The recent revelation by the health minister that it was measles that killed the children in the Orang Asli Bateq tribe is just the tip of the proverbial iceberg with regard to the care of our indigenous people.
The aboriginal tribes and people have been sidelined with many settlements moved to the fringes of towns during the communist insurgency times. In a study conducted on Orang Asli settlements, it was found that the weight and height of the children in these resettled areas was lower than their brethren who were left in the jungle. This was attributed to scant natural flora and fauna for them to survive on. Now, with rampant and uncontrolled deforestation, the traditionally nomadic jungle tribes 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 brought to indigenous populations from outsiders – explorers in the past and loggers and others currently. In the past, the Orang Asli Affairs Department, later renamed the Department of Orang Asli Development (Jakoa), was entrusted with the healthcare of the communities with the cooperation of our health ministry (MOH). This was then handed over completely to MOH, which is not a bad thing. Some things still need local input and buy-in to provide a successful and acceptable service.
While we know that MOH and many NGOs provide healthcare and immunisation services to many communities, we also know that the nomadic tribes are hard to track and many will disappear into the jungles 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 local paediatricians who wanted to see an end to treating the end-result of malnutrition in their wards. Measles in a malnourished child ends in disaster, without exception.
The government has to re-look at re-allocating manpower and funding resources to these neglected populations without looking at 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 in helping NGOs that deal directly with the indigenous people and MOH will help.
As we know that the best prevention of measles is through vaccination, the immunisation strategy for these populations has to be strengthened. At the same time, we need to help with their nutrition and general hygiene. This can only come through education and what better way than to teach the young ones directly and through their mothers. Groups like Imaret (Imam Response and Relief Team) have been going around installing local water treatment facilities for the Orang Asli populations in addition to providing basic healthcare, but we need more and we need a concerted government commitment to 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 the marginalised Orang Asli populations. The sooner we start, the better the preservation of these people will be. These measles deaths are a tragedy that we need to recognise and learn from, and our condolences and prayers go to the relatives.
Dr Zulkifli Ismail is the Asia Pacific Paediatric Association secretary-general and an executive committee member of the Malaysian Paediatric Association.
The views expressed are those of the author and do not necessarily reflect those of FMT.