Asking what good would come of achieving respect for indigenous peoples human rights without ensuring that indigenous communities were healthy enough to enjoy those rights, the Permanent Forums focal point on health this morning suggested health be considered the first priority of the bodys work.

As the Forum began its discussion of health, Forum member Mililani Trask praised the World Health Organizations definition of health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. That definition reflected the holistic understanding of health articulated by indigenous peoples and could serve as a good foundation for collaboration between indigenous peoples and the United Nations system. It was, therefore, disappointing to see that the Forum had received no documentation or information from the World Health Organization (WHO) during its present session.

The principle of non-discrimination implied that States had an obligation to ensure equal access to and equity in health services for all, said Siri Damman, a research fellow with the University of Oslo, Norway. Timely measures were needed to bring populations whose health lagged behind up to speed. States should adopt and implement national health-action strategies, establish indicators and benchmarks for action, and identify vulnerable populations through the disaggregation of statistics.

In that process, she added, the Forum could play a role in coordinating collection and dissemination of indicators on indigenous health and facilitating collaboration across the United Nations system and the international community.

During the subsequent discussion, attention was drawn to the health situations of specific indigenous groups, which were generally of lower standard than those of non-indigenous populations. For example, noted one speaker, the median life expectancy of an Australian aborigine was only 50 years; if that statistic carried over into the non-aboriginal population, it would be considered a national crisis.

Indigenous representatives also repeatedly highlighted the importance of incorporating traditional medicinal practices into conventional health systems, especially with regard to womens reproductive health. There should also be national and international funding and support for training indigenous healers. Another issue of concern was the spread of HIV/AIDS and other sexually transmitted diseases among indigenous women and girls.

Also making a presentation this morning was the representative of the Pan-American Health Organization.

The Forum will reconvene at 10 a.m. tomorrow, 20 May, to discuss its future work and the draft agenda of its fourth session.

Background

The Permanent Forum on Indigenous Issues met this morning to continue its third session with a discussion on health. (For background on the current session, see Press Release HR/4741 of 4 May.)

Discussion

Forum member MILILANI TRASK, who served as the Forums focal point on health, suggested that health should be the first priority of the bodys work. After all, what benefit would arise from achieving human rights without ensuring that indigenous communities were healthy enough to enjoy them? Health had been recognized as a human right in four primary international human rights instruments. Furthermore, the right to health comprised two elements - recognition of the individuals right to the highest attainable standard of physical and mental health, as well as the obligation of States to take measures to achieve the full implementation of that right.

The World Health Organization (WHO), charged with responsibility for health within the United Nations system, had defined health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, she recalled. That definition reflected the holistic understanding of health articulated by indigenous peoples, who had repeatedly stressed the need to address the complete spiritual, physical and mental well-being and balance of individuals.

Thus, she said, there was a good foundation for indigenous peoples to work with the United Nations system on the issue of health. Thus, it was doubly disappointing that the Forum had received no documentation or information from WHO this year, nor was that agency represented here. The Forum would be drafting a recommendation to WHO since that absence was unacceptable.

Among the common truths that must be acknowledged, she continued, were that indigenous peoples globally had generally been excluded from health services available to the general population; that indigenous peoples were the poorest of the poor and suffered from malnutrition and lack of access to safe water; and that indigenous women and girls were the most discriminated members of their communities. Indigenous women and girls were subject to much violence, prevented from attending school or from accessing health services specific to their biological needs.

Future work regarding indigenous health should be informed by enlightened approaches such as that adopted by the United Nations Childrens Fund (UNICEF) and which focused on three main principles: that States were accountable under instruments to which they had ascribed; that all human rights were universal; and that all human rights were interdependent. UNICEFs programmes aimed first to analyze processes particular to indigenous cultures, then to analyze the basic problem as manifested within statistics and finally to take action.

