Brasil - Guiana - Suriname Border
Consultant: Fabio Tozzi
Collaborator: Roberta Cerri
2022
GEOGRAPHICAL SCOPE AND INDIGENOUS TERRITORIES
The area studied covers the Mapuera, Trombetas, Jatapu, and Paru de Oeste river basins in Brazil, located in the extreme east of the state of Roraima and the northwest and north of Pará.
The entire length of the Brazilian frontier in this region is covered by forest, either in conservation areas or Indigenous Lands. In Guyana, the area covers its southern portion in the Essequibo and New River basins, also bordering Suriname and where there is one indigenous territory formally recognized by the state, the Kanashen Community Owned Conservation. Access to the indigenous territory is overland. In Suriname, the area is inserted in the large district of Sipaliwini, which covers the entire southern region of the country.
The Brazil/Suriname border is an area of traditional occupation of the Tiriyó people. On the Brazilian side, their communities are located in the Tumucumaque Park, and in Suriname, in the Sipaliwini Environmental Reserve. Access to the region is mostly by air. However, there are communities on the border that are accessed by indigenous people from one country to another by river and land.
MAPA INTERATIVO
Observe no mapa interativo do Módulo Povos Indígenas, onde se localizam os territórios indígenas na região amazônica e observe as regiões fronteiriças estudadas pelos consultores da OTCA:
INDIGENOUS TERRITORIALITY
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Indigenous People
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Territory
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Watershed
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Reference City
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ANTHROPOLOGICAL CONTEXT
Caribbean peoples and paths of interconnection
The region of the triple border Brazil/Guiana/Suriname is traditionally populated by the Tiriyó, Katxuyana, Kahyana, Waiwai, and Tunayana, speakers of languages and dialects of the Carib family; and the Zo’é people, speakers of languages of the Tupi family. The Tiriyó (Pará/Brazil border with Suriname) and Waiwai (Roraima/Brazil border) maintain frequent transits and continuous exchanges of indigenous families and individuals across the borders of the three countries, so we characterize them as transboundary.
The Zo’é Indigenous Land is located in the border zone and its inclusion was motivated by the fact that the Zo’é people are considered to be of Recent Contact by the Brazilian State. Furthermore, the region has unconfirmed references to indigenous peoples in a situation of isolation, yet to be identified.
The indigenous peoples of the region are involved in an ancient and extensive network of exchanges based on linguistic, kinship, ritual, political, economic, and territorial ties. With the exception of the Zo’é and isolated indigenous peoples, the other peoples included in the study area have experienced similar processes of colonization, suffered severe depopulation due to the spread of epidemics in the 19th and 20th centuries, and were agglomerated in large Catholic and Protestant mission villages in the second half of the 20th century. In recent decades, they have been protagonists of territorial redispersion processes in Brazil, occupying again former dwelling places from which they had been removed by state and religious mission actions.
These villages are interconnected by land and river paths, periodically traveled by people during trips to trade, to meet relatives, to go to the cities, for health treatments, festivals, and others. Before the arrival of the missionaries in their region, the Tiriyós were differentiated into several Carib groups and maintained intense networks of exchange and trade, migratory flows and episodes of war among themselves. With the arrival of the Franciscan missionaries, on the Brazilian side, and the Protestants, on the Surinamese side, all these groups were encompassed by the name Tiriyó, in Brazil, and Trio, in Suriname.
SOCIOECONOMIC PROCESSES
Mining: from industry to mining
On the Brazilian side, the region concentrates ́two large-scale industrial enterprises in the region: bauxite mining (Mineração Rio do Norte – MRN) in Oriximiná and the wood and cellulose industry (Grupo Orsa) in Almeirim. In the other municipalities, the service sector predominates, with a greater participation of the municipal public sector (emphasis on the payment of public employees and the funding of health and education) and commerce. There is a tendency for mining exploration in the region demonstrated by the various mining request projects, including in indigenous lands.
Unsustainable logging and tourism are pressures that can trigger undesirable events in the health of the indigenous population. In addition, there are plans for the installation of government enterprises in the municipalities of Oriximiná and Óbidos that would directly affect indigenous territories: the construction of a highway cutting through the Amazon forest and connecting Brazil to Suriname and the construction of a hydroelectric plant on the upper course of the Trombetas River. Another major project planned for the region is bauxite exploitation in the Curuá/Cuminapanema river basin by Rio Tinto Desenvolvimentos Minerais Ltda.
