Expanding Public Health Infrastructure in Tamil Nadu

In February this year, I was invited to visit a patient admitted to the Government Multispecialty Hospital in Guindy, Chennai. Reaching this hospital is not particularly easy, as it is not located directly along one of Chennai’s main arterial roads. Perhaps this location was chosen because it offered one of the few large parcels of government land available for such a facility.

As I entered the hospital building, I quickly realised that this was not a typical government hospital. The lobby itself was large and spacious. As one walked further inside, the corridors continued with the same generous width. There were two sets of elevators: one set serving the first two floors, where the emergency wards are located, and another set serving the remaining floors up to the seventh.

I went up to the fourth floor to see the patient. The corridors remained wide and airy. The patient was accommodated in a private suite. The room included an anteroom with a refrigerator and a cot for the attendant. From the anteroom, one could enter the patient’s room, where the essential medical supplies for care were maintained.

I happened to arrive at a fortunate moment. First, the neurology consultant came to review the case. He carefully examined the patient and spent considerable time assessing the condition. As he came out, he kindly shared his observations and plans with me, as a fellow physician visiting the patient. Shortly afterwards, the nephrology consultant also visited. He too spent time understanding the patient’s condition before proceeding with further evaluation.

From my brief visit and observations, I could understand why several people have described this hospital as a special gift for the citizens of Chennai.

As I reflected on this visit, I realised that this is not the only major government hospital built in recent years. The Government Hospital in Tambaram is another significant addition. Built within the Tambaram Sanatorium campus, it occupies a large open space in the centre of the campus. Unlike the Guindy hospital, this one has direct access from the main arterial highway.

Over the past few years, I had also noticed a large building coming up near the Arignar Anna Cancer Hospital in Kanchipuram. For some time, I wondered who was constructing it. Later, when the entrance arch was completed, it revealed the name: Arignar Anna Cancer Research Centre.

I was also reminded that the Thoothukudi Medical College is being upgraded with a large new building inside its campus. This made me realise that similar health infrastructure projects may have been constructed in many other parts of the state that I have not personally seen.

If readers are aware of other major health facilities being built in different parts of Tamil Nadu, it would be valuable to share that information in the comments section.

Alongside the expansion of infrastructure, the quality of services also appears to be improving. For instance, I recently learned that costly medications for emergency stroke treatment are now available even in some peripheral government hospitals. With improved infrastructure, it is likely that the quality and reach of services will continue to grow.

The steady expansion of Tamil Nadu’s health infrastructure suggests a deeper commitment to public health. When such investments are matched by improvements in services and accessibility, they can significantly strengthen the health security of the population.

If readers are aware of other major public health facilities that have recently been built or upgraded in Tamil Nadu, it would be valuable to share that information in the comments. Such collective observations can help build a broader picture of how health systems are evolving across the state.

#TamilNaduHealth #PublicHealthInfrastructure #HealthSystems #GovernmentHealthcare

Field-Based Lessons from RUHSA, Tamil Nadu

Launching the Poverty Reduction Knowledge Portal

For much of my professional life, I did not set out to “write about development economics.” What I did instead was work — in villages, with families, with institutions — trying to provide affordable health care, trying to understand what actually reduced poverty and what quietly failed. This portal grows out of that lived experience.

The roots of this work go back to the mid-1970s. In 1975, Christian Medical College (CMC), Vellore, faced a major employee strike that lasted nearly three months. When the strike was later reviewed, one insight stood out sharply: the surrounding local population was largely indifferent to it. CMC served patients who came from faraway places, but for the people living around Vellore, there was little sense of ownership or connection. That realisation led to a deliberate decision — CMC would commit itself not only to curative care, but to the health and development of an entire block.
K.V. Kuppam was chosen, and RUHSA was born.

From that point onward, the work unfolded slowly and unevenly — through drinking water programmes, women’s groups, livelihoods, agriculture, health systems, education support, and environmental action. None of this followed a textbook. Much of what later economists would describe in theory was first encountered in practice: how catastrophic health costs push families back into poverty, how women’s collective action reshapes communities, how institutions matter more than credit alone, and how poverty reduction depends as much on reducing avoidable expenditure as on raising income.

