1 May 2002

United Nations
Economic and Social Council
Permanent Forum on Indigenous Issues
First Session, 13-24 May 2002, New York
Item 6 of the provisional agenda

 

INDIGENOUS PEOPLES AND HEALTH

A Briefing Paper For The Permanent Forum On Indigenous Issues

Prepared by the Committee on Indigenous Health

 

Annex 1

 

THE GENEVA DECLARATION ON THE HEALTH

AND SURVIVAL OF INDIGENOUS PEOPLES

 

 

PREAMBLE

 

We, the representatives of indigenous communities, nations, peoples and organizations attending the International Consultation on the Health of Indigenous Peoples, held in Geneva from the 23-26 November 1999, and organized by the World Health Organization, reaffirm our right of self-determination and remind States of their responsibilities and obligations under international law concerning health, including the health of Indigenous Peoples;

 

Concerned that the health of Indigenous Peoples in every region of the world is acknowledged to be in a poor state due to the negation of our way of life and world vision, the destruction of our habitat, the decrease of bio-diversity, the imposition of sub-standard living and working conditions, the dispossession of traditional lands and the relocation and transfer of populations;

 

Welcoming the initiative of the World Health Organization for convening this International Consultation with Indigenous Peoples;

 

Recalling United Nations General Assembly resolution 48/163 proclaiming the International Decade of the world's Indigenous People (1995-2004), resolution 50/157 establishing the Programme of Activities for the Decade, as well as the World Health Assembly resolutions WHA47.27, WHA48.24, WHA49.26, WHA50.31 and WHA51.24, with a view "to strengthening international co-operation for the solution of problems faced by Indigenous Peoples in areas such as human rights, the environment, development, education and health";

 

Calling on the various institutions of the United Nations to act in partnership with Indigenous Peoples' communities, nations and organizations, to recommend to governments that they address the particular needs of Indigenous Peoples who experience disproportionate poverty, illness, social exclusion, habitat destruction and oppression and to develop policies which will enhance the health and survival of Indigenous Peoples world-wide to reverse this disparity;

 

Believing that a partnership between Indigenous People and the World Health Organization in co-ordination with other specialized agencies and bodies within the United Nations system plays an essential role with respect to the promotion of the health of Indigenous Peoples and our health systems;

 

Considering the non-recognition of the health knowledge and practices of Indigenous Peoples, and the limited access to health services, both of which we condemn as expressions of discrimination and intolerance;

 

Believing that the leadership of Indigenous Peoples in all aspects of development and implementation of health programmes is essential for the health needs of Indigenous Peoples;

 

Acknowledging that Indigenous Peoples have developed effective and viable scientific knowledge and systems of health that have contributed, and continue to contribute, to the health and survival of all humanity;

 

Reaffirming our commitment to our civil, political, economic, social and cultural rights, including the right to benefit from our own resources and our right to develop them;

 

Reminding the international agencies and other bodies of the UN system of their responsibility, and the obligation of States, towards the promotion and protection of Indigenous Peoples' status and rights, and that a human rights approach to indigenous health and survival is based on the said international responsibility and obligation to promote and protect the universality, indivisibility, interdependence and interrelation of the rights of all peoples; and finally;

 

Reaffirming the indivisibility of human rights with regard to the health and survival of Indigenous Peoples as essential to an effective and meaningful response to the health needs of Indigenous Peoples.

 

 

PART I

RIGHTS AND INTERESTS OF THE WORLD'S INDIGENOUS PEOPLES

 

Considering that the rights, philosophy and principles contained in the United Nations Draft Declaration on the Rights of Indigenous Peoples and all existing international instruments dealing with human rights and fundamental freedoms are essential for the attainment of the health and survival of Indigenous Peoples;

 

We hereby solemnly declare, affirm and assert that Indigenous Peoples are equal in dignity and in rights to all other peoples and, as such, have the right of self-determination;

 

In accordance with the status and rights of Indigenous Peoples, we:

- Affirm the right to control preventive and curative health systems and programmes in our own communities and the means to train and involve indigenous personnel in all facets of health;

- Affirm the right to the highest attainable physical, mental, social, cultural and spiritual health and survival, commensurate with Indigenous Peoples' definition of health and wellbeing;

- Call on Governments to recognize the sciences, systems of knowledge, sacred and ceremonial sites, doctors, medicine people and practices of Indigenous Peoples in health and medicine;

- Insist on free access to quality and culturally appropriate health care according to our needs, funded by the State without discrimination, that extends to support services, and to ensure accessibility of services for all Indigenous Peoples, including those in isolated, marginalized and remote regions and communities;

- Call for urgent and decisive actions to protect and preserve the integrity of indigenous territories, to stop environmental degradation and to ensure access to healthy and safe traditional food sources;

- Call for the promotion of adequate nutritional programmes and to support the campaign against substance abuse;

- Call on governments where Treaties, agreements and other constructive arrangements exist, that the original spirit and intent of these international agreements be honoured, respected and implemented;

 - Call on the World Health Organization to make a substantial contribution within the context of the International Decade, in the form of a special study on the health of Indigenous Peoples, with the co-ordination, collaboration and participation of the Indigenous Peoples; and finally,

- Invite all Indigenous Peoples to support and promote this Declaration and to consider it as part of a global campaign, to obtain the largest possible participation of Indigenous Peoples in the elaboration of future documents and strategies on the health and survival of the Indigenous Peoples. 

