Kerela's Healthcare state..what does it reflect?

One has to ask oneself.

We live in a country where we told the world we could deal with our own tsunami problems.

Then, how is it that Kerala needs the help of WHO?

One has to really ask such questions. Given Kerala's communism based political atmosphere work and progress are often very much disconnected from reality. This is the most probable natural explanation for the lack of progress in the state.