Only much later, as I began reading and engaging more deeply with development economics, did I realise how far mainstream economics had drifted from these realities. Growth, markets, and efficiency had become central; poverty reduction had become secondary. This portal is therefore not a theoretical treatise. It is an attempt to bring field-based knowledge back into conversation with economics, grounded in real experience rather than abstract models.

The Poverty Reduction Knowledge Portal brings together these lessons in five parts:

  • why poverty reduction disappeared from mainstream economics,
  • what worked (and failed) in field practice,
  • how institutions shape economic outcomes,
  • what can be learned from states, nations, and global systems,
  • and the principles that consistently guided lasting poverty reduction.

This release marks the first public sharing of this work. It is not presented as a final or closed statement. The intention is dialogue.

I invite feedback from practitioners, researchers, economists, students, policymakers, and development workers — especially those who have worked closely with poor communities. Questions, disagreements, corrections, and additional insights are welcome. They will help refine what follows.

If you find this work useful, I encourage you to share it widely — with colleagues, classrooms, organisations, and networks. Poverty reduction advances not through isolated insights, but through collective reflection and shared learning.

This portal is meant to grow — shaped not only by my experience, but by the conversations it provokes.

Happy New Year 2026

Each New Year invites reflection — not only on what lies ahead, but on what truly matters. As some of you are aware, I am working with ChatGPT to eventually bring my poverty reduction into the knowledge pool of AI.

Over the past months, work on the Poverty Reduction Knowledge Portal has continued more quietly than planned. Life, health, and responsibilities intervened, as they often do. Yet the direction has become clearer: to re-centre poverty reduction as the heart of development and economics, grounded in field experience rather than abstraction.

This Portal is not being built in a hurry. It is being shaped carefully — beginning with the question of why poverty reduction disappeared from mainstream economics, and closing with principles drawn from decades of practice. The practical chapters are largely in place; the opening and closing are now being polished so the whole can speak with clarity and purpose. The portal should be released shortly.

In the coming year, I hope this space will grow steadily — not through frequent posts, but through thoughtful ones. Poverty reduction deserves patience, honesty, and dialogue, not slogans.

As we step into the New Year, my hope is that we can continue learning together — practitioners, students, policymakers, and communities — and keep the poor at the centre of our thinking and action.

Wishing you a thoughtful and hopeful New Year 2026.

Rajaratnam Abel

#NewYear #PovertyReduction #Development #LearningTogether

Blessed Christmas

Christmas comes to us each year as a reminder that hope often arrives quietly, not with power or spectacle. The story of Christmas is not one of abundance, but of humility — a child born into poverty, welcomed by ordinary people, and entrusted to those who had little by the world’s standards.

In my years of working with poor communities, I have learned that real change often begins in similar ways. Not through grand theories or dramatic promises, but through small, patient acts — clean water reaching a village, women gathering to save together, families protected from illness, children staying in school.

As we reflect this Christmas, I am reminded that poverty reduction is not only an economic challenge. It is a moral and human one. It asks whether we are willing to see, to listen, and to walk alongside those whose voices are rarely heard.

The Poverty Reduction Knowledge Portal is slowly taking shape as a space to share such field-based lessons — not as finished answers, but as lived experience offered in humility. This Christmas, my prayer is simple: that our work, in whatever form it takes, contributes in some small way to dignity, justice, and hope for the poor.

Wishing you and your families a blessed Christmas.

#Christmas #PovertyReduction #Hope #HumanDignity

Holidaying in Europe

God gave us a unique opportunity to spend three weeks in October with our daughter’s family in Europe. The primary reason for our visit was to attend our grandson’s graduation in his Master’s in Business Entrepreneurship. Watching him walk up the stage at Erasmus University in Rotterdam and receive his degree was a solemn moment for the graduates and a joyful moment for us as grandparents.

During our stay, our daughter contacted my first boss, Dr. C. P. Jaggi, from the hospital in Nepal where I had worked for a year. Now retired in Switzerland, he insisted that we spend five days with him. He planned a full and memorable itinerary.

