A/HRC/39/17/Add.3 F. Health 89. The majority of the indigenous population does not have access to primary health care. State investment in health services is among the lowest in Latin America. The Special Rapporteur was able to observe the lack of facilities, personnel and medicine in the territories that she visited. Maternal mortality in Guatemala is the second highest in the region. 90. Indigenous midwives are essential in providing accessible and culturally appropriate mother-child health services. The Special Rapporteur considers the adoption of the National Policy on Indigenous Midwives to be a positive step and calls on the Government to guarantee the budget necessary for its full implementation, thereby honouring the work of these women. G. Education 91. A previous Special Rapporteur, Mr. Stavenhagen, stated in his report as long ago as 2002 that intercultural bilingual education should be strengthened as a national priority. 9 In 2016, the Constitutional Court ruled, in the case of Santa Catarina Ixtahuacán, that the Ministry of Education must develop intercultural bilingual education and put it into operation within six months, but the necessary measures have not yet been adopted. 10 The Ministry reported that, in 2018, it had developed Maya, Garifuna and Xinka curricula. Indigenous organizations allege that there has been serious retrogression in this regard, owing to a failure of political will and inadequate funding. 92. Indigenous children continue to have very restricted access to education. Half of indigenous children do not go to school. The situation of indigenous girls is particularly alarming, inasmuch as they receive only two years of education, on average, as against six years for non-indigenous girls. 93. In addition to the failure to implement proper intercultural bilingual education, conditions in the education service are abysmal, including overcrowded classrooms, poorquality teaching, dilapidated facilities and racism and discrimination in the education system. The Special Rapporteur was repeatedly informed of school fees that forced indigenous children to leave school and led to a rise in the overall dropout rate. 94. The national curriculum does not contain information on the impact of the armed conflict on the indigenous peoples. The Special Rapporteur considers it essential for this topic to be covered, so that children and young people, both indigenous and nonindigenous, can learn about the legacy of the conflict and its consequences. H. Indigenous women and girls 95. The Special Rapporteur held separate meetings with the indigenous women in all the communities that she visited and she is concerned at the multiple forms of discrimination and violence that women suffer, despite the existence of national legislation on domestic violence, sexual violence, trafficking, sexual exploitation and femicide. She was told of a number of cases of the rape or murder of indigenous women and girls, of abuse against them during forced evictions and of the impunity for those crimes. 96. Women who have been criminalized, and the wives of men who have been criminalized, are stigmatized in their communities. They face serious financial difficulties in feeding their children and sending them to school. The presence of corporations in indigenous territories exposes women and girls to sexual and labour exploitation. In the Ixil region, the indigenous women claim that there is a direct correlation between the presence of mining projects and the increase in prostitution and domestic slavery. 9 10 16 E/CN.4/2003/90/Add.2, para. 77. Consolidated files 4783-2013, 4812-2013 and 4813-2013, of 5 July 2016. GE.18-13268