Word about the unexpected arrival of a team of volunteer doctors spread feverishly through the orang asli villages of Kampung Ralak and Kampung Penseg in Gerik, Perak.
Within an hour, the small bamboo meeting hall was packed with every man, woman and child from the village waiting patiently to be treated.
For many of these Temiars, it has been years since they were last seen by a doctor. Healthcare services are difficult to come by when you live deep in the rainforest amidst mountains and rivers. (See story on the malnutrition crisis among these orang asli here.)
Many of the indigenous folk ask the Persatuan Kebajikan Saudara Perak (PKSP) volunteer medical team for extra medicine to last them as long as possible. They say they have no way to get to the clinics to replenish their supply.
The nearest government clinic and school in the resettlement scheme (RPS) called Pos Kemar is at least an hour away on foot. Only a few villagers here own motorbikes that enable them to send their children to school or the clinic.
PKSP’s medical team members weigh, measure and examine each patient, finding a host of undiagnosed ailments such as hypertension, diabetes, and fungal infections, but what they are most concerned about is the lack of immunisation among the children.
“Most of the orang asli children here have not received all the vaccinations a regular child would get,” says paediatrician Dr Lee Kim Seng, who leads the PKSP team.
“They’ve only received the first vaccination for bacille Calmette-Guerin (BCG) and hepatitis B in the hospital at birth.
“After returning to their villages, many of them do not get the required follow-up vaccines because they have no access to the clinics and nobody comes to give them the vaccinations,” Dr Lee claims.
As the rest of Malaysia debates the right to not vaccinate children, these Temiar parents do not have the privilege of choice.
The Health Ministry’s vaccination schedule recommends that babies receive vaccine shots when they’re one month old, two months, three months, five months, six months, nine months, 12 months, 18 months, and 21 months.
As the child reaches school age, he or she will receive three more vaccinations at ages seven, 13 and 15.
This comprehensive immunisation schedule protects children against diphtheria, tetanus, pertussis, polio, hepatitis B, haemophilus influenza type B, measles, mumps and rubella, human papillomavirus, and tuberculosis. Children in Sarawak also receive protection against Japanese encephalitis.
However, as dropout rates among orang asli students are high, many of them miss out on the vaccinations they would have received in school.
“In these orang asli communities, no one is protected. If one person falls sick, it will spread to the whole community as both unvaccinated adults and children could get infected,” Dr Lee says.
“As most of them are not vaccinated, they are not protected by herd immunity,” he explains.
Herd immunity occurs when the vaccination of a significant portion of a population provides protection for individuals who have not developed immunity.
Dr Lee says the risk of infection is predominantly from external visitors unknowingly carrying the bacteria into the community.
An outbreak in one village could also be transmitted to another village.
“It can wipe out the entire village,” says Dr Lee.
According to Centre for Orang Asli Concerns founder Colin Nicholas, the effectiveness of government clinics in providing vaccinations to these rural communities depends on the initiative of the doctors.
“In some areas it is your responsibility to bring the child out to the clinics, while in other areas the mobile clinics go in and provide the vaccinations,” he says.
Nicholas says there is no national standard on orang asli healthcare provisions.
“The health provisions in some areas are poor as the orang asli are badly treated, while in other areas they have good outreach teams that really take the initiative to reach the community,” he says.
Some communities, he adds, are so deep within the forest that the medical team may not have a way to reach them.
“The healthcare schemes should be more proactive in making sure all kids are vaccinated instead of making it the parents’ responsibility,” he says.
According to the Orang Asli Development Department, 36.9% of the orang asli population live in the interior while the majority, 62.4%, live on jungle outskirts. Only 0.7% of them live in the cities.
Nicholas says the orang asli are a community that understands and values the importance of good health.
“In some areas, when they see people coming in white attire, they will run out and willingly line up to be treated.
“But a lot also depends on the team bringing in the health facilities. If you treat the orang asli badly, no matter how sick they are, they will not want to be treated by you,” he says.
The Health Ministry did not respond to The Star’s requests for comments.