He took us to the Rheine Falls, almost as spectacular as Niagara. We walked across the border to a corner of Germany. Later, we visited one of the smallest countries in the world—Liechtenstein. At my request, we visited a cowshed, where I observed how they managed dung with biogas production possibilities in mind. Dr. Jaggi took us to two significant sites in Christian history, and later to both a cheese factory and a chocolate factory, where he gifted us generous boxes of chocolates. Five days were not enough to take in the beauty and hospitality of Switzerland.

Our time in the Netherlands was equally enjoyable. Amsterdam, a city of canals, offered us a lovely canal cruise. Cycling seemed to be the primary way people travelled—for work, shopping, and leisure. Every Metro station had ample parking space for bicycles. Many riders would cycle to the station, take their bicycles on the train, and continue riding at the other end. This model, I knew, was not directly practical for India, but some ideas were worth noting—especially the widespread adoption of rooftop solar electricity.

We also visited two museums connected with the Holocaust. Anne Frank’s house narrates the story of a family hiding from the Nazis. Corrie Ten Boom’s house told a different story—how a family risked their lives to help many Jews escape. Both were deeply moving.

A day trip to Cologne (Köln) in Germany brought us to the magnificent cathedral built in the 1600s, which survived the Second World War. We crossed the Rheine River in a cable car, a memorable experience.

We encountered the Rheine River at many points—first at the Rheine Falls, then in a quiet riverside village, again viewed from the hilltop of Dr. Jaggi’s home, later at Cologne, and finally as it flowed toward the sea at Rotterdam. Each encounter gave us a different perspective of this great European river.

I had always wanted to see the dykes of Holland. When I finally did, they were quite different from what I had imagined. What we saw was a long earthen embankment stretching for many miles. A Dutch passerby corrected a childhood story I shared—that a boy once saved a city by plugging a leaking dyke with his finger. He clarified that while the coastline is below sea level, the dykes were gradually built by manually dumping earth to keep the seawater out. Over time, the protected land became fertile farmland.

Our daughter and son-in-law had organised a trip that was both enriching and unforgettable in many ways.

Intro Blog 1: Why This Blog Series.

A Lifetime in Poverty Reduction

For more than half a century, my life and work have been intertwined with one central question: how do we actually reduce poverty?

I have seen poverty not as an abstract number in an economist’s table but as a daily struggle for millions of families—for food, for dignity, for opportunity. I have also witnessed, up close, the resilience of the poor and the ways in which communities, organizations, and governments have found pathways out of poverty.

Why Share Now?

What strikes me, however, is how often these real experiences remain hidden from the larger conversation. Economists and policymakers debate theories, models, and ideologies—sometimes detached from what truly works on the ground. Too often, their assumptions about markets, incentives, or “trickle down” benefits have left the poor behind.

This blog series is my attempt to bring the two together—lived experience and economic thought. I want to share what I have learned, what I have seen succeed, and where I believe economists went wrong. Not as an abstract critique, but as a way of showing how real-life experiences challenge false assumptions—and point us toward what actually works.

An Invitation

I hope to write weekly, sharing my lifetime experience of poverty reduction through the health and development programmes of RUHSA, promoted by Christian Medical College, Vellore, India. I also link this experience to the poverty reduction witnessed in the state of Tamil Nadu, India.

Along the way, I will reflect on the flawed assumptions of mainstream economics and highlight organizations and people who are quietly making a difference.

I invite you to walk with me in this exploration. My hope is that these writings will not just inform but spark dialogue—because reducing poverty is not the task of one discipline or one generation. It is humanity’s shared responsibility.

A Pause Before Moving Ahead in Reducing Poverty Portal

Dear friends,

After a short pause, I am glad to return to my blog series on poverty reduction. Sometimes, taking a step back gives clarity on how best to move forward. From now, I will begin sharing each chapter of the Poverty Reduction Knowledge Portal in blog form. These shorter blogs will make the ideas on reducing poverty more accessible, while still linking to the full chapters for those who wish to explore further.

This week’s post is a transition piece — a bridge between what has been shared and what is to come. I hope you’ll take a moment to read it, and I warmly invite your comments and thoughts. Together, we can keep this conversation on poverty reduction alive and growing.

