DOCUMENT: IMC-96.TXT U N I T E D N A T I O N S Economic and Social Council ENGLISH Distr. Original: ENGLISH GENERAL E/CN.4/Sub.2/AC.4/1996/3/Add.2 GE. 96-13042 (E) 28 June 1996 COMMISSION ON HUMAN RIGHTS Sub-Commission on Prevention of Discrimination and Protection of Minorities Working Group on Indigenous Populations Fourteenth session 29 July - 2 August 1996 Item 5 of the provisional agenda REVIEW OF DEVELOPMENTS PERTAINING TO THE PROMOTION AND PROTECTION OF HUMAN RIGHTS AND FUNDAMENTAL FREEDOMS OF INDIGENOUS PEOPLES: HEALTH AND INDIGENOUS PEOPLES Information received from indigenous peoples' organizations ADDENDUM INDIGENOUS MISSIONARY COUNCIL [Original: Portuguese] [20 May 1996] 1. Of the various forms of aggression against indigenous peoples, disease is perhaps the most widespread and the least heeded. An analysis of the health situation of the indigenous peoples points to a sad reality: the high incidence of epidemics and endemic diseases, the increase in the occurrence and extent of especially infectious/ contagious diseases, the growth of rates of mortality due to inadequate care, with a predominance of infant mortality resulting from preventable and curable diseases. This is due to omission on the part of the public authorities and/or direct or indirect participation in activities which expose the indigenous peoples to risks and destroy the resources they need in order to remain healthy (not just physical elements, but cultural, religious and other elements). 2. Among the factors which determine or influence the current health situation of the indigenous peoples we may mention: the lack of demarcation of indigenous lands; the reduction in the areas they occupy; denial of the right to exclusive usufruct of the resources of their territories; failure by the official health organs to execute directives and proposals originating from the national indigenous health conferences. 3. The health situation of the indigenous peoples is causing concern, as reported in the survey carried out by the Institute of Tropical Medicine in Manaus (IMTM). In the 47 FUNAI (National Indian Foundation) administrative units which exist in Brazil there were a total of 2,591 deaths of Indians between January 1993 and October 1994. Almost half of these deaths (1,079) occurred in children under the age of five years. The main cause is inadequate care, which is responsible for 22.3 per cent of deaths. The same survey reveals a steady and emphatic decline in the life expectancy of Indians. In 1993, average life expectancy was 48.2 years and in 1994 this figure fell to 45.6. The lowest rate (37.7 years) was recorded in Mato Grosso do Sul, followed by the States of Roraima, Para and Amazonas. 4. Throughout the country the deterioration of the health situation is well known; however, for this study it was not possible to compile data on all areas and thereby reach broader conclusions concerning indigenous health. 5. The analysis below was carried out on the basis of data compiled in 1994 and 1995 and relates to the health situation of 43 indigenous peoples, who represent 20.7 per cent of the total indigenous peoples in Brazil. MALARIA 6. There has been an increase in cases of malaria and, more seriously, in the rates of mortality resulting from this disease. In this study, 6,222 cases were recorded (2,367 in 1994 and 3,855 in 1995), an increase of 1,488 from one year to the next. The number of deaths also increased: in 1994, there were 132 deaths and in 1995, 272, giving a total of 404 deaths over the period covered by the study. 7. In many regions, outbreaks occur successively, which means that there is no time for the population to recover their health and return to their fields. Consequently, living conditions become even more precarious and hunger- related problems such as malnutrition and anaemia increase. 8. Cases of malaria have been recorded in all villages in the Northern Region. The Pauman, who live along the middle reaches of the Purus (Amazonas), state that all members of their population have already contracted the disease at least three times. 9. Among the Deni in the River Xerua-region, the frequency of malaria attacks is apparent from the percentage of persons suffering from splenomegaly (enlargement of the spleen): 181, or 75 per cent of the population. Anaemia, resulting from the various epidemics, affects 38 per cent, which indicates the precarious living conditions to which they are subjected. 10. In the Javari valley, a region inhabited by the Mayoruna, Matis, Matses, Kulina, Marubo, Kanamari and more than 6 other isolated peoples, with an estimated population of at least 3,000 Indians, there have been recurrent outbreaks of malaria, owing to the frequent encroachments by loggers and the non-demarcation of the area. In 1994 there were 37 deaths caused by malaria (10-15 per cent of the infected population); in 1995 there were over 14 deaths and 313 cases. 