Involvement of Pastoralists in the Development of an Innovative Health Service System in their Areas.

Researcher: Yohannes Fassil

Taking the broader framework of health care defined by the Alma Ata Conference the author discusses how the concept of community involvement can be applied to the pastoralist community given its specific circumstances.

By recognising the existence of conflict of values and goals between the change agents and the clients and by understanding the structure of the pastoralist communtiy it is possible to provide a model which will succeed in delivering health services.

The author proposes the use of a wide range of methods to invove the community and suggests that this approach is equally relevant to the more settled urban communities who share many similarities.

Case Study on Pastoral Health Policy in Eritrea

Researchers: Dr Mineab Sibhatu and Dr Eyob Azaria

Years of conflict and the persistence of several years of drought and the ensuing large displacements of people have compounded the difficulties in providing health care in the country.

The government has attempted to organise a health service which encourages participation from communities and where essential amenities will be decentralized. Village health workers and traditional birth attendants will be trained and they will be responsible for educating the rural population on health matters.

There is of course an important body of knowledge held by traditional medicine but it is important to separate harmful practices from the rest and efforts are made to change these.

Pastoralists have been encouraged to make use of mobile health teams and to attend hospitals.

The State of HIV/AIDS in Eritrea

Researcher: Dr Tesfazion Negash

The present pandemic is taking a heavy toll on the population of Africa and until medical advance for curing the disease in found, Information Education and Communication remains the best way to contain the epidemicc and prevent further spreading.

While the number of cases reported by 1995 had greatly increased from the time of the first reported case, there is no doubt that a lot of under reporting persists.

Pastoralists too, are exposed to the disease. Campaigns are being run jointly by the Minsitry of Health and external agencies.

The paper recommends that research on sexual behaviour among the pastoralists special education and information programmes and the elimination of poverty and iliteracy, to name a few, are essential to protect pastoralists from AIDS.

Pastoral Health Policy Issues in Ethiopia.

Researcher: Dr Gebremedin Gebreselassie

Concentrating on the Afar population, the author examines the causes of health problems in the region, the state of the existing health and veterinary services and recommends measures to improve present conditions.

The pastoralist community is scattered over a large area and health provision is mostly to be found close to roads, therefore leaving a large part of the population without access. Little has been done to address the health needs of pastoral people.

Similarly veterinary services do not reach large part of the animal population.

Traditional medecine is used to treat various ailments but some practices can have undesirable effects.

The situation is one which needs to be remedied. As is often the case, however, the question of whether development or health provision should be given precedence has not allowed room for a more pragmatic approach which argues that a holistic and integrated strategy is needed.

Health and environmental education could go a long way towards improving the situation. Training pastoralists in preventive and remedial healthcare would be an effective way to do this. However the long-term goal should be that of a development strategy in which nomadism would be replaced by mixed animal and crop husbandry.

Problems of Zoonoses among Pastoralists

Researcher: Dr Teclemariam Zeggu

The paper highlights why zoonoses are commonly found among pastoralists. The author lists the various diseases and their cures and importantly offers recommendations for both short term and long term strategies.

The provision of water points for human and livestock use in order to decrease movement and animal concentration is seen as a necessary short-term measure and would allow better surveillance and the implementation of control programmes.

Broader long-term programmes should run alongside educational and economic improvement measures to stop nomadism.

Significance of Traditional Medecine, the Problems and Appproaches to its Development.

Researcher: Dr Dawit Abebe

The paper discusses the significance of indegenous medecine and the need to preserve this body of knowledge which is danger of disappearing. At the same time developing countries are under pressure from the rest of the world who sees the potential for the use of plants for pharmaceutical purposes.

In the Third World, however, the situation is not one of choice or of going ‘back to nature’. The use of traditional medecine fulfills basic health needs relatively cheaply.

The new generation is not being handed down the knowledge accumulated in indigenous medecine. It is necessary to begin programmes of research that will determine the efficacy and safety of plants. This is likely to uncover new substances which will complement if not replace drugs which are at present purchased from the West.

An urgent task is to collect and compile traditional healthcare knowledge before it is lost.

Traditional Healers in Somalia

Researcher: Sadia Ahmed

Traditional healing practices are widespread in rural areas. Practioners vary from those who perform bone setting, midwives, religious healers and those who practice magic.

The author mostly discusses the idea of spirit pacification as therapy in the Somali context. Various forms of cures are prescribed for the cure of hysterical patients.

With the growing role played by modern health care this form of healing ought to decline. Nevertheless attempts are being made at combining both abd the Ministry of Health has decided to incorporate traditional medecine with conventional health care. Healers are registered and monitored.

Case Study on Pastoral health Policy Issues in the Sudan

Researcher: Dr Khamil Mirghanie

This paper looks at the situation of pastoralists involved in cattle and camel rearing. Health problems in these communities are environmentally and culturally determined with tuberculosis and malnutrition as the main problems.

The nomadic population is around 20% of the total but because their migration patterns vary greatly, mobile PHC has been seen as the only practical option. Modern health care is very limited and a traditional system of birth attendants, herbalists, bone setters and spiritual healers still prevails.

Droughts and other catstrophes have claimed the lives of many pastoralists but apart from some relief work little has been done.

General distrust between governmental and non-governmental bodies make it difficult to move towards more developmentak activities.

Health Status of Pastoral Women in the Sudan

Researchers: Dr Azia El Neima and Aisha Mustafa

Although no systematic study has been carried out in the Sudan, women are known to make up a significant proportion of the traditional healers.

The paper highlights the difficulty in reaching pastoral women in the delivering of health care. Some programmes are provided jointly by government and aid agencies and focus on reproductive health, mother and child health and PHC.

The government has decided that MCH programmes should be devolved to the regions.

The author offers the following recommendations:

collection and documentation of pastoralists’ traditonal knowledge, integration of traditional and conventional health, support of women in their effort to cultivate traditional plants, introduction of mobile health care system among others.