When engaging with indigenous populations in COVID-19 response programmes, the United Nations Human Rights Office of the High Commissioner (OHCHR) recommends:
“Specific rights that are of particular relevance to indigenous peoples during this crisis - both individual and collective in nature - include the right to self-determination, and the right of indigenous peoples to participate and be consulted on measures that affect them, including the requirement to seek their free, prior and informed consent.” and “States and key stakeholders should take into account indigenous peoples’ distinctive concepts of health, which are inextricably linked with the realization of other rights, including the rights to self-determination, development, culture, land, language and the natural environment.”
Indigenous people have shown great resilience in the response to COVID-19 worldwide. They are turning to traditional knowledge, practices and values to remain strong and healthy in this crisis. It is important to consider the key principles for COVID-19 response programming and be familiar with global, national, and regional guidelines for engaging with indigenous populations. However, keep in mind that historically, government-led responses to health issues among indigenous populations have been inadequate, which has led to the mistrust of government efforts by indigenous communities.
1. Connect and work with indigenous communities prior to implementation and conduct formative assessments
It is crucial to communicate with indigenous people and to learn from indigenous communities prior to the design and implementation of response programmes. As a part of this process, prior informed consent should be obtained from the community. Therefore, the first step in the response should be to identify indigenous and non-governmental organizations, as well as indigenous community leaders, that know and have worked in the areas where the target population is located to consult and learn from them. A list of some indigenous organisations around the world is available here. Such consultations, rapid or in-depth, may reduce potential negative effects on the acceptability and effectiveness of a COVID-19 response. In South Suriname a Knowledge, Attitude and Practice (KAP) survey revealed a lack of information about COVID-19 in an indigenous community. From the survey, they learned that the community had received some information, including that they should limit the visitors entering indigenous territories but not much more guidance was provided. The KAP survey served as a baseline for monitoring activities and to inform the development of materials for their COVID-19 response such as risk communication materials. Learning from the community should be an ongoing process, repeated as the response and outbreak progress.
2. The response programme should be delivered in a culturally appropriate way using local language
Information on the pandemic should be timely, accurate, and produced in culturally sensitive formats using indigenous languages. The below list outlines some considerations that may be taken to ensure programmes and communications materials can be delivered in a culturally appropriate manner.
- Feature indigenous populations on communication materials (this should be approved by indigenous leaders)
- Document and share the experiences of people from indigenous populations who have had COVID-19 and survived
- Understand traditional communication channels and utilise these where appropriate
- Work with elders to identify safe ways to allow for the continued practice of spiritual and cultural practices
- Train people from indigenous communities to be part of the COVID-19 response
The Inter-American Development Bank has developed a list of critical questions to address when designing a culturally and linguistically appropriate COVID-19 response in indigenous communities.
Here are more examples of promising linguistically and culturally appropriate COVID-19 communication in indigenous communities:
- In a multi-sectoral collaboration in Colombia, the United Nations Information Centre, the Colombian National Indigenous Organization and the Colombian National Army developed seven radio messages about COVID-19 and distributed them throughout indigenous territories in indigenous languages.
- In the United States, the Native American Tribe, Pueblo Pojoaque, has published a website focused on health information and coordinating the closure and safe reopening of education programmes and activities. They have also adapted content from the US Centre for Disease Control to be distributed in the communities.
- COVID-19 messaging is being spread through loudspeaker, radio and TV in indigenous languages in Cambodia to reach indigenous communities.
- The non-governmental organization CIELO produced a series of short animated videos without text and then added voice-overs in a number of indigenous languages to be delivered in Latin and South America.
Image: Example of IEC videos providing information about COVID-19 in the languages of indigenous groups in Mexico and Guatemala produced by CIELO.
3. Multi-sectoral collaboration and coordination is crucial
To curb the spread of the pandemic, it is recommended that governments and actors work with and for indigenous people to ensure that no one is excluded from response programmes. This may include implementing measures to ensure increased access to medical supplies, more health workers, COVID-19 tests, as well as treatments and vaccines when they become available. Research has found that if health-care services are managed by indigenous people themselves, the quality and use of primary health care is improved due to culturally appropriate general public services. (Study 1, Study 2, Study 3). Including indigenous people in the response team, response coordination committee and government advisor panels may increase ownership and acceptability in some settings.
The effects of the pandemic in the Amazonian region led the Pan American Health Organization (PAHO) and the Coordinator of Indigenous Organizations of the Amazon River Basin (COICA) to coordinate and release a joint statement, urging countries and actors to collaborate and to provide supplies, medical devices, COVID-19 tests and human resources. The statement by PAHO and COICA especially urged countries to collaborate in regions where indigenous people live in areas by international borders. Some collaborations like these have been implemented successfully to combat COVID-19 in the Amazon region. Two examples of such collaborations include the municipality São Gabriel da Cachoeira, Brazil that demonstrated how multi-sectoral collaboration can help reduce the impact of the pandemic in an area home to more than 20 indigenous ethnicities and the Covid-19 Indigenous Alert, a mobile application launched to aid in collaboration and information sharing among indigenous groups, organisations and authorities in the Amazon Region.
4. Make sure all indigenous ethnicities are reported when collecting data
The data should be disaggregated to include all ethnic group categories represented in the indigenous groups. Data disaggregated by ethnicity should be routinely collected and used to report on the health impact of COVID-19 and also the availability of necessary health care resources: testing, health-care facilities and treatment and information about the outbreak. It is important to note that questions about ethnicity during data collection should be optional to answer.
Want to know more about engaging with indigenous people for COVID-19 response?
- Are indigenous populations particularly vulnerable to COVID-19?
- Why are indigenous people at increased risk of COVID-19 morbidity and mortality?
- Why are indigenous populations often left out of outbreak responses?
- What are the secondary impacts of COVID-19 in indigenous communities?
- What COVID-19 preventative actions can be implemented to reduce transmission in indigenous communities?
Author: Astrid Hasund Thorseth
Last update: 28.10.20