Draft first regional report on the implementation of the Montevideo Consensus on Population and Development

Chapter III
Economic Commission for Latin America and the Caribbean (ECLAC)
recorded on numerous occasions and in most countries of the region. The occupation of territory by police
forces results in these people becoming victims of harassment and repression, and there have even been
cases of criminal punishment of minors, in violation of international commitments assumed by the States in
the area of children’s rights.
Against this backdrop, gender violence affecting indigenous women is defined by both gender discrimination
in communities, where patriarchal values also prevail, and a scenario of colonization and militarism, racism and
social exclusion, and economic and “development” policies that increase poverty in their territories. These
phenomena interact and influence each other, as do the different aspects of identity that define the experiences
of violence faced by women and their resistance strategies. The methodologies designed and implemented
by indigenous women themselves shed light on the power relationships within and outside communities,
using principles of cosmovision, but also questioning the elements of it that generate violence, in addition
to external factors. This facilitates a greater level of sensitivity, knowledge and ownership of the themes to
be explored further. Therefore, to address violence against indigenous women, boys and girls, organizations
are proposing a holistic approach that implies examining violence that is structural, spiritual and against the
Earth. The policy challenges, including the availability of data to shed light on these subjects, are enormous.
(a) Summary of initiatives implemented by countries
ECLAC (2007) has proposed five dimensions of the minimum standard for indigenous peoples’ rights and
their rights in the area of health: (i) right to access health care without discrimination; (ii) right to the highest
level of physical and mental health through adequate and high-quality access; (iii) right to use an indigenous
language, to apply the concept of integral health and well-being, to the use, strengthening and control of
traditional medicine; (iv) right to conserve plants, animals, minerals and territorial spaces of vital interest for
the health-illness-healing process, and (v) right to participate in the design, responsibility and social control
(resources) of health programmes and policies. Under this framework most countries in the region have
developed legislation and policies which reflect different approaches, areas of emphasis, and specific features,
which range from the recognition of the right to health as an individual good, mentioning indigenous peoples
as priority groups, to the recognition and promotion of collective rights and traditional medicines. According
to national <strong>report</strong>s, several countries in the region (the Bolivarian Republic of Venezuela, Brazil, Colombia,
Chile, Guatemala, Mexico, Panama and Peru) have continued developing their intercultural health models and
making progress in the collective dimension of the right to health of indigenous peoples.
Brazil has a national health-care policy for indigenous peoples, which incorporates comprehensive initiatives
for indigenous health, including traditional indigenous practices. During the period examined, measures
involving sanitation and infrastructure in indigenous territories were expanded and initiatives were taken to
strengthen indigenous communities’ participation in and control over health-care management (Government
of Brazil, 2017). Some health indicators <strong>report</strong>ed by that country include indigenous child mortality, which
decreased considerably, from 43.5 deaths of children under the age of one for every 1,000 live births in 2013 to
29.5 deaths per 1,000 live births in 2016. The annual parasite incidence of malaria in the 25 special indigenous
health districts of the Legal Amazon also diminished, from 79 positive malaria tests for every 1,000 inhabitants
in 2014 to 49.78 positive tests for every 1,000 inhabitants in 2016. The nutrition gap in indigenous children
under the age of five narrowed from 8.8% in 2014 to 7.7% in 2016. However, there was an increase in the
proportion of underweight pregnant indigenous women and a decline in the percentage of villages with access
to water treatment (Government of Brazil, 2017).
Chile has continued mainstreaming the intercultural perspective in health programmes in different
areas and examining the morbidity and mortality profiles of indigenous peoples. The country has also made
progress in the participation of indigenous peoples in developing health-related initiatives (see box III.9). In
2013 Colombia created a health subcommittee of the permanent committee for cooperation with indigenous
peoples and organizations, which is responsible for health-care policies targeting indigenous peoples and
involves the participation of the indigenous community and authorities in the different decision-making bodies.
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