Indigenous Peoples’ access to Health Services
mistrust of government. Therefore, the provision of essential drugs and supplies was considered more helpful; ɜɜ H aving nomadic pastoralist community health workers who can be trained to provide a mix of essential services, obtain regular medical supplies and refer complicated cases is likely to be more affordable and sustainable in the long run.
HIV/AIDS and indigenous peoples in the African region As of December 2012, there were 22 million people living with HIV in sub-Saharan Africa.40 As most indigenous peoples live in remote regions, they may be protected by their isolation from HIV/AIDS and have lower prevalence rates than their neighbours. For example, in Botswana in 2002 it was found that while the adult prevalence for HIV was 35.3 per cent, it was 21.4 per cent for the San in Ganzi. However, with settled lifestyles more and more San are exposed to HIV. An increase of HIV/AIDS was also noted among the indigenous peoples of Cameroon and this was attributed to the influx of labourers working in the commercial logging industry. In Kenya, the HIV prevalence in North-Eastern Kenya was less than 0.5 per cent in 2007 compared to the national figure of 7.2 per cent,41 and rose to 1 per cent in 2008-2009 while the national prevalence decreased to 6.3 per cent.42 The current national prevalence is at 5.6 per cent. This area of North-Eastern Kenya was omitted during the study due to the outbreak of conflict in the region. In Tanzania, there is awareness that indigenous peoples like the Maasai pastoralists are at increased risk of HIV by nature of their lifestyle.43 At the same time, data are difficult to find. The community also has low literacy and there are the usual challenges of language barriers. Some cultural practices like FGM, early marriages, polygamy and multiple sexual partners also make women in this community more vulnerable to the infection. The provision of HIV testing, treatment and care services is made difficult by the harsh terrain, long distances to facilities and low literacy levels. Most of these areas are served by faith-based organizations. The above information highlights the plight of indigenous peoples in the African region. The situation globally may not be very different; however, there has been some attention at this level to look more closely at HIV/AIDS and indigenous peoples. For example, United Nations Permanent Forum theme for the 2009 International Day of the World’s Indigenous Peoples on 9 August 2009 was “Indigenous Peoples and HIV/AIDS”. In his message, the Secretary-General of the United Nations emphasized that it was essential that “indigenous peoples have access to the information and infrastructure necessary for detection, treatment and protection”. He noted that indigenous peoples “tend to suffer from the low standards of health”, which is perpetuating the gap in many countries between the recognition of their rights and the actual situation on the ground. He called on governments and civil society “to act with urgency and determination to close this implementation gap, in full partnership with indigenous peoples”.44 40
http://www.afro.who.int/en/rdo/speeches/3732-message-of-the-who-regional-director-for-africa-dr-luis-g-samboon-the-occasion-of-world-aids-day-2012.html.
41
National AIDS and STI Control Programme, Ministry of Health, Kenya. July 2008. Kenya AIDS Indicator Survey, 2007. Nairobi, Kenya.
42
Kenya National Bureau of Statistics (KNBS) and ICF Macro. 2010. Kenya Demographic and Health Survey, 2008-2009. Calverton, Maryland: KNBS and ICF Macro.
43
Hilde Basstanie and Rafael Ole Moono Ngorongoro District HIV/AIDS Programme Formulation Report, 2004.
44
http://www.unaids.org/en/Resources/PressCentre/Featurestories/2009/August/20090811IntDayWorldsIndigenous/.
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