Orang Asli (Indigenous Malaysian) biomedical bibliography

The Orang Asli are the first people of the Malayo-Thai Peninsula. The first edition of the Orang Asli biomedical bibliography was appended in a book; the second edition was part of a general bibliography on Orang Asli. This third edition includes more recent studies but is also timely because Orang Asli healthcare has plummeted over recent decades. New revelations have made this situation widely known. Some officials in West Malaysia have chosen to ignore the problem, others have denied it exists, and still others have said that Orang Asli are dirty or negligent and thus justify blaming them for their poor health. Officialdom takes a lordly stance with all policies and practices being “top down.” There is no attempt at “bottom up” solutions. The top-down measures include eviction of Orang Asli from their native lands to make way for golf courses, palm oil plantations, and cities. Orang Asli are moved into small quarters on bulldozed tracts with scant access to areas for foraging, fishing, or even gardening, but with promises of modern infrastructure. New-village medical clinics may indeed be built but too often no doctor or nurse is ever seen there. The Gombak hospital near Kuala Lumpur, once dedicated to Orang Asli healthcare, is now run largely by non-Orang Asli for non-Orang Asli. Doctors and nurses there can be prejudiced against Orang Asli, ignorant of their cultures and languages, and derelict in their duty to provide basic care to Orang Asli, both in hospital and in home villages. For example, when a British dentist who worked at the hospital in the 1960s revisited it decades later, he learned that Gombak dentists were primarily interested in the income level of dentists in England. \ud Another excuse for poor Orang Asli healthcare, besides invoking fault-finding, is that many of them live in remote areas. This excuse is belied by the situation in the Malaysian state of Sarawak, which is just as vast and has fewer roads but more mountainous terrain. There, rural health clinics are manned conscientiously and competently, and many distant villages have volunteer health promotors equipped with medical kits. When a Sarawak medical official was asked by a West Malaysian colleague how he got people to show up for work at rural clinics, the Sarawak man replied, “We don’t have that problem in Sarawak.” In West Malaysia, man’s inhumanity to man is complacently at home. \ud This bibliography contains over 500 entries on health issues, organized under 19 topical headings. It covers general topics plus individual diseases, demography, dentistry, ethnobotany, genetics, and on through to women’s health. Many of the entries are annotated to identify study locations, the ethnic groups investigated, and other data. A problem with some entries is that health information is sequestered in texts that are primarily on a non-health topic. Another problem is that reports such as theses and government documents are readily available only at the one institution where they were produced.\ud Many reports in the bibliography are now available on-line. While some are only available through library databases, a growing number are in the “open access” category on the internet. Readers are encouraged to navigate the net to obtain downloadable copies. The best general database for medical topics is Medline; while it does not provide full texts, it does provide abstracts, whenever available. \ud The entries in this bibliography stretch back more than 100 years, to a time when the British were consolidating their control over Malaya. The British, however, provided few health services to the people of the country and had little interest in doing so, despite epidemics of smallpox, cholera, and other plagues. The Orang Asli were the last to receive government services. Modern health services were not continually available even to a minority of Orang Asli until several years after World War II ended. Since that time Malaysia has risen out of the ranks of poor countries, but Orang Asli healthcare, purportedly free to them by the government, has stagnated. The minority Orang Asli still are far behind other Malaysians in major measures of health status, including life expectancy, childhood nutrition, and other indicators of well-being