State of the World’s Indigenous Peoples
Moreover, because the cultures and world views of indigenous peoples are not taken into account in the formulation of the MDGs, the goals do not consider indigenous peoples’ concept of health, which extends beyond the physical and mental well-being of an individual to the spiritual balance and well-being of the community as a whole. To improve the health situation of indigenous peoples, there must thus be a fundamental shift in the concept of health so that it incorporates the cultures and world views of indigenous peoples as central to the design and management of state health systems.12 Reports from countries reviewing progress on MDGs have shown that data on indigenous peoples are missing in national monitoring and reporting. The reviews also reveal that there is no clear mechanism identified to include indigenous peoples in the design, implementation and monitoring of policies designed to achieve the MDGs.13
An analysis of the health situation of indigenous peoples in the African region Maybury-Lewis14 estimates that there are over 14.2 million self-identifying indigenous peoples in the African region. The African Charter on Human and Peoples’ Rights (ACHPR)15 report lists some of the best known indigenous peoples whom they divide into two groups, hunter-gatherers and pastoralists. The report gives 11 examples of hunter-gatherers in 13 countries and 23 examples of pastoralists in 22 countries. These indigenous peoples often occupy hard-to-reach areas with poor infrastructure and harsh terrain. To further compound the problem is the lack of recognition of indigenous peoples by African states. This means that disaggregated data on indigenous peoples’ health status are hard to find. In fact, because indigenous peoples are essentially invisible in the data collection of many international agencies and in most national censuses, the disparities in their health situation as compared to other groups continues to be obscured.16 For example, in Kenya, demographic and health surveys have been undertaken every five years since 1989, excluding the hard-to-reach areas of North-Eastern Kenya because of the terrain. It is only the last two surveys of 2003 and 2008-2009 that these areas were included. The reason given for this omission is that those districts account for less than 4 per cent of Kenya’s population.17 These areas are occupied by nomadic pastoralists and hunter gatherers, all of whom have poor health indicators which, as a vulnerable minority, should justify their inclusion instead of exclusion.
Indigenous peoples of Central Africa The indigenous people in central Africa have often been collectively identified as “Pygmy”. Due to the fact the term “Pygmy” carries negative connotations due to its association with the assumption of inferior status, there is now a policy in some central African countries to officially designate such groups as indigenous peoples or populations autochtones. 12
State of the World’s Indigenous Peoples, United Nations publication (2009)
13
Ibid.
14
Maybury-Lewis D. 2002. Indigenous peoples, ethnic groups and the state. Needham, Massachusetts: Allyn & Baker.
15
Report of the African Commission’s Working Group of Experts on Indigenous Populations/Communities by the African Commission on Human and Peoples’ Rights and the International Working Group on Indigenous Affairs (2005).
16
State of the World’s Indigenous Peoples, United Nations publication (2009).
17
Kenya Demographic and Health Service 1989, 1993, 1998: National Council for Population and Development, Central Bureau of Statistics.
014 ξ Chapter 1