Indigenous Peoples’ access to Health Services
Indigenous peoples in Central Africa number between 300,000 to 500,000 peoples. They consist of at least 15 distinct ethnolinguistic groups including the Gyeli, Kola, Baka, Aka, Bongo, Efe, Mbuti, western Twa, and eastern Twa. They live in ten central African countries: Angola, Burundi, Cameroon, Central African Republic, Democratic Republic of Congo, Equatorial Guinea, Gabon, Republic of Congo, Uganda and Rwanda.18
In general, access to health services is a challenge due to regional overpopulation, poor infrastructure and indequate personnel. For indigenous peoples, this is even worse as they live in remote areas. In his report following a vist to the Republic of Congo, Professor James Anaya, the Special Rapporteur on the Rights of Indigenous Peoples noted there is inadequate cultural adaptation to the delivery of health services, which appears to create a barrier to the enjoyment of the right to health by indigenous peoples that goes beyond proximity to the health facility. He noted that while the government had taken important steps to improve indigenous health, more needs to be done so that there is equal access to health services especially in remote areas.19 Indigenous peoples also reported the challenges they face in accessing health services even where they are free, such as maternal and child health. Lack of money to pay for prescription drugs and obstetric services are significant blocks, creating difficulties and barriers. Most villages do not have health facilities, so they are forced to rely on those located in majority Bantu villages which often discriminate against indigenous peoples.20
Mr. Jean Dominique Dambo, the leader of the indigenous people in Dzaka, a village near Ouesso, the main town in the Sangha region in northern Congo said, “It is difficult; we don’t have a health centre, no school, even though we are near the capital”. He further stated, “Over there, not far from our village, the people are getting free treated mosquito nets and other goods while we are not informed about it; I am sure they forgot about us”. He also confirmed that recent health campaigns by the government targeting mothers and children in Ouesso excluding indigenous peoples in the area.21 Indigenous peoples rely heavily on traditional medicines. This however poses another challenge. The growing inaccessibility to forests and lack of support by the government is seriously eroding their knowledge and skills in the area of traditional medicine.22 A study carried out by the Ministry of Health and the United Nations Populations Fund (UNFPA) in 2012 indicated that indigenous women are virtually excluded from reproductive health services. According to the study, while 94 per cent of the Congolese women access antenatal care, only 37 per cent of the indigenous women have access to such services.23 As a result of this study, the
18
Jackson, D. Implementation on International Commitments on Traditional Forest Related Knowledge: Indigenous peoples’ experiences in Central Africa.
19
A/HRC/18/35/Add.5.
20
A/HRC/18/35/Add.5.
21
http://www.irinnews.org/report/79995/congo-we-remain-marginalised-indigenous-people-say, 2013
22
Report of the Country Visit of the Working Group on Indigenous Populations/Communities to the Republic of Congo, 15-24 March 2010.
23
http://www.irinnews.org/report/97574/in-congo-few-pygmy-women-have-access-to-reproductive-health-services.
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