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The Yanomami: Malaria, Genocide and Policy Prospects

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A Black Mark for Brazil
The situation couldn’t be more urgent

The Yanomami of the Brazilian Amazon have been decimated in the last 20 years by an incursion of prospect-miners (garimpeiros) who brought diseases (especially malaria) and other maladies to their hitherto relatively isolated communities.  Here we follow the history of the garimpeiros incursion  examining the current  trying situation and make urgent policy suggestions.

Background on the Yanomami Way of Life

The Yanomami live in an area of approximately 192,000 km² spanning both sides of the Brazil-Venezuela border.  Their land varies in ecological biomes from lowland tropical rainforest in both the Orinoco and Amazon River drainages to mountainous highlands.  The Yanomami numbered approximately 29,000 in 2005 with about 14,000 living within Brazil. They are dispersed throughout this region and live at low population densities.

This research essay primarily concerns the Yanomami who live on the Brazilian side of the border who are being seen as the most affected by both garimpagem (prospecting) intruding on their native lands and malaria epidemics.

Likewise, this situation, is even being termed as a genocide due to the inexcusable behavior of a number of Brazilian government officials who both lent support to the garimpeiros and knowingly adjusted to the spread of disease in order to wreak havoc on the Yanomami people (particularly due to the exposure of the tribe to malaria, against which they did not have immunity).  During the height of the gold rush from 1987 to 1999, it is estimated that the malaria epidemic, combined with the armed battles against garimpeiros, shockingly led to the loss of thirteen percent of the Yanomami population living in the region.

This modern gold rush on Yanomami lands began in the mid-1970s when the Brazilian military dictatorship assessed and identified the value of mineral deposits (including gold) on Yanomami lands under the mapping project Radambrasil.  At the same time, between 1970 and 1980 the international price of gold increased seventeen-fold.  In 1980, an estimated 5,000 garimpeiros moved onto the Yanomami lands at Furo de Santa Rosa.  Garimpeiros generally were destitute men, as a result of protracted urban unemployment, or were landless rural workers. At Furo de Santa Rosa, garimpeiros quickly outnumbered the local Yanomami population of the Shiriana subgroup, twenty-five to one.  According to University of Brasília Anthropologist, Dr. Alcida Ramos, less than six months after the arrival of garimpeiros, the Shiriana began contracting malaria.  There were some deaths and anemia became widespread.

Garimpeiros used the town of Furo de Santa Rosa as the starting point from which they journeyed out onto the tributaries of the Uraricoera River, approaching a National Foundation for the Indian (FUNAI) outpost located at Ericó  Notably, the garimpagem sites were, and are still, almost always accessed by small aircraft using remote jungle airstrips. Without airstrips, garimpagem would not have been feasible due to the lack of other transportation means in the forested Yanomami lands.

In 1986 the Polícia Federal drove most of the garimpeiros out of the region.  Simultaneously, the military began a secret operation in the Northern Brazil’s Northern Amazon called Calha Norte. This intiative has been described by scholars as a covert plan of the military to move settlers into the region to thwart a feared foreign influence.  Under the plan, the Air Force would widen a landing strip at a site called Paapiú without declaring the purpose.  They then would evict the local Yanomami and declare Paapiú a national security area.   However, after this was done, the Air Force did nothing further at the site. The ploy should be understood as a pro-garimpagem (or at least pro-settlement) act due to the absence of any other explanation as to why the Air Force would have built this airstrip in the first place.  This interpretation of the purpose of this act is in accordance with previous findings that Calha Norte was a clandestine operation to settle the region.

This Air Force-improved landing strip at Paapiú soon proved a catalyst for a gold rush.  By August 1987, thousands of garimpeiros had arrived at the airstrip.   From that location, according to Dr. Ramos, they were able to access most of the Yanomami territory.

While the military and FUNAI permitted garimpeiro’s entrance to Yanomami territory, they simultaneously forced the eviction of all medical personnel, anthropologists, other researchers, missionaries and NGO workers.  Dr. Ramos states that for the two years following the expulsion of humanitarians aid-worker contingentsm.the Yanomami became infected with malaria at far higher rates than normal and were increasingly subject to other perils as a result of the incursion of garimpeiros, yet received no assistance.

