STATE OF THE WORLD's INDIGENOUs PEOpLEs - CINU

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EMBARGOED UNTIL 14 January 2010STATE OF THE WORLD’S INDIGENOUS PEOPLESNot for distributionUmoja: Combating violence against indigenous women in KenyaUmoja, which means “unity” in Swahili, is an independent, women-run village for survivors of genderbasedviolence in Kenya. Founded by Rebecca Lolosoli, an indigenous Samburu woman, and 15 otherwomen, Umoja serves as a place for women who have been forced to leave their communities afterbringing “shame” on their families for having been raped by British soldiers stationed on their ancestrallands. After being granted a neglected field of dry grassland by the local District Council, the womencollectively filed a lawsuit against the British military for the rapes of over 1,400 Samburu women duringthe 1980s and 1990s. The women of Umoja have since participated in human rights training sessions led byRebecca Lolosoli, actively took part in local government, and organized to demand an anti-violence unitwithin the local police force.As part of their anti-violence strategies, the women of Umoja have also developed systems of resourcesharing and collective means for promoting women’s economic independence, which they see as integralto women’s ability to be independent from abusive men. Moreover, while they draw heavily on theirtraditions and cultures in their strategies to combat violence, they have also used economic independenceto avoid the pressure to submit their daughters to female genital mutilation and marry them off at a youngage. Instead, they ensure that their daughters attend school and draw on the parts of their culture thatempower them rather than those that are used to limit their choices as women.Source: International Indigenous Women’s Forum/Foro Internacional de Mujeres Indígenas (2006), 45-46.Barriers to accessing health servicesIndigenous peoples’ lack of access to adequate health care manifests itself in a variety of ways. There arepractical obstacles such as geographical distance or seasonal isolation, and “although health care services arelargely free to indigenous peoples, the real cost of care, including the out-of-pocket costs of transportation, food,accommodation, family care, medication, and loss of workdays, poses a threat to health care access”. 65 Whenaffordable health services do exist in indigenous communities, they are often of lower quality than the servicesthat are available to the non-indigenous population.Moreover, expressions of racism and other forms of discrimination are widespread, creating an even greaterbarrier to indigenous peoples’ access to health services, even when full access to quality health care basedon Western medicine is possible. This is because most state health systems are not culturally sensitive, andtheir services and management do not reflect the socio-cultural practices, beliefs or visions of the indigenouscommunities. The Pan-American Health Organization has notedCultural barriers present the most complicated challenge because there is little understanding ofthe social and cultural factors deriving from the knowledge, attitudes, and practices in health ofthe indigenous peoples. The bias towards Western medicine and intervention can be offensiveor inappropriate for practitioners of traditional medicine. Finding health staff that speak andunderstand indigenous languages is difficult, and poor communication between providers andclients at all levels compromises access to quality care. Moreover, indigenous people are often65PAHO (2006), 3.HEALTH | 173
EMBARGOED UNTIL 14 January 2010STATE OF THE WORLD’S INDIGENOUS PEOPLESNot for distributiondiscriminated against in health centres by non-indigenousstaff and both fear and distrust caused by the attitudes andbehaviours of health care workers prevent indigenous peoplefrom seeking the health care they need. 66These factors are even more acute for indigenous women, many of whom facemultiple layers of discrimination based on the fact that they are poor, womenand indigenous.Lack of recognition of, or support for, indigenous health systemsAnother fundamental aspect in the status of indigenous peoples’ health is thatmost national governments do not provide technical or financial support toindigenous health systems, nor do most state health systems recognize, respector incorporate the abundance of knowledge and experience of traditionalmedicine. Thus, because state health systems neither incorporate the indigenousconcept of health nor work in harmony with traditional health systems, indigenouscommunities are marginalized, and health disparities between indigenous andnon-indigenous populations persist.Treating HIV/AIDS with traditional medicine in SenegalIndigenous peoples are particularly susceptible to contracting HIV becauseof their situations of poverty, unemployment, and vulnerability to violenceand displacement. Yet, there are few efforts that address HIV/AIDS amongindigenous peoples. Traditional treatments for HIV are widespread inindigenous communities, however, and, if recognized and supported, theyare promising practices for combating the illness among all populations.most nationalgovernments do notprovide technical orfinancial support toindigenous healthsystemsFrench doctor and academic Yvette Parès trained for 15 years underAfrican traditional healer Dadi Diallo, and in 1980 founded the KeurMassar Leprosy Treatment Center outside Dakar. 67 The center usestraditional therapies to treat a wide range of illnesses, including leprosy,tuberculosis, malaria and HIV/AIDS. The treatments are based on theindigenous concept of health, which sees the therapist as a spiritualmediator who stimulates the healing forces of the sick person ratherthan trying to cure the disease through a cocktail of synthetic drugs. KeurMassar’s traditional healers have succeeded in developing treatmentsfor HIV/AIDS that have the benefits of being non-toxic, of addressingsecondary infections such as tuberculosis, and of being formulated withnatural plant components that do not require the support of rich nations inorder to be synthesized. Parès has noted, “In addition, traditional medicinedoes not attack a pathogen in only one way, but through a combination66PAHO (2006), 4.67For a detailed account of Parès’s work in Senegal, see Parès (2004)174 | CHAPTER V
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STATE OF THE WORLD's INDIGENOUs PEOpLEs - CINU

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