Among the indigenous communities, health is not just conceived as an absence of disease, but is closely bound up with relationships to community and the environment – both physically and spiritually.
“Weather and water affect health and wellbeing,” said Deuane, 80 years of age. “In the past, I slept well in the mountains where the weather was cooler and we didn’t have to worry about where to get water as it was available all year round”. Deuane and his family are one of the many families who belong to the Alak ethnic group that were relocated from the mountains to the lowlands by the Lao government as part of the program ostensibly aimed at improving access to health, education and other services. The name of his village, Ban Dak Kiat, goes with them wherever this community of about 30 families go. Many years ago, they were initially resettled in the lowlands of Sansai District, Attapeu, Lao PDR but after settling there, nine villagers died so the people consulted a spiritual healer who said that this location was the market place of the spirits, so they moved again to a ‘safer’ place in the same district.
Many indigenous communities now have access to health services, but they still apply many of their traditional knowledge.
“When my family and I get sick, we immediately go to the health center with trained health staff, which is in a neighboring village. Before the change of government in the 1970s, we used to go to spiritual healers...we started to change our belief in spirits but I still use some traditional treatments like steam baths with herbs to treat backache and body pains” , said Nang Daen, a 53-year old grandmother who belong to the Oye tribe.
Chansamay, a 19-year old mother from the Taleang ethnic group, prefers to use a traditional medicine for birth spacing. “The spiritual healer told me to take a mixture of leaves of a bitter vine and herbs for two days in a month, two weeks after my menstrual period to prevent pregnancy. I prefer the traditional medicine than western medicine because I heard a lot of stories about the side effects of pills and my mother experienced it herself. Besides, we don’t have money to pay for western medicine. Anyway, traditional medicine can be found in the forest and is easier to use.”
It must be pointed out that there is a need to systematically document the communities’ intensive knowledge. But the documentation of their traditional knowledge must be for the improvement of the entire community and not for individual material gains.
The importance of the environment in the indigenous communities’ survival cannot be underscored enough. But development approaches are frequently unhelpful to the indigenous peoples. In her appeal during the third session of the Economic and Social Council, Permanent Forum on Indigenous Issues in New York, a Health Unlimited-trained Tampoen Community Educator said, “After years of relative isolation, the region has recently opened up to so called development where logging, cash cropping and industrial farming were introduced. Traditionally, we have depended on the forest for our livelihoods and now we are threatened by diminishing forested areas, migration, land loss due to confiscation of ancestral lands and border insecurity. These are affecting our ability to survive.”
For example, commercial pressures and environmental degradation result in the continued loss of land and water resources upon which the livelihood and traditional ways of life of indigenous people depend. At the extreme, indigenous peoples suffer systematic repression and deprivation, to the extent that their survival is threatened. For most, life is a constant struggle in the face of poverty, ill-health and social disintegration.
Different organizations have taken up the cause of indigenous peoples, but they sometimes take on paternalistic and patronizing attitudes towards the IPs. In the long run, such attitudes defeat their noble purpose.
By Susan Claro, Jerry Clewett & Alison Sizer
Health Unlimited, Laos PDR
About Health Unlimited:
Health Unlimited, a development organization working with the indigenous peoples of Laos and Cambodia, is careful not to fall into this trap. The core of its program is the empowerment of the indigenous peoples. At all times, Health Unlimited seeks to understand that for indigenous people, their worldview, their health and their wellbeing are rooted in traditional belief systems that must be recognized if the communities are to develop.Health Unlimited works directly with indigenous peoples. It seeks to 1. improve their access to effective and culturally appropriate health care, 2. support them in articulating their own health needs while challenging inequity and discrimination and, 4. tackling obstacles that impede access to health services and achieving the health Millenium Development Goals. Health Unlimited has supported, financially and technically, the Provincial Traditional Medicine Station and the Traditional Healers of Attapeu Province with the aim at integrating the tradional health and western health modalities. Village women are also trained as volunteer educators in each village. They are active partners in conducting health information and education activities in their own ethnic languages. To facilitate the activities, culturally-appropriate interactive communications methodologies like role play, puppet shows, radio programming and story telling are adopted.
Note:
1 Tampoun is an ethnic community in Ratanakiri Cambodia.
2 Utz’ Wachil, Health and Well-being among Indigenous Peoples, Health Unlimited and London School of Hygiene and Tropical Medicine, 2003.
The authors are connected with Health Unlimited. Ms. Susan Claro may be contacted at susanclaro@laopdr.com. For more details about Health Unlimited, visit its website at www.healthunlimited.org
The original article of this appeared in Health Alert Asia Pacific Issue No. 10, 2007 (Supplementary issue). For copies of the newsletter, please email hain1985@gmail.com
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