Hunter-gatherer health and development policy: How the promotion of sedentism worsens the Agta's health outcomes. (January 2018) - Page, Abigail E.
Abstract: Many hunter-gatherer groups live on the outskirts of wider society, experiencing poor health outcomes with little access to medical care. From a development perspective, key interventions include the sedentarisation of these mobile peoples into camps nearby larger towns with sanitation infrastructure and medical care, as increased access to services is assumed to improve outcomes. However, recent research in the Agta (Philippine foragers from North-east Luzon) has demonstrated that individuals residing in more 'developed' communities suffer from increased morbidity and mortality. Here, using quantitative and ethnographic data on health collected between 2002 and 2014, we explore why this trend occurs by examining the relationship between key development initiatives with self-reported illness and the uptake of medical interventions with 415 Agta men, women and children. We demonstrate that health outcomes worsen as sedentarisation progresses, despite some increases in medical access. We argue this is because the development paradigm is not evidence-based, but rather stems from an ideological dislike of mobile hunter-gatherer lifestyles. Compounded by cultural insensitivity and daily discrimination, current interventions are ill-suited to the unique needs of hunter-gatherers, and thus ineffective. Based on our findings we offer future short and long-term policy suggestions which seek to reduce the Agta's vulnerability, rather than increase it. Highlights: Explores the health of Agta hunter-gatherers who have been pressured to settle. Argues that agencies wrongly assume that sedentism boosts health and wellbeing. Shows the importance of mixed methods in revealing the reality of 'development'. Cultural relevance, cultural competency, and discrimination by health workers are all key issues. Policy suggestions include the training of Agta mobile health workers and demarcation of Agta land.