THE STATE OF ACCESS TO HEALTH CARE AMONGST ITU & KEREYU PASTORALISTS IN ETHIOPIA

Access to primary health care amongst (African) countries over the years have been or is widely accepted as germane to revamping health outcomes. The world Healty Organizatio (WHO) in 2008 opined this to mean that when there is access or reach to essenyial health care, ranging from acceptable social methods, services and or technology; health issues across communities stay on significantly laudable parlance.

However, indigenous communities or people are faced chiocelessly with disparate narratives. Accessing essential health care has been barricaded by several factors such as culture, economy, lack of awareness, system factors, lifestyle of the community and geographical concerns. The culture of indigenous people sometimes see administering or getting engaged with “white medicine” as they refer to modern health care is a taboo or sacrilege, others have become accustomed to the use of herbs and or other crude methods in handling health issues (handed down from ancestor or fore fathers). Whilst others are geographically distant from any form of civilization. They live in creeks and caves, have menstrual flows in earth dug holes sat on for as long as it lasts, use leaves with sharp edges to cut umbilical cords have been researched to be typical of some indigenous people/communities mostly in Africa. They resort to other ways that may or may not suffice. Chances are slim, lives hang in the balance. These has been one of the causes of inant and mother mortality.

Itu & Kereyu Health Care Scenario

It is not so much of a different ball game for Itu & Kereyu of Ethiopia. Largely pastoralists, inhibiting Fentalle district to the north of Afra regional state, to te east, south and west of Oromia region, they merely depend on the meagre proceeds of livestock production. From the standpoint of ” equal access to health care for all”, the prevalent preoccupation of Itu & Kereyu makes access to health care a hard nut to crack. The “static health post” system of health care delivery makes for the strain in accessing essential health care by I&K who are “mobile pastoral communities”. such as immunization, antenatal visits, vaccination (Teklehaimanot et al., 2019).

From findings of study conducted August 2021 using qualitative designs such as focus group discussions and key informant interviews, the following distinct barriers we identified as reasons for I&K’s lack of access to primary healthcare;

• There is no current or existing health care program to meet or link I&K migrants who have to leave their settlements for seasonal/recurrent drought sakes to new destinations. This results to refusal of healthcare providers to reach them in their new locations.

“…Although there is health post closer to our new destination, we are not allowed to access health services from it, because we were told to get services only from health post of our previous residence, which is very far from the current one“

• Distrust for modern health care amongst Itu & Kereyu pastoral communities. They believe in natural and supersticios methods for health care.

“…it is not medicine that cure diseases, but Gootyaa (god)…”

• Health care workers do not reside in remote villages of pastoral communities due to lack of basic social services and amenities.

“…animals move in and out as they want. When we go out for home visit in Ganda, our houses are damaged by monkeys and other wild life..”

“…sometimes poeple we domt know threaten us We fear for our safety”

• There is also the salient issue of geographical proximity to health care services. Although WHO recommends 5km radius access to health care, some Itu & Kereyu pastoralists travel as high as 30 to 35km on foot to access health care. Sometimes there are women carrying children on their shoulders arriving at dusk to health care accessible areas. Other times, health care providers ask them to return to their former settlements where they began a healthcare service.

The Call…

The health care system of Itu & Kereyu need be paid urgent attention, if health for all is not just a mantra. They need physical accessibility to health care that goes hand in hand with their local culture, mobile pastoralism, geographical uniqueness and social perculiarities.

There is urgent need for change and innovation in the Ethiopian health systems and accebility to it.