A/HRC/15/37/Add.5 these regular visits by medical brigades and at least one village, the very small Pareni village in Kamchatka, has had no access to medical care for two years. 77. Environmental contamination has significant negative impact on the health of indigenous people. The contamination of the river Amur, which flows from China, has been a major concern in Khabarovsky Krai. The pollution of the river causes a much higher than natural occurrence of parasites in fish, and raw fish is a main staple of food for the indigenous people in the region. The regional government has enacted the “Clear Water” and “Fresh Bread” programmes to attempt to make clean drinking water available and encourage consumption of grains in addition to the heavily meat-based diet of indigenous people, and so far the region has established water purification stations and built 22 bakeries in compact settlements. 78. Traditional methods of healing are not rejected by the official health institutions; however, hospitals and medical centres are not directed to take traditional medicinal methods into account when prescribing medications or issuing diagnoses. Persons may be considered “traditional healers” if they have formal medical education, and acquire a licence to practise alternative medicine from the regional health department. Shamanism, the traditional practice of using spiritual healing methods, is studied academically, but the practice itself is suffering. In Evenkiya, for example, the Special Rapporteur was informed that there are only two practising Evenki shamans left. V. Conclusions and recommendations General legal and policy framework 79. The Russian Federation has taken important steps towards ensuring the realization of the human rights of the country’s “small-numbered indigenous peoples”. However, continuous and focused attention is necessary in order to accelerate positive developments, to ensure better implementation of existing legal guarantees, and to ensure that the Russian Federation’s commitment to human rights principles and to specific policy benchmarks are realized for all indigenous peoples throughout Russia. 80. Moreover, the federal and regional Governments should work together to establish optimal and harmonious legislation and policy on indigenous issues, allowing sufficient flexibility for regional authority without compromising federal priorities and guidance. Special attention should be paid to ensuring the successful implementation of legal guarantees at the local level for all indigenous communities, such as by establishing reliable ways to monitor implementation and to remedy breaches of the guarantees. 81. The rights of ethnically distinct indigenous groups that do not meet the legislative criteria for designation as “small-numbered indigenous peoples”, but that nonetheless have characteristics similar to those within this category, should be protected. Consideration should be given to adapting this category, or to otherwise extending special protections for the benefit of such groups, in accordance with relevant international standards. 82. The federal Government should consider declaring its support for the United Nations Declaration on the Rights of Indigenous Peoples, engage in a comprehensive review of the laws and policies of the Russian Federation to ensure their compatibility with the Declaration, and take further coordinated action to implement the standards of the Declaration within the particular context of indigenous peoples in Russia. GE.10-14779 19