In northern Brazil, the land of the Yanomami people extends 96,650 km² across the states of Amazonas and Roraima, an area equivalent to the territory of Portugal. This land houses more than 31,000 inhabitants considered by the country's National Foundation of Indigenous Peoples (Funai) as “peoples of recent contact” – indigenous people who maintain selective relations with segments of society.
Boa Vista, March 8, 2023
The Yanomami retain their own form of social organization and collective dynamics, with a high degree of autonomy in their relationship with the State and society.
Reaching the Yanomamis is a challenge, deforestation and illegal mining have damaged the area over the years, making access even more difficult. In addition, according to the Brazilian Ministry of Health, contamination by mercury and other heavy metals have affected not only the rivers in the region, but also the soil and animals, directly impacting the indigenous’ diet, which consists mainly of fish, gathered fruits and roots, and agriculture.
This scenario has aggravated cases of malnutrition, acute respiratory infection, diarrhea, malaria and tungiasis among the Yanomami population. In response, on 20 January the Federal Government declared the Yanomami situation in Brazil a Public Health Emergency of National Concern.
The (PAHO) has been providing technical support in the response to the emergency since 15 January, when a PAHO team participated in an investigative mission to deepen the understanding of the situation and identify emergency health care needs.
Currently, in coordination with the Ministry of Health and other national institutions in Brazil, as well as the Oswaldo Cruz Foundation (Fiocruz), civil society, Non-Governmental Organizations (NGOs) and United Nations agencies, PAHO supports the response both in the indigenous communities and in the national Public Health Emergency Operation Center (EOC Yanomami).
This structure – EOC Yanomami – was established by the Ministry of Health of Brazil to plan and organize measures in a coordinated manner across the areas of surveillance and provision of healthcare, as well as in the assessment of the socio-environmental impact of the illegal activity of miners in the Yanomami indigenous land.
PAHO teams have also cooperated with the Ministry to respond to malaria and malnutrition, as well as to increase vaccination coverage among inhabitants of the Yanomami Special Indigenous Sanitary District (DSEI) and others receiving care at the Indigenous Health Support House (Casai) in the municipality of Boa Vista, in the Brazilian state of Roraima.
In response to cases of malnutrition, the Brazilian Ministry of Health carried out, with the support of the Integral Medicine Institute Professor Fernando Figueira (IMIP) and PAHO, a training for professionals who are working in this area. The first one was on measuring arm circumference – a simple and effective malnutrition screening for children– and a second one included nutrition assessment, treatment and monitoring.
Through the partnership, a workshop was also held on the preparation of therapeutic milk (water, powdered milk, sugar, oil, electrolyte, and micronutrient solution) for malnourished children. As a strategy to increase acceptance of this milk among the Yanomami, local foods such as açai and banana were included in the formula. The involvement of indigenous health agents helped in the process.
PAHO has also supported the implementation of emergency vaccination efforts by the Ministry of Health – including in the acquisition of essential cold chain inputs and in training and mobilizing vaccinators to work at the indigenous health units.
PAHO support includes developing training materials for medical and nursing professionals to quickly identify warning signs of complications from prevalent childhood diseases, as well as in carrying out first responses and timely referrals.
To fight malaria, PAHO has worked with the Ministry of Health in actions for the prevention, treatment, and diagnosis of the disease at the Yanomami DSEI – including through the use of a rapid test for detection using blood drops. The Organization has also supported the mobilization of a team of technical experts in malaria control.
In order to contribute to the provision of pharmaceutical services and maximize medicine usage and strategic health supplies, PAHO has made its Strategic Fund for the acquisition of medicines available to the Ministry of Health, and is providing assistance in the management of existing stocks at Casai, in Boa Vista.
This set of measures, coordinated by the Ministry of Health and other national and subnational authorities seeks to both reduce the immediate impact of the emergency and to strengthen healthcare services in indigenous communities to prevent future emergencies.