By Dr Kokila Konasinghe
Dr Kokila Konasinghe
Noncommunicable diseases (NCDs) - such as cardiovascular disease, cancer, and diabetes - kill 41 million people each year, equivalent to 71% of all deaths globally (World Health Organisation). This has not gone unnoticed by the likes of Betty Kabarega, a Queen Elizabeth Commonwealth Scholarship (QECS) alumna turned Technical Officer at the Africa Centres for Disease Control (CDC) and Prevention in Ethiopia.
‘NCDs continue to be the leading cause of morbidity and mortality, placing a significant burden on health care systems worldwide. A lot of time and resources have been invested into communicable diseases while inadvertently neglecting NCDs in the process. With globalisation it’s becoming evident that we need to shift more attention towards noncommunicable diseases’ Betty explains.
The Africa CDC is a specialised technical agency of the African Union whose mandate is to strengthen the capacity and capability of Africa’s public health institutions to quickly and effectively detect and respond to disease threats and outbreaks based on data driven interventions and programmes. As a technical officer specialising in non-communicable diseases, Betty supports Member States across Africa by strengthening their capacity to prevent and control non-communicable diseases. This includes providing strategic guidance and support, workforce development, strengthening NCDs surveillance, health promotion and protection policies development. She is currently working on the first ever five-year continental strategy for NCDs and injuries prevention and control and mental health promotion, which will act as a high-level document and source of guidance with practical interventions and responses to address the current burden of NCDs, injuries and mental health problems across the African continent.
‘If a Member State wants to implement an initiative in the area of NCDs prevention and control such as a national strategy, they can reach out to us to request support. At Africa CDC, partnerships are at the centre of our day-to day work, we believe in respected action-oriented partnerships as reflected in the new public health order for Africa. We work with international and local partners to ensure coordinated efforts and efficiency', Betty recalls.
Thinking global, acting local
Studying a Master of Public Health (MPH) at the University of Mauritius (UoM) built a solid foundation for Betty’s career in non-communicable diseases. In fact, it was at UoM that Betty conducted a clinical trial on the consumption of Moringa Oleifera Lam infusion - an indigenous plant used in herbal teas – and its relationship to biomedical markers of health that relates to NCDs (eg. Blood glucose, Hyperlipidaemia, BP, etc. . Nearly 20% of the population above the age of 30 and nearly one in two of those above 50 suffer from diabetes in Mauritius (World Diabetes Foundation). Not only did this experience contribute to her knowledge but it also provided an opportunity to collaborate with her supervisor on a local problem which cut across the continent.
The Veddah community is an indigenous group in Sri Lanka, predominantly found in the country’s dry zone called the ‘Adivasi Gammana’, comprised of the five main areas of Dambana, Pollebadde, Rathugala, Hennanigala, and Dalukana. Few other groups of coastal Veddahs are found in Batticole and Trincomalee.
The historical traces of Veddahs go back to the 5th century BC, as recorded in The Great Chronicles of Ceylon, ‘Mahawamsa’. The origin of Veddahs can be traced back to Jeevahatta and Disala - the two children of King Vijaya, an Aryan Prince from India and of the Lady Kuveni, who belonged to the Yakkha clan of the natives who populated the island at the time.
Today, the Veddah community is negatively impacted by changes in biodiversity, weather and temperature caused by climate change. It is also impacted by the regulations and restrictions imposed on traditional livelihoods and habitats, which are enforced by strong environmental protection regimes designed to combat climate change.
This has led to a paradox in which the Veddah community suffers simultaneously from climate change impacts, as well as the environmental standards imposed to combat them. It is an area that many global climate initiatives have overlooked, and one which requires serious attention with immediate effect.
Cut off from traditional methods of sustenance
Hunting used to be the traditional method of sustenance for ancient Veddahs, but it is no longer sustainable due to restrictive forest and wildlife conservation laws. Now, the Veddah community require a permit to enter local forests, which have been increasingly marked out as National Reserves. Under current laws, Veddah community members are only allowed to carry bows and arrows to collect bee’s honey and pick herbal plants, and they must obtain special permission to carry their traditional Keteriya – an indigenous axe – when entering a Forest Reserve.
The law also prohibits Veddah from hunting wild animals in sanctuaries and national reserves, pushing them to adopt new means and ways of sustenance that challenge the traditional ways of life which have prevailed since the time of their ancestors.
The Veddah community must also deal with multiple climate-related issues on a regular basis, ranging from severe drought and low rainfall levels to unpredictable weather patterns. In an interview conducted with Dambane Wimale, an official interpreter of Uruwarige Wannilaeththo – the indigenous leader of the Sri Lankan Veddah community – it was revealed that many changes have taken place in the natural environment of the Veddahs which have severely affected their lives.
Wimale notes that the scarcity of water supply for cultivation is now recognised as the predominant concern, as traditional Chenna and paddy cultivation are the main sources of livelihood for the Veddah community today. He also emphasized that the Veddah community only cultivates during one season, following the traditional pattern of annual paddy cultivation. Therefore, seasonal rain is a significant factor deciding the duration the Veddahs’ engagement in cultivation. Due to extreme weather patterns and erratic rainfall, cultivation has become a highly unpredictable livelihood.
The scarcity of clean drinking water is another struggle. In most places across the dry zone, sources of clean water have become limited due to severe drought conditions, and often the water available is not fit for consumption.
In addition, Veddah communities trade honey to local markets as a popular form of income. According to indigenous honey harvesting dealers, there is a noticeable decline of bees due to climate change. They believe global warming has affected the breeding of bees, and that biodiversity losses have upset the availability of proper food supply for them.
Over time, climate change impacts have combined to push the Veddah community to abandon cultivation and bee honey trade for new forms of livelihood.
The indigenous community of Veddahs experience clear injustice in Sri Lanka due to both the direct and indirect impacts of climate change. Unjust consequences also result from human interventions in traditional indigenous habitats, such as the clearing of forests for government development projects. As far as climate justice is concerned, the indigenous Veddahs are more affected than any other foreign or local community on the island.
The connection between Veddahs and nature is a very close one. Livelihoods, food, shelter, spirituality, recreation, social and cultural relations, and many other aspects of the Veddahs’ lives are derived from, and strongly interlinked with, nature and other natural phenomena. The anthem of the Veddah community reads as follows:
Everything that is natural- God given, the sun, the moon, the wind, the trees and the beauty of the blowing wind, the wild animal who is a part of nature itself belongs to us the vanniyalaththo the men of the jungle.
This anthem depicts the intrinsic link that the Veddahs and their ancestors have maintained with nature, and their belief that Vanniyalaththo – the people of the jungle – belong to nature and vice versa. The words of the anthem designate Vanniyalaththo as the guardian of the forests and its biodiversity. However, with the intensifying impacts of climate change, the guardians are themselves facing injustices that seem to be unresolvable and continuous. Unless the Veddahs find justice, a significant part of the global civilization who presently live in the island of Sri Lanka will soon go extinct without much notice.