 

 

PART II

INDIGENOUS PEOPLES CONCEPTS OF HEALTH AND SURVIVAL, EXPRESSIONS OF CULTURE AND KNOWLEDGE ESSENTIAL TO THE HEALTH AND WELL-BEING OF INDIGENOUS PEOPLES

 

Indigenous Peoples' concept of health and survival is both a collective and individual inter-generational continuum encompassing a holistic perspective incorporating four distinct shared dimensions of life. These dimensions are the spiritual, the intellectual, physical and emotional. Linking these four fundamental dimensions, health and survival manifests itself on multiple levels where the past, present and future co-exist simultaneously.

 

For Indigenous Peoples, health and survival is a dynamic equilibrium, encompassing interaction with life processes and the natural laws that govern the planet, all life forms, and spiritual understanding.

 

Expressions of culture relevant to the health and survival of Indigenous Peoples includes, but is not limited to, individual and collective relationships, family and kinship systems, social institutions, traditional justice, music, dances, ceremonies, ritual performances and practices, games, sports, language, narratives, mythology, stories, names, land, sea and air and their resources, designs, writings, visual compositions, permanently documented aspects and forms of Indigenous culture including scientific and ethnographic research reports, papers and books, photographs, digital images, film and sound recordings, burial and sacred sites, human genetic material, ancestral remains, and artefacts.

 

PART III

POLICIES, STRATEGIES AND MECHANISMS OF ACTION

 

While there are some policies and legal frameworks in the national and regional contexts, which address the health needs of Indigenous Peoples, there is still an enormous gap between policy and action. This gap is mainly caused by a lack of political will on the part of governments to implement existing policies. It also stems from the failure to recognize Indigenous Peoples' rights to self-determination, and to adhere to the principles of holism, meaningful participation, mutual respect and reciprocity, and to recognize the validity and revitalization of indigenous cultures and institutions.

 

Existing appropriate policies on health are also threatened by some programmes and activities of the World Bank, International Monetary Fund, and the World Trade Organization which often have negative impacts on the health of Indigenous Peoples. The WHO must take responsibility for engaging these institutions to rectify their policies and programmes and the imbalances and inequities in the World Trade Organization Treaties which have adverse health impacts. This would include overview of regional trade agreements such as the North American Free Trade Agreement and MERCOSUR.

 

Policies and programmes should be formulated in the following areas:

 

1.  Capacity building through human resource development and empowerment strategies.

2.  Research programmes designed for indigenous health with the leadership of Indigenous Peoples.

3.  Education programmes for health professionals and others involved in health services to make their practice more culturally appropriate.

4.  Proposals to rectify the inequities and imbalances in globalisation.

5.  Increased funding and resources for Indigenous Peoples' health.

6.  Effective co-ordination between various United Nations bodies.

7.  Ensuring participation of Indigenous Peoples at all stages of policy development and implementation.

 

As an example of a successful policy, Indigenous Peoples welcome the recent establishment of the Circumpolar Co-operative Programme, "Health and Environment of Indigenous Peoples", conducted in partnership between Indigenous Peoples, the Arctic Monitoring and Assessment Process, the United Nations Environmental Programme (UNEP) and the WHO.

 

Indigenous Peoples urge the implementation of the following mechanisms of action:

- Constitutional and legislative mechanisms that oblige national governments to recognize Indigenous Peoples and to fulfil their health needs based on their own specific priorities and aspirations.

- Constitutional and legislative mechanisms that oblige national governments to abolish harmful practices and stop all programmes and research activities that are conducted without the free prior and informed consent and the meaningful participation of Indigenous Peoples.

- Mechanisms to monitor and evaluate the implementation of policies, in order to identify the gaps between policy and effective action.

- Mechanisms for complaints, arbitration, redress and remedial measures.

 

 

PART IV

BROAD DETERMINANTS ON THE HEALTH AND WELL BEING OF INDIGENOUS PEOPLES

 

The health of Indigenous Peoples is overwhelmingly affected by determinants outside the realm of the health sector, namely social, economic, environmental and cultural determinants. These are the consequences of colonization, and are amenable to intervention to protect and improve the health of Indigenous Peoples. As a means of achieving this, we call on the World Health Organization and other United Nations institutions, along with their member states, to act in partnership with Indigenous Peoples to address, among others, the following;

 

*  The loss of identity due to removal from family and community, displacement and dispossession of lands, resources and waters, and the destruction of Indigenous Peoples' languages and cultures, all of which have impacted the ability of Indigenous Peoples to be productive, contributing members of society;

 

*  The impact of environmental degradation caused by mega-projects, extractive industries, and toxic waste disposal including trans-boundary contaminants.

 

*  The need to promote sustainable forms of development rather than promote this type of industry;

 

*  The need for community development as a participatory process;

 

*  The limited choice and accessibility to professional care, including the lack of culturally appropriate healthcare provision, that reflects our values, beliefs and traditions;

 

*  The effects of war, declared or undeclared, conflicts and vigilantism.

 

In order to be intellectually rigorous, scientifically sound, socially just and morally defensible, indigenous health strategies require concerted action on the part of governments and responsible agencies in relation to the social, economic and cultural determinants of the health of Indigenous Peoples.  They should adopt a precautionary principle when working on development with Indigenous Peoples and act in good faith by being transparent in their dealings with Indigenous Peoples.

 

 

PART V

Nothing in this Declaration shall be construed as diminishing or extinguishing existing or future rights Indigenous Peoples may have or acquire.


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