A Double Whammy for Assam’s Miya Muslims: How Political Exclusion Impacts Health

• Political exclusion of Assam’s Bengal-origin Muslims (Miya) is driving a severe health crisis within the community.
• The Miya population faces a "double whammy" of structural violence—such as forced detention and threats of deportation—and systemic denial of healthcare access.
• Government policies are increasingly weaponizing public health infrastructure for surveillance, further alienating the community from essential services.

Impact of Political Action

• During the National Register of Citizens (NRC) process, community members were labeled "termites" and subjected to intense fear and mental distress; 89 percent of those surveyed reported extreme anxiety.
• Structural violence, including forced evictions and prolonged detention, has led to a prevalence of hypertension, heart disease, and severe mental health conditions.
• Mobility restrictions imposed on former detainees further compound health issues by limiting access to specialized care and routine follow-ups.

Limited Access to Healthcare

• Nearly 2.5 million Miya Muslims reside in river islands (chars) with critically insufficient medical infrastructure: only 132 sub-centres and 52 primary health centres serve this population.
• Living conditions are dire, with 91 percent of residents lacking access to clean drinking water and only 1.4 percent possessing sanitary latrines.
• Public health initiatives, such as the boat clinic model, remain ineffective, leaving 81 percent of the river islands excluded from regular public healthcare.
• The state’s refusal to provide biometric data for millions has rendered many unable to obtain Aadhaar cards, effectively blocking access to vital welfare and health schemes.

Weaponization of Health Systems

• The Assam government has leveraged public health concerns, such as child marriage, to transform healthcare institutions into surveillance hubs rather than spaces for care.
• This practice has created a profound trust deficit, where health workers and institutions are viewed with fear, further discouraging the community from seeking medical assistance.