THE announcement by the Health Ministry that it was measles which killed 15 Orang Asli from the Kuala Koh Bateq community reveals the healthcare situation for our indigenous people, “Mystery solved: It is measles” (The Star, June 18).
During the Malayan Emergency (1948-1960), many Orang Asli villages were moved into settlements on the fringes of towns as a government strategy to defeat the communist insurgents. In a study conducted on Orang Asli settlements in the 1990s, it was found that the weight and height of the children in these resettled areas were lower than their counterparts who were left in the jungle. This was attributed to scant natural flora and fauna for them to survive on.
Now, due to rampant and uncontrolled deforestation, the traditionally nomadic jungle communities have scant natural resources to tap for their survival. Contamination of the rivers leads to diseases like leptospirosis and other enteric infections. For centuries, measles has been brought to indigenous populations by outsiders (explorers in the past and loggers and possibly well-meaning others currently).
The Department of Orang Asli Affairs, later upgraded to Department of Orang Asli Development (Jakoa), was entrusted with the healthcare of the communities with the cooperation of our Health Ministry. This was subsequently handed completely to the Health Ministry, which is not a bad thing. But some areas still need the local input and buy-in to provide a successful and acceptable service.
While we know that the Health Ministry and many non-governmental organisations are providing healthcare and immunisation services to many Orang Asli communities, we also know that the nomadic groups are hard to track and many will disappear into the jungle when they know that a health team is coming to give vaccinations. These teams will then run clinics to see the ill ones for treatment, not prevention.
The way out of the situation is through education. Sending the best (or better) teachers and doctors to these communities will make a change in mindset from childhood. Many communities have made a change for the better, especially in Perak, where the local health and education officers take it upon themselves to push the indigenous people’s agenda. This agenda was initiated by the local paediatricians who wanted to see an end to treating the effects of malnutrition in their wards.
Measles in a severely malnourished child ends in disaster, without exception. The government has to look at re-allocating manpower and funding resources to these neglected populations without considering their voting power. It is time to even out the wealth of the nation to the underprivileged and marginalised from the rich who have benefited for the last few decades. More commitment from big corporations to help NGOs that deal directly with the indigenous people and the Health Ministry would help.
The best prevention against measles is through vaccination, hence the immunisation strategy for the population has to be strengthened. At the same time, we need to help with their nutrition and general hygiene. These can only come through education, and the best way is to teach the young ones directly and through their mothers.
Groups like the Islamic Medical Association of Malaysia Response and Relief Team have been going around installing local water treatment facilities to the Orang Asli population in addition to providing basic healthcare, but we need more. We also need government commitment for these people. We need to teach them to fish rather than provide the fish!
There is a lot more work to be done in a consistent manner for these marginalised populations, and the sooner we start, the better. These measles deaths are a tragedy that we need to recognise and learn from. Our condolences and prayers go to the relatives.
DATUK DR ZULKIFLI ISMAIL
Secretary-general, Asia-Pacific Paediatric Association
Executive committee member, Malaysian Paediatric Association