ARCTIC OCEAN

RUSSIA

JAPAN KAZAKHSTAN NORTH MONGOLIA KOREA UZBEKISTAN SOUTH TURKMENISTAN KOREA KYRGYZSTAN TAJIKISTAN PACIFIC Jammu and AFGHANIS- Kashmir CHINA TAN OCEAN

PAKISTAN TIBET Taiwan NEPAL BHUTAN BANGLADESH Hong Kong INDIA BURMA LAOS PHILIPPINES THAILAND VIETNAM CAMBODIA Andaman and Nicobar BRUNEI SRI LANKA Islands Bougainville PAPUA NEW MALAYSIA SOLOMON ISLANDS MALDIVES GUINEA SINGAPORE Borneo Sulawesi Wallis and Futuna (FR.) Sumatra INDONESIA TIMOR-LESTE FIJI ISLANDS French Polynesia (FR.) Java New Caledonia (FR.) INDIAN

OCEAN AUSTRALIA

NEW ZEALAND Asia and Oceania Jack Dentith, Emily Hong, Irwin Loy, Farah Mihlar, Daniel Openshaw, Jacqui Zalcberg Right: Uighurs in Kazakhstan picking fruit from Central a tree. Carolyn Drake/Panos. which affects the health of the most vulnerable people living in the region. In March, the Asian Asia Development Bank (ADB) reported that the shrinking of the Aral Sea and drying up of two Daniel Openshaw major rivers, the Amu Darya and Syr Darya, would particularly affect Karakalpakstan – an inority groups live in some of the autonomous region of Uzbekistan, home to the poorest regions of Central Asia; majority of the country’s Karakalpak population, M Pamiris in Gorno-Badakhshan as highlighted in MRG’s 2012 State of the World’s Autonomous Province in Tajikistan; Uzbeks Minorities and Indigenous Peoples. in South Kazakhstan province; Karakalpaks in In an already poor region, climate change Uzbekistan’s Karakalpakstan region; and high is especially significantly affecting the most numbers of Uzbeks and Tajiks in Kyrgyzstan’s vulnerable. Most people in Karakalpakstan Ferghana Valley. Poverty has a direct impact depend on agriculture, so water shortages have on their health. The right to free health care is reduced farmers’ income and resulted in food enshrined in the constitutions of four of the five shortages and poor health through malnutrition. Central Asia states; Turkmenistan abolished free Overuse of pesticides has also polluted water health care in 2004. However, the reality is not supplies and caused health problems, such as as straightforward as reports are commonplace of kidney and liver disease, tuberculosis and cancer. bribes being necessary to gain access to Many people want to migrate due to poor health care. environmental conditions. Official health data – disaggregated by either Climate change and mismanagement of water ethnicity or gender – is not widely available in resources have also led to water shortages in the region, but some information is available southern Kyrgyzstan, home to many minorities, from international organizations. For example, a particularly Uzbeks, according to a 2012 report 2008 World Health Organization (WHO) report by the ADB. The ADB report highlights other found that inequity of access to mental health environmental problems in the region: glacier services was an issue for minorities in Kyrgyzstan melt in Tajikistan – the poorest country in the that should be addressed. region – which will reduce access to water, and The rate of new HIV infections continues to desertification in Kazakhstan. rise across Central Asia according to UNAIDS; in Kyrgyzstan and Kazakhstan new infections Kazakhstan rose by 25 per cent between 2001 and 2011. Incumbent president Nursultan Nazarbaev and Drug resistant tuberculosis and malaria also his Nur Otan party won parliamentary elections disproportionately affect people living in in January with 80 per cent of the vote. The poverty or social exclusion, including minorities, Organization for Security and Cooperation according to the United Nations Development in Europe (OSCE) criticized the elections for Programme (UNDP). failing to meet democratic standards yet again. Prisoners are another population at risk of Two other political parties considered loyal contracting HIV and tuberculosis, or suffering to Nazarbaev also gained seats in parliament. from mental health problems and other problems Women continue to be under-represented in associated with drug use. This particularly affects government, with 27 of 77 seats in the lower minorities, given the high numbers of ethnic and house of parliament and 2 of 47 in the upper religious minorities among prison populations in house. Kyrgyzstan, Uzbekistan and Kazakhstan. There are still very few ethnic minority Climate change is exacerbating the effects of representatives in senior government, which long-term mismanagement of water resources, could in part be because of language barriers.

118 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Although knowledge of Kazakh is not required sound more Kazakh. While offering substantial for government and civil service positions – positive rewards and glory for successful except for presidential candidates – non-Kazakh competitors, this practice reportedly led to speakers complain that Kazakh speakers are resentment towards ‘plastic’ Kazakhs, which favoured for government positions. could contribute to discrimination. Nazarbaev’s victory is seen to reflect a growing The situation for religious minorities Kazakh nationalism in the country. Under his deteriorated in 2012, following the adoption of a leadership, the creation of Kazakh-language new Religion Law in late 2011. The law compels schools and the conversion of some Russian- public organizations and religious groups to language schools to Kazakh reduced the overall register with the Ministry of Justice and regional number of Russian-only language schools. In authorities, and has been enforced through March, Nazarbaev called for fewer home-grown fines and imprisonment. For example, in East films to be made in non-Kazakh languages and to Kazakhstan members of an unregistered Baptist show the country in a more positive light. group were fined almost 18 months’ wages each. At the most elite end of public health Registration processes have been described promotion, home-grown nationalism was less as complex, arbitrary and expensive. The 2013 of an issue for the government as naturalized or United States Commission on International so-called ‘plastic’ Kazakhs made up over half of Religious Freedom (USCIRF) report documented Kazakhstan’s delegation to the London 2012 cases of corruption involving the re-registration Olympics. The athletes included several Russians process. and three Chinese-born weightlifters, who took During 2012, numerous groups were not Kazakh nationality and changed their names to allowed to re-register. For example, members

State of the World’s Minorities Asia and Oceania 119 and Indigenous Peoples 2013 of the Grace Protestant Church in Karaturyk, legal documents. with a mainly Kazakh and Uighur membership, Increasing numbers of Kyrgyz women are were pressured to remove their names from moving to Kazakhstan in search of work where registration documents to prevent the church they are vulnerable to exploitation. There were from registering. Some congregations of the reports in 2012 that some migrant Kyrgyz Russian Orthodox Church Abroad were also women face mistreatment and exploitation. Poor affected. The government raided numerous places female migrants are vulnerable to becoming of worship and confiscated religious material, forced sex workers, drug mules or victims of affecting Pentecostal Christian, Methodist, Hare human trafficking to other countries, especially Krishna and Jehovah’s Witness groups. Russia. Their situation risks being compounded Muslim groups have also been affected. Only by medical problems, lack of access to proper groups that are part of the state-backed Sunni health care and unwanted pregnancies caused by Muslim Board can register and in November rape or forced prostitution. some independent mosques belonging to This trend sparked debate in Kyrgyzstan in Shi’a and Ahmadi Muslim communities were April when a female member of parliament refused legal status. As a result the Ahmadiyya proposed that women under the age of 23 community in Almaty has nowhere to legally should be banned from leaving the country for worship. Other mosques have also been work in order to protect them from mental and threatened with demolition if their communities physical abuse. However, this proposition is don’t register with the authorities. an inappropriate attempt to control women’s Human rights activists report that prison freedom of movement. administrators do not allow prisoners to practise their religion. If members of unregistered groups Kyrgyzstan were incarcerated they would face a prison system Ethnic minorities are under-represented in that has been criticized for providing insufficient the Kyrgyz government; non-Kyrgyz citizens access to medical care and having inadequate constitute 35 per cent of the population but only numbers of medical personnel, including 12 per cent of members of parliament. Women infectious disease doctors, not monitoring are also under-represented. Non-Kyrgyz speakers antiretroviral treatment of HIV-infected complain of a glass ceiling within the civil service, prisoners, having shortages in medication, and even though the law provides for the preservation having inadequate heating and ventilation and free development of minority languages systems. alongside Kyrgyz as the state language and In September, Uzbek Pentecostal pastor, Russian as an official language. Makset Djabbarbergenov, was arrested in More positively, in December 2012 President Kazakshtan at the request of the Uzbek Almazbek Atambaev refused to sign a bill that government for conducting religious activity. He would introduce fines for public officials who do was not extradited, partly due to international not have sufficient knowledge of Kyrgyz language. pressure, but he was held in detention for In January Kamchybek Tashiev, leader of three months. Upon his release in December, the nationalistic Ata-Jurt party, which holds Djabbarbergenov and his family left the region; seats in parliament, called for the then prime he is banned from returning to Kazakhstan minister, Ormunbek Babanov, to resign because before 2017. Djabbarbergenov had previously his mother was not from Kyrgyzstan. Tashiev been recognized as a refugee by the UN refugee said: ‘I should say openly, and let people not be agency, UNHCR. offended, that the head of government should The plight of Kyrgyz migrant workers also be a pure-blooded Kyrgyz, who will actually be made the news in 2012 when three Kyrgyz who rooting for the interests of the country.’ The had suffered de facto slavery in Kazakhstan statement sparked debate and media attention, for about a decade were found and released in as well as reportedly an investigation by the State Almaty. Rights groups say that migrant workers’ Security Service. rights are often violated due to their lack of Ata-Jurt also supported nationalistic protests

120 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 in Osh in the run-up to council elections. The ‘biased attitude’ and that it review their poll led to a strengthened position for nationalist guilty verdicts. However, Uzbeks continue to mayor Melisbek Myrzakmatov, with his supporters report police harassment, and continue to be almost achieving a majority in the city council. disproportionately prosecuted and incarcerated. This is a sign of growing Kyrgyz nationalism Throughout 2012 crowds of courtroom in the city. The election results prompted the spectators, including family members of victims, International Crisis Group (ICG) to warn that disrupted trials of ethnic Uzbeks charged with Uzbeks are being pushed to breaking point by the crimes related to the 2010 violence, threatening discrimination and anger directed towards them, the security and the safety of defendants, and that Myrzakmatov is largely to blame for this. attorneys and judges. Too little has been done in the way of inter-ethnic The strength of inter-ethnic feeling can be seen reconciliation, according to ICG. in an incident in September; Kyrgyz residents in June 2012 marked the second anniversary of Ala-Buka, Jalalabad (another site of violence in the ethnic clashes between Uzbeks and Kyrgyz in 2010), beat up a judge following the exoneration Osh and the neighbouring region of Jalalabad, of a local ethnic Uzbek who was found not guilty in which more than 400 people were killed and of assaulting a local Kyrgyz citizen. thousands more displaced. In the run-up to the In prisons, a disproportionate number of ethnic anniversary, authorities tightened security and minority prisoners serve life sentences and so carried out passport checks expecting trouble. face numerous health risks, including high levels A National Remembrance Day – 10 June – was of drug use. UN Special Rapporteur on torture instituted and marked by the opening of the Juan Mendez noted poor prison conditions, country’s biggest mosque in Osh city in a bid to including the use of torture, on his visit to the instil some unity. However, a bell dedicated to country in December 2011. In January 2012, those who lost their lives during the violence was prisoners organized a nationwide hunger strike also unveiled in Osh in the summer with ‘Peace by sewing their mouths shut in protest against all over the world’ written in Kyrgyz, Russian and poor conditions. The protests, led by an ethnic English – but not Uzbek. Uzbek, also aimed to highlight the corruption and Ethnic tensions remain high. In June an Uzbek criminality rife in the prison system. rap song about regional leaders in Osh province Ethnic Uzbek citizens in Osh and Jalalabad offensive to Kyrgyz people started circulating face discrimination when looking for work, online, where the song had been said to spark particularly within public services, according several minor ethnicity-based incidents and was to the 2012 US State Department report on promptly banned by the provincial court for human rights in the country. There have also inciting ethnic hatred. been multiple reports of seizure of ethnic Uzbek The US State Department 2012 human rights businesses and property. report states that trials of ethnic Uzbeks for crimes As 2015 approaches, assessment of how committed during the 2010 violence continue, countries have lived up to the Millennium with some cases of previously lenient sentences Development Goals has begun. In 2012, being overturned in favour of harsh ones. Human research published in The Lancet medical journal Rights Watch questioned the fairness of trials for showed that Kyrgyzstan and Uzbekistan were non-Kyrgyz citizens after one ethnic Uzbek and the two most equitable countries out of 54 one ethnic Russian were sentenced to death in studied in terms of mother and child health October for crimes committed during the inter- interventions. This is not to say that interventions ethnic violence. were necessarily good, but that access was not In April 2013, the UN Committee on determined according to wealth.1 Elimination of Racial Discrimination reported In terms of HIV, 70 new cases in children – 10 that Uzbeks were the main victims of the June in Jalalabad and 60 in Osh, both with large Uzbek 2010 events but were also the most prosecuted populations – were announced in June 2013 and and condemned. The committee recommended attributed to accidental transmissions in regional that the government investigate the courts’ hospitals. This follows an incident in 2010 when

State of the World’s Minorities Asia and Oceania 121 and Indigenous Peoples 2013 a large number of women in Osh were infected for remarks he made about Islamic mullahs in a with HIV. Even though it was accidental, reports radio interview, but he denied trying to stir up following the aftermath of this incident cite a religious hatred and says he is being targeted for debilitating stigma – within and outside the health his Tengristic beliefs. The case drew attention service – attached to those with HIV. They also to Tengrism, which is an ancient Central Asian highlight a wider problem of client confidentiality religion incorporating elements of shamanism, not being observed by health care professionals, as animism, totemism and ancestor worship. the identities of the women became widely known Although largely tolerated in Kyrgyzstan, some among their relatives and neighbours. clerics claim that Tengrism proselytizes against The Kyrgyzstan government, despite promises, Islam. has not reviewed the restrictive 2009 Religion Law, which among other things requires religious Tajikistan groups to undergo a laborious registration Ethnic minorities and women are politically process. The government has consulted with under-represented in Tajikistan. There are no external bodies to discuss measures, such as a female or minority ministers; and out of the ban on sending students abroad for religious 96 seats in the upper and lower chambers of education without state permission, a ban on parliament, only two are occupied by ethnic foreigners carrying out religious practices without minorities and 17 by women. a state licence and amending registration criteria In May Salim Shamsiddinov, an Uzbek that would require groups to have 200 founders community leader in southern Tajikistan’s within the same locality; all of which would Khatlon region, was seriously assaulted after he further restrict religious assembly and freedom. publicly claimed the government was pursuing By early 2012, only 135 Muslim communities nationalist policies. He has since gone missing and three Russian Orthodox parishes had in what Amnesty International suggest was a been registered, leaving hundreds of mosques, political abduction. Elsewhere in 2012, the US Protestant churches, Jehovah’s Witnesses State Department reported occasional harassment and Hare Krishna communities unregistered, of Afghans and Uzbeks by law enforcement according to the USCIRF 2013 report. Ahmadi officials. Muslims are also affected. In February the South In Tajikistan 7,500 children under the age Korean-based Unification Church was banned. of five die every year of undernourishment Uzbek imam Khabibullo Sulaimanov faced according to a 2012 report by the World extradition to Uzbekistan at the beginning of Bank and UNICEF. A third of children have 2013 after his arrest for illegally crossing the stunted growth and there is high prevalence of border in 2012. In March 2013 the courts anaemia and other health impacts from lack of decided not to extradite him, partly due to food, according to the report. This was found international pressure over the ill-treatment he to be most prevalent in rural Khatlon, with would probably face in Uzbekistan. However, he a significant Uzbek population, and Gorno- is still incarcerated. Badakhshan Autonomous Province, where The authorities continued to target religious ethnic Pamiris mainly live. President Emomalii minority groups for ‘inciting racial hatred’, Rahmon’s lack of connection with his people – particularly the banned Islamist group Hizb- especially minorities in these rural areas – was ut-Tahrir. The group calls for the peaceful shown when he criticized his citizens’ unhealthy establishment of an Islamic caliphate, but is seen eating habits and lack of exercise, which he as a terrorist organization by the government. thinks leads to high levels of obesity. In August, a Hizb-ut-Tahrir leader was arrested Violence erupted in Gorno-Badakhshan in Jalalabad, allegedly for planning to overthrow Autonomous Province in July, after a local the government. Another imam was arrested in state security official government official was October for suspected membership of the group. murdered. The government sent 3,000 troops In January charges of inciting religious and to the autonomous Pamiri region to arrest ethnic hatred were also used against a Tengrist Tolib Ayombekov, an opposition leader from

122 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 the 1990s Tajik civil war who was blamed for women are particularly repressed since a fatwa or the assassination. The violence led to numerous religious decree issued in 2004 banning women deaths and injuries, including among civilians, from praying in Tajik mosques remains in effect. according to HRW. A majority of the region’s Women are also banned from wearing the hijab population belongs to the Ismaili sect of Islam; in schools and government offices. representatives of the movement’s spiritual leader, In 2012, the Tajik government arrested citizens the Aga Khan, were involved in negotiation for belonging to alleged extremist groups such efforts to diffuse the situation. as Hizb-ut-Tahrir and Jamaat-i Tabligh (Society Tensions continued through August, however, for Spreading the Faith), which has been banned as local Pamiris protested after the murder of since 2006. Members dispute claims that these another former opposition leader, Imomnazar groups have connections to terrorism and say Imomnazarov. The government conceded that they belong to peaceful organizations. In May, they would withdraw at the end of August but several alleged members of the Islamic Movement sporadic killings and skirmishes continued into of Uzbekistan were arrested and tried behind September. closed doors. The Tajik government further tightened restrictions on religious freedoms in 2012, Uzbekistan introducing new penalties for those receiving Only 11 members of the 150-seat strong lower religious education abroad, preaching and chamber of government and 11 of 100 seats teaching religious doctrines, and establishing in the lower chamber are occupied by ethnic connections with foreign religious organizations. minorities. Furthermore, officials reserve senior This move led to Tajikistan joining government positions for ethnic Uzbeks despite Turkmenistan and Uzbekistan as a ‘country of laws prohibiting employment discrimination particular concern’, according to the USCIRF based on ethnicity or national origin. 2013 report. The US State Department 2012 human rights The report notes that restrictions and abuses report cites widespread restrictions on religious primarily affect the majority Muslim population, freedoms, including harassment of religious but also Seventh-day Adventists, Baptists, Baha’is, minority groups. The report also highlighted a Protestants, Jehovah’s Witnesses and Hare government crackdown on international NGO Krishnas. activity and further suspicion of unregulated A repressive 2009 Religion Law prohibits all Islamic and minority religious groups. For religious activity independent of state control. example, in March security cameras were installed Those who participate in unregistered religious in more than 30 mosques in the religiously activity face up to two years’ imprisonment. conservative Ferghana Valley. Authorities claimed The 2011 Parental Responsibility Law stipulates that cameras were installed in order to prevent that parents must prevent their children from theft, but locals argue it is to ensure preachers toe participating in religious activity, outside state- the party line. approved religious education. Uzbekistan remained a ‘country of particular According to the Tajik State Department, as concern’ according to the USCIRF 2013 report. mentioned in the USCIRF 2012 report, only Persecution of unregistered Christian groups was 74 of the 4,000 registered religious are non- commonplace throughout 2012. For example, in Muslim, including Ismaili groups. Minority December a group of Protestants were charged Muslim groups continue to face persecution; the for discussing their faith and singing Christian Islamic Renaissance Party claims that numerous songs; they also had their songbooks confiscated unregistered mosques have been demolished; and fingerprints taken. In November, leaders the Salafi Muslim group has been banned since of some registered Protestant churches were 2009; and in February it was reported that gathered in Tashkent and instructed to re-register in December 2011 a mosque was raided for within one month. They were also warned observing a Shi’a Muslim holiday when only against missionary activity. Baptist congregations Hanafi Sunni rituals should be observed. Muslim have made similar reports.

