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IACHR Warns of the Specific Vulnerability of Indigenous Peoples to the COVID-19 Pandemic, Calls on States to Adopt Targeted, Culturally Appropriate Measures that Respect These Peoples’ Land

May 6, 2020

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Washington, D.C. - Washington, D.C. – Through its Rapid and Integrated Response Coordination Unit on the COVID-19 Pandemic, the Inter-American Commission on Human Rights (IACHR) urges States to address the serious risks faced by indigenous peoples and to take urgent measures to protect the right to health of indigenous communities. In particular, the Commission warns about the specific vulnerability of indigenous peoples, especially those who are in voluntary isolation or initial contact. The IACHR stresses the need to design specific responses for these communities, ensuring respect for their worldviews and cultural diversity.

The IACHR notes that historical discrimination against indigenous peoples has led to a structural, systematic violation of their human rights, particularly their economic, social, cultural, and environmental rights. The proportion of indigenous persons who live in poverty and extreme poverty in the Americas is clear evidence of this. According to the World Bank, 43% of all indigenous persons in Bolivia, Brazil, Ecuador, Guatemala, Mexico, and Peru live in moderate poverty, compared to 21% of non-indigenous persons in those countries. Further, the percentage of indigenous persons who live in extreme poverty in those countries is three times as high as it is among non-indigenous persons.
The Commission has repeatedly warned States about the growing risks faced by indigenous peoples in the Americas, particularly concerning land-related and environmental disputes linked to extractive activities, which also directly affect these peoples’ rights to food, water, and health. The Commission acknowledges the role of indigenous peoples for the protection of nature. It notes the special relationship these peoples have with their land and natural resources, a connection that is essential for these peoples’ very existence. Taking all this into consideration along with the current exceptional context, the IACHR is profoundly concerned about the impact of the COVID-19 pandemic on indigenous peoples.

Regarding food security, the State of Honduras gave the Commission details about Operation Solidarity (Operación Honduras Solidaria), noting that vulnerable communities have been provided with food and that indigenous communities have been prioritized in that effort. The report says that, by April 17, the National Commissioner on Human Rights (CONADEH, by its Spanish acronym) had monitored the delivery of 4,700 food rations to communities in the departments of Intibucá, Lempira, Atlántida, and Gracias a Dios. The IACHR also notes that the Administrative Court in San Pedro Sula has granted a writ of amparo in favor of families in the Tolupan Tribe, in Locomapa, in the department of Yoro. The Court ordered the enforcement of Executive Decree PCM-025-2020, to ensure coordination with the authorities of the community’s preventive council in the delivery of sufficient quantities of food of appropriate quality, based on the applicable international standards. Healthcare services must also be provided to this community, respecting its cultural diversity, the Court said.

The State of Colombia informed the IACHR about its program Colombia Stands With You–One Million Families (Colombia Está Contigo–Un Millón de Familias), which seeks to manage and deliver humanitarian food aid to indigenous and other communities in 32 departments and a total of 720 municipalities. According to this report, the program involved prior coordination with indigenous authorities, with a view to mitigating the needs of vulnerable families.

Concerning the right to health of indigenous peoples, the Commission has been informed of various obstacles faced by this group in the context of the COVID-19 pandemic. Some of these challenges concern socioeconomic and access problems. Hospitals and healthcare centers are generally far from the rural areas where a major portion of indigenous peoples in the Americas live.

Further, the services that are available to these communities often face structural deficiencies, which in the current context include shortages of basic supplies and lack of access to diagnostic tests to detect COVID-19. The IACHR is concerned about the insufficient number of beds available in hospitals and healthcare centers in regions with high percentages of indigenous persons in several countries in the Americas, including Bolivia, Ecuador, Honduras, Mexico, Nicaragua, and Peru.

According to the overview that Ecuador has provided the IACHR, the country has 42 public hospitals and 35 private hospitals offering a total of 1,870 inpatient beds and 403 ICU beds devoted exclusively to treating suspected and confirmed cases of COVID-19. As noted by the State, Ecuador has a further 7,161 hospital beds and 161 ICU beds to treat patients with other conditions.

The State of Honduras reported the construction of at least three hospitals for patient isolation, with 91 beds each, that are to be built in Tegucigalpa, San Pedro Sula, and Choluteca, and four further 51-bed hospitals that are to be built in other cities. In order to assist patients with severe symptoms and ensure they receive an effective response, the State’s healthcare institutions have prioritized hospital treatment in departments where cases of COVID-19 have been confirmed, which has entailed a rise from 9 to 16 priority hospitals. This approach has also sought the support of leaders of indigenous peoples, to ensure these measures reach as many individuals as possible.

