A Young Batwa Medical Student Advocates for Health Care for his People Forcefully Displaced From Their Forest in Uganda
For thousands of years the Batwa people lived in the Impenetrable Forest of Uganda. Hunters and gatherers who are often derisively referred to as pygmies, the Batwa are the original people of a lush and beautiful land where they gathered food and collected wild honey through the generations. In 1991, conservationists seeking protection for the endangered mountain gorilla of this East African country forcibly displaced the Batwa from their ancestral home, causing disruptions of such enormous proportions that, though the gorillas have been saved, it is the Batwa people who are now in danger of becoming extinct.
The emotional, psychological and social consequences of eviction from their homes are compounded by health issues that, to the Batwa, are new—and deadly. One Batwa man stands among the many Twa who are advocating to improve the plight of the people.
Niwamanya Rodgers Matuna is a 22-year-old student poised to earn his diploma in clinical medicine and community health from the Kampala International University in Bushenyi. Makuna traveled from Uganda to New York this month to attend the first United Nations Expert Group Meeting on Indigenous Youth. The theme is “Indigenous Youth: Identity, Challenges and Hope: Articles 14, 17, 21 and 25 of the United Nations Declaration on the Rights of Indigenous Peoples.” In May 2013, the final report and recommendations of the Expert Group Meeting will be submitted to the twelfth session of the UN Permanent Forum on Indigenous Issues.
Matuna was identified to attend this meeting largely because of his advocacy in the area of community health. He has worked with two organizations based in Uganda, Pastoral Women Alliance to Break Cultural Chains and Let Us Save Uganda. Under the auspices of these organizations, he has focused on women’s health and reproductive health, but the primary health concern that Matuna says plagues the Twa as a result of their dispossession is malaria.
“When people were still inhabiting the forest,” he explains, “the temperatures were still low, very low for the mosquitoes, by that there was less spread of malaria. But look at when you are displaced. Some of the forest is being cut down, and temperatures have risen, and mosquitoes are able to survive.”
Increasingly high rates of malaria, Matuna says, should be fixed—and could be fixed, quite easily. Discrimination and poverty degrade Twa and limit their access to life-saving medication. “With all the measures [like mosquito nets], with all the drugs on the market,” Matuna says as his voice trails off a bit. “But it still kills us. That's quite disappointing.”
As a Batwa man working toward professionalization in the field of medicine, Matuna sees on-the-ground community health as the path to wellness among the displaced Twa. “The way we can stop malaria, we need to go back to the grassroots, communicate with people in their own languages,” he says. “When we go back and sensitize people in local languages, it is easier for them.”
Matuna says he has heard of local people in communities throughout East Africa who have used mosquito nets to fish or to reinforce chicken coops. “There should be regular talk shows on these issues in local languages,” he says. Sharing information on how to repair a mosquito net through local media would help save lives. Like the types of public service announcements Americans hear frequently about the dangers of smoking, or the constant reminders through signage in local stores reminding pregnant women that they should not consume alcohol, or television programs that focus on wellness on American television, this type of media outreach would increase life expectancy throughout many local communities in East Africa, not just among the Batwa.
Matuna also would like to see more health care professionals who were born and raised in communities where needs are greatest. “We need to get these youth, because they are the power of the future,” he says. “They can institute change in their communities.”
With his diploma, Matuna will be qualified to help create the change he seeks. As a Clinical Officer he will have the credentials needed to diagnose diseases and look over lab tests. But Matuna wants to do more. “When we go to rural countries,” he says, “we are only allowed to do minor surgeries, and carry out other physicians’ work, and then do community health.” He plans to continue his schooling so that he can become a medical doctor.
Speaking, perhaps, of all the indigenous youth present at the U.N. meeting, Matuna says, “We have challenges in the places we originate from. These challenges continue to eat up people we are born with. Because of greed of money we don't look at our societies. Look at cervical cancer, look at lack of reproductive health among indigenous peoples. These are all challenges. My goal is to move to the horizon, far, without limit, in education, so that I can acquire the required knowledge and bring it back home to my people.”
But Matuna isn’t waiting to finish his degree programs and become a medical doctor to save the lives of his Twa sisters and brothers living on the margins of Ugandan society. “I'm a full time student, but I have what other people call free time. What other people call free time I use to give back to people in my society.”
Matuna identifies HIV as yet another public health issue that, he says, was unheard of among the Batwa prior to their dispossession in 1991. He tries to educate his fellow youth, particularly young women, about their rights regarding reproductive health. “When you look at the indigenous society,” he says, “we come from the forest, and that forest is being protected, so that leaves us with no place to survive. That means young girls are going to conceive when they are still young. They need knowledge. They need care. This knowledge needs to be given to them. As people who are born from that area, we need to help our sisters.”
Sudden, forced homelessness has created other specific health concerns among Batwa women and men. Living like squatters, literally positioned at the edges of the forest that they called home from time dating back to antiquity, Twa struggle to maintain basic health care today. “There are those infectious diseases that come up when you move to another area,” Matuna explains. “You are congested. We look at diarrhea, we look at skin infections, we look at things like typhoid because water is being contaminated.
Joblessness has also impacted women and men who remember working for themselves just decades ago. In addition to the problem of prostitution and HIV/AIDS, persistent underemployment in legal occupations devastates the health of underpaid, undervalued, overworked Batwa women and men. Matuna says, “When you are being overworked, you are not looking at the long-term consequences. And these consequences are impacting our people.” To make his point clear, Matuna asks us to imagine a medicine bag meant to hold two grams. “What happens if you put in 10?” he asks.
He understands the impact of underemployment on Batwa families because he experienced it in his own. Though he was 1 at the time of Twa eviction from the Impenetrable Forest, Matuna retains cultural memory of the violent assault he experienced as a baby in 1991.
“Back then, I was a young kid, but memories that are impacted into my mind through the speech of my father fill the gap. Back then, our family was displaced. We went to Bunyonyi. My father struggled to work hard. He had to walk a mile more than the miles others had to walk because he was an indigenous man. I want to thank him. He did not look at the challenges he had at that time. He looked at the future of his six children.” Matuna’s voice trails off again as he speaks. “It was quite horrific to lose whatever you had. As time went on, his mind became focused on what he had to give us to make our future moving.”
Now that his homeland has been turned into a tourist attraction, Matuno says, “I had to pay to access the land that I was born from.” Claiming Batwa homes also claims Batwa power, Batwa authority. “It puts us to a level where they take us like, ‘I'm a child on my own land, and they know better what to do on our land,’” he says. Matuna pauses, then fills the silence between us with these words: “Do you know how it feels to leave the dry bones of your ancestors in the hands of people who don't know them?”
Despite his forced estrangement from the ancient land of his people, Matuna is not without hope: “I look at a young man who has skills to turn wood into an art piece—he would have money. I look at the young man who can find herbs to treat an ulcer—he would make money and help his community.” The key needed to turn the lock and open the door to a brighter future, he says, is education.
Matuna is a Muwa, the person within Batwa society whose job is to inspire people, “to give them courage. A Muwa,” he says, is “the person who gives you the courage to stand and say, 'let's go and do this.'”
“When you look at the sun in the evening, when it is setting, your eyes can't tell you that there will be a sunrise,” he explains. “But after 12 hours, there is a sunrise, bringing hope and joy.” The sun will rise again for the Batwa people, he insists. “We have the rights and we have the power to determine our affairs and fight for who we are.”