11. From 1991 to 1993 there were 3,132 recorded cases of malaria among the Yanomami and 21 deaths. In the past two years (1994 and 1995) the number of deaths resulting from malaria rose to 223, according to data provided by the Indigenous Council of Roraima. Since the beginning of encroachment by the garimpeiros (gold prospectors), malaria has been the chief cause of death among the Yanomami. At present, in the region of Marari alone in the State of Amazonas, indices of up to 80 per cent of the population are being recorded for persons suffering from the disease. In the other regions where garimpeiros are present the pattern is similar. Even more disturbing is the finding that 43.6 per cent of malaria cases are of the falciparum, or most lethal, type. 12. In Rondonia, according to information from Dr. Gil de Catheu of the Diocese of Guajara Mirim, malaria is endemic in 6 of the 10 indigenous posts run by the FUNAI authorities in the region, where 1,350 people live, and is on the increase. In 1994, the incidence was 1,000 cases per 1,000 inhabitants or, in other words, an average of one case per inhabitant. The preventive measures taken by the National Health Foundation are not controlling the situation. In March 1995 alone, an epidemic affected 50 per cent of the 256 inhabitants of Santo Andre Indigenous Post. 13. About 21 per cent of the Rickbaktsa in Mato Grosso were affected by malaria in 1994, representing 157 people. In 1995 the figure was 149, or 20 per cent of the population. Also in this State in 1995, malaria was rampant among the Kayabi (29.5 per cent of the population), the Apiaka and the Munduruku (33.5 per cent), and also affected the Myky, Tapirape and Karaja to a lesser extent. 14. In the State of Para, there were no less than 1,207 cases of malaria (40.2 per cent of the population) among the Munduruku people, resulting in 26 deaths. The frequent encroachments on the area and the presence of more than 500 gold prospectors along the River Tapajos are factors in this situation and also affect other peoples in the region, such as the Tembe and the Asurini. In the Xingu region there were 542 cases of malaria (48.5 per cent of the population). The village of Ipixuna was the most seriously affected, with 99.5 per cent of the Indians suffering from the disease. TUBERCULOSIS 15. This is another disease whose incidence has increased among the indigenous peoples owing to lack of assistance in prevention, control and treatment. Poor nutrition resulting from the decrease in the numbers of fish and game fosters the spread of the disease and is responsible for the high indices recorded in some areas. As difficult as treatment is the diagnosis of tuberculosis, especially in the interior of Amazonia, where the facilities for satisfactory diagnosis do not exist. In nearly all cases, the few health posts that exist are barely operational, lacking equipment and medicines, and their personnel are unqualified. The encroachments on indigenous areas are further important factors in that the Indians are exposed to the disease. 16. In 1994, 595 cases were diagnosed and in 1995 this figure rose to 837, giving a total of 1,432 cases and 22 deaths in the period covered. 17. There were 19 cases of tuberculosis among the Deni on the River Xerua (Amazonas) in 1994 and 32 in 1995. In 1995 again, there were 5 recorded cases among the Pirana, 10 among the Paumari and 50 among the Yanomami. In Para tuberculosis is occurring among the Asurini in Trocara; in Rondonia it is being recorded among the Pakaas Novas, the Karitiana and the Uru-Eu-Wau-Wau. But the highest recorded rates are among the Guarani Kaiowa in Mato Grosso do Sul: 550 cases in 1994 and 450 in 1995, with a total of 15 deaths. The lack of land is cited by the leaders of the local indigenous organization, Aty Guacu, as the principal factor responsible for the current situation. The lack of food, resulting from the shortage of resources and the impossibility of creating more cleared land, has contributed to this serious situation. HEPATITIS 18. Hepatitis is considered endemic in some regions and represents a threat to the survival of the indigenous peoples. Four hundred and fifty-two cases were recorded in 1994 and 1995, resulting in six deaths. 19. In the Javari valley (Amazonas), which is inhabited by the Mayoruna, Matses, Marubo, Kulina, Matis, Kanamari and other isolated peoples, an outbreak of hepatitis B has already hit about 300 Indians, or 10 per cent of the population. A study carried out by the Epidemiology Centre in Manaus confirms the endemic nature of the disease and gives indices of 21 per cent of the population of the valley as carriers of the virus. 20. In Rondonia, hepatitis B broke out among the Pakaas Novas in August 1994 in highly endemic form. At the Deolinda post, which has 65 inhabitants, there were 15 cases of hepatitis. Of these, hepatitis B was diagnosed in nine cases and there were two recorded deaths. Hepatitis was also found in Amazonas among the Paumari (3 cases) and in Para among the Arara, Kayapo, Parakana, Munduruku and Tirio (over 14 cases). There were six deaths resulting from the disease. CHOLERA 21. In 1995, the cholera epidemic went almost unreported, but the media's silence does not mean that the problem has disappeared. In 1994, 276 Indians suffered from cholera and in 1995 the figure was 193, giving a total of 469 cases, and 7 deaths, for the period covered by this study. 22. On the Jurua and Purus Amazonas rivers, where various peoples such as the Kulina, Kanamari, Apurina and Paumari live, there were 269 cases of cholera. In the Upper Solimoes region, 100 Ticuna contracted the disease, resulting in 6 deaths. There were 92 cases among the Kaxinawa in the State of Acre. In Pernambuco, the Pankararu also suffer from the disease: one case was recorded, indicating that the bacterium is present in that area and so the possibility of new cases exists. The changes in the environment and traditional habits of the villages resulting from contact and domination have undermined disease-control mechanisms. Health conditions have been a determining factor in cases not only of cholera but of various types of verminoses, high levels of which have been recorded among the indigenous peoples. INFLUENZA AND BACTERIAL COMPLICATIONS 23. Other diseases such as influenza and bacterial complications, including diarrhoea and conjunctivitis, continue to be rampant among the indigenous populations. Ninety cases of influenza were recorded among the MyKy in 1994. Since the total population is 63, we conclude that there were at least two outbreaks affecting almost all the inhabitants of the village. In the same year there were 1,611 cases of influenza among the Yanomami. In 1995, there were 174 cases of influenza (23 per cent of the population) among the Rickbaktsa. Pneumonia is one of the complications which appears after an influenza outbreak. The level among the Rickbaktsa was 6.4 per cent. Among the Yanomami in the Demini, Toototobi and Balawau regions, with a population of 624, there were 159 cases of pneumonia, representing 24.4 per cent. Conjunctivitis affected 162 Yanomami (25.9 per cent) between December 1993 and September 1994. 