The State of Mexico informed the IACHR of the action it had taken to prevent infections and deal with indigenous persons who are suspected with having COVID-19. Mexican authorities told the Commission that the country has more than 24,000 people who have been trained to exclusively assist patients with COVID-19 within the IMSS-BIENESTAR program. This program is active in very vulnerable areas and runs 80 rural hospitals, 3,622 rural medical units, 45 rural obstetric care centers (CAROs, by their Spanish acronym), 140 mobile medical units, and 184 healthcare brigades. The State says that these assets have joined communication and prevention efforts, which have included 2,172 messages broadcast on 110 local radio stations used by indigenous communities, in these communities’ own languages.

According to the information that Colombia provided the Commission, the country assists indigenous peoples through its general healthcare and social security system. The country reportedly has a special program where indigenous healthcare service providers assisting their own communities receive specific resources that help them apply traditional medicine. In the context of the current emergency, the State has also provided the details of the plan for urgent action to mitigate the COVID-19 pandemic in indigenous territories and to encourage self-care through the Indigenous Intercultural Healthcare System (SISPI, by its Spanish acronym), in coordination with the General Social Security System for Healthcare (SGSSS, by its Spanish acronym). This plan seeks to promote, encourage, and use health-related knowledge, to provide relevant training, and to encourage indigenous and intercultural care.

There are also cultural challenges. In particular, the IACHR is concerned about the fact that most services on offer are not culturally appropriate, which leads to care that ignores the practices of traditional medicine and the linguistic and cultural diversity of indigenous peoples. The Commission has been informed of a lack of prevention and medical treatment protocols aimed at indigenous communities in countries around the Americas. For example, the IACHR received reports that said Ecuador had adopted a medical treatment protocol for indigenous peoples in voluntary isolation. The Commission notes the details that the State of Ecuador has provided about the protocol to prevent and address COVID-19 in the area around the Tagaeri–Taromenane Intangible Area. This protocol, issued by the National Emergency Operations Committee, establishes procedure for institutions active in that area—including decentralized autonomous governments, the National Ministry of Defense, the Ministry of Water and the Environment, the Human Rights Department, and the Ministry of Public Health—to get involved in both prevention and treatment of suspected and confirmed cases of COVID-19. According to the information that has been provided to the IACHR, this protocol also includes guidelines for community-based action that take into consideration the customs and traditions of each community, and entrusts community leaders with the task of disseminating those guidelines. However, the IACHR has been informed that this protocol has been drafted with no input from representatives of indigenous communities.

According to the information provided by Ecuador, the document sets up a procedure for coordination among different institutions active on that land to prevent and treat suspected cases of COVID-19 in different communities and villages, and among various peoples (whether indigenous, Afro-Ecuadorian, or Montubio), through interculturally relevant healthcare and risk management. It further provides for coordinated action through an Inter-Institutional Committee that brings together the leaders of indigenous organizations and peoples along with State institutions including the Ministry of Public Health, the Human Rights Department, and the Communications Department.
The Commission notes the information provided by the State of Colombia concerning external circular letter 000015 of 2020, issued jointly by the Interior Ministry and the Health Ministry. This circular letter stated the first recommendations to prevent, contain, and mitigate COVID-19 in specific ethnic groups, including indigenous peoples, that were distributed in coordination with the community leaders and authorities of each territory. According to this information, the essential aspects of measures and guidelines concerning COVID-19 have been translated into Uitoto, Iku or Arhuaca, Sikuani, Nasayawe, Tikuana, Inga, Ikun, Wayuunaiki, Cubeo, and Bora, a total of 10 indigenous languages.

On March 25, the State published guidelines to prevent, detect, and handle cases of COVID-19 among Colombia’s ethnic communities, which include lockdowns within their own territories to prevent exposure and the risk of infection, as well as restrictions of entry into indigenous territories for individuals who do not belong to the relevant peoples, and bans on community activities and mass events. The State further noted, along similar lines, that a plan is being drafted to support indigenous communities who have lost their daily livelihoods to comply with lockdown measures, by providing them with food and essential toiletries.

In the context of the COVID-19 pandemic, the IACHR stresses that indigenous peoples have the right to collectively and individually enjoy the best possible physical, mental, and spiritual health. Public policies need to be formulated and implemented to protect indigenous peoples’ right to health. These include ensuring they have access to services and supplies (including tests to diagnose COVID-19); drafting and implementing prevention and contingency protocols that are both specialized and culturally appropriate and include designing training strategies targeting indigenous healthcare providers (such as carers and traditional healers) and providing these indigenous healthcare providers with any necessary protection equipment, including masks, gloves, and disinfectant; and culturally appropriate healthcare that respects these communities’ worldviews. These public policies must integrate the fundamental principles of the human rights approach, including social participation, equality, and non-discrimination.