In the Amazon region of Suriname and Guyana, the mining industry is also the main economic activity. In the case of Guyana, mainly gold, diamond and bauxite. Suriname, on the other hand, besides gold and bauxite mining, also explores for oil in its territory. Because mining plays a central role in the economy of these countries, the impact of mining is an important determinant of the health of the indigenous peoples in the region, whether due to the consequences of the possible presence of mercury in the rivers or due to the transmission of malaria.
EPIDEMIOLOGICAL PROFILE AND ASSISTANCE
Distinct health situation realities
The health contexts within and between countries are distinct and heterogeneous, even in Brazil where there is a common health system. Within the Tumucumaque Indigenous Park there is an institutionalized health system linked to the Ministry of Health (Polo Missão Tiriyó – DSEI Amapá e Norte do Pará) present in the territory. However, the remote location of the IT, as well as the territorial dispersion of its population brings difficulties regarding the access of the population and the resolutivity of the system.
Based on the morbidity data of the population living in the Tumucumaque Indigenous Park, the numbers of infections, especially respiratory ones, are quite high. Considering the greater susceptibility to respiratory diseases and the difficulty of access to the territory, the local indigenous community is considered to be vulnerable to epidemics of infectious diseases.
On the other hand, the Zo’É in another Indigenous Land have a health team located in the UBSI of the Cuminapanema village committed not only to assistance, but also to epidemiological surveillance. This means that their services respond to local health needs. The outcome of this practice is effective in the results of morbidity and mortality, that is, diseases and deaths are controlled. The assistance in the locality, values the resoluteness of the actions in the area through articulation with other institutions and the training of the team that, by knowing the local health profile well, are more assertive in the interventions.
HEALTH SYSTEMS
Health services to the indigeneous people
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General Features
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Brazil
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Guyana
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Suriname
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Particularities of Health Services
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Brazil
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Guyana
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Suriname
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PUBLIC POLICIES AND TYPES OF GOVERNMENT
In relation to other border countries, while Brazil has a specific health service for the indigenous population, in Guyana, for example, the health care systems are all municipalized, covering the entire local population and following the logic of social participation through committees and councils integrated by indigenous representatives. In practice, the health professionals in primary care are made up of mid-level technicians, the Medex, while in Brazil, the indigenous health team is made up of multidisciplinary professionals with a university degree.
In Suriname, with a centralized government system, primary care is delegated to an NGO, Medical Mission, which has a certain autonomy in the planning and execution of actions, while the Ministry of Health is responsible for epidemiological surveillance, as is the case of the Malaria Program. A common characteristic in the three countries is the low supply of doctors in primary care services, and as a result, the Medical Mission usually promotes medical journeys – a concentration of medical services on site for a short time – in the indigenous territories of the Amazon.
COVID-19
The region has a high mortality rate when compared to other countries in the world, and heterogeneity regarding vaccination coverage, with Brazil having the highest coverage, especially among indigenous peoples. The problems observed in the region led to the development of the following recommendations:
- Maintenance and strengthening of the vaccination campaign;
- Campaigns against false news and information about the benefits of vaccination;
- Education and training programs for health professionals who work in indigenous areas;
- Strengthening and improvement of the assistance network;
- Incentive to the structuring of health units in the villages, with the possibility of resolving cases of low and medium complexity;
- Establishment of routes and means of removal based on criteria contained in a contingency plan – including references and counter references.
- Establishment of an information and monitoring system for positive COVID-19 cases and flu-like symptoms for the indigenous population.
- Participation of indigenous peoples in the continuous maintenance of the strengthening measures against COVID-19 with protagonism of local indigenous organizations.
- Establishment of dialogue between different levels of government;
- Construction of meeting agendas between Member Countries;
- Formation of working groups with reference teams in the countries to participate in the development and operationalization of contingency plans
- Restructuring of existing contingency plans that have cross-border characteristics and that have specific components for the registration areas of isolated indigenous peoples, identifying health barrier areas.
