| Abstract|| |
Background: This paper outlines the environmental health conditions arising from the synergistic effect of the rampant human activities (illegal logging and rapid expansion of oil palm plantations) that are exploiting the nature resources without proper planning. This led to the unsolved health problem caused by multifaceted of hazards among the remote indigenous Baram communities at Borneo, Sarawak. Methodology: This is an observational survey, which conducted in two phases, that is, June 2014 and January 2016. A random sampling of locations from the downstream and reservoir zones of the Baram River were selected for site surveillance. A total of 10 indigenous villages were visited and 3 main populations of affected indigenous people (Kayan, Kenyah, and Penan) were recruited for short interviews. Result: The result showed that at least 80% of the interviewed villagers held clear views on the identified environmental hazards; however, site surveillance to review the environmental health conditions of their living area showed that the health of the indigenous community is in the vulnerable and precarious conditions. Discussion and Conclusion: This observational survey provides insights of the current environmental health conditions among the remote aboriginal communities at Borneo Island. The data provides a detailed picture of the state of environmental health conditions and discuss the potential health consequences among the indigenous communities across Baram communities.
Keywords: Environmental health, health condition, indigenous, inequality, remote
Key message: This paper outlines the environmental health conditions arising due to the synergistic effect of rampant human activities (illegal logging and rapid expansion of oil palm plantations) that are exploiting the nature resources without proper planning. This led to the unsolved health problem caused by multifaceted of hazards among the remote indigenous Baram communities at Borneo, Sarawak.
|How to cite this article:|
How V, Othman KB. A snapshot of environmental health conditions among indigenous baram communities at borneo, Sarawak. Ann Trop Med Public Health 2017;10:90-4
|How to cite this URL:|
How V, Othman KB. A snapshot of environmental health conditions among indigenous baram communities at borneo, Sarawak. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Oct 18];10:90-4. Available from: http://www.atmph.org/text.asp?2017/10/1/90/205549
| Introduction|| |
Sarawak is the largest State of the Federation of Malaysia and is located on the Borneo Island. For thousands of years, this island is mainly inhabited by indigenous people. To date, worldwide health reports have shown that indigenous people are more prone to suffer from poor health, as well as likely to experience reduced quality of life as compared to their nonindigenous counterparts., Studies have shown that this poor health is associated with poverty, malnutrition, overcrowding, poor sanitation and hygiene, water supply, housing problem, and consequences of environmental contamination, which cause an increase in prevalent infections., The situation is partly aggravated by the inadequate clinical care and health promotion, and poor disease prevention services at the remote indigenous villages.
With the unresolved conditions faced by remote indigenous people, the problem arises when there is rampant used of large tracts of indigenous customary land for expansion of oil palm plantations, illegal logging, and other development projects. In other words, hidden environmental health problems shall be considered as prevalent among these remote indigenous people due to these environmental exploitation activities. Nevertheless, limited study has been focused into the problem of potential human health effect due to these environment exploitation activities among remote indigenous communities in Borneo Island, Sarawak.
Although Malaysia shows his responsibility to the indigenous people, it is among 1 of the 143 member states of the United Nation (UN) General Assembly that voted to adopt the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). The UNDRIP articulate the minimum standards for the “survival, dignity, and well-being of indigenous people.” In other words, the local government is obligated to comply with the Native Customary Laws (Rights' to land), as well as to ensure that their actions do not violate the provisions outlined in the UNDRIP and the international conventions to which Malaysia is signatory. Therefore, the purpose of this study is to observe and address the potential of environmental health conditions arising from the identified human activities among remote indigenous Baram communities in Sarawak, Borneo Island.
| Materials and Methods|| |
This is an observational (environmental health) survey, which was done among 10 remote indigenous villages in two intervals, June 2014 and January 2016. During these intervals (June 2014–January 2016), the generalizable survey (Refer [Table 1] for Environmental Health Survey Item) was used to outline the potential environmental health hazards observed, at the same time, to examine whether the identified hazards remained the same on the following year of follow-up study. Besides, a face-to-face interview among the remote indigenous villagers was conducted to determine their individual perspective for any potential environmental hazards that could affect the health from (i) their living environment and/or (ii) human activities.
