The San Community, NamibiaJessica Doyle - Health Poverty Action - 19 Jul, 2018
Our partner charity Health Poverty Action sees health as not merely a medical challenge, but a fundamental issue of justice and human rights. They believe that where you are born should not determine your right to health. They prioritise the health of marginalised communities, who have been forgotten by the rest of the world.
Health Poverty Action has been working with the indigenous San community in Tsumkwe, Namibia since 1997. The San, known for their unique clicking languages, have long been treated as second class citizens, and this has meant the San people are significantly poorer than the majority of the Namibian population and have much worse health. HIV is on the rise amongst the San people, malaria is endemic and multi resistant tuberculosis is widespread. The closest hospital is some 300 kilometres away and there is a severe lack of nurses and doctors.
The San people face many barriers to good health; local health staff do not speak their language or understand their culture and so San communities are often ill-treated and thus less confident when attempting to access health care services. These cultural barriers, when combined with a lack of nutritious foods, the nomadic lifestyle of the San, living in remote areas and frequently going on long hunting expeditions far from health centres contribute to poor health.
Health Poverty Action believes it is important to work closely in partnership with the San to understand the barriers to healthcare. They support communities with the practical knowledge they need to take charge of their own health, whilst working with local government to strengthen existing health systems to ensure they receive good quality, culturally appropriate care. We do this in a number of ways:
Strengthening local organisations and community groups to carry out health awareness-raising on HIV, TB and malaria.
Meet ≠ioma N!ania. When he began having chest pains and sweating in the night, he didn’t know what his symptoms meant. It wasn’t until a community representative from his local area attended some health training from Health Poverty Action that he learnt he had TB.
“When he returned from his training, he started to teach us in the village that chest pain and night sweats can be signs of TB. He encouraged me to go for a test.”
Training treatment supervisors.
Many San people live a nomadic lifestyle which makes moving to a big town for months of treatment very difficult- both socially and financially. Health Poverty Action is training treatment supervisors to visit families in their communities, take samples for diagnosis to ensure treatment starts early to prevent hospitalisation, and visit them again to deliver their medicine to ensure they complete their treatment. To prevent the further spread of multi drug resistant TB it is essential patients complete their course of medicine.
Di//ao Cwi a young woman who lives in a village 36km from the nearest clinic in Tsumkwe said:
“My treatment supervisor made sure I took the prescribed medicine every day. I really thank him for being with me right through my treatment
Strengthening the capacity of local health services to provide quality, cultural health care.
Sarah Zungu is a senior counsellor in Tsumkwe working to ensure that the San people have representation in government. She understands the importance of health services that are culturally appropriate as she has seen the rates of HIV and TB drop since health professionals began speaking San languages. She is pleased to see more San people training as nurses.
Working with the San people to establish small-scale agriculture projects to provide nutritious food to people living with TB and HIV.
Shonongeni Auaseb is trained in health education and teaches other San people about HIV, malaria and tuberculosis. He also works in the gardens in Tsumkwe growing fruit and vegetables for TB patients receiving treatment.
Providing training for the San people in health rights, which enables them to demand their right to health.
Health Poverty Action has set up Clinic Health Committees in the San community to provide a space where San community representatives can speak to local health officials. Local services can then be adapted and feedback collected and passed onto government officials at regional and even national level. Although the process has often been challenging and slow, the voices of the San are finally being heard. Health Poverty Action has found that when, communities are able to participate in decisions about their health services and culturally appropriate options are available, health improves.
To support health professionals working in challenging circumstances abroad, we are asking NB Medical members to join our ‘As One’ campaign and either donate their time or money to support their colleagues around the world.