State of the World’s Minorities Asia and Oceania 123 and Indigenous Peoples 2013 The state-run media encouraged intolerant being in prison in Uzbekistan is detrimental to views towards Protestants, Jehovah’s Witnesses prisoners’ health. The WHO has launched a and other groups, sometimes equating their prevention and treatment programme in prisons practices with extremism. to stop the spread of tuberculosis as well as In the autonomous republic of Karakalpakstan HIV/AIDS. – with a mainly Karakalpak population – only The Uzbek government claims that conditions Muslim and Russian Orthodox religious in the jail are improving. However, a letter communities have been registered, making the from an inmate – published by French human activity of more than 20 Protestant and Jehovah’s rights group Association for Human Rights in Witness congregations ‘illegal’. Most churches are Central Asia (AHRCA) – tells of being beaten for now closed and there have been reports of Hare something as minor as not showing interest in Krishna and Protestant students being expelled nationalist books written by President Karimov. from university. Members of the South Korean- based Unification Church have been told that Sokh enclave they cannot contact members in other countries. Sokh is a small pocket of Uzbek territory almost Many citizens arrested for alleged religious completely surrounded by Kyrgyzstan’s Batken extremism continue to end up in prison. In July province in the Ferghana Valley. It is home to an 2012 ethnic Kazakh Ermek Qosmaghambetov estimated 60,000 people, with the vast majority was charged with attempting to smuggle ‘materials ethnic Tajik and other minorities. propagating religious extremism’ into Uzbekistan Ethnic tensions have simmered in the small on his laptop. Most arrests for extremism affect region amid border disputes since the dissolution members of banned religious groups Hizb- of the Soviet Union. Both Uzbekistan and ut-Tahrir and Nur (a movement founded by Kyrgyzstan have a strong security presence and theologian Said Nursi, who died in 1960), whose strict border checks. members comprise the majority of political Territorial disputes have hampered local prisoners in Uzbekistan. Pressure to break up development and the region remains one of the ‘extremist’ cells has led to police and security poorest areas in Kyrgyzstan. The Sokh enclave services to use measures such as detention and has been targeted by the Uzbek authorities as a mistreatment of accused persons’ family members suspected breeding ground for Islamic extremism. and attaining confessions through torture. As a result large numbers of residents have Trials rarely meet international standards emigrated, particularly to Russia. and once they are incarcerated prisoners In January 2013 ethnic violence erupted as report religious discrimination. The US State Sokh residents attacked Kyrgyz guards erecting Department 2012 report highlights the case of an electricity poles in disputed territory. The ensuing imprisoned Jehovah’s Witness reaching the end riots, which spilled over into Kyrgyz territory, led of his term and being told to renounce his beliefs to the destruction of Kyrgyz property – mainly or face trial once again. Also, despite periodic vehicles – and almost 40 Kyrgyz were taken presidential amnesties to mark public holidays, hostage, among them women and children. political and religious prisoners remain ineligible. The enclave border was sealed and barbed Large numbers of prisoners are sent to the wire fences erected along some borders. The infamous Jaslyk Prison in the autonomous republic residents, mainly ethnic Tajiks, were cut off from of Karakalpakstan. The institution is colloquially the rest of Uzbekistan. Aid agencies were initially known as the ‘House of Torture’ or ‘Place of No prevented from entering the enclave although Return’. It became a destination for those charged restrictions were relaxed by the end of January. with religious extremism after bombings in 1999 Talks between the governments of Kyrgyzstan that were blamed on Islamist groups. HRW now and Uzbekistan to solve the crisis quickly broke places the number of inmates at between 5,000 down, although Uzbekistan did agree to pay and 7,000. It is well known for housing prominent compensation in some instances to Kyrgyz citizens dissidents and political prisoners. for damage to their property. Tajikistan also has As in other Central Asian states, simply long-standing territorial claims in the region.

124 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 likely to have HIV or other sexually transmitted Case study diseases. In Kazakhstan, child marriage is more common among ethnic minorities who follow Islam and Child marriage live in rural areas. Women in such communities often occupy a subordinate position within their in Kazakhstan families and this is a contributing factor to the prevalence of the practice. Many families are also poor, and seek to marry their daughters off ‘There were problems both during pregnancy early in order to obtain kalym or bride price. and after the birth, but my mother-in-law Many child brides do not want to enter into the thought it was nothing to worry about: it marriages chosen for them. happens to many women and that’s how it Child marriage is rarer in Kazakhstan than in should be. My mother-in-law said I should put other Central Asian states, but 2012 statistics still up with all the pain.’ Child spouse, member suggest that 1 per cent of girls are married by of an ethnic minority.2 the age of 15 and 7 per cent by 18. Data from the Republic of Kazakhstan Agency for Statistics If you are a married child in Kazakhstan then shows that child marriage is most prevalent you are likely to both be a girl and belong to among Kurds with 6 per cent of all married an ethnic minority. Child spouses are those women being under 18, followed by ethnic Turks who enter marriage under the age of 18, (4.3 per cent), Azerbaijanis (3.5 per cent) and which the UN Committee on the Rights of lesser numbers of Dungan (2.5 per cent) and the Child considers to be the minimum age Uighurs (1.5 per cent). By contrast, only 0.64 per for marriage. In Kazakhstan, research by the cent of married Kazakh women are under age. UN Population Fund (UNFPA) has found In some of these communities, child marriage this to be particularly prevalent amongst is an out-of-date tradition that is still the norm: Kurdish, Turkish and Azerbaijani minorities. Child marriage in many cases is quickly ‘Early marriage is typical for the Uighur population. followed by pregnancy, which has the They believe that a girl who doesn’t marry before potential to cause physical and mental health the age of 18 has failed.’ Child spouse, member of problems to both the mother and infant. an ethnic minority.3 Girls’ bodies are less ready than those of adult women for childbearing, leading to Child marriage in Kazakhstan is illegal. The complications during both pregnancy and legal age to enter into marriage is 18 for both childbirth. men and women except in certain circumstances, UNICEF global figures suggest 70,000 such as pregnancy, where the age can be reduced maternal deaths of girls and young women to 16 but only with the consent of both parties. aged 15–19 occur annually as a result of However, in the communities identified, many these complications. An infant born to a child marriages are performed by imams and mother aged under 18 is 60 per cent more remain both unofficial and unregistered, giving likely to die before his or her first birthday the girls involved few legal rights. than an infant born to a mother aged over A lack of education in general is one social 18. And if the infant survives he or she consequence of child marriage, but access is more susceptible to a range of health to sexual health education and sexual health problems, including low birth weight, a lack services are also particularly restricted. Under of nutrition and late physical and cognitive Kazakh law, if a 16-year-old girl seeks medical development. assistance, a doctor does not have the right to Child brides often marry older men, who conduct a full medical exam without informing because of their age are statistically more the girl’s parents or guardians. Often child

State of the World’s Minorities Asia and Oceania 125 and Indigenous Peoples 2013 Case study continued brides are accompanied by their husband or South mother-in-law when they go to the doctor. This restricts their personal decisions about contraceptive use or treatment for sexually Asia transmitted infections. The UNFPA research found that most girls interviewed did not Jack Dentith and Farah Mihlar know what contraception was. A preference for sons over daughters within communities Afghanistan where child marriage is prevalent also leads to While the US and the governments involved in pressure to become pregnant as many times as the NATO-led International Security Assistance it takes to have a boy, before family planning Force (ISAF) are gradually withdrawing their is an option. troops from Afghanistan, serious concerns Further physical and mental health regarding human rights violations and the issues arise from the unequal nature of the protection of minorities remain. At the marriage, which puts child brides at risk same time, there were some overall positive of domestic violence, sexual abuse and developments during 2012. Civilian deaths exploitation by both their husband and dropped for the first time in 2012 by 12 per husband’s family; many girls recount bullying cent compared with the previous year, to 2,754, from their mothers-in-law. Child brides are according to the United Nations Assistance also at risk of becoming isolated from Mission in Afghanistan (UNAMA). Over 80 per family, friends and their communities. cent were killed by armed groups. Kazakhstan has ratified both the UN The Taliban continue to control large areas Convention on the Rights of the Child of Afghanistan, particularly in the south and the (CRC) and CEDAW but failure to prevent east, where the situation for religious minorities child marriage puts the state in contravention along with dissenting Muslims is insecure. In of Article 24 of the CRC that states all territory controlled by the Afghan government, children have the right to health and to too, there have been incidents of violations of access to health services; and protection from religious freedom. In July, the case of Baljit harmful traditional practices. And Article Singh, a Sikh, raised concerns about attitudes 16.1(b) of CEDAW states that women towards religious minorities. Singh was held should have the right to freely choose a in detention in Afghanistan and later released spouse and enter into marriage only with over allegedly ‘false claims’ of being an Afghan their free and full consent. ■ national after having been deported from the UK, where he had unsuccessfully sought asylum. Singh described how he had been abused by Afghan security personnel and other prison inmates, and forced to convert to Islam. Singh was detained for 18 months but was never formally charged with any crime. The case shone a spotlight on both the Afghan criminal justice system and the Afghan Sikh community, which has gone from several thousand families to merely a few hundred in the last decades. Ethnic tensions between Hazaras and Tajiks, reported for many years by MRG, remain a key issue in Afghanistan. In September 2012, a number of people were killed as violence broke out in Kabul between members of the

126 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 two communities on the day that otherwise Above: A Hazara labourer returns home from commemorates the death of Tajik military work in Kabul, Afghanistan. REUTERS/ leader Ahmad Shah Massoud, who was killed Adnan Abidi. by two Tunisian men posing as journalists in 2001. A convoy of Tajiks from the Panjshir the traditional Ashura festival. Approximately Valley passed through the largely Hazara 80 people died during the attack on the 2011 neighbourhood of Pol-e-Sokhta; a cyclist was procession. injured by one of the vehicles. When the Despite extensive development and police failed to act, violence erupted. The final humanitarian assistance efforts, continued unrest number of casualties from the incident was has meant that the benefits of international aid not confirmed. Known as the ‘Lion of the have been unevenly distributed. Conflict has Panjshir Valley’, Massoud is officially regarded had a negative impact on the health of Afghans, as a national hero; however Hazaras recall and the health care infrastructure throughout a devastating attack on their community in the country is poor – with a particularly negative western Kabul by his forces in the early 1990s. impact on marginalized groups. Bamyan province, There was a reminder during 2012 of a large- for example, has a large Hazara minority scale attack against the Shi’a community that had population and has faced discrimination on the occurred during the previous year. In November, part of central governments in the past. According the Afghan police announced that they had to the United Nations Development Programme arrested two persons planning a suicide bombing (UNDP), there are hardly any services available against Shi’a Muslims gathering in Kabul for in the region. This has resulted in low vaccination

State of the World’s Minorities Asia and Oceania 127 and Indigenous Peoples 2013 rates, widespread waterborne diseases, and high ethnicity has been shown to increase the risk of levels of maternal and infant mortality. human rights violations for women at a drug There have been mixed results from attempts abuse treatment centre. Recent studies suggest to open the region up to mining in order to that Afghan women continue to face cultural, exploit its deposits of ores and coal. While the religious and social barriers to accessing health closure of unlicensed mines may have protected care.4 Issues include limited autonomy for children from dangerous and unhealthy work, the women, preventing them from visiting clinics Chinese firm that won the tender for mining in for check-ups, as well as a lack of emphasis the region had reportedly not replaced the jobs on the importance of regular antenatal care. with new ones. Reports emerged in 2012 that the Patients also reported that the attitudes and lack of opportunities may have pushed people behaviour of public health staff deterred women into the employment of the Taliban, which the from using medical facilities, with abusive and government has vigorously denied. disrespectful practices being reported, along with Independent human rights monitoring discrimination and charging for free services or remained in question throughout 2012, adding medication. to the general climate of impunity that helps to Concerns about the mental health status of keep minorities vulnerable. Posts remained vacant women and children in Afghanistan continue. on the Afghan Independent Human Rights With diminished rule of law and increased Commission (AIHRC) during 2012, including economic hardship, practices such as selling or after one member was killed by a suicide bomber exchanging girls have become more common, in early 2011 and three more were removed and domestic violence continues to be a source by President Hamid Karzai at the end of that of distress. Establishing the social and medical year. A fifth commissioner was also dismissed. A structures to prevent abuse and treat women landmark AIHRC study of war crimes remains who have suffered violence remains a significant unpublished, despite having been completed two challenge in Afghanistan. years ago. Bangladesh Women’s rights Religious minorities in Bangladesh, including The situation for women in Afghanistan Hindus and Buddhists, faced a spate of showed little improvement in 2012. Despite violent attacks in the middle of the year that constitutional provisions on women’s rights, earned the country national and international grave incidents of violence against women condemnation. In September, dozens of Buddhist continue to be reported from the country. temples, at least one Hindu temple and homes According to HRW, in early 2012 there were and shops belonging to these communities were 400 women and girls in detention centres for set alight in Cox’s Bazar and Chittagong, in one ‘moral crimes’, which usually involved attempts of the biggest targeted attacks against places of to escape forced marriage or domestic violence. worship in recent years. According to media The antipathy of the Taliban towards reports, at least 20 people were injured in the international aid organizations and government attacks. Amnesty International quoted police as agencies makes it difficult to assess the health saying they had arrested around 300 people, but of communities living in areas under Taliban according to media reports tens of thousands of control, particularly the health of women who Muslims were involved in the attacks, sparked have suffered in the past under the Taliban. In by the posting of a derogatory image of the 2012, Afghan intelligence officials accused the Qur’an on Facebook. The government did little Taliban of poisoning schoolgirls in Bamiyan to protect the targeted communities. While province, although the accusation was denied. the government condemned the attacks, they Similar poisoning incidents were reported in unhelpfully politicized them by blaming Islamic other provinces as well. radicals and opposition party members. Even in urban areas under government control, MRG has documented continuous incidents of vulnerable women still face big health risks, and violence and human rights violations, including

128 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 extra-judicial killings, rape and destruction of harm; and the manner of refoulement, by push property against indigenous Jumma peoples in backs into dangerous waters, including in unsafe the Chittagong Hill Tracts (CHT). MRG has vessels are matters of serious concern.’ also reported in previous State of the World’s Minorities reports that these communities are In July, Bangladesh ordered charities to stop also attacked, harassed and face land grabs from giving aid to Rohingya refugees, exacerbating Bengali settlers in the area. In September 2012, the already precarious health situation of these at least 20 people were injured when Bengali groups. Acute malnutrition rates were already settlers attacked Jumma shops and homes in critically high in the camps for registered Rangamati. According to some reports, the figure Rohingya refugees – approximately 24,000 of the was as high as 60 injured. The incident was estimated 200,000 population in Bangladesh – sparked by an altercation on board a college bus. while rates of malnutrition for the unregistered Security personnel reportedly did little to stop Rohingya were reported as being even higher. the violence. The Bangladeshi government refuses to recognize Bangladesh’s Ahmadiyya community also and register the vast majority of Rohingya who continues to face harsh treatment and threats. have escaped to Bangladesh from persecution In October, in Kisamat Menanagar, a group of in Burma. Registered Rohingya are served by Islamic extremists obstructed the construction inadequate health facilities in their camps, while work of an Ahmadiyya mosque. The local unregistered Rohingya are essentially reliant authorities subsequently called for construction on what they can find for themselves. The lack to be suspended. On 25 October, the group of aid money has meant health assessments conducted a procession in the area abusing have been impossible since the crackdown, but and threatening the Ahmadiyya community. reports suggest that the situation of unregistered In early November, they made public calls for Rohingya is growing increasingly desperate. the community to renounce their religion. On 7 November, the makeshift mosque and two Health adjoining houses, one of which was used for As in many South Asian countries, there is a prayer, were burned down. Fifteen people were general lack of official health data disaggregated injured in the incident. The community had by ethnicity or religion in Bangladesh. on several occasions reportedly sought police Nevertheless, studies from UNICEF and other intervention and protection but had not received international organizations help to build a partial any. There is a history in Bangladesh of Ahmadis picture of health problems faced by marginalized being attacked and persecuted. minority and indigenous groups. In June, Bangladesh’s Foreign Minister Approximately 600,000 indigenous Jumma declared that the government would not be peoples live mainly in the CHT, one of the opening the country’s borders, preventing the country’s most deprived areas, and suffer entry of thousands of the Muslim minority particularly extreme rates of ill health. The Rohingya people who were fleeing brutal attacks CHT has the highest incidence of underweight in Burma. This was in response to a request by newborn babies – a strong indicator of poor the UN refugee agency UN High Commissioner infant health. The amount of unmet need for for Refugees to keep the border open. family planning services (i.e. married women who Referring to a widely held principle of want but do not have access to contraception) international law forbidding forced return to in Chittagong (at 21 per cent) is also the highest situations of persecution, MRG and a group of in Bangladesh (for which the average is 14 per international non-governmental organizations cent), and contraceptive use, at 51.4 per cent, is issued a joint statement in July saying: considerably lower than the national average of 61.2 per cent. ‘The refoulement of these refugees by Bangladesh to The prevalence of malaria in Bangladesh Myanmar, where they face a very immediate threat reflects the geographic distribution of Adivasis to life and freedom, and a danger of irreparable (the term used generally for indigenous peoples).

State of the World’s Minorities Asia and Oceania 129 and Indigenous Peoples 2013 This is largely attributable to less investment in strong effects on the chances of having malaria in proper housing and health services in these high- Rajasthali. risk areas. Marginalized communities, such as the Adivasis often live in remote areas where access Marma tribe of Rajasthali for example, are at risk to mosquito nets and health care is limited, and, of the disease. One study found that members on the other hand, their higher rates of poverty of the Marma community had higher prevalence mean they often cannot afford health care. The of malaria, and that both the amount of forest remote location of Adivasi communities like the cover and the elevation of a person’s home had Mro make accessing health services much more

130 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Left: Dalit woman in Bangladesh. Livia minorities would be put on hold until the Saccardi/MRG. elections ended. The quota proposal suffered a further blow difficult than for their Bengali counterparts. when in May a high court in Andhra Pradesh The most recent national demographic health rejected the government order to implement the survey showed that the CHT region, home to quota, saying it was designed purely on religious the Jumma peoples, had the second lowest rate of grounds and had no empirical data to justify the basic vaccinations in the country, at 81.8 per cent necessity for it. The central government’s efforts – the national average was 86 per cent. to override the high court through the country’s A 2009 UNICEF study showed that Christians Supreme Court also failed, when the court and Adivasi groups have higher prevalence of refused a stay order against the Andhra Pradesh diarrhoea than other religious or ethnic groups, decision. which is attributable to higher levels of poverty In February, Justice Rajinder Sachar, who and lower levels of education. The incidence for headed the panel that produced a landmark Christian households was 9 per cent, whereas report on Muslim education in 2006, said in for Buddhist households it was 5.6 per cent; an interview with the Deccan Herald that the among Saontals, an ethnic group who live government was ‘fooling’ minorities by promising mostly in the Himalayan foothills, it was 12 per reservations during elections when the greater cent in comparison to 6 per cent for Marmas need was to strengthen the education system to of Rajasthali. Poverty and a lack of education support minorities. are shown in the UNICEF study to increase Reports of Muslims being targeted under the prevalence of diarrhoea, and Christians in national security laws for arrest and detention Bangladesh have higher rates of both. continued. According to media reports, in May, The lack of adequate sanitation facilities at a special meeting, Muslim leaders under the in CHT and other remote areas where many banner of All India Muslim Majlis-e-Mushawarat Bangladeshi ethnic minorities and indigenous expressed concerns about the growing trend peoples live also impacts strongly on these of Muslim youth being arrested by police on differences. suspicion of being involved in terrorist groups. Bangladesh’s rush to lift itself out of poverty The meeting took place against the backdrop of through a boom in manufacturing has also reports that three young men – one from Bihar affected Bangladeshi health, with the tragic and two from Kashmir – had been arrested by collapse of a garment factory in Dhaka in April police that month. In November, the Students 2013 reminding the world that it still has a Islamic Organisation of India organized a protest long way to go in ensuring the health and safety march in Delhi, demanding an end to the arrests. of its workers. The leather industry also faced Also in November, several Muslim leaders signed criticism in 2012 for flushing untreated waste a letter to India’s Home Affairs Minister making water containing chemicals and animal flesh the same call. into the city’s main river, as well as exposing February marked ten years since the Gujarat children to hazardous work conditions. Minority riots, when some 254 Hindus and close to 800 communities, including Dalits, who often live Muslims were killed during communal violence on the margins of communities, are particularly in 2002 that in some areas was sanctioned and vulnerable to the effects of such contamination. supported by Hindu extremists and politicians. The government has taken little action towards India achieving justice and accountability. The state of Elections that took place in five states in India Gujarat has not properly compensated victims in the early part of the year had some significant and has been very slow to bring perpetrators impact on minority issues. First, the country’s of crimes to justice. In August, however, in a election commissioner announced that a much significant turn of events, a court convicted 32 awaited implementation of a 4.5 per cent quota people, including senior politicians from India’s for jobs and seats in the education sector for Bharatiya Janata Party for their involvement in

State of the World’s Minorities Asia and Oceania 131 and Indigenous Peoples 2013 the rioting and attacks in Gujarat. The charges between the government of India and Maoists were for a variety of crimes ranging from murder for decades. The Communist Party of India, to arson. Maya Kodnani, an ex-minister, received minorities and indigenous peoples have been 28 years in jail for her role, while 30 others targeted for attack and human rights violations were given life sentences. Although the verdict by both parties to the conflict. Violence in caused some embarrassment to Gujarat’s Hindu the state reportedly significantly decreased in nationalist chief minister Narendra Modi, who 2012, according to the Institute of Conflict held the post during the riots, he managed to win Management in Delhi. However, targeted back his seat in December 2012 and remains in violations against minorities continued. The power. Asian Human Rights Commission (AHRC) has In November, Mohamed Ajmal Amir Qassab, reported at least five prominent cases in 2012 the only surviving gunman of the Mumbai 2008 of torture in police custody, some from West attacks, was executed in a prison in Pune. In Bengal. One was a member of the indigenous September, the Supreme Court upheld his death community and one was a Muslim. sentence but the execution happened without In July ethnic violence in the north-east warning and Qassab’s family was only notified between indigenous Bodo people and Muslim later. The news of the execution sparked mass settlers saw an upsurge, leaving at least 78 people celebrations on the streets in parts of India, killed and more than 300,000 displaced. HRW but human rights activists in the country and issued a statement calling on the government internationally were critical of the execution and to rescind ‘shoot on sight’ orders issued to the the manner in which it was conducted, adding police to quell the violence and asked that police that it was politically motivated. action be taken according to international law. Arrests and detention of persons belonging to Violence between these two communities has minorities and indigenous peoples under national been ongoing and is mainly over land and natural security laws continued to take place in West resources. The failure of Assam local government Bengal. The region has been plagued by conflict officials to manage the conflict has exacerbated

