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 Collaborative activities Malaria control for ethnic minorities
Ethnic minorities associated with poverty and disease

There are 54 different ethnic minority groups inhabiting Vietnam. The Kinh people (or Viets) account for 85 percent of the country's total population, the others are of ethnic minority groups. Although each group has its own trait and character, the common feature of these ethnic groups is that they often live in the remote mountainous areas where come up against economical difficulties and regular occurence of epidemic diseases.

 

Some characteristics of the ethnic minority groups in Vietnam

Although the number of ethnic groups is the highest 53/54, their population account for the lowest rate > 14% (12.3 Million people) in comparison with the population of the whole country. The ethnic groups that have at least 1 million people are Tay, Thai, Kho-me, Muong, Hoa; from half to nearly o­ne million people: Nung, Mong, Dao; from 100.000 to nearly 500.000 people: Gia rai, E de, Ba Na, San Chay, Cham, Xo Dang, San diu, HRe, Co Ho...; no more than 100.000 people: Raglay, Mnong, STieng, Kho mu, Van Kieu, Giay, Gie trieng, Ta Oi, Ma, Ha Nhi, Xinh Mun, La Chi, Phu La, La Hu, Chut...; from 200 to nearly 1000 people: O du (Nghe An province), Bo Rau, Ro Man (Kon Tum province), Pu Peo (Ha Giang province), Si La (Lai Chau province). These ethnic groups locate primarily in the mountainous and midland areas and about 3/4 the area of Vietnam such as the North-Western region (Thai, Mong Muong; the North-Eastern region (Tay, Nung Dao, Mong); the Northern Central region (Chut, Van Kieu, Pa Co); the Central Coastal region (Ka Tu, Raglai, Cham); Western Highland (E de, Gia Lai, Ba Na, MNong, Xo Dang, K'Ho, Cil, Ma, Chu ru); the South-eastern region (Stieng, Kho me, Chau ro, cham, Ma); the Mekong river Delta region (Kho me, Cham, Hoa)...

The resident characteristic of the ethnic groups is scattered but gathered by descents in the settled villages, alternating among other groups in the same mountainous, upland, border, remote areas and hinterlands; few groups settle in the plains, islands and towns. Beside the ethnic groups that have had settled agriculture and fixed-residence and developed stably like Tay, Nung, Thai, Muong, Cham, Kho me, Hoa who almost settled in the plains where have considerable conditions of soil, water, climate, weather, near the marker; there are also many underdeveloped ethnic groups like Mong, Dao, Co Ho, La Hu, Raglai, MNong, Kho Mu, Stieng and some other groups who often settle in the uplands, hinterlands, border routes, their traffic is underdeveloped, the productivity is at low level with the forms of extensive cultivation, extractive agriculture, the custom is obsolete, some groups in the Western Highland region are also affected seriously by the matriarchy, even some groups also earn their living by depending o­n the nature, hunting and gathering like La Hu (Lai Chau province), Chut (Quang Binh province)... Nowadays the provinces that have ethnic groups account for high rate: over 80% in comparison with the provincial population, they are Cao Bang (93%), Ha Giang (90%), Lang Son (86%), Son La (82%), Lai Chau (81%); the provinces that their proportion of ethnic groups are higher than 50% are Dak Lak, Dak Nong, Kon Tum,Gia Lai, Bac Can, Tuyen Quang, Soc Trang... Especially, in recent nearly 20 years, the waves of "free migration" are the people of the ethnic groups (Tay, Nung, Mong, Dao...) from the Northern mountainous provinces (Cao Bang, Lang Son, Ha Giang...) mass into the Western Highland regions to seek for "promised land", which make the local government difficult in controlling the epidemic diseases as well as eradicating famine and reducing poverty in these regions. Basically, almost the people of the ethnic groups in Vietnam settle and earn their living in the mountainous areas - the riverheads of the rivers and springs, they have the favourable conditions for reclaiming lands, tilling the fields, developing forestry and exploiting forest and native products... which results in the limitation of their approach to social and cultural information.

The real situation of poverty and epidemic diseases in ethnic minority areas

Poverty

Although the Communist Party and the State have implemented many policies to give priority to the ethnic groups' development and many extraordinary achievements were recorded in comparison with the past, the mountainous areas where the ethnic groups settle have difficult economic situations, the income gap is still bigger than other regions of Vietnam, the infrastructures for the welfare of the people are insufficient, the poor household rate is three times higher than the average poor rate of Vietnam. The quality of general education and manpower development is low, the illiteracy is widespread in the ethnic groups, and most of the people in working ages haven't been trained; the professional qualification of the local medical staff is weak and medical equipment is defective, the quality of medical services are not good enough. The capacity and professional qualification of the native staff haven't met the requirements of the society; the security, politics and public order in some areas are not perfectly stable; the activities of extractive agriculture, nomadism, free migration and deforestation still occur complexly in many areas, especially the Western Highland provinces. These limitations, weakness and shortcoming resulted from the low starting points of the ethnic and mountainous economy, difficulties of natural condition, regular occurrence of natural disaster, limitation of investing resources; beside that, the improvement of people's intellectual standard and social awareness has not been concentrated appropriately, the policy for national priorities is not coherent and slow in supplementation, amendment to accord with the development of present society. From those situations, many ethnic groups continue maintaining the obsolete habits and customs (superstition, funeral, ceremonial offerings...) and traditional handcrafted cultivation (deforestation for exploiting lands, till the fields and sleep under field-hut, settlement and extractive agriculture or extractive agriculture and nomadism...), through those activities the ethnic groups not o­nly destroy the national natural resources but also create favourable conditions for vectors (mosquito, flea, tick, rickettsia, mite...) to suck the blood and transmit dangerous infectious diseases from human to human and animals to human.

