Preparations and campaigning for the 2013 elections dominated life in Kenya for much of the year 2012. During the first political campaigns since the adoption of a new Constitution in 2010, Kenyan minorities and indigenous peoples struggled to find their voice in the new political landscape. The delineation of electoral boundaries was contested by many communities in Kenya, including minorities and indigenous groups. The multiple petitions were consolidated in a single, large case that was decided by the Kenyan courts in 2012. In many cases, the court took account of minority interests in addressing boundaries and redrew electoral units to afford minority groups a chance to have a member of their community elected either at the local or parliamentary level. However, civic education to ensure that minority and indigenous communities understood new political structures and were well-prepared to vote in the election remained a concern in 2012. Smaller indigenous communities, and indigenous women in particular, reported a low level of understanding of the new Constitution, despite important provisions in the Constitution that protect the rights of minorities and indigenous peoples.

The presidential campaign was dominated by candidates from the two largest ethnic communities in Kenya. Ultimately Uhuru Kenyatta, son of Kenya's first President and a member of the Kikuyu ethnic community, was declared the winner. Ethnically aligned politicking and the formation of political alliances based on large ethnic blocks left less room for minority groups, especially very small communities, to wield influence at this level. Candidates from minority and indigenous groups did, however, emerge in many areas to contest for elective office. In particular, the constitutionally reserved women's parliamentary seats opened opportunities for women from minority and indigenous communities to contest for office. MRG documented women candidates from the El Molo, Maasai, Pokot, Rendille and Somali communities, among others, contesting for 'women representative' seats in their respective regions. MRG partner organizations nevertheless reported that at least some minority and indigenous communities saw their representation decrease at the local and national levels.

The right to health is protected in Kenya's 2010 Constitution and provides that all Kenyans have the right to the highest attainable standard of health, including health care services. Despite this guarantee, minorities and indigenous peoples in Kenya face substantial challenges, including lack of physical and financial access to care as well as discrimination.

A major complaint from many in Kenya, especially those in marginalized areas, is that health personnel are only rarely present in health centres. Community members report arriving at health centres with serious, urgent conditions only to have to wait for days because no health care staff are available. For example, a human rights monitor in the Ogiek community, which lives in remote regions in and around the Mau Forest, reported that community members who can find transport to the nearest health centre are often told to return another day. In early 2012, thousands of health workers in government health facilities around the country went on strike over pay and benefits. The strike left patients unattended and some died as a result of lack of care. The government threatened to fire 25,000 of the strikers after they ignored demands to return to work. Ultimately, the strike was resolved when Prime Minister Raila Odinga finally agreed to meet the strikers' representatives and address some of their demands. The end of the strike, however, did not resolve the underlying challenges in Kenya's health sector. For minority groups, marginalization, poverty and displacement all contribute to an inability to realize the right to health. Decades of marginalization in many areas have left roads non-existent or impassable during rains. Government-run health centres remain under-staffed and often without essential supplies and medicines. Kenya's constitutionally mandated Equalization Fund is designed to help remedy these disparities, specifically to raise the level of basic service provision – including water, roads, health facilities and electricity – in marginalized areas. However, legislation to implement the fund has not yet been drafted and initial government proposals on how 'marginalized areas' would be defined for the purposes of the fund would leave many minority and indigenous communities without any access to equalization resources. Land loss and displacement has also deepened poverty in many minority communities, to the extent that the financial cost of health care can be a major burden. For instance, Sanye community members, who reside in the interior coastal regions of Lamu County, report that no one in the community has sufficient resources to pay the fees charged by health centres, so they use traditional medicine or someone outside the community must pay for health care costs.

Another serious, yet under-analysed, health concern in minority communities is the effect of violence – including deaths, serious injury, long-term disability and reduced quality of life, as well as psychological trauma. Kenya's Coast region, home to several ethnic minority and indigenous communities as well as many members of Kenya's minority Muslim community, was a particular flashpoint in 2012. In August 2012, a well-known Muslim cleric was executed in Mombasa leading to deadly and destructive rioting; five people were killed and churches were attacked. In the Tana River region, hundreds of Kenyans including civilians and members of the security forces were killed in a series of massacres and revenge raids that pitted ethnic Pokomo agriculturalists against Orma pastoralists. In December 2012, simmering conflict between Turkana and Samburu pastoralists resulted in the killing of 42 Kenyan police officers, who were in the midst of an operation to recover cattle, in the Baragoi region. The government's response to the attack on the police led to the displacement of hundreds of families from the area. While deaths are the most often reported tragic outcome of this violence, many communities live with permanent scars, both physical and emotional. Often the long-term trauma is disproportionately borne by women. The director of the Consortium for the Empowerment and Development of Marginalized Communities (CEDMAC) identified the health and psychological consequences of violence as the top issue facing minority and indigenous women in Kenya.

Finally, minority and indigenous communities continued to confront threats to access and control over their land and natural resources. Land loss and displacement have negative health consequences through entrenching poverty and reducing communities' ability to gather and use traditional healing products. In many instances, displacement is for the purpose of development, which in Kenya has often led to environmental degradation and resulting food insecurity. In March 2012, the Kenyan government announced the discovery of oil in Turkana County. The discovery of oil has led to extensive exploration around Lake Turkana, a major environmental asset for Turkana and other minority groups such as the Rendille and El Molo, who fish and hunt animals that live near the lake. Communities in the region fear environmental changes for Lake Turkana as a result of oil exploration in Kenya and the Gibe III dam project in Ethiopia. On the Kenyan coast, multiple minority and indigenous groups continued to oppose the construction of the Lamu Port, which was officially launched in March 2012. The Save Lamu Coalition filed a case in a Kenyan court in 2012 to stop the port project. The port is anticipated to have severe negative environmental impacts for the Aweri, Bajuni, Orma, Sanye and other communities through loss of fishing grounds and traditional lands.

The Endorois community continued to advocate for implementation of a 2010 decision of the African Commission on Human and Peoples' Rights (ACHPR) that recommended that the government compensate them for eviction and loss of access to their ancestral lands; however there had been no significant steps towards implementation by the government before the end of 2012. The Ogiek land rights case was referred by the ACHPR to the African Court on Human and Peoples' Rights in 2012; it will be the first case on indigenous peoples' rights to be considered by the court (see case study on p. 61).

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