"If People Know, They Will Think Something Is Wrong with Me": An Ethnography of Sickle Cell Hemoglobinopathy, Stigma, and Health Disparities in Tribal Odisha, India.

Sickle cell hemoglobinopathy is not merely a genetic disorder but a deeply embedded socio-cultural phenomenon in the remote regions of Odisha. Drawing on long-term ethnographic fieldwork in Koraput and surrounding districts, this study explores the lived experiences of individuals with sickle cell trait (SCT) and sickle cell disease (SCD), focusing on social discrimination, medical uncertainty, and healthcare accessibility. The findings reveal reluctance toward screening, particularly among unmarried women, due to fears of marital exclusion and family stigma. Misconceptions about SCT, including beliefs that it can appear or disappear over time, further reinforce social anxiety and misinformation. Inconsistencies in diagnosis, limited genetic counselling, geographic isolation, and economic insecurity exacerbate these challenges. The study also examines women's caregiving roles, therapeutic pluralism involving traditional healers, and youth perspectives on reproductive futures. By foregrounding the social consequences of carrier status alongside disease, the article challenges assumptions that SCT is negligible. These findings highlight the need for culturally sensitive genetic education, decentralized health services, and community-based interventions, contributing to a holistic understanding of sickle cell hemoglobinopathy within medical anthropology.