we can build the bridge to a future shaped by insight and reason. If knowledge is power, how can we each help ensure it flows to where it’s needed most?

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Climate

A Green Turn with Gaps: India’s Budget Backs Clean Tech but Skips Climate Adaptation

India’s Budget 2026–27 doesn’t shout climate ambition—but it hardwires it into clean manufacturing, carbon capture and energy supply chains, quietly reshaping the country’s green economy from the inside out.

Dipin Damodharan

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Clean Energy, Carbon Capture—and a Quiet Omission: Reading Budget 2026–27 Through a Climate Lens
India’s Union Minister for Finance and Corporate Affairs, Nirmala Sitharaman along with the Minister of State for Finance, Pankaj Chaudhary as well as her Budget Team of the Ministry of Finance before presentation of the Union Budget-2026 at Parliament House, in New Delhi. Image credit: PIB

India’s Union Budget 2026–27 may not carry a standalone climate chapter, but its green intent runs deep through the fine print. From carbon capture and battery storage to critical minerals and clean manufacturing, the budget signals a strategic shift: climate action is no longer framed as an environmental add-on, but as industrial policy and economic risk management rolled into one.

Presented by Finance Minister Nirmala Sitharaman on February 1, 2026, the budget places clean energy and climate-aligned manufacturing at the heart of India’s growth narrative. With a GDP growth target of around 7 percent and a sharp focus on fiscal discipline, sustainability is being embedded into supply chains, cities, transport and finance—quietly but deliberately.

Carbon Capture Takes Centre Stage

The most striking climate-linked announcement is the Rs 20,000 crore allocation over five years for Carbon Capture, Utilisation and Storage (CCUS), aimed at hard-to-abate sectors such as power, steel, cement, refineries and chemicals. For the first time, industrial decarbonisation is being backed at scale through public finance, signalling recognition that renewables alone cannot carry India’s net-zero journey.

As Arunabha Ghosh of CEEW notes, the budget’s “prioritisation of carbon capture, utilisation and storage across power, steel, cement, refineries, and chemicals” places these sectors squarely at the centre of India’s long-term climate pathway. This marks a decisive move from aspiration to infrastructure.

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Building the Clean Energy Ecosystem

The energy transition is supported by coordinated allocations across key ministries: Rs 32,915 crore for New and Renewable Energy, Rs 29,997 crore for Power, and Rs 24,124 crore for Atomic Energy. Customs duty exemptions have been extended to lithium-ion cells used in battery energy storage systems, inputs for solar glass manufacturing, and nuclear power project imports till 2035.

Aarti Khosla of Climate Trends captures this shift succinctly: “Coupled with the exemption given to battery manufacturing, VGF for BESS and grant to CCUS, the focus of the government is rightly tilting towards building an energy transition ecosystem.” She adds that continued reforms in power distribution could bring “360-degree improvement in India’s green energy supply chain.”

At the household level, the PM Surya Ghar Muft Bijli Yojana receives a major boost, reinforcing decentralised clean energy as a pillar of inclusive growth. Rooftop solar is increasingly being positioned not just as a climate solution, but as a competitiveness tool for small businesses and urban households.

Supply Chains, Not Just Solar Panels

Rather than headline-grabbing renewable capacity targets, Budget 2026–27 leans into industrial resilience. Duty exemptions for critical minerals processing equipment, solar glass inputs, and battery storage components underline a focus on domestic value addition.

Energy analyst Duttatreya Das of Ember observes that while there are “no big-ticket announcements for renewables,” the continued duty exemptions and manufacturing reforms are expected to “quietly strengthen clean energy supply chains.” This reflects a broader policy philosophy: competitiveness before capacity, foundations before scale.

Rare Earth Corridors and incentives for mineral-rich coastal states further indicate a push to secure upstream inputs essential for EVs, batteries, wind turbines and electronics—areas where geopolitical vulnerabilities are growing.

Clean Mobility and Greener Cities

Sustainability also shapes transport and urban planning. The budget proposes 20 new national waterways over five years, aims to double the share of inland and coastal shipping by 2047, and identifies seven high-speed rail corridors as environmentally sustainable growth connectors. Municipal finance incentives—such as Rs 100 crore support for cities issuing large bonds—open space for green urban infrastructure, including pollution control and climate-resilient services.

Labanya Prakash Jena,Director, Climate and Sustainability Initiative, highlights that such incentives can catalyse “green municipal bonds, particularly for pollution control and urban environmental projects,” linking fiscal reform directly with urban sustainability.

The Gaps That Remain

Despite these advances, the budget remains notably silent on climate adaptation. Heat stress, floods, water scarcity and climate-resilient agriculture receive no scaled-up fiscal roadmap. Vibhuti of IEEFA points out that while support for decentralised renewables and bioenergy has increased, spending on transmission and energy storage has stagnated or declined—areas that are “not optional but indispensable” for a high-renewables grid.

The absence of strong EV demand-pull measures and limited risk-sharing instruments for private capital also signal unfinished business in India’s clean transition.

A Budget of Signals, Not Slogans

Budget 2026–27 is not a climate manifesto. Instead, it is a signal budget—one that rewires incentives, de-risks clean manufacturing, and treats decarbonisation as an economic strategy rather than a moral appeal. Its strength lies in industrial tools and fiscal realism; its weakness, in adaptation and social resilience.

Whether this quiet green turn translates into measurable emissions reductions and climate resilience will depend on execution, state capacity, and private investment. But one thing is clear: India’s clean-tech transition has now entered the core of its economic planning.

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