In December 1987, shortly after the eviction, the President of FUNAI and the Governor of the State of Roraima proclaimed that the “reserves of gold mining” on Yanomami lands could now be legally extracted.
By December 1987, garimpeiros numbered more than 5,000 near Paapiú.  An atmosphere of “gold fever” spread in the Northern Brazilian Amazon, particularly in the capital of Roraima, Boa Vista.  A large portion of Boa Vista residents, including most small farmers and many professionals, left their jobs to head for the placers on Yanomami lands.  By January 1988, garimpeiros numbered approximately 10,000.  By 1989, they numbered 20,000 to 40,000.

The cumulative effect of this incursion is the estimation that from 1987 to early 1999—the height of the gold rush—thirteen percent of the Yanomami residents in the region died due to environmental impact and malaria.  During these years, the pernicious gold rush overwhelmed the Yanomami in the state of Roraima with garimpeiros eventually outnumbering the indigenous population nearly six-fold.

FUNASA’s Model for Delivering Health Care to the Indigenous: Successes and Failures

In order to understand the current successes and failures of the administration of health care to the Yanomami, an examination of the National Health Foundation’s (FUNASA’s) health care delivery model is necessary.  FUNASA first implemented its present model for administering health care to the indigenous people in 1999 with the Lei Arouca.

This model is designed around the Sanitary Indigenous District (DSEI), the organizational structure for the administration of health services. The Yanomami have their own designated Sanitary Indigenous District, which includes Yanomami lands in both the states of Roraima and Amazonas.  The Lei Arouca states that local leaders, anthropologists, indigenous groups, government entities, NGOs and others were consulted in the formation of these districts.

The DSEI is organized around an Indian Health Office in a regional urban center adjacent to the indigenous area.  The Indian Health Office maintains common hospital resources.  The Pole Base is the head office inside the indigenous area and has basic health equipment.  Finally, there are many health posts, which branch out all around the DSEI.  Health posts have very limited infrastructure and are designed to attend to common diseases such as malaria and diarrhea.

The human resources structure for personnel who deliver healthcare in the field in Lei Arouca contains both the Multidisciplinary Teams for Indigenous Health (EMSIs) and the Indigenous Health Agent (AIS).  Relevant to malaria care, the EMSIs consist of doctors, nurses, nurse technicians and lab professionals who work primarily in the Pole Bases. The AISs, accordingly, do the majority of their work in native villages.  FUNASA states that in the past ten years it has done extensive work in training indigenous health agents, and that it has selected them based on specific criteria, including community recommendations.

From the 2009 publication presenting Lei Arouca’s structure, DSEIs appear self-sufficient, or in other words, one would assume that they have contracts with all the personnel who are directly employees of FUNASA.  However, this has not been the case in the Yanomami DSEI.  FUNASA sub-contracted other organizations to deliver health care in the Yanomami DSEI.  These organizations have had varied success with treating malaria epidemics.

The NGO Urihi, sub-contracted from 2000 to 2004, states that it had great success in mitigating malaria among the Yanomami population of Brazil.  Accordingly, malaria cases in the Yanomami DSEI fell almost ninety-nine percent.  However, in 2004 Urihi opted to end its contract due to increased restrictions by FUNASA. This change stipulated in 2004 that contracted organizations (such as Urihi) would simply be personnel providers and all staff would effectively work under FUNASA’s guidelines.  Prior to these restrictions Urihi was more autonomous.   A professional researcher on the Yanomami, Francois Michel Le-Tourneau, confirmed that Urihi was effective in providing excellent care with great monitoring and treatment of anyone in various locations who presented a case of malaria.

Following the termination of the relationship between FUNASA and Urihi, FUNASA subcontracted The University of Brasília Foundation (FUB).  Unfortunately for the Yanomami people, the FUB was not nearly as effective at administering health care despite increased funding.  Corruption rumors circulated in the press regarding FUB’s healthcare management and consequently the public ministry forced FUNASA to abandon the FUB contract.

Consideration of Genocide

An essential question surrounding the Gold Rush on Yanomami lands, and its related problems, such as the malaria epidemic and environmental degradation is: what, if any, policy or action on the part of individuals or groups can be interpreted as genocide?  If indeed there are potential criminal cases, the parties involved should be indentified and investigated.  Additionally, if consideration of genocide were to resurface with indictments and international news media attention, it would have a profound effect on a future Brazilian government policy for the Terra Indigena Yanomami.  Under these conditions one could expect a new political presence in Brasília to end the current negligence of its politically damaging inadequate delivery of health care to the Yanomami; moreover, better resources for health care would reach the Yanomami and probably, if the new development has the political play to do it, one could witness the eviction of currently resident garimpeiros.

