Cost-effective COVID measures for preventing indigenous community’s pandemic genocide
A collaborative project by Jessie Huang and Charmian Molina
Introduction
Since the initial outbreak of Covid-19 early this year, the virus has spread to 217 countries and has infected over 60 million people to date. Each country and region have adopted different strategies and have made varying degrees of progress in fighting the global pandemic. Interestingly, even within countries, there have been communities that have been worse off than others. Brazil is one of the countries that has struggled with controlling the spread of the virus, registering more than 6 million cases. Looking closer, the data shows that indigenous communities in Brazil have been hit especially hard, with their death rate averaging 250% higher than the general population (Thomson Reuters Foundation, 2020).
The Yanomami Tribe
The Yanomami tribe consists of around 35,000 members, and it is among the most populous indigenous tribes in Brazil who live in the remote Amazon forest. It is reported that the Covid-19 severely threatens the existence of the Yanomami tribe, after they have suffered from the deteriorating habitat due to climate change (Survival International, 2020).
Xawara is what they call diseases brought by whites to their communities. The first case of Covid-19 in the Yanomami tribe was a 15-year-old boy, Alvaney Xixirana, who eventually passed away three weeks after first showing symptoms. Given their isolated nature, one could wonder how the virus even got there in the first place. Some argue that the transmission of the virus started with infected healthcare providers who visited without being tested. Over 20,000 illegal miners, locally known as garimperos, have invaded their lands and might also be responsible for bringing the coronavirus into the region. Whatever the case may be, Covid-19 is a xawara, just like their previous outbreaks of flu and measles over the past four decades.
Challenge
The Yanomami tribe has been historically living in thatched yano (“communal house,” see the image on the right), which can house up to 400 tribe members. The crowded residential space makes it easy for coronavirus to spread. Meanwhile, the Yanomami’s livelihood consists of hunting and fishing, and it is nearly impossible for them to follow Shelter-in-Place while maintaining the subsistence activities. Since June 2019, the government started to provide aid to the tribe, but it is insignificant and was not brought directly to them — Yanomami members had to travel to the nearest city to collect the aid from the government office. Dozens went back with COVID-19 symptoms that can potentially infect the people in their yano, leaving the aid with a notorious name — “$120 for death” — as called by the local residents. Lastly, Yanomami tribes are located up to ten hours walking distance away from medical facilities equipped with intensive care. The members unable to travel were left dying. All these factors put the Yanomami tribe at extreme risk for an uncontrollable spread of COVID-19. The Brazilian government has been heavily criticized for the lack of effective action.
Supply-Side: Provision of Sufficient Hygiene Kits
Given the lack of health services in remote areas where Yanomamis reside, the need for basic hygiene kits with which they can take preventative measures is particularly acute. The policy’s priority should be to establish a distribution center within a radius of 5 hours away from every community house to dispense standard hygiene kits. A hygiene kit would contain three reusable masks, a hand sanitizer, organic soap, a set of washable utensils (bowls and spoons), toiletries, and a brochure containing information about the coronavirus and the prevention measures. The hygiene kits should be provided for free to the Yanomami communities as humanitarian provisions.
In the Yanomami tribe, men are responsible for hunting, and the women travel miles to fetch water and collect firewood. The program could work with the Tuxawa (leader) or Shamans (healers) to recognize 2–3 the “women of the tribe” who would take turns to deliver the kits for their villages, who would be honored and celebrated during the tribal festivals.
It is important to note that considering that the risk of spreading the virus is exceptionally high among the uncontacted tribes, the distribution centers will be set up on a need basis and prioritize the contacted tribes to avoid any unintentional spread of the virus. The priority to protect these tribes is to continue the government’s recent military mobilization to prevent illegal miners and loggers from approaching the tribal areas.
The Brazilian National Health Foundation and the Special Secretariat of Indigenous Health remain the major responsible healthcare services providers, who are operating on the shoe-string budget. Given the unlikely sufficient budget reallocation, an alternative is to repurpose the fines collected from illegal miners to provide the hygiene kits. Meanwhile, the policy should encourage donations to be solicited from the corporations operating within the vicinity of Amazon Forest. This proposal is highly cost-effective. Each hygiene kit costs approximately US$10 if bought in bulk, and the estimated cost would be less than US$ 400,000, covering the whole Yanomami population for a one-time provision. Furthermore, since the program is focused on preventive measures, its success will lessen the transportation and treatment costs incurred when a community member gets infected.
Demand-side: Self-Determination and Contextualization
It is important to recognize the Yanomami tribe’s rights to “consultation and free, prior, and informed consent” as stipulated in the 1988 Brazilian Federal Constitution. This includes the right to determine their path towards healing and health. Unfortunately, in many instances, especially when rolling out country-wide government programs, these rights are not being upheld. The tribe, through the Tuxawa or their Shaman, must consent to the Covid-19 initiatives, and their suggestions and needs must be taken into consideration prior to the implementation of the program. Abiding by the consultative procedure is expected to increase the community’s uptake of hygiene kits.
Also, let’s not forget that the Yanomami tribe’s successful fight against malaria in the 1990s was primarily attributed to the tribe’s health workers trained under the self-initiated medical organization Urihi. However, the Brazilian National Health Foundation took control over Yanomami healthcare in 2004 despite the protests by the tribes. Given Yanomami’s distrust in government and modern healthcare, self-education is crucial to stop the virus’s internal spread.
The self-education will first start with the brochure provided as part of the hygiene kit. The brochure will be designed using Yanomami language and will include a graphic representation of the origin of the virus in line with the Sharmianic view of nature. A special brochure should be designed for Shamans who are believed to be called upon to divine the causes of illness. It will urge the Sharmans to assist the tribe’s “collective healing” through adopting standardized hygienic practices. To enhance the tribe’s understanding of the disease and the usage of hygiene kits, the local government could consider collaborating with Pro-Yanomami Commission, an NGO consisting of Yanomami tribe representatives, to carry out an information campaign. The message should be relayed in a spiritual tone highlighting care for others. The Yanomami have a strong sense of community, so rather than being very restrictive on what they should not do, the message should be positive in highlighting what they can do to safeguard the well-being of others.
Conclusion
The Covid-19 outbreak has amplified the health and social inequality experienced by indigenous communities. On July 8, 2020, the Supreme Court of Brazil ruled that the national government must issue an emergency plan to fulfill its Responsibility to Protect its indigenous people from a preventable epidemic genocide. Despite a lack of political will in the Bolsonaro administration, the local governments and NGOs are proactively seeking cost-effective protection for the tribe. Establishing distribution centers to make hygiene kits accessible and self-education are measures deemed best suited for the Yanomami community, given their lack of basic protection and the mistrust in the external healthcare providers. Except for reallocating the government budget, the policy could potentially crowdfund among private corporations and the prominent international indigenous people’s rights groups such as The Indigenous People’s Advocates Network and Survival International. To lift the heavy cost of “pandemic cultural genocide” and the burden on local health facilities, the time is now to facilitate the Yanomami tribe with the knowledge and preventative capacity to cope with the spread of this foreign virus based on the principle of basic human rights and self-determination.
References:
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