In Lahiri village of Gadchiroli district in Maharashtra, 65-year-old pujari Pengda Kuma Bongani has been practising ‘jhar phook’ for decades — a faith-healing ritual of chants, rice grains and belief. Grains are scattered, counted or pressed on the body to read illness, or spirits, and ward them off. But since the beginning of this year, when someone arrives with a fever, he has also been sending them to a government health worker.
“For generations, this has been our only profession. For us, it is not about money, but about doing good for people and the society we live in. After attending several counselling sessions, I realised that things have changed with time and the sisters (Accredited Social Health Activists and Auxiliary Nurse Midwives) do make sense. If our joint effort can save lives, I don’t mind this collaboration,” he says.
“From this year onwards, I have been referring all kinds of fever cases to the sisters at the Lahiri PHC (primary health centre). Once the patient returns from the hospital, I perform the ritual for a double impact,” he adds.
Traditional healers attend a workshop at SEARCH to understand their role in addressing malaria and other health concerns in the district.
For a man whose authority stems from faith, the shift is significant. “Pengda is among the few pujaris willing to listen,” says Kamal Ramdas Sidam, 44, an Auxiliary Nurse Midwife who has worked in the region for over a decade.
This change is now at the centre of Maharashtra’s malaria strategy in Gadchiroli — among India’s 10 worst-performing malaria-endemic districts — where faith healers have long been the first point of care. Over the past year, the government has identified 1,759 pujaris and begun training them to recognise symptoms and refer suspected malaria cases, effectively turning a cultural gatekeeper into a link in the public health system.
“So far, we have identified and listed 1,759 pujaris in our registry. We have counselled 1,200 of them so far, who participated in our ongoing workshops since April 1, 2025. The number of pujaris is over 2,000 in the district,” says Dr Sujita Wadiwe, Gadchiroli District Malaria Officer.
The healers are being encouraged to refer any fever case to ASHAs and ANMs. “Since January 2026, they have referred 27 patients, of which four were positive. When a pujari refers a patient, they get Rs 15, and if that patient turns out to be malaria positive, they get an incentive of Rs 500,” says Dr Wadiwe.
The move reflects a deeper challenge. Despite accounting for barely 1% of Maharashtra’s population, Gadchiroli continues to carry a disproportionate malaria burden, a pattern seen across several tribal and forested regions in India, where delays in seeking medical care, often rooted in belief systems, can prove fatal.
In 2025, the Maharashtra government launched an intensified malaria elimination initiative in the district, including a dedicated task force, expanded surveillance, and community-based strategies such as involving traditional healers to improve early detection. The push followed the Centre’s finding in 2022 that identified Gadchiroli among the 10 worst-performing malaria-endemic districts in India, with an Annual Parasite Incidence (API) above 1.
The geography compounds the risk. With over 70% of the district under dense forest cover, average annual rainfall of 1,700 mm, and large sections of the population sleeping outdoors without mosquito nets, transmission remains high. “The number of malaria cases usually increases during two seasons: July to August and December to January,” says Gadchiroli District Health Officer Dr Pratap Shinde.
Gadchiroli recorded 6,436 malaria cases in 2013, rising to 34,206 cases in 2015. While cases declined in the following years, the trend reversed again, with 12,326 cases reported in 2021. The district continues to report a steady burden, with 7,293 cases and 14 deaths in 2025.
Health officials say the intervention targets a long-standing gap, which is the time lost between the onset of fever and medical diagnosis. In many villages, families first consult pujaris, often attributing illness to evil spirits or black magic.
To identify infections early, targeted campaigns are conducted in villages with higher API levels and in areas reporting malaria deaths. Bringing pujaris into this system is now central to that effort.
In the coming months, they are also expected to be trained to use rapid diagnostic kits. “We will also include them to report and treat other health concerns such as child birth, routine checkups, sickle cell, anemia etc,” says Dr Shinde.
Winning the trust of healers has taken years. “In the early years, when we approached patients directly and urged them to get tested for malaria, they would shut their doors on us, chase us away. There was deep mistrust of any form of medical care. Fever was rarely seen as something that needed treatment, many believed it was the result of black magic, something only a pujari could cure. So, we changed our approach. From 2025, we began rigorous counselling of the pujaris first, bringing them on our side. Because once they are convinced, the villagers follow without question,” says Sidam.
For over three decades, the Society for Education, Action and Research in Community Health (SEARCH), a non-profit based in the district, has worked to bridge this gap between belief and medicine. It is now also working with the district health officials in the new effort.
“Our studies showed that most tribal people first go to a healer when they develop a fever. That delay, even for a few days, can be fatal,” says Dr Abhay Bang, founder and director of SEARCH.
Explaining their central role, he says, “Pujaris are needed in childbirth, death, wedding, housewarming or any auspicious event… In tribal society, these pujaris are considered as someone who can provide a protective armour to the community.”
Instead of replacing this system, SEARCH chose to work within it. “This is not about choosing between faith and medicine; it is about survival. We told them that if both treatments happen together, patients won’t die,” says Dr Bang.
Noting that most fevers subside within three or four days, reinforcing belief in traditional healing, he adds: “But malaria does not follow that pattern. It does not improve and sometimes the patient dies”. This, he says, has made some healers more receptive. “They also do not want their patients to die,” he says.
Dr Bang says earlier attempts at collaboration failed, but attitudes are now changing. “Twenty years ago, they did not accept this idea of medicine. There was hesitation and a gap in trust. Some of them found it intimidating, as in the structure of a tall hospital building, so we built a familiar infrastructure that does not intimidate them, we placed a deity they believed in and over time, with continuous engagement and culturally sensitive approaches, that trust has been built,” he says. “The very fact that they are willing to cooperate now is a positive step.”
Gadchiroli district health department visits homes to counsel traditional healers to become part of the healthcare system to tackle malaria cases in the district. 
Traditional healers attend a workshop at SEARCH to understand their role in addressing malaria and other health concerns in the district.
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