132 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Left: Muslim boys from the Chowduli commu- as Uttar Pradesh and Nagaland, which have nity catch fish in India. Sanjit Das/Panos. relatively large populations of SCs/STs, are consistently poorer than for other regions such the violence. as Goa. In August, nationwide panic swept the country Infant mortality rates are 25 per cent higher based on rumours of reprisal attacks by Muslims for SCs/STs than for non-SCs/STs, according to against people from north-east India. Ethnic and a 2007 study by the UNDP. More recent studies tribal community people living and working in in Andhra Pradesh show that infant mortality India’s big cities boarded trains in their millions rates among SCs are double the national average and fled to their places of origin in fear of being and maternal mortality rates are 50 per cent attacked. higher than average. In May, India faced its Universal Periodic According to a 2007 UNDP study, a higher Review (UPR) by members of the UN Human number of SCs/STs have no access to public Rights Council. In September, the Council made health services compared to other groups; a series of recommendations to India to improve furthermore, since 1990, in some regions, the its human rights record on issues including number of people with access to health services torture in police custody; repealing the Armed had actually declined. Forces Special Powers Act; religious freedom; and Problems with lack of health services are the rights of minorities and Dalits. compounded by broader socio-economic Many international organizations campaigned problems faced by communities. Examples for Dalit rights issues ahead of India’s UPR. include malnutrition caused by poverty, and the Dalits, who make up a little over 16 per cent of inability to take time off work to travel to health the population, suffer consistent and continuous facilities or see a health worker. It was calculated grave human rights violations by members of by UNDP that, in 2000, 23 per cent more SC higher castes and have virtually no access to children, and 27 per cent more ST children, justice. In December 2012, the brutal gang rape were undernourished than their non-SC/ST and killing of a girl in Delhi sparked a national counterparts nationwide. outcry as hundreds of thousands of women For many groups living in remote or forested took to the streets to mourn her death and areas, who have never had access to health protest against violations of women’s rights in care services, medicinal plants and traditional the country. MRG and its partner organizations healing practices are a crucial resource for their receive reports of many similar incidents of gang health. Yet many communities, such as the rape on Dalit women that go unreported and Sartang in the Monpa area and the Baiga of unnoticed. Attempts by victims to seek justice are northern Chhattisgarh, face threats from the often very difficult, as they face further violations unsustainable exploitation of forest resources and attacks by the law enforcement authorities by outsiders who gather valuable plants like they complain to. ginseng for trade. Forest peoples in India face a number of threats to their cultures and Health livelihoods, through biodiversity loss and urban In India, discrepancies in health outcomes migration. The unsustainable harvesting of occur on the basis of region, gender and social medicinal plants simultaneously threatens the group. Although there is a lack of health data well-being of communities while withholding any for minority and indigenous groups, the wide compensation for resources taken from their land. discrepancies between regional provisions of Discrimination suffered by marginalized services and health outcomes in India is telling. groups also affects their health. In 2012, for The majority of India’s Scheduled Castes (SCs) example, the AHRC reported that an Ahirwar and Scheduled Tribes (STs) live in rural areas, Dalit community in Maregoan village, Madhya where there is worse health care provision and Pradesh was being deprived access to water and worse health outcomes than in urban areas. food following their refusal to carry animal Similarly, health indicators for regions such carcasses; the local shopkeeper had been

State of the World’s Minorities Asia and Oceania 133 and Indigenous Peoples 2013 intimidated into refusing to provide rations to company Vedanta Resources and its Indian the Ahirwar by the dominant caste, and the subsidiary’s plans to open a mine on land held local water pump and communal water tank sacred by the local community had a positive were fenced in. The AHRC similarly noted in moment in April 2013, however, with India’s 2012 that the dominant caste preventing access Supreme Court ruling that the indigenous of Dalits, tribal and minority communities communities will have the final decision on any to government welfare schemes is a common bauxite mine plans practice in Madhya Pradesh, Uttar Pradesh, Bihar The ongoing unrest in Jammu and Kashmir and Orissa. has also had drastic health consequences for This kind of discrimination and exclusion the population there. Violence or the threat of makes minority groups much more vulnerable physical violence continue to have significant to disease, and dramatically increases the risks effects on mental health, with a number of of malnourishment. It also directly affects their studies in recent years identifying high prevalence ability to access treatment from health services. of mental health problems, from post-traumatic In 2000, Action Aid found that in 21 per cent of stress disorder and bipolar disorder to high levels 555 villages sampled from 11 states in India, SCs of generalized anxiety, panic and phobia. were denied access to health centres. The same The increased presence of the military also study found that 48 per cent of villages denied makes it difficult for some people to access health SCs access to public water or drinking places. care. Nomads like the Gujjars, who traditionally A 2010 study by Navsarjan, a grassroots Dalit live in higher altitudes, have been left unable rights organization, and the Robert F. Kennedy to access facilities, or unable to sustain their Center for Justice and Human Rights, found that livelihoods due to restrictions on movement doctors in 10 per cent of villages would refuse and access to land. One study, published in to treat Dalit patients. A follow-up study in 2012, revealed that 39 per cent of the Gujjar 2012 found that three times more Dalit children community had relinquished their migratory were unvaccinated against polio than non-Dalit tradition during the past two decades of conflict. children. Minority and indigenous groups in India also Nepal face discrimination in the way in which their The deadline to agree on a new constitution land is appropriated and their voices ignored expired in May as members of the country’s in the drive to capitalize on India’s natural Constituent Assembly failed to come to an resources, in particular through the mining agreement. Then Prime Minister Baburam industry. The effects of mining on health are Bhattarai, member of the Maoist Party, went on twofold. First, removing a population from the to dissolve the Assembly, but elections were not land on which they depend without adequate held in 2012. The Assembly had also served as compensation results in impoverishment and the country’s parliament. ensuing indirect health effects. And, second, there One of the major areas of disagreement for are the direct impacts on health from pollution members of the Constituent Assembly was resulting from the mining. The first kind of on the issue of creating federal units based on deprivation was shown in 2008, when hundreds ethnicity. This is a major demand for some of displaced villagers from Jagatsinghpur minority communities that want greater self- district in Odisha protested against inadequate rule in their areas. However, the large numbers compensation from Paradeep Phosphate Ltd. of different ethnic groups in Nepal and their The second kind has been demonstrated across geographical dispersion has complicated the issue. India, from reproductive health problems due to The failure to reach agreement on this issue and uranium mining in Jharkhand to skin disorders the subsequent dissolving of the Constituent associated with bauxite mines and refineries in Assembly has left Nepal in political deadlock. Orissa and Andhra Pradesh. The country effectively spent much of the year The well-publicized case of the indigenous without a legislature. More concerning is that the Dongria Kondh’s battle with the UK mining constitution-making process linked to

134 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 indigenous communities have yet to reap the Case study by Dr Audrey Prost, Dr Prasanta social and economic benefits of mining-related Tripathy and Soumendra Sarangi development. In eastern India, competing claims over existing natural resources are increasing the risk of conflict. Power of Amidst this charged political backdrop, Adivasis remain the poorest socio-economic participation: group in India, with low literacy and the highest maternal and child mortality rates women’s groups in the country. The risk of an Adivasi child dying before the age of five is 25 per cent dramatically higher than that of a non-tribal child, and the maternal mortality ratio (MMR) in tribal areas improve health for of Jharkhand and Odisha is three times the national MMR. Adivasi mothers Although access to quality health services is critical to saving mothers and infants, in and newborns in tribal areas of Jharkhand and Odisha around half of women still deliver at home, and fewer eastern India than 20 per cent access postnatal care. This is because of the remoteness of tribal villages, concerns about the costs of health care and fear Involving Adivasi women in the of discrimination at the hands of non-Adivasi planning and evaluating of health care professionals. There is also a lack of information has significantly reduced deaths and about simple prevention strategies and care for empowered women among India’s Adivasi common problems during pregnancy, childbirth communities in Jharkhand and Odisha. and the postnatal period. Over 84 million Adivasis (original Fortunately, in some areas this is beginning inhabitants) from more than 500 tribal to change through processes led by Adivasi groups live in western, central, eastern women themselves. Since 2005, the civil and north-eastern India. Today a quarter society organization, Ekjut (meaning ‘coming of all Adivasis reside in the central and together’), has worked with women’s groups eastern states of Jharkhand, Odisha to improve maternal and newborn health in and Chhattisgarh. Traditional Adivasi remote tribal areas of Jharkhand and Odisha. livelihoods revolved around the use of forest Building on a methodology first developed with products and cultivation (both shifting the indigenous Aymara community of Bolivia, and upland). Laws imposed under the Ekjut selected local female facilitators to support British administration led to the widespread 244 women’s groups to meet every month nationalization of forests and subsequently as part of a participatory learning and action large forest areas were contracted to process. During these sessions women identified private companies. Adivasi ownership of common problems they faced in pregnancy land and resources has yet to be addressed and after giving birth. They also found feasible through government legislation, such as strategies to address these problems and evaluate the recently enacted Forest Act. Because of the results. The facilitators were not health this, and large infrastructure projects such workers but local women whom others could as the construction of dams, Adivasis now trust and relate to. They were given training in constitute over half of India’s displaced participatory communication techniques and people. Adivasi homelands also span some basic knowledge about maternal and newborn of the world’s largest mineral reserves, but health. The women’s groups discussed common

State of the World’s Minorities Asia and Oceania 135 and Indigenous Peoples 2013 Case study continued are implementing the participation learning and action cycle with self-help groups in Bihar problems using role plays, picture cards and and Odisha. storytelling, followed by reflection and analysis. There are a number of lessons from this The groups also organized large community work. First, women can be catalysts for meetings to share their priority problems and change. Many organizations and governments enlist the support of other community members endorse the right to participate in the to implement their chosen strategies. These planning of health care, but methods to ensure activities were meant to improve individual this are rarely evaluated, and tribal women and community knowledge of maternal and are seldom in control of the process. Using newborn health, but also foster reflection and participatory methods to involve Adivasi the confidence to change existing practices. women in planning and decision-making The intervention had hugely positive results. resulted in substantial reduction in mortality The impact of the women’s groups was and a significant sense of empowerment evaluated using a cluster-randomized controlled among women. In the first local elections held trial, published in a leading medical journal. An in the areas where Ekjut implemented the indigenous demographic surveillance system programme, several facilitators of the women’s was used, in which local women reported births groups won seats as people’s representatives, and deaths among women of reproductive age testifying to women’s increased confidence. in their communities. A data collection team Second, good evaluation pays off. Many interviewed women who had recently delivered organizations do outstanding work to improve to find out about events around the time of health among indigenous communities but birth. The women’s groups led to a 32 per cent low-cost surveillance systems and evaluation reduction in neonatal mortality (deaths in the methods lend credibility to demands for first 28 days of life), significant improvements scaling up. Finally, scaling up interventions in hygienic practices at the time of delivery and is often not – and need not be – a linear increases in exclusive breastfeeding. process: change happens in many ways, and At the end of the trial, Ekjut decided to so efforts to scale up interventions require introduce the women’s group intervention long-term commitment and flexibility. Today, into control areas for ethical reasons. Neonatal combined with increased government efforts mortality fell sharply in the control areas, and to strengthen health services and a national an estimated 500 newborn infants have been conditional cash transfer scheme to increase saved through these interventions since 2005. the uptake of institutional deliveries (Janani Further analyses also showed that the groups had Surakjsha Yojana), women’s groups from succeeded in attracting the poorest mothers and Jharkhand and Odisha are paving the way to mortality reduction has been greatest among the a better future for Adivasi mothers and their poorest. newborn babies. ■ After these early successes, Ekjut is also adapting the participatory learning and action Endnotes method to address other pressing health issues, including the prevention of childhood illnesses 1. F. Gonzales, E. Arteaga group led community and under-nutrition, and carrying out new and L. Howard-Graham, mobilisation intervention evaluations. Ekjut have also supported a scaling ‘Scaling up the Warmi on maternal and newborn project: lessons learned’, Save health outcomes: the Ekjut up of the intervention through their own the Children Federation, trial process evaluation’, facilitators and other actors. The government of retrieved July 2013, http:// BMC International Health www.eldis.org/vfile/ and Human Rights 2010, India’s flagship National Rural Health Mission upload/1/document/0708/ retrieved July 2013, http:// programme now supports women’s groups DOC15246.pdf www.biomedcentral. 2. S. Rath et al., ‘Explaining com/1472-698X/10/25 facilitated by accredited social health activists in the impact of a women’s several areas of Jharkhand, and other agencies

136 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 peace-building has been stalled, which does not celebrations of Tibetan holidays. In March, augur well for a country that has been out of for example, the authorities arrested 100 conflict for a relatively short period. Furthermore, Tibetans who were protesting to mark the 53rd the continuum between the old Constituent anniversary of the Tibetan uprising. These Assembly and the new process is unclear, leaving restrictions appear to have been imposed at the in doubt the impact of the groundwork done by behest of the Chinese government. minority and indigenous members of the former Constituent Assembly and civil society groups on Health minority rights promotion and protection. Although Nepal’s 2012 demographic health A further pressing issue is lack of survey did not provide data about inequalities accountability. While in August the Council of across caste or ethnic groups, previous population Ministers proposed a Commission of Inquiry on surveys have indicated serious disparities between Disappeared Persons, Truth and Reconciliation, the health of minority populations and that of the Commission was reportedly granted powers the population at large.5 The life expectancy of a to recommend amnesties but not prosecutions. Hill Brahmin was 68 years, while for a Hill Dalit The situation was exacerbated by a number of it was only 61 in 2009, according to UNDP. In high-profile appointments of persons alleged to 2001, UNDP found that upper-caste Brahmins have committed serious human rights violations. and Newars live, on average, between 11 and 12 Amnesty International noted that this climate of years longer than Dalits and Muslims. impunity was a particular problem in the Terai Disadvantaged minority groups face difficulty region, where it reported abuses by the security in accessing health services in Nepal, due to forces, police and armed groups. Fear of reprisals geographical remoteness, social stigma, or prevented victims from coming forward. refugee status. Marginalized groups, including Human rights protection in the country Dalits and indigenous Janajatis, face barriers to was further affected when, in March 2012, the accessing family planning services due to their Office of the High Commissioner for Human illiteracy (which may prevent them filling in Rights (OHCHR) field presence was formally required forms), poverty (which may prevent shut down after the Nepali government refused them from paying for services), or their low to extend its mandate. They also refused to social status (as a result of discrimination on the allow an OHCHR staff member to be housed part of health workers). The very distribution in the country’s UNDP office. This removal of of health workers is, in the first place, highly the UN human rights office has left a vacuum unequal across regions. in international human rights monitoring and A number of factors that contribute to health reporting. outcomes, such as sanitation, nutrition and Caste-based, ethnic and religious access to health care, are marked by significant discrimination continued to be reported. In disparities between rural and urban populations October, Bhim Bahadur, a Dalit from Dailekh that recent Nepalese surveys have captured. These district, sustained severe injuries after having factors disproportionately affect ethnic minorities, been attacked for touching the front door of a who make up a higher portion of the population house belonging to a person of a dominant caste. of Nepal’s rural regions. Dalits experienced restrictions on their religious A number of sources suggest that insecure freedom; Hindu priests and villagers prevented access to food and water is especially pronounced Dalits from entering temple precincts and for indigenous groups, especially in mountainous participating in Hindu festivals. Christian groups regions, as well as for Dalits in Nepal. As a reported receiving threats from Hindu extremists; result, disadvantaged minority groups are more these were usually linked to extortion. vulnerable to disease and malnutrition. The rights of Tibetan exiles and Nepalis Maternal mortality for Muslims, Terai of Tibetan origin continued to be curtailed, Madhesi and Dalit groups is higher than for particularly with regard to public assembly and other social groups. These rates are linked to the

State of the World’s Minorities Asia and Oceania 137 and Indigenous Peoples 2013 comparative lack of access to pre- and post-natal 2012, HRW reported that 320 members of the care for marginalized groups. Shi’a community had been killed during the The latest figures from Nepal’s Demographic year, noting that this was an escalation of the Health Survey, in showing sharp disparities in violence against the minority. Most of the attacks child mortality between the far-western and in the largely Sunni country were targeted ones eastern regions, strongly suggest that these trends by militant groups such as the banned Lashkar-e have continued to create health differences Jhangvi. In one of the attacks in August, gunmen between ethnic groups. Similarly, under-five ambushed a bus, searched ID cards, singled out mortality rates among Dalits are higher than Shi’as and shot them dead, HRW said. Violent among any other group, and well above the attacks against Shi’as increased again towards the national average (95 out of 1,000 Dalit children latter part of the year, as the community marked do not survive to their fifth birthday, while for its major religious festival, Ashura. In the run- Newar children the figure is 43). up to the event at least 30 people were killed Although a 2012 Samata Foundation study and over a hundred injured in a series of bomb in Sapatri district found that health workers do attacks in Rawalpindi and Dera Ismail Khan. not in general discriminate against low-caste Seven children were killed in one attack on 24 members at the point of service delivery, there is November. believed to be more widespread discrimination Many of the attacks on Shi’as were targeted in terms of access to information about health against ethnic Hazara living in the conflict- care that Dalits in Nepal have, as well as health affected Baluchistan province. According to workers requiring increased interest rates or fees media reports over 100 Hazara were killed for services. in Baluchistan in 2012. The Human Rights Dalits also suffer discrimination in accessing Commission of Pakistan (HRCP) reported that water due to their untouchable status. The there were 213 incidents of sectarian-related AHRC reported in 2012 an instance where attacks in 2012, which killed 583 people and the non-Dalit community in Koteli village, injured 853. Dadeldhura district prevented the water from Intolerance towards other religious minorities flowing to Dalit households. The affected in Pakistan continued to be reported throughout villagers, particularly women, have to walk five 2012. In August 2012 the AHRC reported on hours to fetch water – back-breaking work that a rise in emigration of Hindus from Pakistan’s causes stress as well as physical problems, and Sindh Province to India. The AHRC noted that takes time away from crop cultivation. large numbers were fleeing the country due to For refugees in Nepal, the situation in terms the increase in incidents of religious intolerance. of accessing health resources remains precarious. The exodus was believed to have been prompted One study of Pakistani and Somali refugees by the abduction and forced conversion of a noted that, given the lack of attention to or 14-year-old Hindu girl to Islam in Jacobabad, in budget for mental health care for the population Sindh. Earlier in the year, in Mirpur Mathelo, a at large, provision for refugees was negligible. For 17-year-old Hindu girl was allegedly abducted, Tibetan refugees, the Nepali government’s recent forcibly married and forcibly converted. The rejection of a plea to grant them identification AHRC reported that the case was brought before papers represents a major obstacle to their ability a civil court, where the girl, Rinkle Kumari, to secure livelihoods and access essential services. was slapped and abused, and, despite her pleas that she wanted to return to her parents, the Pakistan girl was converted to Islam. Her family was Pakistan has become one of the deadliest threatened and forced to accept the conversion. countries in the world for ethnic and religious Kumari’s case was later heard by the Supreme minorities. In 2012, targeted attacks against Court, which ruled that the girl should choose. the country’s minority communities rose The question raised by human rights defenders significantly, with little or no action taken by and community spokespersons was whether her the government to protect them. In September decision ultimately to remain with her husband

