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. |