Free migrants burn the forest to clear up lands for housebuilding and cultivation
The evidence that proves the movements of population in the mountainous areas is the free migration of the people, according to the statistics from 1990 to 2010, there were hundreds thousand migrants who are members of the ethnic groups (Tay, Nung, Mong, Dao, Muong, Thai...) moving from some North mountainous provinces to the Western Highland region, the peak of the waves is the period of 1991 - 1995, each year there were about 160,000 free migrants; the period of 1996 - 2000 the number reduced by 90,000 people, the period 2000 - 2010 this number was over 40,000 people/year. In the recent years the waves of migrants is not massive like the past but it still occurs complicatedly and became out of the control of local government as well as local medical staff because the migrants came with small groups and lived in the local people's houses in all over Western Highland regions, along with the excessive deforestation and lack of access to medical services.


Along with the free migration, the shifting cultivation (going into forest, tilling and sleeping in the field) of ethnic groups in these areas nearly became popular in the Western Highland region as well as the mountainous areas of Central and South-eastern provinces. It could be said that shifting cultivation plays an important role in providing food for the ethnic groups in these areas because wet-rice cultivation hasn't been popular to them, however shifting cultivation also contributed in reducing the coverage, resources of the forest and destroying forest ecosystem.

Ethnic minority people in Western Highlands live in a field-hut 

Health care and epidemic diseases

From the difficulties of socio-economic life of the ethnic groups, the health issue needs to be focused o­n. The results of the health investigation have shown that the proportion of malnutrition of under 5 years old children in the ethnic groups and mountainous areas accounted for the highest rate: from 25% - 35% in comparison with the whole country; particularly higher than 40% in the ethnic groups in the hinterlands like Mang, La Hu, Co Lao... the mortality rate of the under 1 year old children is at the high level such as Western Highland (27.3), midland and northern mountainous region (24.5); particularly some areas where the mortality rate of under 1 year old children is approximately 40% like Lai Chau(47.7), Dien Bien (39.7), Ha Giang (37.5), Kon Tum (38.2). The result of the investigation of health system organization has shown that nearly 60% of the health stations haven't qualified; the local medical staff is shorthanded and not skilled enough, while the epidemic situation (malaria, dengue fever, encephalitis/meningitis, diarrhea and many other infectious diseases) hasn't been controlled tightly.

Some infectious epidemics still occur frequently in the mountainous areas such as malaria, statistically, with the investment of malaria control program, the malaria has reduced; however over 80% of the malarial morbidity and mortality still concentrated in the severely-hit areas where the ethnic groups live (Western Highland, Central, South-eastern and 4th Military Zone) due to uncontrollable movements of population (forest goers, field-hut sleepers, free migrants, border exchangers...); the vector-borne diseases also have the opportunity to spread and develop such as Tsutsugamushi, dengue fever, scarlet fever, Japanese encephalitis, etc.

A health station and the treatment of a malaria patient in a mountainous commune. 

Those outlines have shown that the famine and poverty always attach to favourable conditions for epidemic diseases in the ethnic groups in the remote areas where always exist endemic epidemic diseases; in order to solve those problems, the State has implemented many policies for hunger eradication and poverty reduction for ethnic groups and the health sector has provided a lot of infrastructures and national standard equipment for the health stations in the mountainous areas, simultaneously strengthening the training to improve the professional skill for the medical staff who are ethnic minority people, particularly the doctors for commune health station and health worker in the hinterlands; most of the projects/national health goals including children malnutrition control, malaria control, widespread vaccination... give priorities to the mountainous areas and the places where ethnic groups live.

In a country where 54 different ethnic minority groups inhabit, the national policies of the Communist Party is establishing fully the equal right in all aspects among ethnic groups, make the necessary conditions to eliminate completely the gap of economic, cultural level among ethnic groups, make all ethnic groups live a comfortable and happy life, develop comprehensively. In the face of the economic difficulties of the mountainous areas and ethnic groups at the present, the national policy of the State is giving priority to hunger eradication, famine reduction along with developing culture, education, health services, protecting mother and children, rolling back epidemic so that the ethnic groups could rise higher to integrate with the development of the country.

 

07/14/2014
Written by Prof. Trieu nguyen Trung
(Translated by Nguyen Thai Hoang and Huynh Thi An Khang)
 

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