A/HRC/45/34/Add.1 provide an opportunity for the visited indigenous communities to express their concerns or shape the agenda of the celebrations. 30. The lack of coordination within the Government to implement activities planned in the national action plan for indigenous peoples, the heavy reliance on international donors and implementers, the weakness of State structures, in particular outside Brazzaville, and continuing discriminatory attitudes towards indigenous peoples, all prevent substantial progress to be made in the fight against discrimination and the promotion of indigenous peoples’ rights. 2. Integration and indigenous identity 31. A significant number of indigenous persons met during the visit said they wished to settle down and be integrated without discrimination in wider Congolese society. Most of them saw their desire for a better life blocked by discriminatory attitudes that prevented them from being successful at school, obtaining employment or participating in public life. This desire to integrate and find a better life may act as an incentive for relinquishing their indigenous identity. 32. A number of indigenous men and women in Sangha reported that their desire to integrate was fuelled by the fact that they had been actively driven away from the forest and forbidden from hunting, and therefore saw no other viable option for ensuring their own survival. Members of the younger generation too may believe that living off the forest, as taught in their culture, is stigmatizing and perpetuates the image of indigenous peoples as inferior.12 33. While the wider picture shows a slow but clear shift of mentality in the majority population and a decline in direct discrimination, further progress is needed to eliminate structural discrimination against indigenous peoples and to acknowledge the importance of preserving the indigenous cultural practices, traditional knowledge and semi-nomadic lifestyle that are inherently linked to indigenous peoples’ spiritual connection to the forest. 3. Discrimination against indigenous women 34. Indigenous women and girls continue to lack access to reproductive health care, and to be subjected to gender-based violence including rape, and early marriages, high rates of maternal and infant mortality and food insecurity. Communities usually lack facilities for drinking water and sanitation, and the burden to look for water and to take care of children who get sick because of lack of such facilities disproportionately falls to women and girls. Women have accordingly requested that the Government drill more wells. The Rapporteur was told that certain Bantu men impregnate young indigenous girls and then abandon them without support. Health care services for women and girls should be made more accessible and designed to be more gender and culturally-sensitive. B. Access to health care and education 1. Access to health care 35. The recommendations made by the previous Special Rapporteur in 2010 included the following: increasing access of indigenous people to basic health services; increasing the cultural appropriateness of services; training indigenous health workers; incorporating indigenous traditional medicine in mainstream health services; and involving indigenous peoples in the design of health services that respond to their needs. Furthermore, it was recommended that the Ministry of Health and Population support health-care initiatives developed by indigenous peoples and train all medical staff to better understand indigenous peoples. 36. Title V of Law No. 5-2011 sets out important guarantees for indigenous peoples’ access to health care. The Special Rapporteur welcomes the adoption of Decree No. 2019202 of 12 July 2019 providing for special measures to facilitate access by indigenous 12 8 Jerome Lewis, “Our life has turned upside down! And nobody cares.”, in Hunter-Gatherer Research, vol. 2, No. 3 (2016), pp. 375–384.