138 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 could truly be voluntary. While the facts of the for the banning of the Ahmadiyya community case remained disputed, it drew considerable in Pakistan. According to the HRCP at least 20 media and political attention to the situation Ahmadis were killed in 2012 because of their facing religious minorities in the country. religious identity. In September, a young Christian girl, Rimsha Baluchistan, where ethnic Baluchis are Masih, who suffers from a learning disability, was fighting for a separate state, has long seen large- held on remand in an adult prison for blasphemy scale human rights violations. In August 2012, and accused of damaging parts of the Qur’an. following a fact-finding mission, the HRCP said Several weeks later, Rimsha was freed on bail the situation had shown little improvement in after witnesses had stated that she had been the past year and serious violations, including framed. Under Pakistan’s oppressive blasphemy enforced disappearances, continued to be laws, bail is normally not permitted; Rimsha’s reported amid widespread impunity in the lawyers had pleaded for her release, however, on province. The HRCP stated in its annual report the basis that the girl was a juvenile. An imam in that 125 mutilated bodies had appeared in the the area was subsequently arrested for planting first 10 months of the year; in addition, the burnt pages of the Qur’an in the girl’s bag. The HRCP recorded 34 disappearances; while 26 case was finally thrown out of court. Rimsha’s people were traced and released, the remainder plight highlighted how the blasphemy laws can are still missing. The HRCP argued that the be abused by individuals. human rights situation in Baluchistan should Despite increasing national and international be seen more broadly beyond the conflict with condemnation, Pakistan has done nothing the Baluch independence movement, given the to remove these laws. In November, when increased targeted attacks against Hazara, other Pakistan was reviewed by the UN Human Shi’as and other religious minorities in the Rights Council under its four-year UPR, more province. than 15 countries raised concerns over the laws Violations also continued to be reported from and asked for them to be repealed. Several Pakistan’s Federally Administered Tribal Areas international organizations, including MRG, (FATA), which are also affected by conflict. drew attention to the difficult and threatening HRW reported that thousands of people conditions under which religious minorities live, arrested in 2009 in the Swat valley and FATA having to face killings, abductions, attacks, rape, on suspicion of being involved with the Taliban forced conversion and extortion, many of which remain in custody under anti-terrorism laws. are conducted by members of violent religious This area is particularly affected by internal extremist groups but commonly supported by displacement due to the conflict. In September state agents and enabled by the legal system. 2012, aid agencies warned that due to the Pakistan’s Muslim minority Ahmadiyya protracted conflict around 400,000 children community continued to face intolerance displaced because of the conflict were at risk from throughout the year. In August, the local malnutrition and disease. Ahmadiyya community was prevented from attending religious prayers to mark the Eid- Health al-Fitr festival in Rawalpindi. In December, Pakistan is not expected to meet the child masked men desecrated an Ahmadiyya grave mortality target set for 2015. At present, the site, in Lahore, breaking down and destroying number of deaths of children under one year over 100 gravestones. A similar incident had of age per 1,000 live births is 75, against the occurred in Faizalabad earlier in the year. Millennium Development Goals (MDG) target No action was taken by the police following of 40. Attaining high immunization coverage for these incidents. The Islamist Tehrik-e-Khatme childhood diseases is an important intervention Nabuwwat organization had previously pressured with regard to reducing child mortality. the police to remove Islamic inscriptions from However, less than half of Pakistan’s children the gravestones. Earlier in the year, this group are fully immunized. Immunization coverage has had held a conference in Lahore that had called actually fallen in all the provinces except Punjab,

State of the World’s Minorities Asia and Oceania 139 and Indigenous Peoples 2013 with the sharpest decline seen in Baluchistan (19 shockingly high, at 758 per 100,000 live births. per cent). Cultural practices of ethnic minorities living in In December 2012, nine health workers Baluchistan do not allow women to seek services/ vaccinating children against polio were shot and information from male health staff. The majority killed in Karachi and Peshawar. Pakistan is one of of Basic Health Units in the province are reported four countries in the world where new polio cases to have no female health workers. Almost a quarter were still emerging, despite a massive nationwide of the Basic Health Units do not have personnel to immunization programme. There were 58 offer family planning counselling or other services; reported cases in 2012, down from 198 cases in almost 40 per cent do not have a maternity kit; 2011. Misinformation about the immunization and almost half do not have a labour room. programme led some Islamists and Muslim Geographical disparities can been seen across the preachers in Pakistan to say the polio vaccine is a country, especially between Punjab (with the western plot against Muslims. The killing of the most personnel and facilities to serve women) and health care volunteers in December was a major Baluchistan (with the least). setback to the effort to reach full immunization coverage for polio and resulted in the UN calling Sri Lanka off the campaign. Minority rights remain critically challenged in Malnutrition contributes to 35 per cent of Sri Lanka as the country’s human rights situation under-five deaths and more than 40 per cent of deteriorated further in 2012 in a climate of children are either moderately or severely stunted; impunity. Serious human rights violations, such malnutrition rates in two provinces are above as abductions, arbitrary arrest and detention, emergency levels. The national nutrition survey torture and sexual violence continue to be of 2011 reveals that Sindh is the poorest and reported from the country’s former conflict areas, most food-deprived province, with 72 per cent which are considered the homeland of the ethnic of families being food insecure. It is followed by Tamil minority. Baluchistan, where 63.5 per cent of families are These areas remain heavily militarized; in food insecure. addition to checkpoints blotting the region, Pakistan’s maternal mortality ratio has the military also runs businesses, farming and declined, from 400 per 100,000 in 2004–5 to development projects, and controls civil society 276 per 100,000 in 2006–7, but meeting the activity in these areas. There is very limited MDG target of 140 per 100,000 will require freedom of expression or assembly in the further immense resources and efforts. The country’s north and east and, while people are maternal mortality ratio in Baluchistan is allowed to move in and out of the area, they

Maternal health status in Baluchistan compared with national figures

70% 60% 50% 40% 30% 20% 10% 0% Prenatal care from a skilled Facility deliveries Delivered by skilled birth health provider attendant

Baluchistan National source pdhs 2006-07, mics 2009

140 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 are heavily monitored. Tamil women in the country’s Chief Justice, Shirani Bandaranayake, country’s north are especially vulnerable in these on corruption allegations that she denies. Sri situations. Lanka’s highest court ruled that the proceedings In March 2012, the Regional Director of the were illegal, and lawyers and civil society activists Jaffna Hospital, Sinnaiah Savaroopan, reported took to the streets for days, protesting against the to the BBC that in the previous two months move and warning against interference with the there were 56 cases of rape and severe violence judiciary and breakdown of rule of law. Despite against women and girl children reported to national and international condemnation, the Sri his hospital. MRG’s partner organizations Lankan parliament voted Bandaranayake out and working in northern Sri Lanka say they receive a she was sacked from her position by the President number of complaints of sexual attacks, violence in January 2013. and abuse, in some cases by the military, but Hardly any effort has been made by the Sri frequently women are afraid to make formal Lankan government on issues of accountability, complaints. They also say women are coerced justice and reconciliation. Over three years since into sex work and/or sexual relationships with the end of the armed conflict thousands of military personnel to gain access to resources victims, including families of the disappeared, are or services. There are also major development awaiting justice in Sri Lanka. Attempts by family projects taking place in the north and east members, women especially, to seek justice or without consultation with local communities, simply mourn for their dead have been brutally and there are serious concerns regarding land obstructed by the government. In March 2012 acquisition and land-grabbing by state agents for the United Nations Human Rights Council development projects. Large sections of minority passed a resolution on Sri Lanka, calling on lands remain under military control with no the government to do more to protect human access for civilians. rights and to implement its own Lessons Learnt In 2012 there were also notable targeted and Reconciliation Commission (LLRC) report attacks against minority rights activists, recommendations. human rights defenders and media personnel. Sri Lanka’s national-level performance on Paramalingham Tharsananth, secretary of the health is generally quite good compared to students’ union of the University of Jaffna, was other South Asian states, but minority areas brutally assaulted by masked men close to a have poorer health outcomes. Available national military checkpoint in Jaffna. statistics on Sri Lanka are from 2006, released The year 2012 also saw a new wave of in 2008 in the Demographic and Health Survey widespread targeted attacks against minority (DHS 2006); they indicated higher levels of Muslim places of religious worship and business child malnutrition in the former conflict areas establishments by extremist Buddhist groups and in the east of the country. The survey was monks. In April 2012 a mosque was attacked not conducted in the north at the time as the in the north central town of Dambulla, and armed conflict was taking place. In the former subsequently the government issued demolition conflict-affected districts, such as Trincomalee, orders for the building. There has been a 28.1 per cent acute and 30.5 per cent chronic national campaign against Muslim religious malnutrition was recorded among children, practices, including on ‘halal’ certification for which is higher than the national average. These food. There is evidence of state involvement figures are expected to be much higher in the or at least complicity in the attacks and police country’s north, where access to medical care was inaction during the attacks. Attacks against limited for nearly three decades. Christian religious places of worship, particularly According to the UNDP 2012 Human Evangelical churches, continued to be reported Development Report, the four districts with throughout the year, especially in the south of Sri the highest rates of maternal mortality were Lanka. areas with high levels of minorities. The At the end of 2012 the Sri Lankan parliament maternal mortality rate in the northern town began impeachment proceedings against the of Killinochchi was 102 per 100,000 births as

State of the World’s Minorities Asia and Oceania 141 and Indigenous Peoples 2013 Above: Tamil tea plantation workers, Sri Lanka. statistics. The health care facilities available to MRG. plantation workers are inferior to those available in other sectors. One health facility must serve against the national average of 39.3. the inhabitants of multiple plantations, which Several thousand, including children, also means the facilities are overextended and lacking faced permanent physical injuries received during in resources. The plantation workers face a the last stages of the war and have faced varying variety of risks (mechanical, medical, etc.) as a degrees of trauma and mental illness. Due to the part of their daily lives. The health care facilities government’s position that there were minimal in place do little to help those who have been civilian casualties in the conflict, many of these severely disabled by their working conditions people are not receiving the required medical (e.g. back, leg, heart injuries). The increase in attention and psychosocial support. NGOs and the use of pesticides on the plantations has had other organizations providing counselling are adverse effects on the workers, including the strictly monitored by the military, and sometimes spread of disease. Despite these dangers, the attacked on the grounds that they are collecting workers are not offered any additional health evidence to support international allegations of care outreach. war crimes. Following the conflict, many female- Within family planning programmes, maternal headed households are facing high levels of and child mortality rates are particularly high. poverty, which is also likely to affect the health Expecting and new mothers are of low body conditions of women and children in these areas. weight and give birth to underweight and Plantation areas where most Tamils of undernourished infants. Mothers lack adequate Indian origin live have some of the worst health pre- and post-natal nutrition education.

142 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 began to ease sanctions following the vote. Observers such as the Alternative Asean Network South on Burma noted ‘widespread irregularities, threats, harassment, vote-buying and censorship’. In three constituencies of conflict-ravaged East Asia Kachin state, authorities postponed the vote altogether. Nevertheless, the international Irwin Loy community responded positively to the by-election. Still, the well-being of Burma’s As the world nears the 2015 deadline to achieve diverse and numerous ethnic minority groups the Millennium Development Goals, events in is necessarily a measure of the extent of the South East Asia during 2012 underscored the country’s reforms. unequal progress that has been made in many Throughout the year there were worrying countries. In many parts of the region, there are developments, including anti-Muslim troubling and consistent gaps in health outcomes demonstrations and violence, the continued between the majority and the often marginalized persecution of ethnic minorities in conflict zones, minorities. In eastern Burma, maternal health and the marginalization of minority communities remains dire for minority women in conflict in tenuous ceasefire areas. In each case, the zones, despite hopeful but tenuous ceasefires. instability had detrimental effects on the health Incidence rates of HIV soar unacceptably of already marginalized populations. In eastern high above the national average in Indonesia’s Burma, for example, the maternal mortality rate Papuan provinces. In the Philippines, a pair of is triple that of the country as a whole, making calamitous natural disasters exposed an uneven this statistically among the most dangerous places response to survivors, while maternal and in the world to be a pregnant woman. At the child health indicators in parts of conflict-torn same time, drug-resistant malaria is spreading Mindanao have actually worsened. Meanwhile, along this eastern border heavily populated by in Vietnam, researchers say the gap in access to minority groups. It now means that Burma maternal health is widening – and it is largely accounts for more than half of all malaria-related drawn down ethnic lines. The year’s events deaths in South East Asia, according to The show that basic rights for minorities are not an Lancet medical journal.6 inconsequential ideal – they have a direct impact The dire health situation in such areas is on health and lives. exacerbated by long-standing conflicts, which displace and destabilize civilian populations. Burma Fighting continued between the Burma Army During 2012, Burma continued to re-engage and the Kachin Independence Army through with the international community following the year, following the crumbling of a 17-year years of isolation. The government continued ceasefire in 2011. Numerous attempts at peace its gradual release of political prisoners, touted talks failed to produce an end to the violence. In tenuous ceasefire agreements with armed ethnic the meantime, civilians caught in the crossfire militias and lifted aspects of its once crippling continued to suffer. A March report from HRW media censorship. accused government soldiers of blocking needed In April, the country held by-elections to fill humanitarian aid, torching villages and firing on vacant parliamentary seats. Opposition figure innocent civilians. Rights groups say the conflict Aung San Suu Kyi ran and won her seat, less has displaced as many as 75,000 civilians. A than 18 months removed from long-term house further 10,000 who attempted to flee to China arrest. Critics charged that the government was were denied basic care, including safe water using a by-election – in which its control of supplies, food, sanitation and health care, HRW power was never in doubt – as a modest show to reported in June. encourage the lifting of international sanctions. Also in June, the Kachin Women’s Association Indeed, the United States and European Union Thailand (KWAT) said it had documented

State of the World’s Minorities Asia and Oceania 143 and Indigenous Peoples 2013 Above: Rohingya families living in basic home- included allegations of arbitrary arrest, physical made shelters in Rakhine state, Burma. Mathias violence and forced labour. Eick EU/ECHO. In Shan state, a short-lived ceasefire with the Shan State Army North (SSA-N) broke down in cases in which 43 women or girls were raped or June as the rebel group clashed with the Burma sexually assaulted in the 12 months leading up to Army. In December, the Shan Women’s Action June 2012. Burmese soldiers, the report stated, Network (SWAN) said civilians were frustrated ‘have used rape systematically as a weapon of by the continuing violence despite a more than war’. A later report documented the killings or year-long peace process. injuries of 26 civilians between September 2012 One of 2012’s most worrying developments and February 2013. was the surge in violence between Buddhists and In Karen state in eastern Burma, the minority Muslims. This was centred in troubled government touted its ceasefire with the Karen Rakhine state, where tensions between ethnic National Union (KNU) and its military wing, Rakhine Buddhists and Rohingya Muslims the Karen National Liberation Army (KNLA). spilled over into bloodshed. Though violence But a May report by the Karen Human Rights often grew from back-and-forth retaliations, it Group (KHRG) detailed abuses post-ceasefire, quickly developed into a humanitarian crisis with either at the hands of the Burma Army or the tens of thousands of mostly Rohingya Muslims Democratic Karen Buddhist Army (DKBA), a driven from their homes. In May, a Rakhine splinter faction of former KNLA fighters. These woman was raped and murdered; the assailants

144 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 disproportionately high. Naw, who lost four of Case study her children before they were five years old, says she feels safer having a baby here in this clinic. That’s why she pays for transport across the Despite the Moei River, which acts as a natural border here between Thailand and Burma, so she can reach ceasefire, health the clinic on the Thai side. Naw says, ‘I’m not young any more. I care woes continue know I’m old to be having a baby. I should be delivering in a proper health centre.’ in south-eastern The year 2012 began with hopeful news in Naw’s native Karen state: the announcement of Burma a ceasefire between the Burmese government and the Karen National Union (KNU), who have been engaged in one of the longest-running civil In a bustling waiting room, Naw sits on a wars in the world. fold-up chair, her hair caught in the breeze of An October survey from The Border a whirling fan. Consortium (TBC), an umbrella organization of Her arms rest over the bump just international groups delivering aid to Burmese beginning to show beneath her clothes. refugees in Thailand, estimated that 10,000 This will be the eleventh time she has been people were displaced in south-eastern Burma pregnant. However, it is the first time she will during 2012. It is still a worrying figure, but far actually consult with a health professional less than the estimated 75,000 a year that had during the sensitive prenatal months. been recorded prior to this. For many like her, the Mae Tao Clinic in Even as hostilities cooled during the year, the western Thai town of Mae Sot along the however, the health situation remains perilous. Burmese border is the only opportunity to The TBC survey suggested almost three-quarters access reliable health care. of people in the south-east’s rural areas do not ‘When I was in the countryside in Burma, have access to safe drinking water, while almost there would be only one midwife for the half cannot access proper latrines. entire village,’ says Naw, who asked that her While Burma has boosted funding for its name not be published. ‘If I wanted to get health services recently, the national health proper health care, I had to go to a big city budget still comprises only 3 per cent of total and spend money.’ government expenditure, according to medical It is a vital issue in south-eastern Burma, journal The Lancet.7 People like Naw have turned which has suffered from years of clashes to the international community, through the between Burmese troops and armed ethnic Mae Tao Clinic, which has a target population militias fighting for autonomy. That includes of about 150,000 people on both sides of the decades of fighting over the border in Karen border. state, where many of the patients who cross For others, who cannot reach the clinic, the the border to reach the clinic live. situation is often dire. Groups like the Backpack The instability means the maternal Health Workers Team, based in Mae Sot, are mortality rate in south-eastern Burma – trying to take health care to those who need it. describing the rate of women who die during For years, the group has sent mobile teams into pregnancy – is more than three times the remote areas to deliver health care. In just the national rate, at 740 deaths per 100,000 live first six months of 2012, health teams dealt with births. more than 45,000 individual cases. Mortality rates for infants and Mahn Mahn is the group’s director. He says children under the age of five are also last year’s KNU ceasefire has made travelling in

State of the World’s Minorities Asia and Oceania 145 and Indigenous Peoples 2013 Case study continued eager to take advantage of the relative calm.8 Mahn Mahn says, ‘There are direct health the region easier for health workers. But even impacts, but also indirect ones from land with a ceasefire, health problems are just as confiscation, conflicts between locals and worrying. Preventable illnesses like malaria, workers.’ diarrhoea and acute respiratory infections are still Mahn Mahn says he hopes a permanent prevalent in the target area. At the same time, end to the fighting will see the health aid workers say the relative calm has sparked situation improve. However, the path ahead a renewed interest in large-scale development remains difficult. projects, particularly in the mining sector. There have been more reports of land confiscation as ‘We see only the ceasefire, but we don’t see proponents of these development projects are the peace process clearly. We need to see what the peace process will be in order for the Below: Karen amputee at the Mae Tao Clinic political situation to stabilize. Without solving in Thailand, found along the Burmese border. the political situation, the ceasefire is not Brendan Brady. sustainable.’ ■

146 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 were reported to have been three Muslim men. most persecuted people on earth’ – refused A week later, an incensed Rakhine mob attacked citizenship by Burma, and unwanted by a bus and beat to death 10 men perceived to neighbouring Bangladesh. While the antipathy be Muslim. The violence sparked a series of in Burma has been cultivated by outspoken retaliatory attacks. According to official estimates, extremist Buddhist monks, ordinary citizens the attacks left 80 people dead and displaced a have also participated in large anti-Rohingya and further 90,000, mostly Rohingya, by the end of anti-Muslim gatherings. This was highlighted the month. by an October demonstration in the capital, Aid workers warned of a burgeoning Yangon, when thousands of monks marched in ‘humanitarian crisis’ for Rohingya Muslims the streets to protest the Organization of Islamic fleeing the violence. Conditions in temporary Cooperation’s stated plans to help the Rohingya. camps were described as ‘alarming’, with health Violence between majority Buddhists and experts expressing particular concern over minority Muslims flared elsewhere in Meikhtila malnutrition rates among displaced Rohingya. in central Burma in March 2013. Media and The violence saw many Rohingya attempt to rights groups reported on a massacre of at least flee Burma in boats, only to be turned back 25 Muslims in late March. by neighbouring Bangladesh, where tens of The future prospects for long-term peace in thousands of displaced Rohingya already live in Burma’s disparate ethnic regions are inextricably official and unofficial refugee camps. In a June tied to the government’s renewed push for the report based on interviews with fleeing Rohingya, development of the country’s natural resources. the UK-based Equal Rights Trust charged that But critics say the push for development in the military had not only turned a blind eye to these still sensitive areas has brought with it the violence against Rohingya, but that it had increased militarization. A November report by actively participated in ‘state-sponsored violence’ the Ta’ang Students and Youth Organization against them: (TSYO) highlighted problems associated with the controversial Shwe Gas Pipeline, which will ‘The military became more actively involved in allow the shipment of oil and gas between China committing acts of violence and other human rights and the Bay of Bengal. Burma has deployed abuses against the Rohingya including killings and additional military units to guard the pipeline mass-scale arrests of Rohingya men and boys in route, amid pressure from armed ethnic militias. North Rakhine State. This has caused an increased The pipeline’s construction has led to land proportion of men and boys to flee the country, confiscation, forced labour and other rights resulting in increased incidences of rape of the abuses, the report states. women left behind, committed by Myanmar security A February 2013 report by the Transnational personnel.’ Institute warns that the sudden development rush sparked by Burma’s political changes has actually Violence again erupted in October, leaving fuelled ethnic conflict. The authors estimated more than 100 people dead, according to that 65 per cent of approved foreign direct official estimates. HRW suggested that the investment had been injected into three conflict- death toll could be far higher. While there ridden states alone: Rakhine, Shan and Kachin. has been violence on both sides, human rights The report states: groups warn that many of the consequent attacks have been focused on Rohingya ‘Instability and the lack of effective regulatory communities, often with the complicity of a mechanisms has provided opportunities for government unwilling or unable to protect rapacious, large-scale resource extraction, such as them. For example, HRW released satellite mining, hydropower dams and logging, as well as images following the October attacks showing illegal cross-border trading. The impact on local whole villages belonging to Muslim families communities has been severe, and the benefits few burned to the ground. and far between.’ The stateless Rohingya are often called ‘the

