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There are an estimated 300 million indigenous
people worldwide. They comprise about 5000 – 6000 distinct
groups in over 70 countries, and have a diverse range of
cultures, languages and heritage.
In all continents, indigenous people’s
integrity and survival has come under attack. This has included
systematic dislocation from their lands and pollution of their
environments, cultural repression, forced separation of
families, and – in the most extreme cases - genocide. It
is testimony to the vitality of indigenous people’s
civilizations that they have survived in the face of this
adversity. However, these attacks have taken their toll.
Today, most indigenous peoples are marginalized socially,
economically, politically, and culturally.
The extent of this marginalization is clearly
reflected in their health status: typically, there are wide
disparities between the health of indigenous and non-indigenous
peoples within the same country. Life expectancy at birth can be
from 10-20 years lower among indigenous peoples than in the rest
of the population, and infant mortality is often 1.5 to 3 times
greater than the national average. Malnutrition, and
parasitic and communicable diseases such as malaria, yellow
fever, dengue, cholera, and tuberculosis, continue to affect a
large proportion of indigenous peoples world-wide.
Indigenous peoples also suffer
disproportionately from psychosocial problems resulting in
alcoholism, high rates of suicide, depression, and violence.
In developed countries, diseases such as diabetes, obesity, and
cardiovascular disease, often the result of changes in diet and
lifestyle, are increasingly affecting indigenous peoples.
Substance abuse (involving alcohol, tobacco, and drugs) is an
additional concern.
Indigenous people do not have full access to
modern health care. The reasons include lack of cultural
sensitivity in health care systems, financial constraints, and
geographical barriers.
Equally, indigenous peoples are concerned
that traditional healing knowledge is being lost and traditional
health care “systems” are deteriorating. Indigenous
peoples’ define health in holistic terms and emphasise the
interconnectedness of physical, spiritual, mental, and emotional
health. Health has cultural, political, and social dimensions
for indigenous people. For example, the unique
relationship between indigenous peoples and their land is
fundamental to spiritual and physical health: “land is health,
oppression is disease.” Indigenous peoples have also
emphasized the critical link between the health of their
communities and control over their own development, lands, and
natural resources. The health of the individual is dependent on
the overall health of their communities, and this in turn
requires cultural integrity and vitality.
Thus, any efforts to address the health
problems of indigenous people must reflect the complex way that
indigenous peoples understand and address health issues.
Everything possible must be done to maintain the culture and
livelihoods of indigenous peoples. Studies show that when this
is done, the health status of indigenous peoples is higher.
Maintenance of traditional lifestyles and culture has been
associated with decreased rates of infant mortality, low birth
weight, cancer, high blood pressure, and diabetes. |
