Indigenous Peoples’ access to Health Services
A report undertaken for the Ministry of Public Health indicated that the IlChamus people, for example, spend an average of 600 Kenyan shillings ($7) on transport expenses to take pregnant women in labour for delivery at Marigat district hospital, while the Waata community in Madogo of Tana River spends an average of 2,000 Kenyan shillings ($24) on transport hire to take their sick to the provincial hospital in Garissa. It has been reported that most deliveries are conducted at home because of these challenges.27 This report included only marginalized peoples and omitted other groups like the Maasai of southern Kenya. Other factors identified as barriers to health services included: ɜɜ Health facilities, where available, are sometimes not operational due to staff shortages; ɜɜ Lack of essential drugs and supplies; ɜɜ B eliefs in the effectiveness of traditional herbs which are free in the villages, while health services require payment; ɜɜ Lack of awareness of the services available, especially because of low education levels; ɜɜ D eliveries occur at home mainly because of the long distances to facilities including the need to adhere to traditional practices performed at birth. For example, some communities do not like male health workers assisting women to deliver babies. ɜɜ Lack of their own indigenous health staff; ɜɜ Language barrier between health workers and indigenous peoples; ɜɜ R esistance to family planning services by women because of perceived negative side effects and lack of support from the men. They feel the need to have many children because of their populations are small. This is explained by an Ogiek community member: “ Why are we being asked to practice family planning so that other people from outside the community can come and occupy our land? We do not want to be continuously referred to as minorities”.
At the Katilu health centre in Turkana south, a community member said: “Men in our community do not allow women to deliver in the clinic because they want to perform traditional rituals and apply herbs. The umbilical cord of the male baby is cut using a common spear in the community, while that of the female baby is cut using a common knife in the community. They only allow women to go to the hospital two weeks prior to the time of delivery”.
Tanzania The indigenous peoples of the United Republic of Tanzania include the Maasai, the Barbaig (Datoga), Akie, Taturu and Hadzabe. The former two groups are predominantly pastoralists, whereas the latter comprise forest-dwelling hunter-gatherers. The groups collectively practice pastoralism and hunting-gathering. The Maasai are the most populous, numbering about 450,000. The 27
Nyambedha, E.O., Final Report for Development of Vulnerable and Marginalized Peoples Plans (VMPPS): Ministry of Public Health and Sanitation, Kenya, 2013.
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