Health care for nomads too, please

Abstract

Pastoral nomadism, a way of life in many developing countries, especially in Africa, has received little attention from planners, economists and governments, partly because the communities in question present what are perceived as difficult logistical problems. Yet it is incumbent on the authorities to develop practical and feasible approaches to the delivery of primary health care for nomadic populations.

PIP: Pastoral nomadism is a way of life in many developing countries, especially in Africa. There are 50-100 million nomads from the Western Sahara to Outer Mongolia. Pastoral nomadism is an efficient low-cost method of animal husbandry based on a deep understanding of ecology. Semi-nomads engage in unspecialized herding and farming, a mixed form of subsistence. Nomads have developed special cultural and social patterns with a system of collective ownership in the clan or tribe. The migrations of nomads are predictable, which is conducive to the delivery of effective services. Infant and child mortality and accidental deaths tend to be high, but health is comparatively good, though diseases like trachoma occur frequently. Although nomads do not use latrines or wash with soap and water, the portable dwellings by nomads favor the maintenance of cleanliness. Traditional healers and birth attendants provide health services. The provision of health care for nomads needs commitment and resources from planners involved in health programs in countries with pastoral nomadism to achieve the goals of health for all. Soil erosion and desertification caused by overgrazing also involve nomadic pastoralism. Public health programs to control prevalent diseases such as malaria may fail to reach migratory populations. Nomads need health services that are designed specifically for them, although the per capita cost is bound to be high because of the small number of patients and the need for mobile clinics. Health planners in developing countries with scarce resources and large nomadic populations should set up primary health care systems.