State of the World’s Indigenous Peoples – 2nd Volume: Indigenous People’s Access To Health
UN DESA
August 2015 :: 198 pages
Advance Copy pdf: http://www.undesadspd.org/Portals/0/SOWIP_final.pdf

[Excerpt from Foreward]
…The United Nations Declaration on the Rights of Indigenous Peoples states that indigenous peo¬ples 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, indig¬enous 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. Indige¬nous 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 in¬clude 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…

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[Excerpt from Introduction]
…The State of the World’s Indigenous Peoples will remain a recurrent “flagship” publication pro¬duced by the United Nations. It is intended that such publications, such as this, will deal with a broad spectrum of indigenous peoples’ issues. It is hoped that such a publication, given its func¬tion of supporting the United Nations Permanent Forum will also promote awareness of indige¬nous peoples’ issues within the United Nations system, with States, academia and the broader public.

The current situation of indigenous peoples remains a concern within the United Nations. It has been estimated that the world’s 370 million indigenous peoples reside in approximately 90 coun¬tries of the world.3 They are among the world’s most marginalized peoples, and are often isolated politically and socially within the countries where they reside by the geographical location of their communities, their separate histories, cultures, languages and traditions. They are often among the poorest peoples and the poverty gap between indigenous and non-indigenous groups is in¬creasing in many countries around the world. This influences indigenous peoples’ quality of life and their right to health.

Indigenous peoples’ access to adequate health care remains one of the most challenging and complex areas that require an urgent focus on the main health issues as well as examining alter¬native health care frameworks. As previously stated, health is one of the six mandated areas of the United Nations Permanent Forum on Indigenous Issues and is one of the focuses of the World Health Organization which recognizes the right to health as a fundamental human right in its con¬stitution. The United Nations Declaration on the Rights of Indigenous Peoples includes articles (21, 23, 24, and 29) that refer specifically to the right to health including indigenous peoples’ right to improving their economic and social conditions in the area of health and that particular atten¬tion to the needs of indigenous elders, women, youth, children and persons with disabilities. Fur¬ther, indigenous peoples have the right to determine their health programmes and to administer these programmes through their own institutions as well as maintaining their traditional health practices. Also, that States take effective measures to ensure that programmes for monitoring, maintaining and restoring the health of indigenous peoples, as developed and implemented by the peoples affected by such materials, are duly implemented.

Indigenous peoples face a myriad of obstacles when accessing public health systems such as the lack of health facilities in indigenous communities, cultural differences with the health care providers such as differences in languages, illiteracy and lack of understanding of indigenous cul¬ture and traditional health care systems. There is also an absence of adequate health insurance or lack of economic capacity to pay for services. As a result, indigenous peoples often cannot afford health services even if it is available. Marginalization also means that indigenous peoples are reluctant or have difficulties in participating in non-indigenous processes or systems at the community, municipal, state and national levels…