SIRI DAMMAN, research fellow with the University of Oslo, Norway, and member of an interdisciplinary team on the right to food in development, presented her findings on infant mortality and chronic malnutrition of indigenous children in the Americas. Her research showed that, although statistics varied across countries and across the urban/rural divide, indigenous children enjoyed a lower standard of health than non-indigenous children. An authoritative interpretation of the right to health suggested that that right should focus on the enjoyment of access to services promoting the highest attainable standard of health, and that non-discrimination implied States obligation to ensure equal access to and equity in health services for all.

Timely measures were needed, she said, to bring populations whose health lagged behind up to speed. States parties should adopt and implement national action strategies, establish indicators and benchmarks for action and identify vulnerable populations through the disaggregation of statistics. Ethnicity should be considered in national health programmes, but in a way that precluded increased discrimination. In that process, the Forum could play a role in coordinating collection and dissemination of indicators on indigenous health and facilitating collaboration across the United Nations system and the international community.

Commenting on the presentations, several Forum members cautioned that the proposed recommendation to the WHO should not be too critical, recalling that the organization had done much good work in the area of indigenous health. States should encourage WHO to participate more fully in the Forums future work.

ROCIO ROJAS, of the Pan-American Health Organization, said that experience had shown that harmonizing indigenous and conventional health systems had contributed to ameliorating health crises, including with regard to malaria, tuberculosis and HIV/AIDS. Blending the intercultural approach with gender and national approaches was also necessary. Her organization had also worked on the issue of reproductive health, where, for example, it was seen that the Peruvian conventional system had improved its respect for indigenous practices. The attention focused on that issue by the International Decade for Indigenous Peoples, the reiterated commitment to health care, and the challenge of meeting the Millennium Development Goals had allowed for headway to be made regarding indigenous health.

A representative of the Association of Iroquois, Allied Indians noted the health crisis among First Nations people, who were like a third world society living in one of the top ten countries in the world. Compared to the rest of Canada, the suicide rate among the First Nations was eight to 10 times higher, the diabetes rate five times higher and communal diseases 10 to 12 times higher. He requested the Forum to call on Canada to meet their obligation for First Nations health care by implementing a health budget to meet their needs.

Canadas delegate said it was imperative that womens needs be recognized, and that his country had supported the workshop on disaggregation of data held in January 2004. Indigenous women not only participated in health-care decision-making, but also acted as pillars in the community, taking part in the planning and delivery of health services. He urged States to encourage the participation of women in ensuring healthy, safe birthing practices with respect to traditional practices.

Forum member WILLIE LITTLECHILD said the treatment of diseases should be accompanied by the promotion of good health through physical activity and sports education. That approach would address concerns about problems such as diabetes and obesity through preventive practices.

A member of the Indigenous Peoples Caucus urged the Forum to inform United Nations bodies of the importance of health care to indigenous peoples, and also to recognize the importance of traditional medicine to indigenous peoples. He recommended the establishment of a panel of indigenous experts to study and make recommendations on the effective use of traditional medicines.

Mexicos delegate said the international community must redouble its efforts to improve health care for indigenous peoples, especially children. Measures had been taken in his country to increase the awareness of health providers of the needs of indigenous peoples. He recommended increased care giving for indigenous peoples in health-care institutions; that health policies include gender and cultural aspects; that health care address the problem of alcoholism; and that increased efforts be made to prevent the spread of HIV/AIDS among indigenous peoples.

A member of the African Indigenous Womens Organization said African women were specialists in traditional medicine, treating such ailments as malaria, hepatitis and sexually transmitted diseases with plants, animal by-products and thermal waters. There had recently been a decline in traditional medicinal practices, however, due to environmental disasters, desertification, the migration of indigenous communities to urban areas, and competition with modern medicine. She also pointed to the need to implement the Convention on Biodiversity.

Nepals delegate said every community was entitled to preserve its traditional community practices. Laws and policies were in place in Nepal to implement international agreements to which it was party. The countrys National Council had representatives from each of the 15 ethnic groups, who had benefited from special programmes to improve health and drinking water. Indigenous peoples had also benefited from programmes of decentralization.

