E/CN.4/2004/80/Add.3 page 18 term “peoples”. The Special Rapporteur believes that the right of peoples to self-determination, as a universal human right (enshrined in article 1 of both the International Covenant on Economic, Social and Cultural Rights and the International Covenant on Civil and Political Rights, which Chile has ratified), applies to all peoples, including indigenous peoples, as reaffirmed in ILO Convention No. 169 and other international instruments. 44. The constitutional reforms undertaken by many countries in recent decades have not been concerned with limiting or circumscribing this human right but rather with establishing the conditions in which it can be exercised, given the particular circumstances in each country. Similarly, a new relationship between the Chilean State and its native peoples could allow them to determine perfectly well the conditions for the exercise of this right on the basis of democratic consensus and with the full participation of the indigenous population, without violating the principle underlying this universal right. D. Health, education and the preservation of indigenous culture 45. There is a pent-up demand for social services by native communities, with particularly strong demands in the fields of education, health and housing. While many indigenous people have benefited from the sustained economic growth of recent years, their standard of living is generally far below the national average and that of non-indigenous Chileans. Despite falling poverty levels, the profound economic inequalities that persist in the country affect indigenous people more than other Chileans. 46. In the field of education, the Ministry of Education is starting up a bilingual intercultural education programme based on sound theoretical and pedagogical principles. Owing to the scarcity of trained staff and resources, most indigenous communities have not yet been able to benefit from the new programme, and so far the country’s educational system has not been able to meet indigenous people’s demand for the protection, preservation and promotion of their traditional culture. 47. In the field of health, for example, the Special Rapporteur was told about systematic discrimination against indigenous peoples in access to medical services and in the quality of these services. The traditional medicine of indigenous peoples has been devalued and ignored, if not banned altogether, although some attempts are now being made to promote intercultural medicine in some hospitals in indigenous areas and have produced promising results; however, the programme is still in its infancy. The municipality of San Pedro de Atacama, a centre for the Atacameño population in El Loa province, does not even have a maternity clinic, which means that women in labour have to go to the city of Calama for care and newborns are registered in that city’s registry office. This anomalous situation gives the impression that the indigenous Atacameño population is decreasing in size, as well as creating serious problems for families. 48. The Special Rapporteur also received information on the problems indigenous children face in gaining access to education and on big increases in school failure and dropout rates, which are already high. He is particularly concerned about the low number of indigenous children going on to secondary education and about the way children with behavioural problems are treated on account of their indigenous origin.