State of the World’s Minorities Asia and Oceania 147 and Indigenous Peoples 2013 pregnant, because they don’t know when they will Case study have to go on the run again. They don’t want to have to flee while pregnant. So they ask us to give them birth control. We try to give things like birth Continued fighting control pills and condoms, but we don’t have enough. They don’t know that you have to keep taking causes human rights the pills and they don’t know where to get other medicine. So if we give them enough for one month, abuses and health they just use it for one month, and that’s it. So they concerns in Burma’s will get pregnant again. ‘One of the women in the camp was heavily non-ceasefire areas pregnant when she had to run away. She suffered a miscarriage on the journey. Pregnant women have to stay in a safe place and not have anything to worry Lway Poe Ngeal is a Palaung woman who left about except to take care of their own health. But she Burma for better education opportunities in couldn’t do that. Then even after she miscarried, she neighbouring Thailand. Now, she works with the still had to run.’ Palaung Women’s Organization, which advocates for the rights of an ethnic minority community Increasingly, some Palaung farmers have had concentrated in northern Shan state. to turn to opium cultivation to survive. The Palaung civilians have become caught up increasing availability of narcotics has sparked an in the violence between the Burma Army and addiction problem. Poe Ngeal has seen the effects armed ethnic militias, including the Kachin in the camps. Independence Army (KIA), the Ta-ang National Liberation Army (TNLA) and the Shan State ‘One of the fathers is a drug user. His wife has to Army-North (SSA-N). Upon returning from her starve because of it. Her husband doesn’t care about most recent aid mission in early 2013, Poe Ngeal anything; he just cares about drugs. So when they says there are at least 2,000 internally displaced fled from the fighting, she was pregnant. She gave people (IDPs) from Palaung communities living birth to her baby after arriving in the camp. After, in five basic camps in northern Shan state near the family didn’t have anything to eat. Eventually, Kachin state. Aid has barely trickled in to these her husband took the baby and sold it. He trafficked camps. Food and water shortages are common the baby. It’s such a horrible story. We don’t know and medicine is difficult to obtain. how we can help them. We can only support them with small humanitarian aid, but we can’t help ‘The new IDPs cannot access humanitarian aid. everyone.’ They don’t have shelter. They don’t have a safe place to stay. They don’t have food, water, or medicine Burma’s president, Thein Sein, has received too. They don’t have anything because they had to international attention because of the country’s run away from their homes suddenly. It is a new life recent political reforms. But Poe Ngeal worries for them. They have to start their lives again.’ that these cautious changes have overshadowed the continuing humanitarian crisis in conflict zones. Many men have fled or migrated elsewhere in search of work. That means women are taking on ‘There are still serious human rights violations in increasing responsibilities and bearing the burden Palaung areas. You see the IDPs running away from of displacement. For many women in the camps, their homeland. So how can they survive and live one of the biggest fears is becoming pregnant again. their lives? If the political situation is not stable, they cannot go back to their homeland. They cannot ‘Some women tell me that they don’t want to get survive. That is very worrying for me.’ ■

148 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Cambodia titles rather than communal ones, which has The issue of land rights dominated concerns for caused division in some communities. By signing indigenous peoples in Cambodia during 2012. on to private titles, some indigenous families have An escalation in controversial economic land given up the right to traditional land cultivation concessions, or ELCs, continued to exert pressure methods and other cultural traditions on their on marginalized communities throughout the ancestral lands inside ELCs. The scheme was country, especially indigenous groups relying initially meant to include access to collective on ancestral and communal lands for their communal titles, with the purpose of honouring livelihoods. At the same time, the government’s indigenous groups’ traditional ways of living. overt support of private firms, often run But the government later decided to delay the by individuals with close ties to the ruling granting of collective ownership, according to Cambodian People’s Party (CPP), contributed to local media. In early 2013, however, authorities what local rights group called the ‘worst year’ on announced a plan to begin mapping the ancestral record for activists trying to defend their land. land belonging to a handful of ethnic Bunong A study by local rights group Licadho reported communities seeking collective titles. that authorities had carved up nearly one-quarter An analysis of a proposed agricultural of the country’s land mass as ELCs awarded to ownership law by Licadho suggests the private interests. Of these, at least 98 concessions, government intends to encourage communities totalling more than 700,000 hectares, affect to abandon traditional shifting methods of land that indigenous communities live on or cultivation. use, according to a September 2012 report from While facing pressure on land issues, Surya Subedi, the UN Special Rapporteur on health statistics for marginalized indigenous the situation of human rights in Cambodia. communities continue to be cause for concern. The government says ELCs are a vital part of For example, births in urban areas of Cambodia its strategy to develop what is a largely rural- are more likely to be attended by a skilled health based country, but critics say the policy has professional, compared with rural provinces seen hundreds of thousands of Cambodians like Mondulkiri or Ratanakkiri, where many threatened by eviction in the last decade. The indigenous groups reside. roots of Cambodia’s land problems can be traced In his report, Subedi, the Special Rapporteur, back to the Khmer Rouge, who abolished private warned that forced evictions and relocations ownership and monetary currency during their resulting from land concessions exacerbate disastrous rule from 1975 to 1979. an already challenging health situation, in The country held nationwide commune many cases making it harder for indigenous elections in June 2012, which were dominated by communities to access water, sanitation and basic the ruling CPP. Before this, Prime Minister Hun health services. Sen announced a moratorium on the granting Yet divisive resource projects slated for of ELCs, as well as a new land-titling scheme development near indigenous communities seem nationwide. But critics say the programme has likely to heighten problems in the near future. been too secretive, while others have speculated Plans for hydropower projects in the Cardamom that it was more likely part of electioneering in Mountains could displace roughly 1,000 mostly the lead-up to the commune elections, or the indigenous people. The Lower Sesan 2, a dam general elections planned for July 2013. project of Mekong tributaries in northern While Cambodia’s land problems have affected Cambodia, will also see an estimated 5,000 a broad cross-section of society, indigenous people resettled. groups have been particularly impacted by ELCs In April, well-known conservationist Chut and the renewed land-titling efforts. The titling Wutty was gunned down while accompanying scheme is especially of interest to indigenous journalists to a suspected illegal logging site in the communities, who have lived for generations Cardamom Mountains. After altering the official on communally run land. But the government explanation of how Wutty died, authorities titling scheme has favoured individual private claimed Wutty was shot and killed by a military

State of the World’s Minorities Asia and Oceania 149 and Indigenous Peoples 2013 police officer, who was in turn accidentally its faults, which include serious allegations of killed by a private security guard working for a political interference, the court’s backers see it logging company. A provincial court convicted as a rare symbol of justice following years of the security guard of causing an accidental death impunity for Khmer Rouge perpetrators. and sentenced him to two years in prison, only to While the court is pursuing crimes committed suspend the remaining sentence. against the Cambodian people as a whole, the Wutty had become a thorn in the side of the two remaining elderly defendants on trial – the government by shining a spotlight on illegal Khmer Rouge regime’s chief ideologue, Nuon logging. He also campaigned on behalf of Chea, and its former head of state, Khieu indigenous communities in Prey Lang forest, a Samphan – are also charged with genocide lowland evergreen forest in central Cambodia. specifically against the minority Cham Muslim Critics saw Wutty’s death as a tragic community and ethnic Vietnamese, who continuation of repeated attempts to intimidate historians believe were both specifically targeted and threaten land rights activists. Throughout by the regime. the year, activists reported numerous cases where community organizers had been summoned to Indonesia appear in court to face charges of incitement, Indonesia, the world’s largest Muslim-majority or where authorities disrupted rights training nation, is also an intensely diverse country whose sessions. A January 2013 report from the citizens are drawn from an estimated 300 separate Jesuit Refugee Service focused attention on ethnic groups, speaking different languages and the under-studied problem of discrimination practising multiple religious faiths. While the against Cambodia’s Vietnamese minority, country is often held up as a model of religious which comprises an estimated 5 per cent of the tolerance and democracy, alarming instances population. Many Vietnamese in Cambodia live of intolerance, which sometimes spilled into in limbo, having been denied the documents violence, shows that the reality is far removed required for citizenship, even though many from the political platitudes. speak the Khmer language and were raised in There were numerous examples throughout Cambodia. The report argues that such groups the year. Members of Indonesia’s Ahmadiyya are at risk of statelessness. Being denied basic community, a Muslim community branded citizenship rights also makes these already heretics by religious conservatives, continued vulnerable groups more susceptible to human to face persecution. In April, members of trafficking. fundamentalist group Islamic Defenders Front Additionally, members of the Khmer Krom (FPI) attacked an Ahmadi mosque in Singaparna, minority – ethnic Khmer from southern Vietnam West Java, according to the Asian Human Rights – continued to report difficulties accessing basic Commission (AHRC), which contends that services. Though the government’s stated policy police did little to stop the damage. is to welcome Khmer Krom in Cambodia, That same month, the AHRC says FPI advocates for Khmer Krom say they face members forced an Ahmadiyya religious leader discrimination in practice. on Batam Island to sign an agreement to The Extraordinary Chambers in the Courts of stop holding religious activities. In July, local Cambodia, the UN-backed war crimes tribunal media reported that ‘an angry mob’ attacked set up to try senior leaders of the Khmer Rouge and injured three Ahmadis in Bogor. Other regime, continued its work throughout the year. Ahmadiyya communities continue to be But it faced increasing questions over the status marginalized. Local media reported that 120 of future cases and the likelihood of seeing a members of the Ahmadiyya community remain full trial against its frail and ageing defendants. displaced in West Nusa Tenggara province, seven In March 2013, Ieng Sary, the regime’s former years after a mob attacked and burned their foreign minister, died at the age of 87. The court homes. They are unable to obtain basic identity also continues to be dogged by funding shortfalls, cards, preventing them from accessing needed which threatened to disrupt proceedings. Despite health and education services.

150 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Ratanakkiri alone, authorities have issued land Case study concessions to private firms for at least 157,000 hectares of land where indigenous communities live, according to estimates from a September In Cambodia’s report by the UN Special Rapporteur on human rights in Cambodia. Naturally, these projects remote Ratanakkiri cause conflict with local indigenous communities. For example, in early 2013, multiple indigenous province, resource communities complained about at least three separate Vietnamese-run rubber firms, according exploitation to local media. Complaints included accusations of the bulldozing of community farmland and puts pressure filling in a lake vital for food and irrigation. Such firms had been granted controversial economic on indigenous land concessions in the area. Despite the resource development, the province remains one of the communities most impoverished in the country. Them worries about the health of her six children, because the nearest clinic is at least 15 km away. Ploy Them is an ethnic Tampuan woman living in Ratanakkiri province in Cambodia’s ‘If my family gets sick, the nearest clinic is far away remote north-east. from here. This year, my son got very sick. He In 2004, Them says the government couldn’t eat anything or even swallow. We spent awarded a land concession to a firm that a lot of money to get there. We had to take loans quickly opened up a large gem mining from other people just to pay for the trip. Now my operation. Her fellow villagers were allowed daughter is sick with diarrhoea. I want to take her to stay, but some of the gem mine infringed to the health clinic, but if we don’t have money, on the local community forest. By the time what can we do? We just stay here and do what we the company left several years later, the water can.’ flowing in a nearby stream had become undrinkable. Today it has an oily sheen and Them says that recently a representative from a villagers are afraid to bathe or wash their new company came to the village and showed clothes in it. A well provided by an NGO residents a map of a land concession they broke down. They now rely on a basic well planned to develop. Some of the concession that villagers dug nearby. overlapped with parts of the community’s land. The company has not yet returned, but Them ‘We don’t drink the water any more. We used to says people in her village are worried about the wash in the stream, but the water is no good to future. use now. If the water is not clean, then it’s not very good for living. The company was trying ‘We really don’t want to lose the land. If we lose the to look for gems and they made the water dirty. land, we will surely die. We can’t live without land When people drank the water, they became sick.’ to farm. All the villagers want to stop the company because we can’t afford to lose our land.’ ■ Ratanakkiri is a hotbed of activity for resource exploitation industries. In recent years, large-scale logging, rubber and agro- business plantations and mining operations have opened up as a result of economic land concessions granted by the government. In

State of the World’s Minorities Asia and Oceania 151 and Indigenous Peoples 2013 A report by Ahmadiyya advocacy group Lajnah of rape and sexual intimidation even after the Imaillah, submitted to the UN’s Committee attacks, while those driven into shelters, as with on the Elimination of Discrimination against the Ahmadiyya communities in West Nusa Women (CEDAW) in July, outlined health Tenggara, have lost their jobs and been prevented concerns for a group of displaced Ahmadis who from registering their marriages. had fled violence from their homes in West Nusa In its concluding statement, the committee Tenggara province. Some children from a group expressed deep concern about the pressures faced of 170 people living in temporary shelters on by rural and indigenous women. Women from Lombok island were suffering from malnutrition, rural settings were much less likely to be able to while others had dropped out of school. give birth in a health facility than their urban Rights groups also called on authorities to stop counterparts, a worrying problem that directly attacks against minority Shi’a Muslims. In July, affects uneven maternal mortality rates, the a Shi’a cleric from Madura Island was convicted committee stated. of blasphemy for his religious teachings. An Overall, Indonesia has made progress in August incident left one Shi’a man dead in the lowering its maternal mortality rate, from a same community after an attack in which a mob baseline of 390 deaths per 100,000 live births to also burned down 35 homes belonging to Shi’a 228, according to the government’s Millennium families. By the start of 2013, rights groups said Development Goals (MDGs) update last year. local authorities were threatening the families The goal is to reach 102 deaths per 100,000 already displaced by the violence with forced live births in 2015. However, the results are eviction. uneven across the vast archipelago, with troubling Persecution against Christians also continued differences between urban areas and the rural in parts of Indonesia, with groups blocking some villages where many minority and indigenous congregations from holding religious services. women live. The discrepancy can be blamed in In April, for example, local officials in an area part on a weaker health system in outlying areas. outside Jakarta obstructed 100 members of the Indonesia’s often heavy-handed crackdown on Filadelfia Batak Christian Protestant Church the movement for autonomy and self-governance from worshipping. In 2009, local authorities in West Papua continued to have detrimental stopped the planned construction of a church impacts on indigenous Papuans in the country’s there, and the congregation has faced continuous easternmost provinces. opposition. In June, police shot and killed independence Overall, the Jakarta-based Setara Institute for activist Mako Tabuni, whose death triggered Democracy and Peace recorded 264 cases of angry demonstrations. Police claim the vice- violations against religious freedoms during 2012 chairman of the National Committee for West – a figure that has risen steadily over the last six Papua (KNPB) violently resisted arrest, but years. activists and rights groups dispute this. Also Rights groups say such persecution against that month, KNPB leader Buchtar Tabuni was religious minorities continues to occur in part arrested after police accused his organization of because of a weak government response. For engaging in violence. example, authorities have encouraged Christian Throughout 2012, activists and rights groups and Shi’a communities to relocate, while court accused police and military of employing prosecutions against perpetrators of violent intimidation tactics against activists, including attacks are rare. arbitrary arrests, shootings and torture. In a June In July’s CEDAW session examining report, the Commission for Missing Persons Indonesia, the country’s National Commission and Victims of Violence (Kontras) outlined on Violence Against Women (Komnas what it said was a drastic increase in reported Perempuan) warned that acts of intolerance torture incidents over the past 12 months, against religious minorities could see an increase predominantly at the hands of police. The rights in violence against women in particular. Women group said they had recorded 86 allegations of from religious minorities face additional threats torture – triple the previous total. Roughly 40 per

152 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 cent of reported victims were from the Papuan … does not recognize the application of the provinces. indigenous people concept as defined in the UN The continuing conflict in West Papua is Declaration on the Rights of Indigenous Peoples exacerbating what is already a worrying health in the country’. situation for civilians. According to Indonesia’s National AIDS Commission, AIDS prevalence Laos rates are at least 15 times higher than the Laos, a single-party state, nominally allows for national average. This suggests a need to step up freedom of religion, so long as worshippers awareness and education efforts in high-risk areas. adhere to one of the state-sanctioned groups At a national level, heightened HIV infection within four recognized religions: Bahá’i, rates are generally found in traditionally high-risk Buddhism, Christianity and Islam. Evidence groups. However, in Papua, health professionals from rights monitors shows authorities continued say the problem is more widespread across the to harass and repress those who attempted to general population. At the same time, NGOs, exercise their rights outside of these parameters, including those working in the health sector, say particularly in rural areas. the authorities have made it increasingly difficult The US-based Human Rights Watch for Lao to work in the area, which suggests that West Religious Freedom (HRWLRF) highlighted Papua’s political stability will be an important a number of cases throughout the year. In determinant in changing health outcomes for February, for example, HRWLRF says local minority groups. officials threatened to expel 10 Christian families Cases of land conflict between private in northern Laos’ Luang Prabang province, unless companies and indigenous communities they renounced their faith. The organization says continued through the year. Protesters have Lao authorities have cracked down in particular often found themselves on the receiving on new Christian converts in Savannakhet end of excessive police force when staging province. demonstrations. In February 2012 for example, A joint 2012 report between the Lao police shot and injured five farmers in Sumatra’s Movement for Human Rights (MLDH) and Riau province. The AHRC said the farmers were Paris-based International Federation for Human peacefully protesting against a palm plantation Rights (FIDH) noted that many Christians in firm. Laos come from already marginalized ethnic The national government’s broad development minority groups. The report stated, ‘Repression plans seem likely to be a source of future conflict against Christians has not diminished and has if not handled carefully. Indonesia’s Economic even intensified in 2012.’ The US Commission Master Plan (MP3EI) seeks to stimulate growth on International Religious Freedom (USCIRF) through a focus on so-called ‘economic corridors’ listed Laos as a ‘watch list’ country because of – clustering and connecting industrial and ‘serious religious freedom abuses’. special economic zones throughout the country. Ethnic diversity in Laos is expansive; officially, It is crucial that indigenous groups themselves the government recognizes 49 separate groups, are included in any such planning that affects but there are likely quadruple the number. Rights their land and livelihoods; failure to do so could groups say the Hmong continue to be among instead increase tensions with affected groups. the most persecuted, because of Hmong leaders’ In May, Indonesia was subject to scrutiny as support of the United States during the Vietnam part of the UN Human Rights Council’s UPR War. Of particular concern are a group of 4,700 process. Member states urged Indonesia to ensure that Thailand forcibly repatriated to Laos in that perpetrators of assaults against religious late 2009 – a group that included 158 who had minorities were brought to justice and to ensure already been granted refugee status before their the rights of indigenous peoples. But some rights deportations. Other than a tightly controlled groups were disappointed by Indonesia’s response visit in 2010, neither rights monitors nor aid to the UPR, which included a passage stating that workers have been granted access to the camps ‘given its demographic composition, Indonesia where the returned Hmong were held. According

State of the World’s Minorities Asia and Oceania 153 and Indigenous Peoples 2013 Above: Hmong boy at a market in Laos. Chris This is representative of Laos’s overall Stowers/Panos. struggle to bring adequate health care to remote communities, where many minority groups live. to the MLDH, ‘repatriated Hmong have been A World Health Organization (WHO) profile victims of imprisonment, re-education and of the health sector noted that the government discrimination’. claims 93 per cent of the population lives within Unanswered questions also remain about an average walk of 90 minutes to the closest prisoners detained in Vientiane’s Somsanga drug health facility, but there are ‘major differences’ detention centre – ostensibly a facility for treating in accessibility compounded by ethnicity and drug addiction that critics say is more of a prison gender. for undesirables. HRW researchers say there is A separate WHO/Ministry of Health report evidence that Hmong have been detained there. on the mental health system noted a large gap in Landmines or other unexploded ordnance the distribution of health professionals between (UXO) still kill or injure about 100 people urban and rural settings. All the country’s each year in Laos, one of the most heavily psychiatric treatment centres are located in the bombed countries on earth. The government capital, Vientiane, rendering it highly prohibitive itself acknowledges that assistance to landmine for ethnic minorities living in the highlands to and UXO survivors is ‘still inadequate’. As the access them. The report concluded, ‘Inequity of International Campaign to Ban Landmines access to mental health services for other minority notes, ‘Most survivors come from the poorer users … is a major issue in the country.’ remote areas, belong to ethnic minorities, and are A study published in the Asia-Pacific Journal disproportionately disadvantaged by the existing of Public Health in November examined health limitations in the provision of service.’ inequalities in the country. The authors found

154 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 highland Mon-Khmer minorities reported staged a large-scale rally in Kuala Lumpur. ‘significantly worse health, even after making Organizers claimed up to 300,000 people adjustments for their living in inaccessible areas’.9 attended. As in previous Bersih protests, police While the government is attempting to reduce responded in a harsh manner, arresting hundreds. the geographic inequalities in the health system, In June, three UN special rapporteurs issued the results have been slow in some cases. For a statement urging the government to protect example, a July news report from Inter Press activists from harassment, drawing attention to Service (IPS) showed that many rural minorities claims of intimidation against Bersih organizer were unaware of a new mobile midwife Ambiga Sreenevasan. programme – a year after health authorities had During 2012, parliament approved legislation launched it. to replace the Internal Security Act, which Land issues in the country continued to had been used to harass government critics in place pressure on minority communities. In a previous years. But its replacement, the Security January report submitted to the UN Committee Offences (Special Measures) Act, still allows those on the Elimination of Racial Discrimination suspected of ‘security offences’ to be detained (CERD), the Unrepresented Nations and without trial. The new legislation, Amnesty Peoples Organization (UNPO) warned that land International stated, ‘merely replaces one concessions for rubber plantations were stripping oppressive regime with another’. In multicultural Hmong people of their land with inadequate Malaysia, the issues of ethnicity and religion are compensation. never far from the surface. Islam is the majority During 2012, Laos broke ground on its religion, with significant Buddhist, Christian controversial Xayaburi hydropower dam. The and Hindu minorities. In June, JAIPP, the 1,285 megawatt dam would be the first project Islamic affairs council in Penang, investigated on the mainstream of the Lower Mekong River after Christians were accused of proselytizing and have adverse effects for the food supply to Muslims. No evidence was found of this, downstream. About 2,000 people around the according to rights group Suara Rakyat Malaysia, area are expected to be displaced – a number or Suaram, but the issue nonetheless highlighted that includes many indigenous Lao Theung the sensitivities of religious matters in the families. Conservationists say the project, and country. In October, Suaram said parents at others planned on the Mekong, could decrease SK Pos Bihai, a school for indigenous children fish supplies and have a major impact on food in Kelantan state, accused a Muslim teacher of security in the future. slapping their non-Muslim children because they In December, prominent human rights activist could not recite an Islamic prayer. Government Sombath Somphone went missing. Supporters officials initially denied the claims. believe Sombath was abducted. The government Peninsular Malaysia’s diverse indigenous has denied involvement, but international rights peoples, collectively known as Orang groups and diplomats have expressed grave Asli, comprise less than 1 per cent of the concern. overall population, yet face worrying health discrepancies. For example, a report by the Malaysia Women’s Aid Organisation (WAO) examined In Malaysia, controversial new legislation drew Malaysia’s progress on gender equality. It pointed broad criticism from rights groups at home and out that studies show Orang Asli women have abroad. The Peaceful Assembly Act was passed in a lower life expectancy than men. They also late 2011. Critics, including civil society groups run a greater risk of malnutrition and have high and the political opponents of Prime Minister rates of postpartum haemorrhage and puerperal Najib Razak, said the law’s ‘excessive restrictions’ sepsis. As researcher Colin Nicholas of the would be used by the government to crack down Center for Orang Asli Concerns has noted, ‘With on public demonstrations, rather than support the majority of them living below the poverty freedom of assembly rights. line, their narrow margin of survival makes In April, the anti-corruption coalition, Bersih, the Orang Asli’s health situation precarious.’