A member of the Transnational Radical Party requested the United Nations Development Programme (UNDP) to provide funds to assist in addressing diseases causing blindness, and to train Khmer Kroms so that they could become self-sufficient in health care. He also urged the United Nations to take immediate action to correct the human rights violations of Khmer Kroms, to save the civilization from annihilation.

Guatemalas delegate said that States should allocate the necessary budgets and funds to help Ministries of Health implement health strategies for indigenous peoples and that indigenous healers and health services should be involved in such strategies, especially regarding reproductive health. International commitments in the area of health should be given priority and implemented fully.

A representative from the World Health Organization said she wished to draw attention to her continued presence during the Forums third session.

Given that the WHO representative had made her presence known, one Forum member asked when the Forum could expect to receive follow-up reports and information on the many recommendations that had been addressed to WHO by the Forum. The WHO representative responded that, due to preparations for the World Health Assembly, currently being held in Geneva, Switzerland, WHO had been unable to submit the requested documentation on time. However, it was the organizations intention to submit follow-up documentation on last years recommendations.

The representative of the Foundation for Aboriginal and Islander Research Action said the WHO must recognize the need for a global perspective on indigenous health, to complement its regional strategies. Although Australias indigenous populations had pioneered many cutting-edge initiatives in traditional health care, Australian aborigines continued to have a median life expectancy of only 50 years. If that statistic carried over into the non-aboriginal population, it would be considered a national crisis. The Government, at the federal and state levels, must do much more to improve the aboriginal health standards.

Several representatives of indigenous womens groups stressed the need for priority to be given to issues of indigenous womens reproductive health and drew attention to the heavy toll of HIV/AIDS and other sexually transmitted diseases on indigenous women and girls.

Others drew attention to indigenous practices which threatened the health of women and girls, including early marriage. Such practices had long-term consequences related to lack of education, early pregnancy and dependency.

Among the recommendations addressed to the Forum, speakers encouraged the body to take steps for the holding of a Latin American conference on indigenous medicine; to promote training in indigenous medicine; and to ensure food security for indigenous populations.

A member of the Jay College of Criminal Justice recommended that Latin American governments endorse recommendations directed at the fundamental freedoms of incarcerated persons. Other participants recommended that governments adopt policies to respect and maintain autonomous indigenous spaces; that the United Nations study both western and indigenous medicine, so that experiences could be shared; that such agencies as the United Nations Children's Fund (UNICEF) and the WHO assist with health indices for indigenous peoples; and that efforts be made to improve the reproductive rights of women.

A member of the Centre dAccompagnement des Autochtones Pygmées et Minoritairies Vulnérables recommended that agencies and international financial institutions involve pygmy organizations in implementing national programmes in the Democratic Republic of the Congo, and that the Forum prioritize the monitoring of previous recommendations.

Other participants requested that governments report on successes and failures in implementing indigenous programmes, and on how they had adjusted their budgets to address indigenous problems. Several also pointed to the need for investment in health care to combat poverty; to develop cultural approaches to health for indigenous women; and to consult with indigenous peoples on their education and training.

A member of the Asian Indigenous Peoples Caucus questioned why the WHO had not followed up on previous health recommendations made by the Forum. He recommended that States set up health-care centres that were in harmony with indigenous needs and cultures; that States and agencies promote and protect indigenous peoples traditional health systems; that States promote indigenous medicines; and that States make efforts to prevent violence against indigenous women, such as rape and sexual abuse.

A member of the Red de Mujeres Indígenas Wayuu stressed the need to raise awareness of positive and universal values held by indigenous peoples. She recommended training for health-care providers in both conventional and indigenous methods of treating pregnancy; the importance of the spiritual and mental health of indigenous children; and the need to combine indigenous and conventional health practices in preventing and monitoring diseases.

A representative of the Foundation for Indigenous Americans of Anasasi Heritage said Anasasi descendants were dying as the environment deteriorated. Their lifeline was connected to trees, which were being cut down. Polluted air had contributed to a high rate of asthma among their members. Statistics from the American office of womens health showed that birth rates were lowest among Anasasi women.

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