Minority groups are trying to address gender discrimination and MDGs 2 and 3 can complement these efforts. MRG’s report on Gender, Minorities and Indigenous Peoples (2004) cites a programme among the Khomani of Northern Cape, which involves the collection of oral histories recounting stories of positive female role models who were successful hunter-gatherers in years past, to be used in educational material for San children (p. 22). Such efforts can be very effective in helping minority communities to do more to ensure girl children’s access to education while at the same time improving the representation of minorities in national curricula. It is notable that gender inequality could negatively affect minority men as well. Brazil’s MDG progess report (2004) indicated that there were marginal inequalities in access to primary school by gender or race (3% difference by race) but that Afro-Brazilian males were least likely to access secondary and higher education. The report notes, “although women are present in higher education numbers regardless of race, among the black and mulatto population the ratio increases: it leaps to 125.9%, reaching 143.3% in higher education.” The report attributed this to “the even more increased dropout of black and mulatto men to enter the labour market, and to the phenomenon of discrimination, which affects blacks and mulattos of both genders and ends up moving them away from school” (Institute for Applied Economic Research (IPEA) 2004, p. 35). MDGs 4, 5 and 6: Reduce child mortality. Improve maternal health. Combat HIV/AIDS, malaria and other diseases. The Human Development Index rate in many countries is low and it is argued that minorities are more likely to experience lower life expectancy due to unequal access to health care and a higher incidence of some diseases than majority groups. These disparities are related to several causes. Health and sanitation conditions are often worse in regions where minorities live. Existing infrastructure for medical services might be more limited in remote or impoverished areas where minorities are based. In hospitals, lack of medical professionals able to communicate in their languages. The cultural practices of minorities may be unfamiliar to mainstream medical personnel, which may inhibit the effective prescription of pre- and post-natal care. All of these factors combine to reduce minorities’ access to good health care, impacting negatively on their infant and maternal mortality rates and causing minorities in many countries to suffer disproportionately from malnutrition, HIV/AIDS or other diseases (on HIV/AIDS see also section 4.6 of this Guide). Strategies to achieve the health-related MDGs will need to take account of these circumstances in order to be successful. According to the UN Committee on Economic, Social and Cultural Rights (CESCR), this means ensuring that health facilities, goods and services are within safe physical reach for all sections of the population; that medical services and underlying determinants of health, such as water and sanitation, are within safe physical reach, including in rural areas; that health facilities, goods and services are affordable for all; and that the right to seek, receive and impart information and ideas concerning health issues is assured.22 Reaching areas were some minorities live may require special effort, as will the provision of primary health care services that are adapted to minority cultures, environments and traditional medical practices. In Thailand, the MDG Report acknowledged that regions with a high proportion CESCR, General Comment No. 14, The Right to the Highest Attainable Standard of Health, UN doc. E/C.12/2000/4. 22 42 M A R G I N A L I S E D M I N O R I T I E S I N D E V E LO P M E N T P R O G R A M M I N g