State of the World’s Minorities Asia and Oceania 155 and Indigenous Peoples 2013 Orang Asli communities also find themselves the population as a whole. battling over land and development in their often Ethnicity remains a hot-button issue in resource-rich areas. Early in the year, 13 Temiar Malaysia, particularly in the lead-up to planned protesters in Kelantan were arrested after they elections in 2013. Analysts say ethnic Chinese protested against an agricultural project slated for voters are becoming increasingly disillusioned development on their ancestral lands, according with Razak’s ruling coalition, with public opinion to rights organization Aliran Kesedaran Negara. surveys suggesting an increasing lack of support. Activists in the area have also warned of the This may have ramifications for ethnic minorities increased threat posed by rubber plantations. in general, should the coalition decide to shore In Borneo’s Sarawak, extensive plans for up its support by instead focusing on policies massive hydropower projects are of major popular with majority ethnic Malays. Already in concern to indigenous communities. The first 2012, minority politicians complained of veiled such project, the Bakun dam, was responsible for threats of violence. the forced displacement of 10,000 indigenous Meanwhile, China continued to show that it people before it was finished in 2011. Now, had the ability to export its domestic agenda to activists are fighting against the next projects in neighbouring countries in its pursuit of minority line – the Murum and Baram hydropower dams, Uighurs. Radio Free Asia (RFA) reported that 11 which rights groups say could displace more than Uighurs whom Malaysia previously repatriated 20,000 indigenous people altogether. to China had been sentenced to prison terms in In October, 450 Orang Ulu villagers – a China on charges of ‘separatism’. At the end of general name used to describe several tribes on the year, Malaysia again bowed to China’s wishes, Sarawak – protested against local leaders who forcibly returning six Uighurs with pending they said had pledged support for the Baram asylum claims. HRW called it ‘a grave violation project without their consent. In September, of international law’. villagers at risk of losing their homes blockaded construction of the Murum dam, which was The Philippines expected to be completed in 2013. A September The year 2012 in the Philippines was bookended report from the Forest Peoples Programme noted by a pair of natural disasters that shone a that the expansion of palm oil plantations in spotlight on the hardships faced by minority Sarawak is proceeding at a rate of 90,000 hectares and indigenous groups – already marginalized each year. populations that suffered from an uneven The WAO report also highlighted the abuse of disaster response in the aftermath of the damage. Penan women and girls in Sarawak. The report Tropical Storm Washi, known as Sendong in included allegations of abuse at the hands of the Philippines, slammed into Mindanao in timber workers, underscoring the interconnection mid-December 2011 before touching down in between resource-exploitation without sufficient Palawan. Both areas have a significant population local consultation and human rights problems. of minorities or indigenous peoples. The storm An April briefing by the Global Health Group killed more than 1,200 people and left 300,000 said Malaysia should focus its anti-malaria fight homeless – one of the Philippines’ worst natural in part on Borneo, where indigenous populations disasters in years. In February 2012, more than remain at high risk. The government has set a month after the storm hit, UNICEF reported a goal of eliminating malaria on peninsular an alarming rise in child malnutrition rates Malaysia by 2015; however, the deadline is five attributable to the storm’s effects. years later on Malaysian Borneo. The malaria One year later, a report on Sendong’s effects issue for indigenous peoples in Sarawak and by the Internal Displacement Monitoring Sabah is indicative of unequal access to vital Centre (IDMC) warned of an uneven response services. While the usage of ineffective traditional to survivors in places like Northern Mindanao’s remedies and environmental factors contribute to Cagayan de Oro. Some respondents told the problem, indigenous peoples on Malaysian researchers that authorities had classified them Borneo also lack the same access to health care as as migrants rather than Sendong survivors,

156 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 preventing them from accessing aid. The January the May shooting death of Margarito Cabal to 2013 report stated, ‘Evidence suggests that his opposition to the controversial Pulangi V Sendong survivors in Cagayan de Oro have not hydropower dam in Mindanao. Groups like received equal treatment on the basis of their KAMP point the finger at the government of political opinion or ethnic or social origins.’ In President Benigno Aquino III or its agents. In surveys of affected areas, there were anecdotal October, KAMP claimed there had been 30 reports of gender-based violence and coerced extra-judicial killings of indigenous activists or prostitution at relocation sites. This suggests an their supporters in the 28 months since Aquino urgent need to study and address this issue as had taken office. In a May statement, the UN’s part of future planning for disaster response. Special Rapporteur on the rights of indigenous In December 2012, Typhoon Bopha, known peoples, James Anaya, urged South East Asian as Pablo in the Philippines, struck Mindanao, governments, including the Philippines, not to killing more than 1,100 people and displacing ‘sideline’ the rights of groups ‘who derive their hundreds of thousands. Again, medical experts livelihoods, traditions and ways of life directly raised concerns of lingering health impacts, from their natural environments’. He highlighted particularly in areas where the storm had the case of the bio-ethanol energy project in destroyed local health clinics and severely Isabella province, which has displaced indigenous damaged larger hospitals. farmers. However, disaster response experts applauded Sadly, the killings continued even after year’s the government in February 2013 for introducing end. In February 2013, Dexter Condez was the Act Protecting the Rights of Internally killed while on his way home from a meeting Displaced Persons. The IDMC called it ‘the first about land rights: Condez was youth leader of its kind in Asia’, particularly for highlighting and spokesperson for the Atis, an indigenous the rights of indigenous peoples and women. community living on the island of Boracay, a While this may be a positive development, fast-developing tourist destination. In 2011, the throughout the year alarming acts of violence government had granted the Atis a certificate of against indigenous people, often land rights ancestral land title to a 2.1-hectare waterfront activists and their supporters, continued to site. This decision has been challenged by tarnish the Philippines’ human rights record. In property developers, and the Atis remain severely March, Lumad leader Jimmy Liguyon was shot marginalized. to death, allegedly at the hands of a paramilitary Since coming to power, Aquino has largely group, according to Kalipunan ng mga staked his legacy on a peaceful resolution Katutubong Mamamayan ng Pilipinas (KAMP) to the long-standing conflict in Mindanao. – an alliance of indigenous peoples’ groups. In Violence between the Philippine Army and July, Willem Geertman, a Dutch missionary pro-independence groups, most notably the who advocated on behalf of indigenous peoples Moro Islamic Liberation Front (MILF), has had in Central Luzon, was shot dead in front of his severe effects on civilians over the course of a office, KAMP stated. In September, the AHRC more than four-decade conflict. In its year-end reported that the son of a tribal leader opposed report, human rights watchdog Karapatan said to local mining operations was shot on his way the military continues to falsely accuse some to school in Zamboanga del Sur in western civilians caught in the violence of being ‘Muslim Mindanao. In October, Gilbert Paborada was terrorists’. shot dead in front of his home in Cagayan de In October the government and MILF reached Oro. Paborada led an advocacy organization that a deal the Aquino administration touted as a opposed plans for a local palm oil plantation. roadmap to peace. The deal sees MILF dropping The reported violence against indigenous its demands for outright independence, in activists often went hand in hand with land favour of an ‘autonomous political entity’ to disputes, primarily over private development be known as Bangsamoro. This represents a projects opposed by local communities in hopeful step towards ending the violence in resource-rich areas. For example, KAMP linked troubled Mindanao. However, much work

State of the World’s Minorities Asia and Oceania 157 and Indigenous Peoples 2013 remains to be done to ensure a lasting peace there were four times as many Muslims exposed in the lead-up to 2016 and beyond, when the to unprotected water sources, while Muslims framework agreement calls for the election of also had to travel double the distance to access the Bangsamoro legislature and the formation health clinics or schools, according to the report. of a government. A disarmament plan must still Previous studies have noted that when displaced be agreed upon and implemented, as must a Muslims seek shelter in Christian communities method of ensuring that the rights of non-Moro women often face the bulk of discrimination, minorities are respected. At the same time, not as many are easily identifiable if they wear everyone is on the same page. Militant group headscarves. At the same time, key health Abu Sayyaf remains on the sidelines, as does statistics in the Autonomous Region in Muslim the Bangsamoro Islamic Freedom Movement, a Mindanao (ARMM) are troubling. The ARMM MILF breakaway group that, in August, clashed has the highest levels of under-five, infant and with the army in the lead-up to the peace neonatal mortality of all 17 regions, according to accord, causing the temporary displacement of a January 2013 study on health inequality in the an estimated 60,000 civilians, according to the Philippines. In Northern Mindanao, under-five IDMC. To its credit, the framework agreement and neonatal mortality rates actually increased includes passages – albeit brief ones – calling between 2000 and 2007. on parties to respect the ‘customary rights and In late December, the Philippines took a major traditions’ of the region’s indigenous peoples. step when President Aquino supported legislation While the peace process is welcome, it does that would make it easier for women to obtain not negate the years of significant suffering by contraceptives and would make sex education civilians. In February 2012, the World Bank mandatory in public schools. The issue was a and World Food Program released a general divisive one in a country where the Catholic population survey of central Mindanao, Church holds significant influence. However, which highlighted the far-reaching effects of abortion remains illegal in the Philippines. the conflict. During the UN’s UPR for the Philippines in The report estimated that 40 per cent of May, the Committee on Economic, Social and families in the survey areas had been displaced by Cultural Rights (CESCR) urged the government fighting at least once between 2000 and 2010. to address the issue of maternal deaths Compared to Christians in the survey area, stemming from unsafe abortions by ‘reviewing’

158 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Left: Karen people from Burma work in fields in towards Malayu in Southern Border Provinces Mae Sot, Thailand. William Daniels/Panos. of Thailand (ACARM) – claimed that state discrimination against Malay Muslims has its legislation on abortions. Sweden urged the ‘created an environment of distrust’ between Philippines to amend legislation to allow for authorities and the local affected communities. abortion in cases of rape, incest or when the ACARM highlighted problems for Malay health of a pregnant woman is threatened. Muslims in accessing health care. These include communication problems for elderly Muslims in Thailand public hospitals and the failure of some health The unresolved conflict in Thailand’s south care centres to accommodate Muslim customs. continued to be a source of instability and human ACARM also says Malay Muslim women have rights abuses throughout 2012. While Thailand been disproportionately affected by the Thai is predominantly Buddhist, its southern border military’s response to the conflict, shouldering the provinces are home to a majority Malay Muslim responsibilities for providing for their households population. A separatist insurgency – and the if male family members are killed or arrested. often-criticized response from Thai security forces Thailand is home to diverse ethnic minority – continued to see civilians caught in the middle communities, particularly in its northern hill and even targeted. Since 2004, more than 5,000 areas. In its CERD submissions, the Coalition people have been killed. on Racial Discrimination Watch (CRDW) In February, a truck bomb explosion in front highlighted problems of racial discrimination. of a public health office killed a retired teacher For example, reports in local media that ethnic and injured 13 other civilians. One month later, minority communities had cut down trees a roadside bomb struck down four soldiers. Also propagated the view that such groups were in March, nine people were killed and a further responsible for the destruction of forest areas. 70 injured after a series of bomb explosions, Indigenous peoples in forest areas have become which authorities blamed on separatists. ‘scapegoats’ for climate change, CRDW argued, Insurgents also continued attacks on public citing an Environment Ministry practice sector civilians. This included a December attack that fines forest-dwelling communities like in which insurgents allegedly shot dead two ethnic Karen or Hmong for practising shifting ethnic Thai Buddhist teachers. Some insurgent agriculture techniques. fighters view civilians such as teachers and civil The report noted that there were still more servants as legitimate targets because they are than 100,000 indigenous people who had no perceived to represent the Thai government. access to the public health system. A significant HRW counted 11 separate attacks on schools problem is many indigenous people’s inability or teachers in the preceding month and a half to obtain legal status. NGOs who work with before the December killings. such communities say that applicants suffer Civilians have also been victims of violence from a lack of information on procedure. perpetrated by the army. In January, for example, While the government allows in-process Thai troops killed four people initially identified applicants to receive health care, the National as insurgents. But the military later admitted the Commission on Human Rights of Thailand four were not linked to the separatist movement. notes, ‘public health services are still elusive for Critics say the military has targeted innocent hill peoples who have not yet received status’. Muslim civilians suspected of being insurgents In its concluding observations from an August with insufficient evidence. In submissions to session, the CERD stated: the UN CERD, a coalition of advocacy groups based in the south said 80 per cent of arrests ‘The Committee is concerned about the inadequate made following insurgent attacks were based on access to social welfare and public services by certain false assumptions or accusations from a third ethnic groups because of language barriers and the party. The coalition – the Alliance for CERD limited availability of such services where these Alternative Report on Racial Discrimination groups live.’

State of the World’s Minorities Asia and Oceania 159 and Indigenous Peoples 2013 Thailand has long been home to tens of unregistered church group, the Vietnam Good thousands of refugees who have fled fighting in News Mission, while according to UNPO, the eastern Burma. Though Burma has struck fragile other belonged to the registered Evangelical ceasefires with some armed ethnic militias, the Church of Vietnam (North). In early January situation remains volatile. Along Thailand’s 2013, authorities began tearing down a western border, more than 150,000 people, both monastery in Hanoi, according to Asianews.it, a registered and unregistered, make their homes Catholic news website. in what have become semi-permanent refugee In late December, Vietnamese police camps. In the past, Thai officials have publicly arrested Le Quoc Quan, a Catholic lawyer mused about sending refugees back to Burma as who was an outspoken advocate for democracy the country opens up. and freedom of religion. In August, police In a July visit to both countries, the UN High conducted a mass raid on Degar Christians in Commissioner for Refugees, António Guterres, Kontum, a highland province. According to said it is imperative that the refugees not be the Degar Foundation, more than 30 mostly forced to return, particularly while the situation elderly people were injured when they could across the border remains uncertain. But life in not disperse quickly enough. In November, the and out of the refugee camps in Thailand remains group reported that police arrested six Degar tenuous. Refugees staying within the camps are Christians in a separate raid. Degar refers to not allowed to work. Those who try to make the indigenous peoples of the central highlands, a living outside the camps are often without who were called Montagnards by the former status and at risk of deportation. A September French colonial administration. report by HRW, meanwhile, said that dwindling Buddhist orders not sanctioned by the funds mean health organizations are struggling government also faced harassment. In June, to provide adequate assistance in the camps. police beat a monk from the outlawed Unified One French NGO downsized its outreach staff Buddhist Church of Vietnam, after arresting and cut its mental health services by 40 per him for not wearing a helmet while driving cent. Camps have also lost skilled refugee health a motorbike, according to RFA. The US workers and teachers to resettlement, resulting Ambassador to Vietnam, David Shear, later met in less experienced replacements and, noted one with the leader of the church in an apparent NGO official, ‘a decline in services’. The HRW show of support. report states, ‘With a reduced support network But the US’s own stance on Vietnam’s and fewer coping skills and after so many years treatment of religious minorities is mixed. with restrictions on movement, proscriptions on During 2012, the USCIRF once again the right to work, and dependency on outside aid, recommended that Vietnam be designated as many camp residents experience domestic abuse, a ‘country of particular concern’ (CPC) by the depression, and other social and mental health US State Department – countries that display problems.’ severe violations of religious rights, which could then be subject to US government sanctions. Vietnam But Vietnam has not been included on the State Vietnam’s Constitution nominally allows for Department’s final CPC list since 2006. Some freedom of belief and religion, but only ‘lawful observers have attributed this discrepancy to religious organizations’ are protected by law. the United States’ renewed strategic interests in Sanctioned religions include Buddhism, Cao Dai, Asia, which include a warmer relationship with Catholicism, Hoa Hao, Islam and Protestantism. Vietnam. Followers of religious denominations that do not A controversial new government decree on enjoy official status faced particular problems religion approved in late 2012 may see the throughout the year. situation worsen for religious minorities. Decree In June, authorities demolished two Christian 92 include new requirements to obtain legal churches built by ethnic Hmong in Dien Bien status, including a provision stipulating that province. One of the churches belonged to an applicants must not previously have ‘infringed

160 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 on national security’. Such broad wording seems Krom community – ethnic Khmer who live in likely to increase the ways in which authorities southern Vietnam – accessing basic health care can crack down on unsanctioned groups. can be problematic. In its CERD submission, Meanwhile, freedom of expression continued the Khmers Kampuchea-Krom Federation (KKF) to be tightly controlled during the year. said many Khmer Krom have difficulty accessing According to the Committee to Protect government-subsidized health care and are Journalists, Vietnam had locked up 14 journalists treated as ‘second-class citizens’ even when they by December. These included journalists who are able to. reported on religious minorities and other In its CERD submission, the Vietnam sensitive topics. Committee on Human Rights (VCHR) said Land conflicts continued to be a contentious the introduction of user fees for health care two issue through the year. In July, authorities jailed decades ago has led to ‘alarming disparities’ three activists who were outspoken about land between ethnic minorities and the overall issues. Land in Vietnam is owned by the state, population. These include significant differences which grants usage rights to individuals. For in infant mortality and poverty rates. And a Vietnam’s indigenous peoples in particular, WHO bulletin from December 2012 warned of uncertainty over land-ownership is a pressing ‘increasing ethnic inequity’ in maternal health concern. care in Vietnam. While women in Vietnam were Vietnam is in the early stages of preparing for more likely than in past years to receive proper REDD – Reduced Emissions from Deforestation antenatal care and give birth in a health facility, and Forest Degradation, the UN-backed initiative ethnic minority women were at greater risk of not that applies financial incentives to preserve forest receiving such treatment. The WHO stated that: areas. But with uncertain tenure rights, this has the potential to be a future flashpoint. A 2012 briefing ‘Inequity in maternal health care utilization has paper by the Asia Indigenous Peoples Pact (AIPP) increased progressively in Viet Nam, primarily warned that pilot projects in Vietnam showed along ethnic lines, and vulnerable groups in the that much work remains to be done to ensure country are at risk of being left behind. Health- that indigenous peoples are properly included care decision-makers should target these groups in meaningful consultation. A 2012 study by a through affirmative action and culturally sensitive local NGO, Culture Identity and Resources Use interventions.’ Management, noted a wide gap between rights in Vietnam’s forestry laws, and the reality for In its concluding observations on Vietnam, indigenous peoples on the ground. the UN CERD said it is ‘deeply concerned As part of its submission to the UN CERD, at the sizeable socio-economic gap between which reviewed Vietnam in 2012, UNPO disadvantaged ethnic minorities and the warned that land disputes are seeing indigenous majority Kinh, even when they live in the communities literally losing ground to Kinh same mountain area’. For many marginalized people, who form Vietnam’s ethnic majority: communities in remote locations, this economic gap compounds the inequality in accessing ‘Indigenous groups … report that large tracts health care. Anand Grover, the UN’s Special of fertile farms and valuable forest lands have Rapporteur on the right to health, noted in a been confiscated and reallocated to ethnic Kinh July report on Vietnam: without fair compensation. In many instances, the indigenous families are relocated to areas that lack ‘The poor and near poor, especially those in rural access to basic infrastructure and services, including and mountainous areas predominantly populated by schools and healthcare facilities.’ ethnic minorities, are often burdened by additional expenditures on food, travel and accommodation Health outcomes among ethnic minority and in order to access basic health services. In many indigenous groups are continually lower than instances, these expenditures amount to more than those of the general population. In the Khmer the cost of the health services sought.’