In her book on the Yanomami, Dr. Linda Rabben generally characterizes the two-year period during which would-be aid givers were expelled from Yanomami lands, starting in 1987 by a FUNAI request to the Federal Police to do so.  It was an incredibly suspicious action to expel groups, which were not directly involved in garimpagem activities from the Yanomami lands, and the following will argue that some individuals should be investigated for having committed genocide.

In 1988, after FUNAI made the initial motion to evict would-be aid givers, FUNAI President Romero Jucá made public statements denying that the Yanomami were dying en masse from malaria epidemics.  Only a few months after these statements, Brazilian President José Sarney appointed Jucá governor of the state of Roraima, a newly created political division.  President Sarney by then already had been petitioned by six Brazilian senators to stop what media and NGOs were already calling “the genocide of the Yanomami.”

At that time, genocide protestors already sought demarcation of Yanomami lands to develop a legal basis to expel garimpeiros.  Counter to the Yanomami’s interests, however, FUNAI proposed a delineation of 19 “islands” which they could populate, reversing their former proposal for a 9.4 million hectare continuous Yanomami reserve. Dr. Rabben believes it appears FUNAI acted against the Yanomami’s interests and, deliberately supported garimpeiros by, in effect, banning foreign and domestic aid providers from having a physical presence on Yanomami land.

This gerrymandering-like attempt to restructure the Yanomami’s land reserves to accommodate garimpeiros was put into action when President Sarney ratified the “19-island” scheme. Sarney then further bolstered garimpeiros’ ambitions with decrees that created two national forests within Yanomami lands and prohibited entrance of any “third party” without prior authorization from the Brazilian National Government’s Institute for the Environment and Natural Resources (IBAMA) or FUNAI.

Considering genocide, many environmentalists fervently believe that Sarney should be indicted. He acted counter to the sheer preservation of the Yanomami.  Dr. Rabben notes that Sarney, under international and national pressure to do so, initially signed a decree to expel garimpeiros from the Yanomami lands, but then signed another decree effectively reversing the first.  This second decree was the creation of two reserves for garimpeiros within the Yanomami indigenous lands.  These reserves were publicly defended by Sarney’s Minister of Justice with the dubious assertion that they were meant to prevent the spread of epidemics to other parts of the country.  The federal attorney general responded by drafting impeachment charges against the president for attempting to foil plans to expel
garimpeiros.  Sarney left office in 1990 with impeachment accusations still pending.

The international legal definition of genocide provides a compelling legal basis for indicting FUNAI employees (including Jucá), President Sarney, members of the Federal Police or others.  According to Articles II and III of the 1948 Convention on the Prevention and Punishment of Genocide, genocide must contain both “mental” and “physical elements”.  The mental element is “intent to destroy, in whole or in part, a national, racial or religious group.”  The physical element contains five distinctive acts, three of which are relevant to this case: “(a) killing members of the group, (b) causing bodily or mental harm to members of the group, (c) deliberately inflicting on the group the conditions of life calculated to bring about its physical destruction in whole or in part.”   Acts punishable and relevant to the case are: “(a) genocide, (b) conspiracy to commit genocide, (c) attempt to commit genocide and (e) complicity in genocide.”

Regarding the mental element, a general anti-indigenous culture can be found in the history of this case among FUNAI officials, President Sarney and, of course, among miners and mining interests in Boa Vista, Roraima.  Indeed, it may not be difficult to prove that in many specific instances there was intent to destroy this ethnic group.  Because President Sarney and others knowingly and repeatedly made decisions that they knew would expose the Yanomami to malaria epidemics and thus a potentially life-threatening illness, a thorough legal investigation of the aforementioned parties would appear to be necessary.

Regarding the physical element, the Convention on the Prevention and Punishment of Genocide definition“(c) deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part.” This is most applicable to the decision by FUNAI to expel all would-be aid givers from the Yanomami lands.  President Romero Jucá’s actions as the head of FUNAI should be investigated for genocide based on the application of these terms, as should those of other FUNAI employees’ actions, due to overwhelming evidence that suggests the organization was deliberately placing the Yanomami under such prejudicial conditions.  Their delinquencies are, of course, even more egregious because FUNAI’s raison d’être is supposedly to protect the indigenous.

Policy Suggestions

The problems identified in reviewing the historical record of this case include: (1) instances of anti-indigenous sentiment in government bodies dealing with the Yanomami, (2) negligence of the Yanomami’s interests and needs, and (3) and the high probability of corruption.  These bureaucratic failures occurred in state and the national government, in FUNAI, FUNASA and in the organizations FUNASA contracted ostensibly to offer the delivery of health care in the field.

