State of the World’s Indigenous Peoples
The pastoralists of North and West Africa The nomadic pastoralists of the Sahel are geographically and socially marginalized, inhabiting large regions unsuitable for agriculture and infrastructural development. Human survival in communities in these environments would be virtually impossible without livestock that provides for basic needs. To pastoralists the well-being of their livestock is important as it is the source of their livelihoods and a basis for recognition and respect.36 The close contact between human and animals and consumption of raw milk contributes to zoonoses like anthrax, Q fever, brucellosis and echinococcosis.37 A paper by A. Sheik-Mohamed and J.P. Velema summarized evidence on the health status of nomadic populations and provided an assessment on the best ways for the provision of health care.38 The authors noted that nomadic peoples had poor access to health services, were prone to infectious diseases (STIs, guinea worm, leishmaniasis, trachoma, tuberculosis, brucellosis) and had higher rates of maternal and childhood mortality. On the other hand, viral infections and intestinal parasites were not so common. In the case of helminths, the migratory lifestyle of the pastoralists minimizes such infections as they move from accumulated dirt and rubbish. For viral infections, serological surveys on measles undertaken on the Tuareg peoples in Niger showed that 64.5 per cent of children five years of age were seronegative.39 This situation not only makes them susceptible, but it is also an indication that they have not been vaccinated. Other possible strategies for nomadic pastoralists include moving from areas where there are health epidemics and avoiding areas which are infested by vectors like mosquitoes and ticks. Their mobility can also bring disease to an area or cause them to acquire diseases to which they have no immunity. Obstacles to health service delivery included: 1. Conventional health systems do not reach nomadic pastoralists; 2. Health services are usually in the hands of settled populations who do not relate well to nomadic pastoralists; 3. Settled populations tend to look down on nomadic pastoralists as uneducated and primitive; 4. There are prohibitive costs for providing health care. The provision of health care includes: ɜɜ M obile primary health care services that are capable of moving with the nomadic pastoralists; ɜɜ D ue to the fact that community participation is important in primary health care programs, it was found that involving nomadic pastoralists was difficult because of their
36
Schelling E., Wyss K., Diguimbaye C. et al. (2008) “Towards integrated and adapted health services for nomadic pastoralists and their animals: a north-south partnership” in Handbook of Transdisciplinary Research. A Proposition by the Swiss Academies of Arts and Sciences (eds G Hirsch Hadorn, H Hoffmann-Reim, S Biber-Klemm, W Grossenbacher, D Joye, C Pohl Springer, Heidelberg, pp. 277-291.
37
Schelling E., Diguimbaye C., Daoud S. et al. (2003), “Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad”. Preventive Veterinary Medicine 61, pp. 279-293.
38
A. Sheik-Mohamed and J.P. Velema, “Health Care for Nomads in Sub-Saharan Africa”, Tropical Medicine and International Health; Vol 4 No 10, pp. 695-707, October 1999.
39
Measles in a West African Nomadic Community, Loutan, L. and Paillard, S., Bulletin of the World Health Organization , Vol. 70, No. 6 1992.
020 ξ Chapter 1