State of the World’s Minorities Asia and Oceania 161 and Indigenous Peoples 2013 to Chinese Human Rights Defenders (CHRD), the law marks a ‘step in the right direction’, East Asia but fails to close loopholes allowing police and government officials to commit political Emily Hong dissidents to psychiatric institutions against their will. The year 2012 also saw major reforms China in China’s Criminal Procedure Law, a process Despite China’s once-in-a-decade leadership that has been ongoing for almost ten years. The transition, political developments and legal Danish Institute for Human Rights argues that reforms in 2012 failed to signal a departure from the law has created a ‘two track criminal system’, long-standing policies towards minorities and representing progress in areas of procedural rights indigenous peoples. The lead-up to the transition and a ban on torture, but only for ‘ordinary was marked by a crackdown in which over 130 criminals’. The legislation simultaneously legalizes human rights activists were detained or faced the detention without charge of those suspected restrictions between September and November. of terrorism, corruption or jeopardizing national During the week of the National Party Congress, security, charges often brought against Tibetan, 11 Tibetans set themselves on fire, reflecting a Uighur and other minority dissidents. However, sense of desperation for political change in Tibet. controversial ‘disappearance’ clauses (which On 15 November, the Chinese Communist would have allowed authorities to detain suspects Party unveiled its new leadership, including without family notification) were removed due Party Secretary Xi Jinping and six others, notably to overwhelming criticism, according to the Dai excluding two senior reformist members. Unlike Hua human rights journal. the last grouping, the majority of new Politburo The government continued to crack down on members have coastal constituencies, prompting activists in China’s ethnic autonomous regions. concern that they may have even less reason to The government intensified its crackdown in tackle ethnic issues in inland China. Xi became Tibetan regions after a record number of self- the country’s president in March 2013. immolations by Tibetans, reflecting a wider In a speech following the congress, Xi only trend in heightened surveillance and repression mentioned ‘ethnic groups’ as part of a narrative since protests in 2008. Eighty-two Tibetans self- celebrating the Party’s transformation of ‘the immolated in 2012; self-immolations continued impoverished and backward Old China into the in 2013. The government opened fire on Tibetan New China that has become prosperous’. China’s protesters in January 2012, and those involved leaders continue to emphasize ethnic unity and in self-immolation-related protests have received modernization but have failed to address the sentences of up to 13 years. In February 2013, grievances of the country’s ethnic minorities, who repression intensified with authorities detaining comprise 8.5 per cent of the population. 70 ‘criminal suspects’ linked to ‘inciting’ acts of In May 2012, the dramatic escape of blind self-immolation. disability rights activist Chen Guangcheng Environmental degradation linked to natural brought China’s human rights issues to world resource extraction in Tibet came to the forefront headlines. Chinese and international NGOs in April 2013, with a deadly mine-related highlighted his case in September when China landslide killing 83 in the Gyama Valley near participated in its first-ever review under the Lhasa. The Gyama mine, along with other major UN Convention on the Rights of Persons with development projects, is part of the government’s Disabilities, which it adopted in 2008. five-year plan to make Tibet a mining centre and The UN Committee on the Rights of Persons hydropower engine of China. with Disabilities criticized the then draft mental Amnesty International highlighted the cases health act for violating the free and informed of several Uighur political prisoners, including consent of the individual. The new mental health a famous writer who died in prison due to law was passed in October and prompted mixed ill health in 2012. Another prisoner remains responses from human rights groups. According critically ill with cancer. Amnesty International

162 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 also reported on new testimony which shows that hundreds of Uighurs disappeared during Case study by Rinnai Ngadan the Urumqi riots of 2009, many of whom are still missing. This is part of wider repression in the Xinjiang Uighur Autonomous Region, as Maternal deaths indicated by the alarming number of Uighurs on trial for ‘endangering state security’. Uighurs, remain high for who account for less than 1 per cent of the population in China, comprise about half of China’s ethnic all those on trial for endangering state security, according to Dai Hua journal. minorities In Inner Mongolia the Southern Mongolian Human Rights Information Center celebrated the news that, after years of efforts by activists, Many minority women in western China the regional government has agreed to consider a do not give birth in hospitals because proposal to bring in new legislation to promote of poor-quality facilities and culturally the use of the Mongolian language in 2013. insensitive care. In November, local NGOs Green Sina and Despite China’s national progress in the Green Earth Volunteers found evidence that areas of maternal and infant health, rural and toxic water from a coal-processing factory was ethnic minority regions lag behind. A 2010 being illicitly dumped in the Tengger desert of UN report tracing China’s progress towards Inner Mongolia, contaminating the underground the Millennium Development Goals shows water and endangering herders in the area. that maternal mortality rates are almost China’s socialist health care system was once twice as high in western regions, where many lauded by the World Health Organization ethnic minorities live, than in wealthier (WHO) as an example for other developing eastern provinces. countries, with ‘Barefoot doctors’ (chijiao yisheng) Since 2000, China has campaigned for providing basic services to some of the most all women to give birth in hospitals, in an rural ethnic areas.10 Market reforms of health effort to reduce the number of mother and care since the 1980s led to widespread public newborn deaths. And yet such a policy focus discontent over the lack of affordable health care. ignores two persistent realities that hinder In response, the Chinese government launched maternal and child health for rural minority major health reforms in 2009, with a goal of women – lower-quality care in rural hospitals achieving universal health coverage by 2020. and a lack of understanding of traditional More than 95 per cent of the population is now birthing practices. covered by some public health insurance, but Studies show that ethnic minority women patients still have to pay for at least 60 per cent are much less likely to seek health care or of out-patient costs and 50 per cent of in-patient give birth in hospitals than the majority costs, according to a 2012 review published Han population. A major study in 2007 in The Lancet medical journal.11 Critics argue investigated the challenges of using maternal that without a focus on structural causes of health care services for Yi and Mong ethnic discrimination, such reforms will have uneven minority women in a remote area of south- impacts. west China’s Sichuan province. China is ‘on track’ towards meeting all of its The study found that accessibility, while health-related Millennium Development Goals, clearly a factor given the lack of good roads but given the lack of data disaggregated for and transport, was not as important as many minorities, it is doubtful that national statistics presume. are representative of remote ethnic areas, which Hospital deliveries are very expensive. The often lack basic health infrastructure. government’s new cooperation insurance Rural migrant workers living in urban areas,

State of the World’s Minorities Asia and Oceania 163 and Indigenous Peoples 2013 Case study continued would prefer not to be shaved, to be allowed to walk around during labour and to give scheme was introduced in the area in 2006, birth in a position similar to the traditional and although most women have paid their semi-sitting position, which was not contributions, many do not know how to use the available as a choice in the hospital. scheme. Furthermore, costs of a hospital birth – The focus on western medical approaches including medication, transportation and family to health and childbirth, and the lack of accommodation – exceed any reimbursement sensitivity to local culture and practices, available through the scheme. contributes to the lack of trust and desire for Women are also staying at home because of the minority women to give birth in a hospital poor quality of care in township hospitals, where setting. The government also does not medical staff cannot perform caesarean sections support relationships between health staff or keep safe blood supplies. and experienced traditional midwives. Lack of understanding of local culture and beliefs In spite of China’s progress towards health among health care staff is another important and targets, health issues among ethnic minorities neglected barrier. The cultural inappropriateness continue to be neglected. The government’s of birthing practices causes women discomfort and emphasis on increasing accessibility and embarrassment; and there is a lack of incentives improving health infrastructure ignores such as pain relief during labour.12 the much-needed improvement in service Researchers noted how women said that they quality. Most critically, a bias towards western medicine in hospitals does not give Below: Yi woman from Yunnan Province, sufficient attention to the potential and role China. Eric Lafforgue. of traditional health practices. ■

164 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 including minorities, are denied access to social would not address discrimination against services and health care under the hukou – or minorities, and called for the government to household registration system. Most of the adopt an anti-discrimination law. estimated 200 million migrants are still registered Following December elections, the Liberal as rural residents and so are excluded from Democratic Party announced it will exclude accessing health insurance, or must pay higher Korean schools attended by third- or fourth- prices for health care they can rarely afford. In generation North Korean students from tuition December, the government announced it will subsidies, citing poor political relations between speed up household registration reform but the the two countries. Since then, local governments, details have yet to be revealed. including the Tokyo municipal government, have followed suit. Schools for children of migrant Japan workers, such as Brazilian and Peruvian schools, Despite Japan’s public narrative of racial and have also not received financial support from the cultural homogeneity, the country is home to government. several minorities. These include the Burakumin, Students of Korean schools have also been the descendants of outcastes during the Tokugawa target of hate crimes, a trend that has worsened period, Ainu and Okinawan indigenous peoples, in recent years. The government has failed to ethnic Korean and Chinese populations, and its respond to violence against girl students, and so ‘newest’ minorities nikkeijin, Latin Americans of schools have changed the design of noticeably Japanese descent who began to return to Japan Korean school uniforms to less conspicuous in the late 1980s. The year 2012 saw several styles. major events for minority rights and health in Japan’s minorities also face multiple forms Japan – its second UPR by the UN Human of discrimination with regard to health care. Rights Council in October and a visit by the Disadvantaged migrants face multiple barriers Special Rapporteur on the right to health in to accessing health care, particularly emergency, November. HIV/AIDS and maternal health care. Migrants In an August 2012 report the Japanese and asylum-seekers held in detention centres NGO Network for the Elimination of Racial are particularly at a disadvantage. In a 2012 Discrimination documented how legal authorities report, the UN High Commissioner for Refugees refused to deal with multiple cases of hate speech (UNHCR) asked the government to consider against minorities on the basis that there is no changing its current policy requiring asylum- legal mechanism or law to prohibit such racial seekers to pay for medical care up front and wait discrimination. The report also documents for later reimbursement. speeches from a handful of elected officials who A 2012 study published in BMC Public have publicly remarked upon Japan’s status as Health showed that, despite the universal ‘one nation, one language and one ethnicity’ and health insurance policies for legal residents, linked economic success to its status as a country documented Latin American immigrants of ‘one race’. The anti-discrimination network disproportionately lack health insurance has pointed to the persistent problem of internet- coverage.13 A joint report by the Ainu based hate crimes including so-called ‘Buraku Association of Hokkaido, the Buraku Liberation Lists’, which name town wards populated by League Central Women’s Division and other descendants of the Burakumin community. One NGOs urged the government to provide boy who discovered his Buraku origins on the counsellors who can offer culturally sensitive care internet committed suicide. for Ainu, Buraku and Korean women who face In Japan’s UPR in October, several NGOs and domestic violence. The minority organizations UN member states underscored the persistence of claimed there is complete failure to ensure direct and indirect discrimination against Japan’s the active participation of Buraku, Ainu and minorities. The Network for the Elimination of Zainichi Korean women in the deliberation, Racial Discrimination expressed concern that preparation and evaluation of women’s policy, the proposed national human rights institution including health.

State of the World’s Minorities Asia and Oceania 165 and Indigenous Peoples 2013 arrived, I saw that there were many homeless Case study by Emily Hong people, like me, working. I realized then that this company recruits in the poorest areas.’ Kazuyuki Iwasa, the first Japanese worker to sue Japan’s Burakumin the government for radiation-related illness, 40 years ago – was a Burakumin. Photographer Kenji minority hired Higuchi, whose work documents the exploitation of nuclear plant workers, has highlighted Iwasa’s to clean up after case, which was rejected by the government. In a speech on the Fukushima 50, he spoke of Iwasa’s Fukushima tragic case and untimely death: ‘Of course his origin had something to do with his job. In our social structure a discrimination creates another The nuclear disaster highlights health hazards discrimination.’ for the country’s marginalized workers. The term ‘Burakumin’ refers not to a distinct In November 2012, Anand Grover, the UN ethnic group but to people living in Buraku, Special Rapporteur for health, made a trip to areas where many but not all residents are Japan to investigate the right to health in the descendants of the outcastes of feudal society context of the triple earthquake, tsunami and during the Edo period. They were given work, nuclear disaster that devastated the country such as leatherwork and butchery, considered in March 2011. His report highlighted the ‘tainted’ according to Buddhist and Shinto beliefs. tremendous health risks for nuclear plant workers Despite the formal abolition of the caste system exposed to high levels of radiation. At a press in 1871 and special government measures in the conference, the Special Rapporteur said, ‘I was 1970s to prevent third parties from searching distressed to learn that there is a practice of Buraku ancestry, the Burakumin – who number employing a large number of contract workers between 1 and 3 million – remain one of the through a layer of sub-contractors’. most excluded and disadvantaged communities in Both Amnesty International Switzerland Japan. and an investigative documentary produced Discriminatory attitudes towards Buraku by European television network Arte have remain deeply ingrained in Japanese society. claimed that many of these temporary workers According to the Buraku Liberation League are from Japan’s most excluded minority – the (BLL), between 10 and 50 per cent of people Burakumin. surveyed in several prefectures do not want It is difficult to verify how many of the clean- relatives to marry a person of Buraku origin and up workers are Burakumin, but one Burakumin do not want to live in a school district which worker, temporarily employed at a nuclear plant includes a Buraku area. in Hamaoka, speaks about his recruitment in the The BLL’s survey of 12,000 Burakumin Arte documentary. ‘The Burakumin, the Japanese women has shown the continued effects of such Untouchables,’ Yoshito Fujita says, ‘when I discrimination on employment opportunities.

Mongolia dominated politics in Mongolia. After the Mongolia is one of Asia’s fastest-growing elections, Amnesty International called for new economies, but the gaps between urban and rural legislation to combat discrimination against populations, particularly among ethnic minorities minorities and marginalized groups, particularly and nomadic communities, continue to grow. A non-Mongolian nationals, who are often targets new governing coalition led by the Democratic of discrimination. Party took power in July 2012, replacing the In a speech at the UN General Assembly Mongolian People’s Party, which has historically in November, Mongolia’s UN Permanent

166 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Between 60 and 70 per cent of women upcoming presidential election in May 2013. surveyed work in irregular precarious jobs, Eighty per cent of the country’s exports are a number 1.5 to 2 times higher than the minerals; the Oyu Tolgoi copper and gold average. In a 2012 report on minority mine, the largest foreign investment project in women in Japan, the BLL claims that Mongolia, is expected to contribute one-third of ‘difficulty for Buraku women in obtaining the country’s GDP by 2020. stable jobs originates in their educational The National Human Rights Commission backgrounds, which leave them no choice of Mongolia highlighted the negative impact of but to take seasonal or irregular work’. mining on the environment, the health of local Such structural discrimination leads some people, and nomadic culture and traditions in an Burakumin to take jobs in some of the October 2010 report. The Chief Commissioner most ‘dirty, dangerous, and difficult’ said the ‘right to health protection is violated industries, including the nuclear sector. during mining exploration, extraction, and According to Yuki Tanaka, a Professor at processing and transportation activities’. Hiroshima City University, Japan’s poor, Hospitals in mining-affected counties are unable including many Burakumin, have difficult to provide adequate services to residents and buying into the national health insurance migrant workers, and there are a high number programme because of the high premiums. of industrial accidents and occupational diseases A further issue is the practice of among those working at mining sites. subcontracting, which causes lack of Dukha, Mongolia’s smallest ethnic minority, accountability. The Fukushima plant is no have also felt the impacts of mining and loss of exception. Plant owner and spokesperson access to natural resources. The 200 remaining for TEPCO, Yoshigi Hitosugi, denied reindeer herders in Mongolia’s north-west have ultimate responsibility for the health and had to abandon pastures due to deforestation safety of temporary workers in an interview and chemical contamination caused by small- with Arte. According to Hitosugi: ‘We scale gold and jade mining. The ban on Dukhas’ currently employ three hundred people traditional hunting methods since 2010 has also at the site of Fukushima through sub- affected the nutritional diet of herders. In a 2012 contractors. In the end, we do not know United Nations Environment Programme report, who is involved or what conditions are one woman expressed concern that Dukha proposed for the most dangerous tasks.’ children are smaller than children born in other The dearth of public information on parts of the country and that pregnant women do workers’ health and safety in the ongoing not have access to regular medical care. clean-up at Fukushima points to a larger In the past few years, UN agencies have problem – the persistence of intersecting focused on projects aimed at benefitting the forms of discrimination faced by Japan’s country’s ethnic and linguistic minorities. most marginalized minorities. ■ The UN Education, Science and Culture Organization (UNESCO) is working with the government to establish public television and radio channels in minority languages and community radio projects in minority populated areas of four provinces. Representative highlighted human rights as a UNESCO has also worked with the WHO to priority of the National Action Plan for 2012– improve health and sanitation in rural Mongolia, 16, including abolishing the death penalty and including areas populated by ethnic and linguistic minimizing the negative impact of business on minorities, by training health care workers, human rights. improving basic water facilities and reducing Natural resource extraction is a hot political the spread of infectious diseases in rural county issue in Mongolia, as evident in debates hospitals. The UN Population Fund (UNFPA) surrounding the parliamentary election and has provided ‘mobile health care’ in remote areas

State of the World’s Minorities Asia and Oceania 167 and Indigenous Peoples 2013 Above: Dukha people in Mongolia. Hamid by 2020. This is in addition to the large number Sardar/Corbis. of migrants who come to Korea for work, approximately 550,000 in 2011. Demographic in the wake of a dzud – severe cold weather – shifts have stimulated public debate on questions which destroyed the livelihoods of thousands of around ethnicity and the Korean ‘nation’, in Mongolian herders in 2010. This has included contrast to the dominant nationalist discourse mental, reproductive and maternal health for historically focused on ‘one blood’ present in women. textbooks just ten years ago. The government, despite outward South Korea encouragement of ‘multiculturalism’ – such as In 2012, Jasmine Lee became the first naturalized sponsoring poster campaigns for the damunhwa Korean to win a seat in South Korea’s National gajeong (multicultural family) in Seoul’s subway Assembly. This marked an important step stations – has not embraced a multicultural ideal. towards Koreans coming to terms with an Government-sponsored ‘multicultural family increasingly ethnically diverse society. However, support centres’ provide courses on Korean despite the government support for ‘multicultural language and culture, prompting criticism that families’, official policies towards immigrants such centres aim to assimilate minorities rather remain pro-assimilation in practice. than foster multiculturalism. Public sentiment In January 2012, immigrants and children also remains ambivalent. Xenophobic discourse of immigrants comprised 2.5 per cent of the was ignited in August, when a group of protesters population. One out of ten marriages in the gathered at the immigration office calling for the country are international and the number of abolition of multicultural policies. naturalized Koreans is projected to reach 200,000 South Korea’s UN UPR in October

168 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 2012 highlighted both positive and negative unknown European diseases, which brought developments with regard to discrimination about the decimation of indigenous populations against minorities. The government noted its throughout the region. efforts to ‘ensure that marriage immigrants However, the perpetuation of disparities adjust well to society’. It referred specifically to in health outcomes today is due to social the Multicultural Family Support Act, which exclusion and the circumstances of disadvantage includes provisions for health care and education in which many indigenous and minority for ‘marriage immigrants’. peoples in Oceania find themselves, including Several states urged South Korea to improve high unemployment rates, low educational treatment of migrants and refugees, and provide achievement, low income, lack of access to children of undocumented migrants with health adequate housing and sanitation, and high levels care. NGOs estimate that 17,000 children of of incarceration. undocumented migrant workers have no access to Furthermore, indigenous and minority health care. NGOs expressed concern regarding communities throughout the region may have the new Refugee Act, which will be enforced in problems in gaining access to quality health care July 2013. The Advocates for Public Interest Law services. Overall, health systems, particularly have noted a lack of any mechanism to assess in small island states, are often weak, due to the dangers a person could face upon return insufficient numbers of trained health workers, to his/her country of origin and the Korean inadequate financing and planning for the health Bar Association has criticized the ‘accelerated’ sector, and unreliability in the procurement, procedures, which they believe could lead to supply and distribution of essential drugs. It is an abuse. In 2010, Korea recognized 11 per cent of added challenge for health services to reach the asylum applicants compared to a global average small, highly dispersed populations that exist in of 38 per cent. many Pacific countries. In July 2012, a New Zealand woman teaching The lack of adequate services is often further English in South Korea appealed to the UN compounded by a lack of culturally appropriate CERD when she was forced to take a second access to services. Indigenous and minority HIV test within nine months. The government women of the region experience higher rates of first introduced mandatory HIV testing for maternal and infant mortality and other poor foreign teachers in 2007. An article in the reproductive health outcomes compared to the Journal of Korean Law has claimed that this majority populations. constitutes racial discrimination since testing Fragile environments and the vulnerability is not required for Korean teachers or ethnic of these ecosystems to extreme weather events Korean non-citizens. Foreign teachers are the and the impact of climate change also impacts only foreign workers still mandated for HIV on the health of the indigenous peoples of the testing, since reforms in 2010. region. For example in December 2012, Cyclone Evan hit Samoa and Fiji, which left both islands heavily damaged and exposed to serious public health risks, including lack of water, sanitation, Oceania hygiene and food security. In 2012, a number of states of the region were Jacqui Zalcberg considered by relevant international human rights bodies, which made clear reference to the right to Indigenous peoples and minority communities health: New Zealand was considered by the UN experience lower standards of health than the Committee on Economic, Social and Cultural majority population all throughout the Oceania Rights and the Committee on the Elimination region. The health disadvantages experienced of Discrimination against Women, both of by indigenous peoples and minorities can be which paid considerable attention to health considered historical in origin, as a direct result outcomes of Māori and minority groups in New of colonization and the introduction of hitherto Zealand. The Committee on the Rights of the

