Survey singles out 22 ethnic groupings discriminated against based on healthcare provision, education and poverty levels
The Ministry of Health has identified and classified 22 of 42 communities as the most discriminated against and marginalized ethnic groupings majority of whom are in areas around the greater Nakuru, Lamu, Marakwet and Mandera regions.
The groups are characterized by low levels of education, lack of formal employment, poor access to health care and lack of representation in political structures. “Communities with higher population of educated members have dominated over the 22 who feel inferior and refer to themselves as ‘jamii duni wenye wamejitenga’ to mean discriminated communities that live in isolation,” says a new report by the Ministry of Health.
To reach these groups with preferential health care services, the ministry is considering the implementation of a special programme called Vulnerable and Marginalized Peoples Plans.
In a study to find out how many such groups are indeed marginalized in health services, the ministry surveyed 13 of them and in some cases found most did not have even a single medical worker employed in the public service where they live.
For instance, among the Sengwer community, in the Kabolet Forest in Cherenganyi hills, there was only one young woman who was trained as a social worker and engaged as a casual at the Kapsara hospital.
“Her presence in the hospital has helped to attract the Sengwer to the hospital because they feel one of their own is working in the hospital and can empathize with their health problems,” says the report prepared by the Multi-face Research and Development Centre of Kisumu for the ministry.
Most of the communities have few health facilities and even fewer workers meaning they cannot get services when they need them. “At the Ogiek Nessuit dispensary, for example, the only health worker can be away for a period extending over two months.”
The report says almost all of the educated people in such communities have left for urban centres and do not participate in the communities’ affairs. But some had very few educated individuals. Among the Munyoyaya of Tana River, there was only one person who had graduated from the university.
This lack of education has denied these communities the opportunity of applying for communal projects such as the Total War Against Aids (Towa), which funds HIV programmes at the grassroots.
In most cases the communities have never heard of such programmes and the few who have cannot write the required proposals. “A few who have approached skilled people for assistance in this area have not been able to raise the Sh5, 000 or more demanded by those writing the proposals on their behalf,” says the report.
Also, most of the communities were found to be living far from medical facilities. The Il Chamus spend an average of Sh600 on transport to take a pregnant women to deliver at Marigat District Hospital while the Waata community in Madogo of Tana River spends an average Sh2, 000 on transport hire to take their sick to the provincial hospital in Garissa.
Some cultural beliefs were also found to be keeping these communities away from modern medicines such as among the Ngikebotook in Turkana South where a traditional spear must be used to cut the umbilical cord of a baby boy.
At the Katilu Health Centre, where the community would get health services, was a maternity wing which had beds but no patients. The community also does not take their women to the hospital for child deliveries where the services are done by men.
But it is family planning services that are loathed most in this region because most residents still believe in siring many children to “fill their land to counter domination by bigger communities”.
“Are we being asked to practice family planning so that other communities can come and occupy our land? We do not want to be continually referred to as minorities,” an Ogiek elder had told the study team.
The draft report which was finalized in March and recently published by the ministry does not indicate whether the proposed plans to reach the communities will be carried out by the national or county governments.