2011 Annual meeting of the UN interagency support

2011 Annual meeting of the UN interagency support group on indigenous Peoples Issues 21 -23 th Nov- 2011, New York Meeting Reproductive Health and Rights of indigenous people in Central African Republic Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 1

Outline ü Background information on CAR ü Geographic location ü Access to basic social and economic services : Challenges faced ü UNFPA Responses : üCurrent and perspective Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 2

CAR : Background information • • • Area (square km): 623, 000 Population size: 4, 570, 000 (est. 2011) Density (Sq km): 7. 3 Total Adult Literacy rate: 55% Total Fertility Rate (TFR)/ISF: 4. 7 births per woman Maternal Mortality Ratio: 850/100, 000 live births (LB) Infant Mortality Rate: 112 deaths per 1, 000 LB Under-5 mortality rate: 171 deaths per 1, 000 LB HIV&AIDS prevalence rate: 4, 9% (MICS IV 2010) Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 3

Geographic Location and Population Size Tchad üOmbela-Mpoko: 15, 200 Soudan üMambere. Kadei: 14, 600 üSangha. Mbaere: 4, 500 üLobaye: 10, 700 Cameroun Bangui Congo Total 45 000 people RDC Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 4

Main characteristics: who they are and How they live • Account for 0. 3% (minimum) of the whole Population (2003 Census) • Originally live in small communities from hunting and gathering with gender division of work (Men hunting; Women gathering and hut building) • Nowadays: “Pygmies” are the most vulnerable ethnic groups with the Mbororos • Changes in their lifestyle due to loss of land natural resources as a consequence of deforestation more involved in farming, agriculture (as “slaves” and underpaid) 5 Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

Main challenges in a changing environment Limited (or no) access to basic social services, Poverty: almost 90%, 93% illiterate, high drop Therese off from school. ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 6

Access to basic social and economic services : Challenges faced Legal Challenges : Considered as “second class” citizens: 60% of Aka people in Lobaye declared they had a Bantu “master” (Survey conducted by COOPI in 2004 (Italian Cooperation Agency) Discrimination/humiliation Victims of SGBVs No access to land Underpaid and exploited Not represented in decision-making processes, 7 Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

Access to basic social services : challenges v Reproductive Health of Aka Pygmies • Total Fertility Rate (TFR): 5. 1 - 6. 2 children per woman (versus 4. 7 for CAR as a whole) • High Infant Mortality rate: 200 – 220 per 1, 000 LB (versus 112 for CAR as a whole) • Maternal Mortality (and morbidity) higher than the country average – (very) early childbirth , no access to ANC; delivery in the bush or at home without skilled assistance), – Obstetrical Fistula as one of the consequences of early childbirth and delay to obtain care 8 Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

Access to basic social and economic services : Challenges (cont’d) Infection after Abortion : Uncompleted delivery , 3 days with placenta retention before reaching a health center Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 9

Access to basic social and economic services : Challenges (cont’d) v Increasing of diseases and infections: Skin diseases: Pian (very easy to cure) Acute Respiratory Diseases (ARI) among children Intestine Parasitic diseases Malaria Tuberculosis HIV & AIDS Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 10

Global Responses v Government , NGOs (national and international), faith based organizations, are providing a range of interventions in several areas for Pygmies and their communities, ü mainly alphabetization, human rights, Education, health/ immunization, environment , Support to agriculture v High commissary for Human rights in CAR, v COPI (EU, UNICEF, BINUCA, OCHA, OHCDH) v BIT, UNFPA v National NGOs ü “Maison de l’enfant et de la femme Pygmee” ( MEFP), ADIBAC, MBOSCUDA ü AFJC (Women legal professional association) Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 11

Reproductive Health and Rights : UNFPA Responses v From 2007 to 2010, UNFPA has provided support for Integrated RHR activities including HIV prevention and Sexual and reproductive health for youth in regions, prefecture/district and heath centers including two out off the four provinces where indigenous people are living in CAR ü Commodities and medical equipments for Health centers and hospital ü Training of health providers in : – – Basic obstetrical care, and emergency obstetrical care Training in maternal death audit Fistulae surgical repair Modern contraceptives methods integration in health centers Minimum Package of Services ü BCC and tests for free counseling and testing for HIV

Reproductive Health and Rights : UNFPA Responses ü 01 ambulance for reference ü Clean delivery kits (25000) ü Mattress for post delivery unit of health centers (100) ü Delivery medical table (22) ü Cesarean kits (1000) ü 3000 unit of extencillin to control “Pian” infection Difficulties to reach “pygmies” v Distance to the health center Ø they dwell in remote areas. They have to go too far fir care, v Services cost too high Ø they cannot pay (monetary poverty very high), v Lack of information, inadequate strategies to reach Pygmies v Discrimination, humiliation Ø they are subject to humiliation by health centre staff and other population because they are Pygmies 13 Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

Reproductive Health and Rights : UNFPA Responses, current and perspectives • In 2011, UNFPA planned to improve impact of all its support to pygmies in the Lobaye on a pilot based, results to be strengthened in the next Country Programme 2012 -2016 through : ü Launch of the community based intervention : Community mobilization to save vulnerable people life, including women empowerment (selection and training of community services providers) ü RHR need assessment in preparation ü Advocacy and BCC interventions in collaboration with MEFP : Administrative leaders, Health authorities at central and operational level, Pygmies and Bantus community leaders : • Strengthen Partnership with BIT, UNICEF, OCHA, BINUCA for Joint project on RHR and women and youth empowerment.

Thank you Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR 15