State of the World’s Minorities Asia and Oceania 169 and Indigenous Peoples 2013 Child considered Australia’s report in 2012, and years. Following the release of the report, 40 highlighted disparities across a range of indicators of Australia’s leading indigenous and non- for Aboriginal and Torres Strait Islander children, indigenous health bodies and human rights in particular noting particularly the gap in health organizations joined forces to launch the Close status between Aboriginal and non-Aboriginal the Gap Campaign for Indigenous Health children. Equality. Now in its seventh year of operation, Samoa was considered by the Committee the two primary objectives of the campaign on the Elimination of Discrimination against are: to close the gap in life expectancy within a Women, which noted the high prevalence generation and to halve the gap in mortality rates of violence against women, in particular for indigenous children under the age of 5 within domestic and sexual violence, and its impact a decade (by 2018). upon women’s health. The committee also Importantly, the campaign was accompanied observed the difficulties women in rural areas by a commitment of AU$1.57 billion over four experience in gaining access to affordable and years (2009–13) to tackle the burden of chronic appropriate health care in a timely manner, disease. In April 2013 the federal government including reproductive and sexual health services. renewed its commitment for a further three The Special Rapporteur on violence against years, pledging AU$777 million for the period. women visited Papua New Guinea and the Although the government releases annual Solomon Islands, observing the negative impacts progress reports, there is a paucity of hard on women’s health due to violence in both data, in part due to the difficulty in measuring countries. outcomes. However, the latest government report indicated that in 2012 the target for under-five Australia mortality was on track to be met in 2013, and Aboriginal and Torres Strait Islander Australians that significant progress had been made against continue to experience lower levels of access to the target to halve the gap between indigenous health services than the general population: in and non-indigenous under-five mortality by 2006-2010, their age-standardized mortality 2018.16 rate was 1.9 times higher compared with Other important outcomes of the Close non-indigenous Australians. They are more the Gap Campaign have been the reform of likely to be hospitalized for most diseases and Australia’s indigenous health institutional conditions; to experience disability and reduced framework. In particular, the National Aboriginal quality of life due to ill health; and to die at and Torres Strait Islander Health Equality younger ages than other Australians. Aboriginal Council (NATSIHEC) was developed to provide and Torres Strait Islanders also suffer a higher a forum through which the government can burden of emotional distress and possible mental work in partnership with the community and illness than that experienced by the wider the indigenous health sector to implement its community.14 Aboriginal and Torres Strait Close the Gap initiatives, and in 2012 focused Islander women also experience poorer health on the development of the National Aboriginal across all areas compared with non-indigenous and Torres Strait Islander Health Plan (the Plan). women.15 Furthermore, the newly established National The issue of health disparity for Aborigines Congress of Australia’s First Peoples (Congress), and Torres Strait Islanders first gained focused has already indicated that health is one of its political attention with the publication of the top priorities. At the end of 2011, the Congress 2005 Social Justice Report by the Australian teamed with 11 Aboriginal and Torres Strait Human Rights Commission. The report Islander health groups to establish the National highlighted the vast gap between the health of Health Leadership Forum (NHLF). The indigenous and other Australians and called NHLF goal is to ensure the active involvement on Australian state and federal governments of Aboriginal and Torres Strait Islander to commit to achieving Aboriginal and Torres communities in health policy at a national level. Strait Islander health equality within 25 The year 2012 was also a significant one for

170 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 Aboriginal and Torres Strait Islander people This tragedy has been followed by numerous because of the important political momentum others, with ongoing deaths at sea throughout gained regarding recognition of their status 2012 by migrants attempting to reach Australia in the Australian Constitution. Following by boat. extensive consultations held throughout 2011, Following these incidents, on 28 June 2012 the an expert panel – which included indigenous Australian government appointed an expert panel and community leaders, constitutional experts on asylum seekers which recommended legislative and parliamentarians – reported to the Prime amendments to allow for the transfer of asylum Minister in January 2012. seekers who arrive in Australia by boat to third It recommended that Australians should vote countries for the processing of their claims for in a referendum to: protection. The proposal in effect re-launched p recognize Aboriginal and Torres Strait Australia’s ‘Pacific Solution’, a policy by which Islander peoples and to preserve the Australian Australia transports asylum seekers to detention government’s ability to pass laws for the centres on small island nations in the Pacific benefit of Aboriginal and Torres Strait Islander Ocean. On 13 August 2012, the government peoples; passed amendments to the Migration Act, p ban racial discrimination by government followed by legislative instruments designating authorities; and Nauru and Papua New Guinea as ‘regional p recognize that Aboriginal and Torres Strait processing countries’. Islander languages were the country’s first In November 2012, a bill to amend the tongues, while confirming that English is Migration Act to extend this liability to all Australia’s national language. asylum seekers who arrive by boat, even if Parliament set up a joint select committee they reach the mainland, was introduced into on constitutional recognition of Aboriginal and parliament. Torres Strait Islander Peoples in November 2012 Although the Joint Parliamentary Committee and has been asked to consult further on the on Human Rights found that Australia’s offshore model, and to help to ensure strong cross-party processing laws raise ‘significant and complex support so that a proposal can be put to the issues’ as to their compatibility with human Australian people at a referendum. rights and ordered an inquiry into the legislation, The government also released the Human offshore processing continued. There remain Rights and Anti-Discrimination Bill in serious concerns about the health and mental 2012, which consolidated Commonwealth health impacts of prolonged and indefinite laws covering discrimination on the basis of immigration detention. race, sex, disability and age, and added new In particular, Nauru and Manus Island pose protections from discrimination on the grounds specific health concerns for possible asylum of sexual orientation and gender identity. It seekers detained there. Nauru’s acting Health also strengthened protections against workplace Secretary acknowledged that the island would be discrimination on the basis of other attributes, unable to cope with any mental health issues of including religion and political opinion. Delays, detainees. Moreover, in Manus Island there have however, have meant that the bill has not yet been reports of a strain of malaria which can kill passed into law. if left untreated for just one day. In October 2012 the Australian government Minorities and migration put forward the Migration Amendment The issue of irregular migrants arriving by boat (Healthcare for Asylum Seekers) Bill for and the processing of asylum seekers remained an consultation. Civil society organizations have issue of national importance, in particular in the welcomed the bill’s proposal to establish an lead-up to the September 2013 national elections. independent health advisory panel of experts to In June 2012, two boats sank within a week of oversee the provision of health care to asylum each other, each carrying migrants trying to reach seekers who are transferred to regional processing Australia by sea. An estimated 100 people died. countries, including Nauru and Papua New

State of the World’s Minorities Asia and Oceania 171 and Indigenous Peoples 2013 Guinea. However, the Australian Human Rights The government released a new draft in March Commission has also noted the need for more 2013 and invited public consultations, but the comprehensive monitoring of health and mental process was much shorter and less transparent health services across Australia’s immigration than the original process. The new draft detention network. Constitution says nothing about protections for indigenous peoples’ land rights, or mechanisms Fiji for resolving disputes between land owners and Fiji has experienced a long history of tumultuous tenants. It also completely scraps the Great politics, most recently marked by the 2006 coup Council of Chiefs, the body of indigenous which led Frank Bainimarama to seize power Fijian chiefs, which has left many indigenous as military ruler. The key issue at stake in the Fijians feeling that they are being excluded from coup was the underlying tension concerning decision-making. the rights of the Indo-Fijian minority against The rejection of the Constitutional the indigenous majority. Since 2006, Fiji has Commission’s draft and the lack of transparency maintained tense diplomatic relations with surrounding the redrafting process will bring into neighbouring countries, and at one point had question whether promised elections in 2014 will severed diplomatic relations with numerous states in fact be free and fair, and will be able to resolve in the region. the simmering ethnic tensions in the country. The year 2012, however, indicated a possible change in political approach. Bainimarama New Zealand announced the lifting of martial law and the Māori, New Zealand’s indigenous people, make government initiated consultations on a new up approximately 15.4 per cent of the country’s Constitution. Following the public commitment population, with nearly a quarter living in the to call elections by 2014, countries of the region, greater Auckland area. The relationship between including Australia and New Zealand, agreed to the Māori and the New Zealand government restore full diplomatic ties with Fiji. is grounded in the Treaty of Waitangi, which Initially, there appeared to be a genuine process contains a powerful expression of the Crown’s of consultation on a new Fijian Constitution. moral obligations to act honourably in its Internationally renowned constitutional experts dealings with Māori. were invited to participate in a newly established There are also more than 22 different Pacific Constitutional Commission, which was charged communities in New Zealand – each with its with producing a draft Constitution and paving own distinctive culture, language, history and the way for a return to democracy with free health status. Collectively known as Pasifika, elections in 2014. The Commission proclaimed the biggest Pacific groups in New Zealand are that its guiding principle was to steer Fiji away the Samoan, Cook Islander, Tongan, Niuean, from the race-based politics of the previous Fijian, Tokelauan, and Tuvaluan communities. Constitution, which favoured indigenous Fijians To date, the majority of the Pacific communities over the Indian minority. It was also based on in New Zealand originate from Polynesian democratic participation, with reportedly more states, however migration to New Zealand than 7,000 submissions received. from Melanesian states has also increased, and The Commission’s draft Constitution was predictions indicate that New Zealand can expect submitted to Bainimarama in December 2012. much larger numbers of migrants from Melanesia However after it was presented, police were in the coming decades. ordered to seize copies and burnt the printer’s It is also important to note that there has proofs. In the first days of the new year, been a rapid increase in the last decade of the Bainimarama, together with Fiji‘s President number of Asians in New Zealand. By 2001 Nailatikau, pronounced that the regime had Asians had displaced the Pasifika communities serious concerns with the draft produced by the as the third most populous ethnic group, with Commission and claimed it entrenched ethnic the 2006 Census data estimating the Asian divisions within the country. population of New Zealand at around 9.2

172 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 per cent, with predicted growth to up to 16 As part of Whakatātaka Tuarua, the Ministry per cent of the national population by 2016. of Health has identified the following areas for Chinese (46 per cent) and Indian (29 per cent) priority: building quality data and monitoring are the majority groups, with populations from Māori health; developing whānau-ora-based other Asian communities including Koreans, models; ensuring Māori participation; and Filipinos, Japanese, Sri Lankans, Cambodians improving primary health care. and Thais. Under the 2000 New Zealand Public Health Despite significant gains in recent years, and Disability Act, health services require Māori continue to have the poorest health community participation and have been of any New Zealand group. Māori have a decentralized. The Act created 21 district health higher mortality rate than non-Māori, as well boards (DHBs), which provide services that as higher rates of illness. Māori infants die meet local needs. This system is important for more frequently from SIDS (sudden infant Māori health as every board is legally required death syndrome), have lower birth weight than to have at least 2 Māori members out of its non-Māori and also experience higher rates 11, and Māori membership of the board must of illness. Māori are 2.3 times more likely to also be proportional to the number of Māori experience and die from cardiovascular disease in the district’s resident population. Moreover, than non-Māori and Māori life expectancy is DHBs must include Māori health and whānau also significantly lower than the life expectancy ora as priority criteria in resource allocation for non-Māori. and disincentives decisions, and should set Other minority groups in New Zealand also funding targets for investment in Māori experience poorer health than the majority health and disability, and report on targets for New Zealand European population. In their regions to increase funding for Māori particular, Pasifika still experience poorer health initiatives. However, in the 2012 assessment outcomes than the majority population. For the auditor general found that DHBs have not example, Māori and Pacific communities have always performed adequately and noted a lack higher rates of diabetes. Māori and Pacific of monitoring and reporting.18 communities experience consistently higher Another important initiative for Māori infant mortality rates than the total New health is the fact that each DHB must develop Zealand population, although this appears to a Māori Health Plan (MHP), which aims be decreasing.17 Moreover, the obesity rates are to improve Māori health and reduce the greater for Māori and Pasifika. disparities between Māori and non-Māori. As key planning and monitoring documents, the Māori health MHPs provide a summary of a DHB’s Māori The New Zealand government has taken some population and their health needs. The plan important strides to address Māori health then documents and details the interventions disparity. He Korowai Oranga: Māori Health and actions the DHB plans to undertake Strategy sets the direction for Māori health to address health issues in order to achieve development in the health and disability indicator targets set nationally, regionally and at sector. The vision of He Korowai Oranga is the district level. achievement of whānau ora (healthy families), The New Zealand Ministry of Health and recognizes the desire of Māori to have has also been working together with Māori control over their future, and to seek their own traditional healing practitioners. Rongoā Māori, solutions and to manage their own services. the traditional healing, is formulated in a The New Zealand government has developed Māori cultural context; it encompasses the targeted action plans that set objectives for understanding of events leading to ill health Māori health. Whakatātaka – the Māori Health and its impacts are addressed through a range of Action Plan – was implemented in 2002, and culturally bounded responses. These responses was built upon by the second Māori Health include rakau rongoā (native fauna herbal Action Plan, Whakatātaka Tuarua 2006–2011. preparations), mirimiri (massage) and karakia

State of the World’s Minorities Asia and Oceania 173 and Indigenous Peoples 2013 (prayer). In December 2011, a new national Footnotes huge and complex health- care reforms’, The Lancet, Rongoā Te Kāhui Rongoā governance body – 1. Barros, A.J.D. et al., ‘Equity vol. 379, no. 9818, 3 March Trust – was established to protect, nurture and in maternal, newborn, and 2012, pp. 1880–1. promote Rongoā Māori, and aimed to become child health interventions in Countdown to 2015: 7. ‘Burma: health and fully operational by June 2012. a retrospective review transition’, The Lancet, vol. Although it is too early to measure the success of survey data from 54 379, no. 9834, 23 June countries’, The Lancet, vol. 2012, p. 2313, retrieved of the initiative, it remains significant, in 379, no. 9822, 2012, pp. June 2013, http://www. particular in light of old repressive laws which 1225–33, retrieved July thelancet.com/journals/ 2013, http://www.thelancet. lancet/article/PIIS0140- banned traditional Maori healers (Tohunga) com/journals/lancet/article/ 6736(12)60998-2/fulltext and outlawed Rongoā Māori. Although the law PIIS0140-6736(12)60113- 5/fulltext 8. Back Pack Health Worker was repealed in 1962, the new Trust is one of Team, Provision of the first initiatives to formally promote Rongoā 2. From UNFPA fact sheet Primary Healthcare among Māori on the national level. on child marriage in the Internally Displaced Kazakhstan. Persons and Vulnerable Populations of Burma, Health of Asian New Zealanders 3. Singh, L. et al., ‘Public 2012, retrieved June 2013, health care in Afghanistan: http://www.backpackteam. It appears that many Asian migrants who an investigation in org/wp-content/uploads/ arrive in New Zealand are relatively healthy, suboptimal utilization of reports/2012%20Mid%20 facilities’, Health, vol. 4, Year%20Report%20final- however this has been attributed to the ‘healthy no. 10, 2012, pp. 794–801; 0409122.pdf immigrant effect’, which requires most migrants Rahmani, Z. and Brekke, M., ‘Antenatal and obstetric 9. Andersson, M. and Lundin, to be in good health in order to be allowed to care in Afghanistan – a A., ‘Socioeconomic immigrate to a new host country. However, this qualitative study among inequalities in global and positive effect on health is reported to gradually health care receivers and relative self-rated health health care providers’, BMC in Laos: a cross-sectional diminish with increased length of residency. Health Services Research, vol. study of 24 162 men 13, 2013, p. 166. and women’, Asia-Pacific In particular, data has demonstrated low Journal of Public Health, use of primary health care, emergency health 4. Thapa, J., ‘The other side 27 November 2012, care and cancer screening for Asian people in of the coin: disparities retrieved June 2013, http:// in achievement of health aph.sagepub.com/content/ New Zealand, particularly for Chinese New related Millennium early/2012/11/22/1010539 Zealanders. For youth this is particularly Development Goals 512466566 (MDGs) in Nepal, worrying, and 15 per cent of young Chinese Himalayan Journal of 10. Hood, J., ‘Between New Zealanders reported accessing no health Sociology & Anthropology, entitlement and vol. 5, 2012, http:// stigmatization: the lessons services at all, which was over three times the www.nepjol.info/index. of HIV/AIDS for China’s rate reported by other New Zealanders. php/HJSA/article/ medical reform’, in W. Sun Another key issue is cardiovascular disease viewFile/7040/5690; and Y. Guo (eds), Unequal Ministry of Health and China, London, Routledge, and diabetes for South Asian people. Indian Population (MOHP) 2013, pp. 141–2. people show the highest rates of self-reported [Nepal], New ERA, and ICF International Inc., 11. Yip, W.C., Hsiao, W.C., diabetes of any ethnic group in New Zealand Nepal Demographic and Chen, W., Hu, S., Ma, J. and they also show high levels of cardiovascular Health Survey 2011, and Maynard, A., ‘Early Kathmandu, Nepal, appraisal of China’s huge disease, similar to Māori. Ministry of Health and and complex health-care Some of these challenges appear to arise Population, New ERA, reforms’, The Lancet, vol. and Calverton, MD, ICF 379, no. 9818, 3 March from underlying structural obstacles for Asian International, 2011. 2012, pp. 1880–1. New Zealanders as a minority group: these include a lack of knowledge of the New 5. ‘Socioeconomic inequalities 12. Harris, A., Zhou, Y., in global and relative self- Liao, H., Barclay, L., Zealand health system, cultural beliefs and rated health in Laos: a cross- Zeng, W. and Gao, Y., approaches to health care that differ from the sectional study of 24 Hood, ‘Challenges to maternal J., ‘Between entitlement and health care utilization New Zealand system, and linguistic barriers. stigmatization: the lessons among ethnic minority Mental health also remains a challenging area of HIV/AIDS for China’s women in resource-poor medical reform’, in W. Sun region of Sichuan Province because of the degree of stigma attached to and Y. Guo (eds), Unequal China’, Health Policy and such illness in many Asian cultures, resulting China, London, Routledge, Planning, vol. 25, pp. 2013, pp. 141–2. 311–18, 2010, retrieved in potential treatment delay and possible June 2013: http://heapol. worsening of prognosis. ■ 6. ‘Early appraisal of China’s oxfordjournals.org/

174 Asia and Oceania State of the World’s Minorities and Indigenous Peoples 2013 content/25/4/311.full. pdf+html

13. Pilar Suguimoto, S., Ono- Kihara, M., Feldman, M.D. and Kihara, M., ‘Latin American immigrants have limited access to health insurance in Japan: a cross- sectional study’, BMC Public Health, vol. 12, no. 238, 2012, retrieved June 2013: http://www. biomedcentral.com/1471- 2458/12/238

14. MacRae, A., Thomson, N., Anomie, Burns, J., Catto, M., Gray, C. et al., Overview of Australian Indigenous Health Status, 2012, retrieved July 2013, http://www.healthinfonet. ecu.edu.au/health-facts/ overviews

15. Burns, J., Maling, C.M. and Thomson, N., ‘Summary of indigenous women’s health’, Australian Indigenous HelathInfoNet, 2010, retrieved July 2013, http://www.healthinfonet. ecu.edu.au/women-review.

16. Department of Families, Housing, Community Services and Indigenous Affairs, Closing the Gap: Prime Minister’s Report 2011, p. 14, Canberra, 2013, retrieved July 2013, http://www.fahcsia.gov. au/sites/default/files/ documents/02_2013/ 00313-ctg-report_ accessible11.pdf.

17. New Zealand Government, Third periodic report to the CESCR, E/C.12/ NZL/3, para. 472, available at: http://www2.ohchr. org/english/bodies/cescr/ cescrs48.htm

18. See: Controller and Auditor-General NZ, ‘Part 5: Reducing health disparities for Māori’, in Health Sector: Results of the 2010/11 Audits, retrieved July 2013, http://www.oag. govt.nz/2012/health-sector/ part5.htm

State of the World’s Minorities Asia and Oceania 175 and Indigenous Peoples 2013