A random sampling of locations from the downstream and reservoir zones of the Baram River were selected for site visits. Three main populations of the affected indigenous people (Kayan, Kenyah, and Penan) were selected for short interviews. The villages visited included Rumah Bangga, Long Lapur, Long Lama Blockade, Long Lama, Long Belok, Long Tebangan, Long San, Long Liam, Long Naan, Blockage 15 km, and Long Keluan Refer [Figure 1].
| Results and Discussion|| |
As defined by the World Health Organization (WHO) (WHO, 1948), health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. In other words, the synergistic effects of all these factors are likely to affect the health condition of the individuals and communities. Considering the influences of environmental hazards on the human health, World Health Organization (WHO) (WHO, 1990) has further justified that environmental health shall comprises of all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviors. Therefore, the effort of preventing diseases shall include the policy maker and stakeholders to perform sustainable health risk assessment and implement appropriate control measures to minimize the risk from direct affecting the health of the community.
[Table 2] summarized the potential environmental health hazards based on the environmental health survey result during the first (June 2014) and a second interval (January 2016). The result indicates that most of the identified environmental health hazards attributed to the poor living environment and rampant human activities (illegal logging and the expansion of oil palm plantation). These existing environmental health hazards are mainly related to water supply or sanitation problem, housing problems (overcrowding and substandard housing), waste water disposal, rubbish disposal, hygiene, and maintenance of communal toilets. This is consistent with past study, which indicates that many of the health problems faced by rural and remote aboriginal community have been attributed to a poor living environment.,
By considering the identified human activities in the remote area, their living environment, and the existing healthcare services, [Figure 2] summarizes the observed trend of interrelating health effects which may likely to induce by these existing hazards. These pollutants can eventually enter the human body through different routes of the pathway (inhalation, ingestion, and skin contact) via air, water, soil, and solid waste. Therefore, it is crucial to highlight that the remote indigenous villages along the Baram river basin are suffering from health risks from these multifaceted environmental hazards and undeniable resource-exploitation type of human activities.
|Figure 2: The observed interrelating health effects due to identified human activity, living environment, and the existing healthcare system in the remote indigenous village|
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This disturbing trend showed disadvantages across all the health indicators which we used to determine the indigenous health, that they have been consistently marginalized within their own land of state. For the past decade, poor hygiene, unsanitary living conditions, the high burden of infections, inadequate nutrition, and so on, are among the underlying causes of health disparities between indigenous and nonindigenous people., Thus far, these inequalities have yet to be solved, but remain to discourage the highest attainable standard of physical and mental health of the indigenous communities. Therefore, the existing human activities have further weakened their resilience and destroying their participation towards a healthy lifestyle as proposed by the Ministry of Health, Malaysia.
This section presents the opinion gathered from indigenous community regarding environmental health issues they have encountered these years. During the interview, indigenous community was asked on their personal views for any potential environmental hazards that could affect the health of their living environment and/or human activities. Overall, most of the interviewed community held clear views on the identified environmental hazards, particularly on water and sanitation with complaints. [Table 3] summarizes the complaints of villagers on their living environmental conditions.
|Table 3: Community's comments based on their living environmental conditions|
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Indigenous people come from thousands of cultures and are always over-represented among the poor and disadvantaged; however, traditional indigenous people were careful custodians of the environments that provided them and future generations with sustenance, including water, plants, and animals that they hunted and fished. This is consistent with the interview output of this study, which highlighted that indigenous villagers can actually identify the remarkable changes in their living environment due to the human activities. They simply lack resources and capacity to build the resilient communities that can protect the health of their indigenous communities. In view of this, the past study supported that there is clear and strong evidence of the effect of health education in preventing communicable and non-communicable disease among the local community.
Outline the environmental health condition among remote indigenous community
This observational survey shows that environmental health conditions at the remote indigenous village of Borneo Island are overwhelmed and somehow discouraged by the great disparities in health and disease development. It can also be described as “the unequal social distribution of environmental risks and hazards and access to environmental goods and services.” In fact, it is known that the major determinant of poor indigenous' environmental health conditions is socioeconomic status, irrespective of ethnicity. Therefore, this environmental inequality has called an attention for environmental justice back in the early 1980s, and the environmental justice ensures three things:
- The right to a healthy environment: everyone should have a good quality of life, with a safe and healthy place to live, work, and play and have enough resources for everyone, both now and in the future.
- No disproportionate negative impact of environmental policies, acts, or omissions on minority or indigenous communities.
- Equal access to environmental information, participation, decision-making, and justice. There should be equal protection and meaningful involvement of all members of society with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies and the equitable distribution of environmental benefits.
