London School of Hygiene & Tropical Medicine

As the International Decade of the World's Indigenous people nears its close, a new study launched today reveals that, far from seeing improvements in their situation over the last ten years, the world's indigenous peoples feel their voices are not being listened to, and that their health needs and rights are continuing to be ignored and marginalised.

There are 350 million indigenous people in the world, representing over 5,000 languages and cultures in more than 70 countries on every continent. Yet indigenous peoples are still dying prematurely, are unable to access the health services to which they are entitled and are routinely discriminated against and dismissed by health staff, who lack training and understanding of their needs.

Tomorrow is International Day of the World's Indigenous Peoples, held every year on 9 August at the behest of the UN General Assembly during the International Decade of the World's Indigenous People, which began in 1994. The goal for the Decade is to strengthen international cooperation for solving problems faced by indigenous people in such areas as human rights, the environment, development, education and health but time is running out for the achievement of these goals, as the initiative ends in August 2004.

This study, Utz' Wach'il: health and wellbeing among indigenous peoples, which is being launched this evening at a reception at the London School of Hygiene and Tropical Medicine (LSHTM), was conducted by Health Unlimited, a British NGO supporting poor people in their efforts to achieve better health and wellbeing, with support from LSHTM. The authors believe it is a unique attempt to document, in indigenous people's own words, their views and concerns about their health and wellbeing and that of their communities, and to make them available to the international community. The views of indigenous people living in Namibia, Guatemala, Burma, Laos and Cambodia are included in the study.

'Indigenous peoples represent an astonishing diversity of cultures, religions and languages and a priceless reservoir of knowledge and skills', comments Dr Carolyn Stephens of LSHTM, 'but the future for many of these groups is bleak. As the Decade draws to a close, indigenous people, far from seeing any real improvements in their situation, are facing a constant struggle in the face of poverty, ill health and social disintegration'.

In the report, indigenous people from many countries tell of their lack of access to health services, constrained by financial, geographic and cultural barriers. Indigenous people know that they are seen as a low priority, especially when they live in remote areas where services are costly to provide. When services are available, they are often reluctant or afraid to use them because staff can be insensitive, discriminatory or unfriendly.

Indigenous people view health and wellbeing as a community issue rather than and individual one, closely linked with ideas of living in harmony with family, neighbours and the village. Physical factors such as the ability to work, the availability of work and of food and water are also important, as are environmental factors, with the exploitation of land belonging to indigenous communities having a detrimental impact on wellbeing.

'Health Unlimited, in its projects, is seeking to address some of the challenges raised by this study. It will be vital to train local people to provide basic health services in remote areas, and to ensure that traditional practitioners are involved, and their views appreciated, so new ideas about health are more likely to be taken on board in isolated, indigenous communities', comments Clive Nettleton, Director of Health Unlimited. 'We also need to do much more to provide safe water and improve sanitation, provide information regarding indigenous peoples' rights and entitlement to health care, and work with state health providers to ensure indigenous peoples are not discriminated against when it comes to accessing health services'.

Professor Andy Haines, Dean of LSHTM and Patron of Health Unlimited who has written a foreword to the report, comments: 'The increasing marginalisation of indigenous peoples makes their health ever more fragile. The destruction of ecosystems on which they rely and pressures on land on which they depend often threatens whole communities, languages and peoples. Yet indigenous peoples' health and rights are not high on the international health agenda and their voices are rarely, if ever, heard in national and international health decisions. Supporting indigenous peoples to articulate their own health concerns and priorities is an ethical and logistical challenge'.

The report is being launched at a reception this evening, Friday 8 August, at the London School of Hygiene & Tropical Medicine, 9 Bedford Square, London WC1, from 5.00 pm. It is initially being published electronically with a printed version available later in the year (in both English and Spanish). Copies (embargoed until the time of the Reception on Friday) can be downloaded from www.healthunlimited.org as of now.

To interview Clive Nettleton of Health Unlimited please call 020 7840 3771/07885 027746. To interview Carolyn Stephens of LSHTM please call 020 7927 2073.