24. In 1994 it was found that 60 per cent of the Tupinikin were suffering from acute respiratory insufficiency. This represents 410 cases. 25. There were reports of a number of cases of bronchitis and whooping cough among Indians, but the data available to us are insufficient for analysis. OTHER DISEASES 26. The unfavourable situation with regard to contact with outsiders has contributed to the outbreak of sexually transmitted diseases, which have been recorded in four peoples in the States of Acre and Mato Grosso, giving a total of 30 cases. 27. This study has also elicited data on new diseases among the indigenous populations. In the last few years there have been a significant number of cases of cancer of the cervix in several peoples, such as the Tirio (Para) and the Terena (MS), with three deaths last year. In Maranhao the disease has occurred in five Guajajara villages and among the Gaviao, Krikati and Kanela, with two deaths during the past two years. ANAEMIA AND MALNUTRITION 28. The incidence of anaemia and malnutrition is an indicator of the serious decline in the living conditions of the indigenous populations and the reduction of subsistence alternatives. The causes are very well known: the decrease in territory, encroachments, and wood and gold prospecting, which destroys the environment where game live and reproduce, where the Indians gather food and medicinal herbs, etc., frequent contact with the surrounding society, leading to the abandonment of traditional eating habits, exploitation by the Indians themselves, noted in various regions, the detrimental and overtly anti-indigenous activity of many State Governments, the non-demarcation of indigenous areas, and the lack of adequate protection and assistance policies are among the main determining factors. 29. In this study a total of 928 cases of anaemia were recorded, but this figure may be said to be far below the actual level. 30. The Deni on the River Xerua (Amazonas) have very high anaemia rates: 91 cases out of a population of 241, or 37.7 per cent. The high incidence of diseases in the village, the lack of food caused by the inability to recover their fields, and the shortage of game and fish in the region are consequences of the long history of exploitation of the labour force to which this people has been subjected in the very recent past and of the current encroachments by loggers. 31. Among the Kaingang on the River Varzea there were 15 cases of anaemia (9.3 per cent of the population) in 1994 and 80 (50 per cent of the population, according to data contained in the Map of Hunger among the Indigenous Peoples II) in 1995. The malnutrition figures are also significant: 30 cases (18.6 per cent) in 1994 and 25 (15.5 per cent) in 1995. The situation in which this people lives is the main reason for this pattern: inadequate sanitary conditions, limited access to health care, poor crop-growing conditions, food shortage, inter alia. 32. In Minas Gerais, malnutrition affects 8.1 per cent of the Maxacali, or a total of 70 people. The population is suffering the consequences of the invasion of 1,852 hectares of its territory. Their land has no forests and hunting is practically non-existent. They no longer have access to the river where they used to fish because of the invasions. The everyday life of the villages is characterized by hunger and deprivation, a clear picture of absolute poverty. 33. There have also been cases of malnutrition among the Guarani (two) and anaemia among the Tapirape (two). MERCURY POISONING 34. There are reports of mercury poisoning in a number of areas. 35. The area of Satere Mawe situated near the River Marau is suffering from the effects of pollution caused by gold prospecting. The Brazilian Amazonia Indigenous Organizations Coordinating Body (COIAB) is investigating the situation and mercury poisoning is suspected. 36. The situation among the Kayapo is disturbing. Mercury levels in water are 100 per cent higher than the limit set by WHO, a fact which is endangering the Kayapo people who live in that area. -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :: -= THE FOURTH WORLD DOCUMENTATION PROJECT =- :: :: A service provided by :: :: The Center For World Indigenous Studies :: :: www.cwis.org :: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Originating at the Center for World Indigenous Studies, Olympia, Washington USA www.cwis.org © 1999 Center for World Indigenous Studies (All Rights Reserved. References up to 500 words must be referenced to the Center for World Indigenous Studies and/or the Author Copyright Policy Material appearing in the Fourth World Documentation Project Archive is accepted on the basis that the material is the original, unoccupied work of the author or authors. 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