Ministry of Health Malaysia is, in fact, putting much effort in minimizing the health inequalities gap as stated in the 10th Malaysia Plan (Country Health Plan) (2011–2015). A few issues have been targeted to tackle the health gaps, such as:
- Reduction in mortality and morbidity, reduction of health inequality between groups and regions [Health Awareness and Healthy Lifestyle].
- To ensure clean water supply to 90% of Sabah and Sarawak by 2012 [Improving the infrastructure in rural areas].
- Introduction of school-level health education program [PROSTART], which encompasses HIV and AIDS, physical and environmental health, mental health, sexual and reproduction health and risky behaviors.
- Introduction of population health program to empower the community, family, and individuals, as well as manage and control of communicable disease, food safety and quality, and so on.
| Conclusion and Recommendation|| |
The health and quality of life of indigenous communities are not improving. The World Health Organization (WHO) (WHO, 2012)  urges to address the gap, and follow up on the commitments to tackle such environmental health inequalities, particularly to the most vulnerable group who exposed to the environmental risks.
Through the preliminary assessment of their living environment which was conducted in this study, it is imperative to highlight that the health of the indigenous community is in the vulnerable and precarious conditions. In order to improve the indigenous health, it requires empowerment from the institutional body, and a sense of participation and commitment from the community. At the same time, integrative strategies that could address an individual's health-related environmental exposure and many determinants of health are of priority concerns.
This paper provide a picture of the state of environmental health conditions in indigenous communities across Baram, Sarawak Borneo. Therefore, action to ensure easy access to adequate quantities of water and secure sanitation should receive greater priority. There is a need for better quality information systems to monitor progress, equity, and accountability in the delivery of water, sanitation, hygiene, and housing system by the institutional system, as well as local agencies to lead the indigenous people toward a resilient community in their inhabited continent.
The authors would like to thank the invitation from Baramkini in the year 2014 and 2016 to assess the environmental health issues among the Baram communities (Baramkini is the non-Governmental Organization which fosters dialogue and mutual understanding in various aspects between remote indigenous and urban community), and also to all the villagers who had participated in this survey assessment.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Stephens C, Nettleton C, Porter J, Willis R, Clark S. Indigenous peoples' health — why are they behind everyone, everywhere?. Lancet 2005;366:10-3.
Bailie RS, Carson BE, McDonald EL. Water supply and sanitation in remote indigenous communities — priorities for health development. Aust N Z J Public Health 2004;28:409-14.
Gracey M, Williams P, Houston S. Environmental health conditions in remote and rural aboriginal communities in Western Australia. Aust N Z J Public Health 199;21:511-18.
Torzillo PJ, Pholeros P, Rainow S, Barker G, Sowerbutts T, Short T, et al
. The state of health hardware in Aboriginal communities in rural and remote Australia. Aust N Z J Public Health 2008;32:7-11.
Gracey M, King M. Indigenous health part 1: Determinants and disease patterns. Lancet 2009;374:65-75.
Lee T, Jalong T, Wong MC. A fact-finding mission report: No consent to proceed: Indigenous peoples' rights violations at the proposed Baram dam in Sarawak. Save Rivers Network 2014.
Reading C, Wien F. Health inequalities and social determinants of aboriginal people's health. National Collaborating Centre for Aboriginal Health 2013.
King M, Smith A, Gracey M. Indigenous health part 2: The underlying causes of the health gap. Lancet 2009;374:76-85.
McDonald E, Bailie R, Brewster D, Morris P. Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature. BMC Public Health 2008;8:1-14.
Mokhtar MB, Murad W. Issues and framework of environmental health in Malaysia. J Environ Health 2010;72:24-29.
Lucas K, Walker G, Eames M, Fay H, Poustie M. Environment and Social Justice: Rapid Research and Evidence Review. Sustainable Development Research Network (SDRN), United Kingdom;2004.
Subramanian SV, Davey Smith G, Subramanyam M. Indigenous health and socioeconomic status in India. PLoS Med 2006;3:e421.
Schlosberg D. Defining environmental justice: theories, movements, and nature. Oxford University Press; 2007.
World Health Organization (WHO) Assessment Report: Environmental Health Inequalities in Europe (2012).
Aaijaz N, Ibrahim MD, Mustapha N, AwgNik HY. Assessing the role of NGOs in alleviating poverty among aborigines habitant in India and Malaysia. 2011 (2nd International Seminar on Poverty Eradication in Conjunction with UNESCO International Days, 16-18 October 2011, University of Battambang, Siem Reap, Cambodia).
Dr. Vivien How
Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor
Source of Support: None, Conflict of Interest: None
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3]