Report blasts severe neglect of San
06 October 2021 | Social Issues
A new Amnesty International report contains damning findings of the Namibian government’s devastating neglect of the marginalised and poverty stricken San community, that has led to a surge of TB among San communities.
“Rampant discrimination against Indigenous San people in Namibia is denying them access to healthcare and leaving them vulnerable to deadly diseases such as tuberculosis (TB) and its multi-drug resistant strain (MDR-TB),” Amnesty International said in a media release.
Amnesty’s international director for east and southern Africa, Deprose Muchena, said the report shows that “for years, Namibian authorities have ignored the healthcare needs of the San people, including those battling tuberculosis, leaving them at the risk of death”.
Historic and current socio-economic burdens, deeply entrenched marginalisation, discrimination and “institutionalised ghettoisation” have led to sub-par health care for San in Namibia.
Amnesty noted that TB and MDR-TB are “ravaging San communities in the Omaheke and Otjozondjupa regions”, and that this “shows how government has failed to take meaningful steps to ensure the San people’s right to health, despite identifying them as one of the groups most at risk of contracting TB”.
Although Namibia has one of the highest rates of TB and MDR-TB globally, the disease is 40% more prevalent among the San, compared to the national average.
The San are the only ethnic group in Namibia whose health status has declined since Independence in 1990, the report notes. “It is time the authorities stopped neglecting the San people, recognised their right to health and ensured access to healthcare like any other people in Namibia,” Amnesty said.
The non-profit human rights group argues that the steep rate of TB among San communities in Namibia “not only constitutes a public health crisis, but that it is also a cause and consequence of the San’s marginalisation”.
The findings in the new report “highlight the failure of the Namibian government to address the structural barriers and social determinants that contribute to the San’s burden of TB”.
The report, ‘We don’t feel well treated: Tuberculosis and the Indigenous San people of Namibia’, warns that while Covid-19 has added to the San’s problems, their historical neglect long precedes Covid-19.
“Due to historically poor access to political and economic institutions, Namibia’s San population has been reduced to an underclass which lacks land rights, experiences high levels of unemployment, social marginalisation and poverty. “Even prior to the current pandemic, San peoples already faced entrenched inequalities, stigmatisation and discrimination. Inadequate access to health care, clean water and sanitation increases their vulnerability to both TB and the coronavirus.”
These factors have led to poor health outcomes in communities “owing to ongoing discrimination and service provision, geographic isolation and language barriers”.
Respondents told Amnesty International that they regularly experience verbal harassment, derogatory epithets, and witness preferential treatment of patients of other ethnic groups.
“Healthcare providers always treat the San people bad and treat non-San people better,” one respondent told Amnesty.
The “entrenched discrimination and prejudicial attitudes have created a reluctance and lack of confidence among the San in demanding their right to health,” the report warns.
Cry for help
Amnesty’s report states that despite various mandates and commitments, the health ministry “has, by and large, failed to respond to the needs of the San community in respect to adequate health services”.
Researchers for Amnesty “documented significant barriers” that hamper access to healthcare services, including but not limited to untrained healthcare professionals, lack of resources and adequate clinics, lack of access to transport, language barriers and discrimination.
“Most San live on the bottom of the social ladder in unacceptable conditions of poverty, leading to alcoholism, violence, disease and despair,” a USAID representative is quoted in the report.
The high rate of TB and MDR-TB can also be linked to widespread malnutrition and food insecurity among the San. “Because malnutrition weakens the immune system, it exacerbates the effects of TB infection, increases the risk of developing active disease and heightens treatment failure, and mortality.”
The report lists multiple steps and recommendations “towards respecting, protecting and fulfilling” the rights of San peoples.