A/HRC/57/47 contributes to society, rather than perceived limitations. 34 A lack of recognition and support for traditional healing practices and ceremonies in Indigenous Peoples’ mental and physical health policy exists, which violates the human rights of Indigenous persons with disabilities. Below, broader challenges faced by Indigenous persons with disabilities in accessing health care are examined. E. Access to health care 39. Indigenous persons with disabilities often face barriers in their day-to-day lives, such as accessing affordable, quality and culturally appropriate health-care services, in particular if they reside in remote areas where health care is unavailable or where they face communication barriers with health and care workers. 35 Such barriers are compounded by additional layers of discrimination in relation to their Indigenous origin and disability. 36 Language barriers, cultural differences in health beliefs and practices and mistrust of mainstream health-care institutions that often have colonial origins all affect Indigenous persons with disabilities.37 For example, Sami persons with disabilities in Norway do not have access to services and opportunities in their own languages or within their own culture. Sami persons with disabilities often have to choose between gaining access to the health and other services that they need by moving elsewhere, or maintaining their languages and culture but without access to such services. 38 This is the experience of many Indigenous Peoples throughout the world. 40. The health problems experienced by Indigenous persons with disabilities are also affected by multiple difficulties in accessing health care. The World Health Organization (WHO) considers the accessibility of health care to be one of the four key elements in actualizing the right to health for Indigenous Peoples. Those four key elements are availability, accessibility, acceptability and quality. WHO further divides the concept of accessibility into four often overlapping subparts: (a) non-discrimination; (b) physical accessibility; (c) economic accessibility; and (d) information accessibility.39 41. Economic accessibility means affordability; since Indigenous Peoples experience some of the highest rates of poverty in the world, insufficiently funded health care is yet another barrier to access. Lastly, information accessibility is critically lacking in Indigenous communities because of the cultural mismatch between the services provided and the communities being served. When information is not available in Indigenous languages, many Indigenous persons with disabilities may not be aware of the health-care services available or may not fully trust them.40 42. In some States, inadequate health coverage generally is a large contributor to the prevalence of disabilities among Indigenous Peoples, specifically in terms of ineffective sexual and reproductive health care. Indigenous persons with disabilities often encounter obstacles such as racial discrimination and linguistic barriers in urban medical facilities, leading to a reluctance to seek medical assistance. 41 43. In Argentina, the lack of access to health-care facilities exacerbates health issues, in particular for Indigenous individuals with disabilities. In addition to the shortage of professionals and specialists and the lack of specialized hospital equipment, extensive 34 35 36 37 38 39 40 41 GE.24-12379 Nicole Ineese-Nash, “Disability as a colonial construct: the missing discourse of culture in conceptualizations of disabled Indigenous children”, Canadian Journal of Disability Studies, vol. 9, No. 3 (2020). Submission from the World Health Organization. Scott Avery, Culture is Inclusion: A Narrative of Aboriginal and Torres Strait Islander People with Disability (Sydney, Australia, First Peoples Disability Network, 2018). Submission from Tilioq, Greenland. A/HRC/43/41/Add.3, para. 25. See https://www.who.int/initiatives/global-plan-of-action-for-health-of-indigenouspeoples/frequently-asked-questions-on-the-health-and-rights-of-indigenous-peoples. Ibid. Shaun Grech, “Disability and poverty in rural Guatemala: conceptual, cultural and social intersections” (London, London School of Hygiene and Tropical Medicine, 2016). 9