their situation is made worse by loss of land which they depend on for medicines women are also at high risk of getting hiv because of interaction with neighbouring communities at risk of rape and having to exchange sex for necessities access to testing and care and treatment is a challenge as they have to pay for services and health workers do not treat them well coordinated action is needed by all sectors to improve the health of the batwa peoples the cost of accessing medical and health facilities in kenya is also costly and often beyond the reach of many indigenous communities who may not have the means to travel long distances to purchase certain prescribed drugs that are unavailable in public health facilities