A/HRC/33/42/Add.2 information on the indigenous peoples, their languages, their cultures or their contributions to the country. 3. Health 71. The health situation of the indigenous peoples of Honduras is precarious, owing to such factors as poverty, discrimination, geographical isolation and the lack of proper health services in the indigenous communities. 72. According to the available figures, neonatal mortality — that is, of children under 12 months old — is 43.5 per 1,000 live births among indigenous children, which is higher than the national average of 35.1 per 1,000, while infant mortality — of children under 5 years of age — is 62.9 per 1,000, higher than the national average of 49.7 per 1,000. The main causes of death include preventable diseases such as pneumonia, parasitic diseases and malnutrition. Chronic malnutrition affects 38 per cent of the indigenous child population under the age of 5 years, as against the national average of 30 per cent. The level is over 55 per cent among Lenca, Tolupán and Chortí children. Among the adult population, life expectancy varies from people to people. For example, it is 52 and 57 years, respectively, for Tolupán men and women and 38 and 43 years, respectively, for Tawahka men and women. The national average is 65 and 70 years, respectively, for men and women. Indigenous children and adults suffer from a high rate of respiratory infections, malnutrition, diarrhoea, malaria, dengue fever, tuberculosis and Chagas’ disease. There are high levels of HIV/AIDS among the Garífuna, Miskito and Tawakha populations. 17 73. The Special Rapporteur was informed that indigenous people used State services such as rural health centres and dental centres in or near their communities and also public and private clinics and hospitals outside their communities. A significant number of people decided not to seek medical care (13 per cent, according to one survey) or preferred to obtain it in their own homes or communities (5 per cent). It has been reported that an average of 96 per cent of indigenous communities have access to practitioners of various kinds of traditional medicine.18 74. The Special Rapporteur heard numerous statements on the lack of facilities, staff and medicines at health centres in indigenous territories and on the social and economic factors that hinder access to health. In La Mosquitia, the representatives of the indigenous people called for more health centres in their communities and a regional hospital. They said that the shortage of staff and proper medical care in the region had led to an increase in maternal mortality and in the number of people who had resigned themselves to dying because they could not meet the costs of transport and medical treatment in distant population centres. They reiterated the need for the State to build roads in a number of areas in order to improve access to health services and other necessities. The Special Rapporteur was told that, in the Lenca region, lack of access to medical services forced some people to go to health centres in El Salvador. 75. Another problem that was reported was the lack of respect for ancestral health practices and the lack of coordination with health officials in accommodating such practices and indigenous world views on health. 17 18 16 Ibid., pp. 51-57. See also OHCHR, Regional Office for Central America, Diagnóstico sobre la situación de los derechos humanos de los pueblos indígenas de América Central (Nov. 2011), pp. 303-305. Alejandra Faúndez Meléndez and Marcos Valdés Castillo, Caracterización de la población indígena y afrodescendiente de Honduras, report by the Programme for the Comprehensive Development of Indigenous Peoples/Honduran Social Investment Fund (2011), pp. 30-37. GE.16-12632

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