Sometimes, even the best-laid plans in poverty reduction need a pause. Over the past weeks, I had intended to share the next part of this series on reducing poverty. Yet, life and work have their own rhythm, and I found myself taking a short break before resuming.

This pause has given me time to reflect on how best to continue the conversation on poverty reduction. One idea I am excited about is to bring each rewritten chapter of my larger work into a blog format. This way, the insights and lessons on reducing poverty will be available to many more people — not just those who can visit the full portal.

Each blog will offer a short, accessible version of the ideas, while the full chapters will remain available on the portal for those who want to go deeper. Every post will carry a link, so readers who are keen to explore more about reducing poverty can read, comment, and share directly.

In this way, the blog and the portal will complement one another: the blog providing an entry point into the practical and human side of poverty reduction, and the portal offering the wider context.

The journey continues here. The next blog will begin this new approach — focusing first on communication and the Tamil Nadu story — and then moving step by step into broader reflections on reducing poverty and the lessons we can learn from real experiences.

Thank you for your patience and for staying with me on this journey toward poverty reduction. The best is just ahead.

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    Creative Commons: How Readers Can Freely Use and Share This Work with Credit

    When I began writing this series on poverty reduction, I had one conviction in mind: knowledge should not be locked away. The lessons we have learned—through practice, mistakes, and decades of experience—are not just mine to keep. They belong to the communities who built them, the institutions that nurtured them, and the future generations who will carry them forward.

    That is why I have chosen to publish this series under a Creative Commons license.

    What Creative Commons Means

    Creative Commons (often called CC) is a global system that allows authors to share their work openly, while making clear how it can be used. Unlike traditional copyright, which restricts sharing and reuse, Creative Commons invites others to use the work—provided they respect certain conditions.

    For this series, I am using the CC BY license. That simply means:

    • Yes, you can share these posts with anyone—your students, colleagues, communities, or networks.
    • Yes, you can adapt the material—translate it, simplify it for training, or expand it for discussion.
    • Yes, you can build on it—combine it with your own experiences or research.
    • The only request is: please give credit by mentioning the author and source.

    In other words, the door is open. Use this work as freely as you wish, but remember to acknowledge where it came from.

    Why Creative Commons Matters for Poverty Reduction

    Poverty reduction is not the task of one person or one organization. It is a collective mission that requires shared insights, shared mistakes, and shared successes. By keeping this series open under Creative Commons, I hope:

    • Educators can use the material in classrooms without hesitation.
    • Practitioners can take ideas into the field and adapt them for their context.
    • Communities can own the knowledge and pass it forward.

    Practical Ways to Give Credit

    • In presentations → add “Source: Rajaratnam Abel – Poverty Reduction Blog (Creative Commons BY)”
    • In your training manuals → cite at the end “Adapted from Rajaratnam Abel’s blog, under CC BY”
    • Online → link back to the original blog post with my name and a note that it is CC BY
    • This work by Rajaratnam Abel is licensed under a Creative Commons Attribution 4.0 International License.

    An Invitation to You

    As you read these episodes, I invite you not just to absorb the content but to use it, share it, and adapt it. If you think a section can spark a conversation in your village, classroom, or office—please take it. If you translate it into another language, even better. Just let others know where it came from so the chain of learning remains intact.

    This is the spirit of Creative Commons: knowledge that grows by being shared.

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      POVERTY REDUCTION: God’s Call in My Life

      When I first wrote about God’s call in my life, it was a personal reflection — an attempt to put into words what has been, for me, an unshakable inner direction. Over the years, that call has been the compass guiding nearly five decades of work in POVERTY REDUCTION — starting from a Nepali village, then through the dusty villages of rural India to policy discussions in government halls, from grassroots innovations to global conversations.

      Village of Nepal (photo by Udit Pandey)

      “Village of Nepal” by Udit Pandey, via Wikimedia Commons, licensed under CC BY-SA 4.0.

