E/CN.4/Sub.2/AC.4/1996/3/Add.2 Statement by the Indigenous Missionary Council to the 14th Session of the UNWGIP re: Impact of diseases on Indian Nations in Brazil - 28 June 1996
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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.
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