Further, States must consult and coordinate with indigenous peoples concerning their efforts to promote intercultural systems and practices through medical and healthcare services provided within indigenous communities, among others by training indigenous technicians and indigenous healthcare professionals. Based on the right to self-determination, the IACHR stresses the obligation to include traditional representatives, leaders, and authorities in the design and implementation of any efforts to respond to the pandemic.

Food insecurity is a further consequence of the historical discrimination of indigenous peoples in the Americas. The Food and Agriculture Organization (FAO) of the United Nations has long been flagging the food risks faced by indigenous peoples in the region. For instance, in Guatemala, more than 60% of all indigenous children under the age of five suffer from chronic malnutrition, a percentage that is almost twice as high as it is among non-indigenous children. According to scientific research, this is likely to boost the impact of the pandemic on indigenous peoples, which in turn entails a threat to these peoples’ very existence. The Commission urges States to protect the right to food of indigenous peoples, especially in the context of the COVID-19 pandemic and its specific impact on these peoples.

The State of Guatemala has informed the Commission that, even before the crisis caused by the current pandemic, it had already planned a Great National Crusade for Nutrition that sought to prioritize 114 municipalities. High levels of extreme poverty and cases of chronic malnutrition in children under five were the priority criteria for this program. The IACHR notes that, according to the State, Guatemala is applying the required methodology—in light of the chronic malnutrition found among a portion of the country’s children—to ensure that school breakfast programs continue even though face-to-face lessons remain suspended, to benefit Guatemala’s children. This food is now being distributed through parent associations. The State of Guatemala reported that more than 130,327 of the food packages known as “We’ll Get Through This” (kits de alimentos saldremos adelante, containing staples like rice, beans, corn flour, oil, sugar, pasta, and incaparina)—set to benefit some 200,000 families all around Guatemala—are to be distributed to protect vulnerable families for as long as COVID-19 is active in the country.

The Commission further notes the State’s efforts concerning the development of policies to transfer resources to the communities worst affected by the measures taken to mitigate the effects of COVID-19. The IACHR also notes public comments highlighting that these efforts are insufficient and/or that indigenous peoples have trouble accessing them, considering that they are particularly vulnerable in socioeconomic terms and face substantial food risks. In this context, the IACHR commends Canada for its financial support for indigenous communities in its northern provinces, so they may prepare themselves to deal with the impact of the pandemic. This support includes ongoing assistance to ensure food and medicine deliveries. The IACHR stresses that States must ensure access to social policies for all people—including members of indigenous peoples—affected by the measures adopted to mitigate the effects of the pandemic, based on the principles of equality and non-discrimination.

The IACHR reminds States of the importance of having disaggregated statistics that reflect key variables like age and gender, among others, to enable the design and implementation of public policies to protect these communities’ right to health in the context of the COVID-19 pandemic. The Commission acknowledges the inclusion of ethnic self-identification in census research made by different States and encourages all countries to integrate this perspective into other instruments used to collect statistical data.

In the context of the COVID-19 pandemic, the IACHR was also informed of efforts to conduct consultations concerning exploitation permits involving indigenous land. The Commission was told of potential discussion in the legislature of bills that would directly affect the material and spiritual life of indigenous peoples. The Commission was also told about external circular letter CIR2020-29-DMI-1000, paragraph ii, issued by Colombia’s Interior Ministry on March 27, which paves the way to implement consultation and free, prior, and informed consent through digital platforms. The IACHR has noted the concern expressed by Colombian civil society organizations about the content of this circular letter and the fact that it has been passed without the required consultation and free, prior, and informed consent of indigenous peoples. These organizations have also pointed out that 90% of the land held by indigenous communities in Colombia lacks Internet access.
The IACHR reminds States that consultation and free, prior, and informed consent upheld in the jurisprudence of the inter-American system and in other international human rights instruments are crucial to ensure and protect the rights of indigenous peoples. The Commission also stresses that, to further develop these procedures, States need to take into consideration the cultural practices of indigenous peoples, particularly their ancestral traditions for collective organization, which often involve holding community assembles. Concerning virtual consultation, the IACHR warns that—due to the structural discrimination they suffer—a large portion of indigenous peoples do not have access to the Internet. Imposing and implementing consultation processes through digital platforms would therefore violate their right to real, effective participation.

In the context of the adoption by States of social distancing measures to mitigate the spread of the COVID-19 pandemic, the IACHR urges States to suspend administrative procedures to grant permits for extractive projects and other plans to exploit or develop natural resources in or around indigenous territories, in order to ensure respect for indigenous peoples’ cultural practices and their effective participation in all decisions likely to affect them directly.

The IACHR is also concerned about respect for the voluntary isolation and initial contact of various indigenous peoples and for the decision to pursue isolation recently made by several Amazonian peoples, after confirming the first few cases of COVID-19 in members of their communities or people close to them, as in the case of the Nukak community in Colombia and other peoples in Bolivia, Brazil, Ecuador, and Peru.