      Looking back, I see not just the outcomes but the wisdom embedded in the process — wisdom that I now recognise as God’s. Often, I had no blueprint in hand, only the lived reality of communities and the conviction that solutions must grow from within them. That is how practical models of POVERTY REDUCTION emerged — models shaped by people’s strengths, tested in their struggles, and refined through decades of patient persistence.

      Today, I find myself at another turning point. With AI tools like this one, there is an unprecedented opportunity to share these lessons far more widely — not as closed, proprietary knowledge, but as an open resource for anyone, anywhere, to adapt and use. This is why I am embracing Creative Commons licensing — so that the stories, strategies, and hard-won insights of POVERTY REDUCTION can travel freely, be enriched by others, and perhaps even spark change in places I may never see.

      This post begins a new series that will weave together my life’s work, the wisdom drawn from it, and the possibilities of sharing and scaling it through AI. In the next post, I will explain what Creative Commons is, why I chose it, and how it can serve those committed to justice and equity.

      Call to Action

      If this message resonates with you, I invite you to help spread it widely:

      • Share this blog on your social media platforms — Facebook, LinkedIn, WhatsApp groups, X (Twitter), or any others you use.
      • Forward it to colleagues and friends working in NGOs, especially those engaged in rural development and POVERTY REDUCTION.
      • Share it with the Economics faculty or students who are exploring development economics.
      • Pass it along to government staff involved in rural development, livelihoods, and community empowerment.
      • If you belong to any faith-based or community networks that care about justice and equity, consider sharing it there as well.

      By doing so, you will be helping to start a conversation that matters — one that challenges old assumptions and opens new possibilities for reducing poverty in real, practical ways.

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      Reducing Poverty: Tamil Nadu, India Leads the Way

      Economists over the years have been grappling with different models of economic development for reducing poverty, focusing on one over the other. Tamil Nadu, one of India’s states, which is larger than several countries in both geographic and population aspects, has been making significant strides in reducing poverty throughout the state.

      In this blog, I would like to highlight the outstanding success achieved in several areas when compared to two other economically well-off Indian states, Maharashtra and Gujarat. I would like to present various indicators of measurement comparing these three states.

      Indicators/StateMaharashtraTamil NaduGujarat
      GDP (Rs)25.3514.968.39
      GDP/Capita1.3 Lakhs1.3 Lakhs1.2 Lakhs
      Multidimensionally poor5.48%1.43%9.03%
      Social Progress Index57.8865.3456.65
      Tax revenues (Rs)4518 Billion3149 Billion1796 Billion  
      HDI Rank4310
      Road Density (km/km2)13.5737.1516.66
      Crime rate8.8%6%49%
      Urbanisation45.2%48.5%42.5%
      Sex Ratio946995918
      Tourist arrivals121 Million348 Million42 Million
      No. of factories28K36 K22 K
      Electrification92%98%99%
      Population126 Million84 Million70 Million
      Geographic area307,713130,058196,024
      Unemployment rate3.6%3.9%3.0%
      IMR per 100 live births161623
      Literacy rate84.8%82.9%82.4%
      Gross Enrolment Ratio35.3%47%24%
      Average Family Size4.74.74.7
      https://www.quora.com/Which-is-the-most-developed-state-in-India-and-why?no_redirect=1
      https://en.wikipedia.org/wiki/List_of_Indian_states_and_union_territories_by_poverty_rate

      In this blog, I am presenting only the key indicators for comparison. A table like this is likely to be cited more often to claim that Tamil Nadu is leading in poverty reduction. There are arguments for and against the poverty situation in Tamil Nadu.

      I would like readers to share their comments on how they consider this important change taking place in India.

      Certainly, I will address this theme in greater detail, as it is part of my understanding of reducing poverty in India.

      I was delighted with the quick response I received from several readers of my last blog. I will be sharing much more on our experiences in reducing poverty in India.

      As you will get used to seeing the links to my book on reducing poverty, they are given below.

      The global paperback version –

      https://www.amazon.com/dp/1791540597

      The global paperback version –

      https://www.amazon.com/dp/1791540597

      The paperback Indian version

      https://notionpress.com/read/businessmen-for-the-poor-1330766

      Rajaratnam Abel

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