E/CN.4/2005/88/Add.2 page 20 This is a major challenge, with many obstacles to overcome. The human, economic and social development indicators for the indigenous population show levels below the national average, particularly in respect of indigenous women and girls. According to a study by the Cauca Indigenous Regional Council, only 50 per cent of school-age children are actually in school, and in Antioquia the figure is less than 40 per cent. 77. For bilingual education to become a reality for all indigenous school-age children in Colombia, a sustained effort will be required, along with extensive resources for, inter alia, teacher training, school construction, production of educational materials, evaluation of results and continuity of teaching methods, all of which are at present compromised by the constraints on the public purse and the various national priorities in resource allocation. 78. The same applies to health services, particularly in the areas of mother-and-childcare, reproductive health for indigenous women, child nutrition (including among the displaced population) and cultural determinants of health among indigenous peoples. In this context, it is worrying to note that the armed conflict has claimed the lives of large numbers of traditional doctors from indigenous communities and that the violence has hampered communities’ ability to collect traditional plants and products in the natural environment for use in health care in accordance with indigenous cultural practice. The violence has also frightened off doctors and health workers and affected vaccination campaigns. 79. The Embera Katio people of Alto Sinú informed the Special Rapporteur of their high mortality rate - more than twice the national rate; what is more, their infant mortality rate is 3.2 times the national rate. They are demanding better health care from the State and allege that there is no effective protection for their cultural integrity. 80. Act No. 691 of 2001 guarantees indigenous people’s right to health services. To date, according to the Government, more than half a million indigenous people are covered by the subsidized health scheme, and President Uribe has indicated that by the end of his term of office all indigenous people in the country will be covered. Seven health-service providers operate in indigenous areas, but this is not enough and they alone cannot guarantee the realization of indigenous peoples’ right to health. IV. CONCLUSIONS 81. The precarious human rights situation of Colombia’s indigenous peoples reflects the gap between progressive domestic legislation and the ineffectiveness of the institutions responsible for protecting these peoples, against a background of internal armed conflict involving numerous warring parties whose actions directly affect indigenous communities’ chances of survival. 82. The spread of narcotics cultivation and trafficking, and efforts to combat that spread, notably by spraying fields from the air, have had an adverse effect on indigenous peoples’ environment, economy, social life, health and culture. 83. Certain small indigenous communities in the Amazon region are especially vulnerable, and indeed are in real danger of extinction as peoples.