By Leão Serva
Folha de São Paulo, May 12, 2014 http://www1.folha.uol.com.br/colunas/leaoserva/2014/05/1452918-a-improbidade-que-mata-os-ianomamis.shtml
While the Truth Commission on the military dictatorship opens its analysis of the near-genocide of the Yanomami in the 1970s (when the Northern Perimeter Highway was built) and 1980s (with the massive gold rush), another investigation is looking into new figures indicating increasing deaths among these Indians.
The Yanomami, living in the far north of the country, are once again afflicted with high rates of mortality, victims of one or another disease typical of contemporary society—such as administrative incompetence and, perhaps, corruption, as the Public Ministry suspects.
In contrast to funding for less well-known indigenous peoples, who suffer from a lack of resources for health care, the Ministry of Health increased funding for the Yanomami by sixfold over the past ten years (2004-2013).
During the same period, however, the incidence of malaria among them rose from 41.8 per thousand inhabitants to 70.6.
While Brazil was becoming a rich country, with a decreasing infant mortality rate of 19.6 per thousand live births in 2013, according to the IBGE, the rate among the Yanomami rose to 113 per thousand live births — similar to that in the war-torn African countries of Sierra Leone and Somalia.
The deterioration in the health statistics among the Yanomami prompted a protest early this year, forcing the resignation of Joana Claudete Schuertz, the Ministry of Health coordinator in Boa Vista, Roraima.
Since then, an interim coordinator, Maria de Jesus do Nascimento, has been appointed to the position. When asked by this journalist if the problems were due to a lack of money, she said, "No, there's no lack of money... The problem was actually in how it was administered."
The lack is not in money, but in doctors, equipment, and medicines. So when someone in a Yanomami community gets sick, the solution is to send him or her to Boa Vista by plane.
Preventative medicine has always been considered the fundamental strategy in indigenous areas. This was the approach advocated by nongovernmental organizations, in a partnership with the government initiated in 2000, for managing health care in the Yanomami area. For four years, the organizations received public funds to contract community health agents and doctors, establish health posts, purchase medicines, and conduct vaccinations. The health statistics improved, but the autonomy of the organizations irritated public employees who no longer ran the health care programs.
After Lula was elected, with support from public employee unions, the corporatist rhetoric gained strength. It was reinforced by conservative groups, which viewed the NGOS as being influenced by leftists and foreigners. Opponents claimed that annual expenditures on Yanomami health care (around R$14 million in today's currency) were excessive. The Ministry centralized indigenous health care once again.
Ten years later, with a budget that is six times larger, the Indians' health has only worsened. One of the expenses incurred by the Ministry of Health that was especially criticized by the authorities that came to power in 2003 has, in fact, increased dramatically since then: the transportation costs for bringing sick people from the Indigenous Reserve to Boa Vista. In 2013, R$21 million were paid to two air transport companies—exactly half of the total of R$42 million spend by the Ministry of Health on health care in the Yanomami area.
The Federal Public Ministry is conducting an investigation into what lies behind the deteriorating situation. Problems in managing funds, when they lead to deaths, are issues of administrative corruption. The Attorney General also wants to know details about air transport expenses, since the figures are too high to be merely a symptom of incompetence. Perhaps they are a reflection of devious schemes.