Today is the International Day of the World’s Indigenous Peoples, and ten years since the creation of the UN Declaration on the Rights of Indigenous Peoples.
There are around 370 million indigenous people in the world. Despite making up less than 5% of the world’s population, they make up 15% of the poorest. This is no coincidence. Cultural and language barriers have resulted in indigenous people being subject to discrimination throughout history. As a result, they are often isolated and marginalised, which impacts on their income and health.
Indigenous people often live in remote or hard to reach areas – places which are rarely prioritised when health centres are built. This makes it even more difficult for indigenous people to access healthcare, and a lack of political voice makes it even harder for them to demand their health rights.
In 2007 the UN created the Declaration on the Rights of Indigenous Peoples. It outlines the rights of all indigenous peoples, and lays down a framework for all countries to follow to ensure their dignity, well-being and freedom.
But what progress has been made, and how could it be improved?
We have observed that progress only comes from working closely with indigenous communities to find solutions.
An early example of this approach from our own work was with women in rural Ayacucho, Peru. In 1999 only 6% of births in the Santillana district of Ayacucho took place at a health clinic, and maternal death rates were high. Through a programme of introducing culturally appropriate facilities in the health clinic, like allowing women to squat during labour and having health staff speak the local language, this figure soared to 83% of births by 2007.
Other organisations and government programmes have had similar success. Indigenous women in Australia were involved in developing vaccine policy and antenatal care. As a result, indigenous health providers were included for the first time in a community-based, collaborative ‘Mums and Babies’ programme for indigenous women in Townsville. A subsequent study found that the number of indigenous women who entered the programme and gave birth at Townsville Hospital trebled to 61% in three years.
As well as working directly with communities, we also work to influence policy and ensure indigenous people have a political voice. In Guatemala we are working with the Maya people to improve their access to healthcare- particularly for maternal health. We are also working with the government to change policy, and allow family members or traditional birth attendants to accompany mothers to the health centre during labour. Technology is also being used to break down barriers – we have supported the development of software that translates key health messages into the indigenous Mam and K’iche’ languages.
These changes can only happen when the needs and rights of indigenous people are recognised by governments. Progress is being made, and should be celebrated. However, it is still too slow. Governments and policy makers must learn from examples like this and start working more directly with indigenous communities. To understand the progress being made we also need data to be recorded, and broken down by ethnicity. It must not take another 10 years to ensure all indigenous people enjoy the human rights as outlined in the UN Declaration on the Rights of Indigenous Peoples.