Ecuador informed the IACHR of the coordination of efforts to plan and implement prevention and contingency activities concerning COVID-19 in the Tagaeri-Taromenane Intangible Area and its (ZITT) and its surroundings, to protect communities of peoples in voluntary isolation like the Waorani, the Shuar, the Kichwa, and mestizo. Ecuador has also noted that its Ministry of Public Health has coordinated efforts to conduct rapid tests for COVID-19 among officials active in that area, to protect the health of those officials as well as that of indigenous communities living nearby—with whom there is constant contact—considering that indigenous peoples in the Amazon, and particularly indigenous peoples in voluntary isolation who live in the Intangible Area and its surroundings, are highly vulnerable. The State further highlighted the general guidelines of its protocol to prevent and address COVID-19 in the area around the Tagaeri–Taromenane Intangible Area, which ban entry into that area except for comprehensive healthcare teams, State law enforcement officers, and people with a warrant issued by the Human Rights Department’s Unit to Monitor and Follow Up on the Protection of Indigenous Peoples in Voluntary Isolation and Ecuador’s Waorani People.

The IACHR stresses its concern about the special vulnerability of indigenous peoples in voluntary isolation and initial contact in the face of external pathogens like COVID-19. The Commission urges States to control the entry into ancestral lands of individuals linked to extractive industries including mining, oil and gas, hydroelectric plants, logging, agroindustry, and logistics. According to reports obtained by the IACHR, the amount of land that was illegally deforested in territories belonging to the Yanomami people in the Brazilian state of Roraima was up 3% in March, compared to the previous month. The Commission was also told that evangelical missionaries continued to conduct unauthorized visits to communities in voluntary isolation in the Vale do Javari, in the Brazilian state of Amazonas, which violates the legal dispositions and guidelines of Brazil’s National Indian Foundation (FUNAI, by its Portuguese acronym).

The Commission was also told of the infection with COVID-19 and subsequent death of a member of the Yanomami people in the Brazilian state of Roraima. According to these reports, the 15-year-old had symptoms for several days during which he had contact with other members of his community. The boy also suffered from malnutrition and anemia, which is evidence of the structural problems and food risks affecting these communities.

The IACHR understands the major challenges faced by States in the Americas in the context of the COVID-19 pandemic and stresses the call of the international scientific community for physical distancing measures as the main containment strategy. The Commission urges States to take action to preserve the voluntary isolation of indigenous peoples, and to increase precautions for access to their land, particularly when it involves external actors linked to extractive industries and anyone involved in religious activities. Given the travelling inherent to these activities, both groups are among the main vectors for the spread of COVID-19.

Considering the context of the COVID-19 pandemic and the considerations held in Resolution 1/2020—particularly recommendations 54–57 made to States concerning the protection of indigenous peoples—the Commission adds the following requirements:

1. Protecting the right to health of indigenous peoples in the context of the COVID-19 pandemic, with an approach that considers intercultural and gender-based perspectives and inter-generational solidarity; taking into consideration preventive care including traditional medicine and healing practices, paying special attention to groups that are particularly vulnerable to this pandemic, especially older adults and individuals with pre-existing conditions, in areas that are far from healthcare centers.
2. Ensuring the participation of indigenous peoples, by including their traditional representatives, leaders, and authorities in efforts to design and implement public policies aimed at preventing the spread of the virus and providing these communities with the relevant medical services.
3. Taking measures—including social policies—aimed at mitigating the socioeconomic effects that health-related action implemented to prevent the spread of the virus (and to provide healthcare services in the context of the COVID-19 pandemic) may have on the way of life and livelihoods of indigenous peoples, respecting the principles of equality and non-discrimination.
4. Refrain—in the context of the COVID-19 pandemic—from promoting legislation and/or authorizing extraction, exploitation, or development projects in or around land owned by indigenous peoples, given that it is impossible to conduct free, prior, and informed consultation procedures in line with the applicable international standards given the World Health Organization’s call for social distancing measures.
5. Maximizing measures to protect the human rights of indigenous peoples in voluntary isolation and initial contact in the context of the COVID-19 pandemic, with a specific focus on preserving their health and way of life, respecting their self-determination and the principles that govern State actions involving these groups.

A principal, autonomous body of the Organization of American States (OAS), the IACHR derives its mandate from the OAS Charter and the American Convention on Human Rights. The Inter-American Commission has a mandate to promote respect for and to defend human rights in the region and acts as a consultative body to the OAS in this area. The Commission is composed of seven independent members who are elected in an individual capacity by the OAS General Assembly and who do not represent their countries of origin or residence.

No. 103/20