Lifelines in the Highlands: Building Rural Resilience through Army Medical Outreach

Nestled close to the India-China border, remote villages such as Shyok, Durbuk, Phobrang and Chushul in eastern Ladakh, stand as a stark reminder of what it means to live at the margins—both geographically and administratively. At altitudes above 4,400 metres above sea level, with limited road access, extreme weather and fragile infrastructure, survival here is shaped by the rugged terrain and long periods of isolation. In such extreme weather conditions, livestock are not just sources of income and nutrition—they are central to cultural identity, mobility and resilience.

For pastoralist communities in Changthang, animals – such as yak, dzo, sheep and goats – continue to function as livelihood anchors, supporting transport, fuel, wool production and dairy-based subsistence in environments where agriculture is minimal and markets are distant. Here, traditional knowledge and home remedies form the primary line of animal healthcare, complemented by formal veterinary support from government departments such as Animal Husbandry and Sheep Husbandry providing an essential complementary layer. Yet, service delivery is constrained not only by distance and terrain, but also by the limited infrastructure permitted in sensitive border zones. Against this backdrop, additional interventions – such as periodic medical and veterinary camps organised under Operation Sadbhavana by the Army – play a valuable role in extending healthcare access for both people and livestock in difficult-to-reach villages.

A medical and veterinary camp organised in Phobrang earlier this year in July, illustrates this role well. The camp provided check-ups and medicines not only for over 100 residents but also extended basic care to their livestock. In doing so, it acknowledged the significance of pastoral practices as a delicate yet deeply intertwined socio-ecological system – an aspect rarely addressed in conventional health planning and beyond the Army’s conventional remit of defence.

Operation Sadbhavana, primarily known as a civic action programme aimed at fostering goodwill in border areas, reflects through this intervention a more holistic understanding of rural needs. It is not the first such effort by the Army in Ladakh. In the past years, similar camps have been held in several parts of the region (mainly in far-flung border areas of Changthang, Nubra, Drass and Turtuk) and also in other remote and strategically-located Himalayan regions in Sikkim and Arunachal Pradesh, with varying degrees of coordination with local administration and civil society groups. The presence of Army Medical Corps teams and logistics support in hard-to-reach areas enables them to deliver services where local formal systems often struggle due to seasonal or geographic barriers.

This broader orientation is also visible in budget allocations. In the Financial Year 2022-23, Operation Sadbhavana earmarked a Rs.8.82 crore budget for the Union Territory of Ladakh supporting 23 projects. These focused on health and sanitation, including medical and veterinary camps, upgrading medical infrastructure and staffing medical aid centres, alongside community development initiatives such as water supply schemes, solar lighting, bore wells, village roads and toilets. Other interventions included skill development, sports promotion and environmental activities.

Beyond such project-based interventions, larger policy frameworks have also emerged. The Vibrant Villages Programme (VVP), launched in 2023 with an allocation of Rs.4,800 crore for 2022-23 to 2025-26, aims to strengthen infrastructure, services and livelihoods in border districts across the Himalayan belt. Now entering its second phase (VVP-II), it brings greater resources and wider coverage. Building on this, Army units have also contributed to VVP delivery. In Sikkim, for instance,  they have organised youth and health activities, expanding the programme’s outreach in areas otherwise hard to reach. In Ladakh too, such initiatives could contribute to the overall development of border villages in a holistic and strategic manner.

This relationship, however, is not only in one direction. In several instances—such as in Chushul and the broader Changthang region—local communities have extended logistical and moral support to the Army. During the standoff between Indian and Chinese armies in 2020, villagers from Chushul voluntarily carried food, fuel cans and warm clothing to forward posts like Black Top, located at altitudes above 4,500 metres above sea level, under harsh winter conditions. Such acts underscore the informal yet vital role that border communities play in supporting national defence in difficult terrain.

As Ladakh faces climatic shifts and resource pressures, the meaning of resilience in border villages takes on new urgency. Here, community resilience depends not only on infrastructure but equally on safeguarding livelihoods against everyday risks such as water scarcity, pasture degradation and livestock losses. In this regard, such initiatives by the Army provide continuity and reach, complementing state services and helping communities cope with both environmental uncertainty and geopolitical fragility.