Over the past two decades, international efforts have been made to improve the rights of indigenous peoples, to bring awareness to their issues, including their engagement in developing policy and programmes in order to improve their livelihoods. In the First Decade of the World’s Indigenous People (1995 – 2004) the United Nations created the United Nations Permanent Forum on Indigenous Issues as well as the Special Rapporteur on the rights of indigenous peoples.
During the Second Decade of the World’s Indigenous People (2005 – 2015), there have been further initiatives such as the creation of Expert Mechanism on the Rights of Indigenous Peoples. The adoption of the United Nations Declaration on the Rights of Indigenous Peoples in September 2007 was a major step for the United Nations as the Declaration had been debated for over twenty years.
The United Nations Permanent Forum on Indigenous Issues is an advisory body to the Economic and Social Council with a mandate to discuss indigenous issues related to economic and social development, culture, the environment, education, health and human rights. At its twelfth session, the Permanent Forum on Indigenous Issues reviewed health as one of its mandated areas and stated the right to health materializes through the well-being of an individual as well as the social, emotional, spiritual and cultural well-being of the whole community.
The United Nations Declaration on the Rights of Indigenous Peoples states that indigenous peoples have the right to be actively involved in developing and determining their health programmes; the right to their traditional medicines, maintain their health practices, and the equal right to the enjoyment of the highest attainable standard of physical and mental health. Unfortunately, indigenous peoples suffer higher rates of ill health and have dramatically shorter life expectancy than other groups living in the same countries. This inequity results in indigenous peoples suffering unacceptable health problems and they are more likely to experience disabilities and dying at a younger age than their non-indigenous counterparts.
Indigenous peoples’ health status is severely affected by their living conditions, income levels, employment rates, access to safe water, sanitation, health services and food availability. Indigenous peoples are facing destruction to their lands, territories and resources, which are essential to their very survival. Other threats include climate change and environmental contamination (heavy metals, industrial gases and effluent wastes).
Indigenous peoples also experience major structural barriers in accessing health care. These include geographical isolation and poverty which results in not having the means to pay the high cost for transport or treatment. This is further compounded by discrimination, racism and a lack of cultural understanding and sensitivity. Many health systems do not reflect the social and cultural practices and beliefs of indigenous peoples.
At the same time, it is often difficult to obtain a global assessment of indigenous peoples’ health status because of the lack of data. There has to be more work undertaken towards building on existing data collection systems to include data on indigenous peoples and their communities.
This publication sets out to examine the major challenges for indigenous peoples to obtain adequate access to and utilization of quality health care services. It provides an important background to many of the health issues that indigenous peoples are currently facing. Improving indigenous peoples’ health remains a critical challenge for indigenous peoples, States and the United Nations.