Simultaneously, according to interviews with anthropologists who work in the region, as well as reports filed from Urihi, since 2004 malaria has been increasing among the Yanomami.  To stop this recurring outbreak and avoid repeating past mistakes, the government and all parties involved must pursue policies in which the delivery of health care truly focuses on the best interests of the Yanomami and does not misappropriate or fail to provide funds and resources intended for them (as the Yanomami cite in their Manifesto Sobre a Saúde Indígena).   Moreover, it is essential the Yanomami be involved as much as possible in the process of administering their own health care system.  Realistically, the best way to accomplish this is to have Yanomami advocacy organizations, such as Hutukara (the Yanomami-formed organization to advocate their needs) and the District Health Councils, to meet regularly with DSEI administrators.  These organizations should establish a routine procedure for registering formal complaints and suggestions about improving the administration of Yanomami health care.

Suggestions on Improving the Quality of and Access to Health Care to Address Malaria

Following the grievances and requests made by the Yanomami people, the Brazilian federal government recently created a new body to specifically oversee indigenous health care  under the aegis of the Ministry of Health.  Based on the document Boletim 92 by Commissão Pro-Yanomami, the new government body will structure their health care hierarchy much like FUNASA under Lei Arouca.

Groups such as the Commissão Pro-Yanomami, which was the original NGO formed to address Yanomami needs, and now Hutukara, are examples of organizations on-site in Boa Vista which should have input in any new policy.  Many recommendations for oversight are put forth in their Manifesto Sobre a Saúde Indígena. An overview of the recommendations follows:
(1)    District Health Councils approve of decisions regarding the hiring of candidates for head of the Sanitary Indigenous District.
(2)    District Health Councils approve of any organizations contracted to provide the Yanomami health care in the field.  (Past examples of contracted organizations include: Urihi and FUB.)
(3)    Indigenous Health Agents should have demonstrated their capacity and have at least a high school education with a preference given to persons trained in indigenous human resources, in an effort to decrease negligence and corruption

Recently, under the restructuring that created a new indigenous health sub-section under the ministry of health, a career track was created with a specific training course for persons to be educated in indigenous health.  Indeed this is a positive development because persons delivering health care to the indigenous should be trained in doing so, and should be concerned about their unique needs. This is incorporated in the design of the new indigenous health organization that will replace Lei Arouca.

Another goal for the new policy concerning the Yanomami is that FUNAI and the Polícia Federal should block the illegal entrance of garimpeiros onto the Terra Indigena Yanomami and evict those mining there illegally.  This should be done because garimpeiros environmentally degrade Yanomami land as well as increase the spread of malaria to the Yanomami.

Unfortunately, it is unlikely that we will see an increase in this type of enforcement in the future.  This is because the Terra Indigena Yanomami is vast, the agencies responsible for this enforcement (the Polícia Federal and FUNAI) are too understaffed and underfunded, and there is at present little political capital in Brasília to effectively pursue this policy goal.   The only way the Brazilian government would finally evict the garimpeiros and make a wholehearted attempt to keep them out is if investigations are begun and lead to individuals being indicted for committing genocide during the period 1987 to 1990.  This legal attention to the issue would create a desire on the part of the Brazilian government, and from the Brazilian populace in general, to demonstrate to the international community that the perilous situation of the Yanomami is being handled carefully and with responsibility.  Likewise this would inevitably lead to the Yanomami receiving better health care.

In general, although evicting garimpeiros is important, addressing health care is a better option for obstructing the spread of malaria.  There are a number of reasons for this, the foremost one being it is the most feasible solution for malaria epidemics as the disease has already been sufficiently introduced by garimpeiros in the Yanomami lands. Evicting garimpeiros now would not be effective at preventing the spread of malaria epidemics (further research is required to make this determination with any authority).  Also, if the Brazilian government evicts garimpeiros they may simply return, and policing their reentrance into a massive piece of land is quite difficult.  One of the best ways to inhibit garimpeiros’ access to Yanomami lands could be restricting access to airstrips in the region, but this solution also falls prey to issues of patrolling a huge swath of land in light of understaffing on the part of the Brazilian government.   One thing is for certain: past history shows that nothing will happen automatically, and enormous willpower on the government’s part is required if the problem is to seriously be addressed.