Indigenous Peoples’ access to Health Services
Discrimination, domination and marginalization violates indigenous peoples human rights as peoples/communities, threatens the continuation of their cultures and ways of life and prevents them from genuinely participating in decisions on their own future and forms of development.8 Africa’s population of about 960 million people already faces health challenges with a high burden of communicable and emerging non-communicable diseases. Access to health is not uniform across the continent, from one country to the next nor within countries. National figures of morbidity and mortality often mask inequities within countries. The vulnerable populations include the poor, the hard to reach, women and children, persons with disabilities and the marginalized. Indigenous peoples often live in remote and hard-to-reach areas, and many are less educated, few in number and culturally different from their more populous neighbours. They face additional challenges of access to health services. This constitutes a violation of the African Charter such as: ɜɜ The right of equal access to the public services of one’s country (Article 13 (2)) ɜɜ The right to education (Article 17(1)) ɜɜ The right to medical care and attention (Article 16(2)).9 Further, they are also discriminated against by health service providers and considered to be ”backward”. This can be seen from the view of a President of an African country who said, “How can you have a stone-age creature continuing to exist in the time of computers? If the Bushmen want to survive, they must change, otherwise, like the dodo they will perish”.10
Indigenous Africans and the Millennium Development Goals (MDG) The Millennium Declaration, signed by 147 Heads of State and Government in September 2000, and the Millennium Development Goals have provided an opportunity for a renewed focus on indigenous peoples in the international development debate. The report of the Fourth Session of the United Nations Permanent Forum on Indigenous Issues, stated that “Indigenous peoples have the right to benefit from the Millennium Development Goals and from other goals and aspirations contained in the Millennium Declaration to the same extent as all others”.11 However, by failing to ground the goals in an approach that upholds indigenous peoples’ individual and collective rights, the MDGs fall short in addressing the health disparities that persist between indigenous peoples and other poor, marginalized groups. By advancing the dominant paradigms of health and development rather than an approach based on individual and collective human rights, the MDGs also promote projects that are potentially detrimental to indigenous peoples by violating their rights to their collective lands, territories and natural resources.
8
Report of the African Commission’s Working Group of Experts on Indigenous Populations/Communities by the African Commission on Human and Peoples’ Rights and the International Working Group on Indigenous Affairs (2005).
African Charter on Human and Peoples’ Rights: OAU Doc. CAB/LEG/67/3 rev. 5, 21 I.L.M. 58 (1982), entered into force 21 October 1986).
9
10
Suzman, J .,An Introduction to Regional Assessment of the San in Southern Africa.2001, Legal Assistance Centre, Windhoek. Namibia.
11
E/2005/43 United Nations Permanent Forum on Indigenous Issues, Report of the Fourth Session (2005).
Chapter 1 ξ 013