Newsletter n. 751

– State of Rondônia: 107 cases of malaria in a village with a population of 250 in 2006  

– Reports of terrible health care situation in the state of Tocantins lead the Federal Prosecutor’s Office and Funasa to take action

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STATE OF RONDÔNIA: 107 CASES OF MALARIA IN A INDIGENOUS VILLAGE WITH A POPULATION OF 250

On Friday, the 26th, Cimi issued a note reporting the death of three children in the Lage Velho village, where the Oro Wari’ people live, in the state of Rondônia. It also reported the hospitalization of 42 other children of these people in January in the city of Guajará-Mirim. Most of them had diarrhoea and dehydration symptoms.

Of the 42 children who were hospitalized, 12 came from the Lage Velho, which has a population of 250. The note drew attention to a high rate of malaria, diarrhoea and influenza as a result of the lack of preventive and follow-up actions by nursing professionals of the National Health Foundation (Funasa).

On Monday, the 29th, Funasa issued a note challenging Cimi’s reports. The Foundation says that “there is no malaria outbreak” and that “local teams carry out follow-up actions at least at 15-day intervals.” The Cimi team in Guajará Mirim, state of Rondônia, of which doctor Gil de Catheau is a member, used data from the Epidemiological Surveillance System (Sivep) to challenge Funasa’s statements.

“In 2006, there were 743 cases of malaria in villages located in the area covered by the central health care station of Guajará-Mirim, which has a population of 4,000 indigenous people,” Cimi reported in its note. From 2000 to 2003, the team in charge of endemic diseases managed to reduce the incidence of malaria. In 2000, there were 557 cases in the area covered by the central health care station of Guajará-Mirim. The figure dropped to 135 in 2003, but it increased again in 2004, when 341 cases were registered.

Of the 743 cases registered in 2006, 107 were in the Lage Velho village, according to data made available by the Sivep.

In the second fortnight of January 2007, 14 cases of malaria were diagnosed in this village, most of which involving children, in less than 5 days. Two of them are still in hospitals of Guajará-Mirim. “Therefore, we can say without any doubt that it is indeed an endemic outbreak,” Cimi said in its note.

Funasa attributes the hospitalization of children with diarrhoea to the nut-harvesting season. “They (the Oro Wari) spend long hours in nut-harvesting areas with their small children eating inadequate food (basically nuts, which are very fatty) and not drinking enough water.

According to the Cimi team in Guajará-Mirim, epidemics of infectious diarrhoea are not caused by eating nuts, but by drinking contaminated water or by transmission among humans, and they occur in all villages, even when it’s not the harvest season. The fact that children from other villages have been hospitalized corroborates the arguments of the team of missionaries.

Funasa also said that, in the area covered by the central health care station of Guajará-Mirim, there are “four teams with nurses and nursing aides working 20 days a month in the area, besides a nursing aide in a fixed location for 20 days a month in the same village, who are monitored by indigenous agents (in this case, Valdito Oro Wari and Regina Oro Mon) who make up the team in charge of the Indigenous Family Health Care Program – PSFI, which is being implemented according to the guidelines of the Ministry of Health and the Unified Health System.”

“Unfortunately, these teams and nursing aides have not visited the village for many months because there were no medicines, fuel, or transportation available,” Cimi said.

The Foundation also explained that “the roads to the village are dirt roads – making it difficult for health professionals to go there or delaying health care actions.” Cimi disagrees with this statement and says that only 11 of the 35 km which separate the village from the city are unpaved. 

In its note, Funasa argues that 79 AISs (indigenous health agents) were hired by Dsei in 2003. In 2006, this number increased to 111.

“FUNASA must be mixing up AISs (indigenous healths agents) with AISANs (indigenous sanitation agents), because AISANs were hired to work in the area covered by the central health station of Guajará-Mirim, but no AISs have been hired to work there in the past seven years. FUNASA’s justification is that candidates for AISs suggested by their communities will only be hired after they take at least one training course. But the last course was delivered in 2003.”

Regarding a project to build a health station in the village, Funasa said that “the construction work has been authorized and the company which won a tender for this purpose will begin to build the health station next week.”

REPORTS OF TERRIBLE HEALTH CARE SITUATION IN THE STATE OF TOCANTINS LEAD THE FEDERAL PROSECUTOR’S OFFICE AND FUNASA TO TAKE ACTION

Reports of the death of two children of the Apinajé people in the state of Tocantins from diarrhoea, respiratory infections, and malnutrition led Funasa to call a meeting in the capital of the state. The meeting was attended by representatives of the Federal Prosecutor’s Office and of other agencies in charge of indigenous affairs. During the meeting, the National Health Foundation made a presentation on its actions in the area of the municipality of Tocanitinópolis, where the Apinajé land is located. In 2006, fourteen Apinajé children died in the state.

 

During the meeting, Funasa said that the situation is under control, that a multidisciplinary team composed of indigenous people had been fully set up, and that the health assistance provided by the hospital of Tocantinópolis, where the children died, will be more closely inspected. The municipality will receive additional funds for providing health care services to the community and it is in charge of hiring the required health care teams.

During the hearing, the Federal Prosecutor’s Office took the commitment to call a new meeting to be attended by representatives of other agencies in charge of indigenous affairs which could not attend the hearing, including representatives of the National Foundation for Indigenous People (Funai). The Federal Prosecutor’s Office will hold a public hearing in Tocantinópolis to discuss the situation of the Apinajé people.

At the meeting, Funasa said that it will take care of distributing basic food baskets to the population as an emergency measure together with other partners to try and deal with malnutrition cases and eliminate nutritional risks for children aged from 0 to 6 years old, pregnant women, and elderly people.

According to Istélia Folha, from the Cimi office in the state of Tocantins, the lack of public policies designed to ensure the sustainability of indigenous peoples is one of the factors leading to the lack of food and to nutritional risks for indigenous people. The Apinajé are also facing problems such as alcoholism and higher consumption needs in their village.

The Apinajé community, which is made up of 600 people, complains that there is no basic sanitation in the village. In 2005, the municipal government of Tocantinópolis failed to implement a project to build 79 toilets in the village because, according to it, there were underground problems. A new study will now have to be carried out by Funasa. 

“There is a dispute for political positions in the region particularly now, when new officers will be assigned to coordinate public agencies after the new federal administration took office. It is important to make sure that people are not assigned to health-care positions in Tocantinópolis based on political interests, because this would have negative consequences for the health care services provided to the population,” Istélia Folha said.

 
Brasília, February 1, 2006