State of the World’s Indigenous Peoples
introduced by the number of people moving into, and establishing themselves in settled areas. Further, the intrusion of people into previously unsettled areas may also expose them to new disease hazards.55 Barkey found that settled Turkana men reported severe complaints and higher rates of infectious diseases than the nomads, including a significantly higher frequency of cold with cough, eye infection, and chest infection than the nomads. They also had higher body mass index.56 Children of pastoralists also experience malnutrition when they live in settlements as their diets change from dairy products to starches and sugars. Comparing settled and nomadic Rendille children in Kenya and Nathan found that sedentary children under six years had significantly higher levels of malnutrition and anaemia than nomadic children.57 This was attributed to the consumption of three times more milk by the nomadic children. Indigenous peoples need to be made aware of the consequences of change in lifestyle and what they need to do to mitigate the negative effects.
Best practices in delivering health services This section provides examples of best practices and innovations that have been used to reach indigenous peoples in remote regions.
Outreach services Mobile outreach clinics or strategically placed health posts have been used to reach remote areas. The challenge has been for these entities to provide services on a regular basis and the fact that they may not be able to deal with emergencies. They are also expensive and difficult to sustain. In many instances, staff do not speak indigenous languages, therefore creating another barrier.
Providing a culturally sensitive health service Indigenous peoples in the African region, apart from having poor access to quality health services, also find the available services are not friendly. At most times the health workers look down upon them as “backward and primitive” peoples. Indigenous peoples also have the problem of language barriers and therefore use health facilities only when their conditions are advanced. As previously stated, cultural sensitivity is important if available health services are to be utilized. Also taking into account traditional knowledge which indigenous communities have relied on for thousands of years is extremely important. In South Africa, Ngomane et al. found that pregnant women in rural districts delayed visiting clinics, preferring instead to be looked after by traditional healers in order to protect their unborn infants from harm.58 They also shied away from delivery in hospitals because of the harsh treatment they received from the nurses. 55
Sheik-Mohamed, A.,Velema, J.P. “Where Health Has no access; the nomadic populations of sub-Saharan Africa” Tropical Medicine and International Health, Vol. 4 No pp. 695-707, Oct 1999.
56
Barkey, N.L., Campbell, B.C. and Leslie, P.W. (2001), “A Comparison of Health Complaints of Settled and Nomadic Turkana Men”. Medical Anthropology Quarterly, 15: 391-408. doi: 10.1525/maq.2001.15.3.391.
57
Nathan M., Fratkin E., Roth E. “Sedentism and child health among Rendille pastoralists of Northern Kenya”, Social Science and Medicine Vol 43, Issue 4, August 1996. http://www.sciencedirect.com/science/article/ pii/0277953695004289.
58
Ngomane, S., Mulaudzi, F.M., “Indigenous beliefs and practices that influence the delayed attendance of antenatal clinics by women in the Bohlabelo district in Limpopo, South Africa”. Midwifery (2010), doi:10.1016/j.midw.2010.11.002.
024 ξ Chapter 1