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Paper short abstract

This paper examines how health crises among tribal communities in Jharkhand, shaped by state, health systems, and structural violence, show vulnerability as both a site of domination and a strategic resource for negotiating care, legitimacy, and agency within development regimes.

Paper long abstract

This paper examines vulnerability not as a condition to be mitigated within development frameworks, but as a politically produced and strategically negotiated relation between the state, health systems, and marginalised tribal communities in rural Jharkhand, India. Drawing on ethnographic fieldwork and Participatory Rural Appraisal (PRA), it analyses how health crises, chronic illness, untreated pain, maternal complications, and therapeutic delay render certain bodies and populations legible to development and humanitarian regimes, while simultaneously exposing others to organised neglect. Rather than treating vulnerability as an ontological attribute of poverty, the paper conceptualises it as an outcome of state withdrawal, uneven public health infrastructure, and moral economies through which suffering is recognised, prioritised, or ignored.The paper intervenes in debates on the politics of vulnerability by showing how communities navigate health and crisis narratives to claim visibility, legitimacy, and access to welfare schemes, public hospitals, and non-governmental interventions. Vulnerability emerges as a double-edged register-while it enables recognition and access to care, it also risks fixing tribal populations within colonial grammars of dependency and biomedical deservingness. Through PRA encounters and everyday practices of care-seeking, including forced mobility for treatment, collective narration of illness, and strategic silences, marginalised actors both inhabit and contest the terms under which health vulnerability is governed. Situating this within political economy and structural violence, the paper argues that agency in crisis rarely takes the form of overt resistance. Instead, it appears as tactical negotiation and survival within constrained horizons of care, contributing to rethinking development beyond binaries of victimhood and empowerment.