The North Sentinelese - an unknowable people

What would happen if modern medicine were suddenly faced with dealing with the health needs of an isolated people? Which factors would come into play, and how would health professionals go about providing care to a hitherto uncontacted community?

 
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Let’s take the North Sentinelese, a people that has been impenetrable and isolated, first mentioned by Marco Polo at the end of the 13th Century. North Sentinel island is located in the Indian Ocean, at the south-west point of the Great Andaman Islands, an archipelago in the Bay of Bengal. Never having made substantial enough contact with its people to know much more about them, including what they call themselves, the world has named them ‘North Sentinelese’ and periodically gain media prominence in the form of, from their point of view, unwanted attention from, and contact with, the outside world, as was the case in November 2018. 

The Age of Discovery and the centuries thereafter has left the North Sentinelese uncontacted for two main reasons. The island itself has no natural harbours and is surrounded by a natural reef, making it difficult to approach and also tricky for its people to leave on a sea canoe. In addition to that, anyone approaching has been met with a fierce defence of their home and privacy. Protective laws enforced by the Indian government in the form of a three-mile maritime exclusion zone also play a part in this situation. 

When in 1880 a young British Naval officer, Maurice Vidal Portman, was given charge of the Andaman and Nicobar colony, he decided to explore the island. Imagining himself as an anthropologist (with a bizarre predilection for measuring genitalia of his ‘specimens’), he captured the only North Sentinelese that he could find; an elderly couple and four children who must have lagged behind, when none of the other locals were to be seen.

These six North Sentinelese soon became very ill, with the elderly couple dying. The children were returned hastily, with a couple of gifts thrown in an attempt to appease the North Sentinelese for this intrusion. 

Since then, numerous documented and accidental visits have proved unfruitful in getting to know more about the North Sentinelese. At best, the people of the island have accepted gifts of coconuts and tolerated the presence of visitors for a short period of time. At worst, unwelcome visitors have been killed and buried. 

Does the fact that those North Sentinelese who were removed became ill tell us anything about the immunity of the people? What other factors play a part in their medical needs? 

Whereas it is unlikely, given past experience, that these people, who number anywhere between to 38 to 400, will one day want to join what the rest of us deem to be civilisation, it would be interesting to study the factors that make us ill from an evolutionary point of view. If the North Sentinelese stick to a specific diet, have no access to the food preservation methods known to us, spend their days mostly naked without UV protection, lead a way of life that is alien to us, communicate in gestures that seem bizarre to us - do they still come down with common ailments, such as a cold or flu?

In a book published by physician Ratan Chandra Kar in 2009 titled Andamaner Adim Janajati Jarawa, first written in Bengali and later translated to English, Kar writes about his experiences with the Jarawa people, another indigenous group that had emerged from semi-isolation after a prolonged period of hostility to outsiders. The Jarawa homeland is roughly 48 km from North Sentinel Island and some scholars believe the Jarawa people migrated to the island on rudimentary sea-going rafts and canoes.

The Jarawa people suffered huge health consequences on their emergence from isolation, so much so that they were on the brink of extinction due to a measles epidemic in 1999. It was Kan himself that prevented this disaster from happening. 

What kind of similar disaster would happen if the Sentinelese were exposed to members of another society, and vice versa?

Have they developed a different kind of immunity to others who have a different lifestyle, environment, and diet? What other factors come into play?

Should the authorities do more to protect the Sentinelese without disturbing them?

Do conditions like obesity, diabetes, hypertension, heart disease, cancer, and mental illness exist in the same way we know them?

What do they know about disease? How do they react to it?

How do they treat broken bones? How do they treat and disinfect wounds? 

What do they know about how their bodies work? Do they plan pregnancies? What is their infant mortality rate? What is their life expectancy? How do they deal with death? 

Survival International, which campaigns on behalf of indigenous and uncontacted populations, is concerned about the idea of contacting the North Sentinelese.

Their statement said,

“Their extreme isolation makes them very vulnerable to diseases to which they have no immunity, meaning contact would almost certainly have tragic consequences for them.”

In other words, we should not try to answer these questions by getting into contact with the North Sentinelese. But what happens if circumstances force them out of their home or if we realise that they are in some sort of danger?  

The island has already had its fair share of unwanted visitors, and this was met with hostility, sometimes even resulting in fatal injury, such as the case of the American missionary who illegally visited the island in 2018.

Danger could come to these people by way of natural disaster (e.g. a storm, earthquake, or tsunami, the latter occurred in 2004) or climate change causing drought or a rise in water level. With much of the land lying so low it is easy to see how disastrous this could be. The coral reef makes it difficult for the North Sentinelese to leave the island unless the sea is very calm. Their geographical position also places them in another sort of danger: the methamphetamine smuggling route from Myanmar passes through the Andaman Sea. What could happen if contact comes in the form of visiting drugs gangs?

In view of these matters, India has taken responsibility to watch over them, to keep them safe and respect their wishes to remain isolated.

By Miriam Calleja, Pharmacist and Author, Malta

and Mark Gibson, Health Communication Specialist, United Kingdom

2nd August 2019

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© 2019 Miriam Calleja and Mark Gibson, protected under British Copyright Law 1988.

 
 
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