Special plan for Amerindians in World Bank US$10M AIDS grant
Stabroek News
May 9, 2004

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An Indigenous Peoples' Development Plan has been included in the US$10 million World Bank Project for HIV/AIDS Prevention and Control in Guyana.

According to the World Bank, this is to "ensure that indigenous peoples do not suffer adverse effects during the development process, particularly from bank-financed projects, and that they receive culturally compatible social and economic benefits."

Guyana's indigenous people fit the five distinguishing characteristics used to identify minority nationality communities:

- they have a close attachment to ancestral territories and natural resources in their regions;

- they identify themselves and are identified by others as members of distinctive cultural groups;

- their languages are different from the national language;

- they still have customary social and political institutions;

- they rely primarily on subsistence modes of production.

The bank noted that poor and marginalized groups are forced to cope through mechanisms that render them susceptible to infection.

"Among the poorest groups are the Amerindian people who live in isolated rural communities in regions One (Barima/Waini), Seven (Cuyuni/Mazaruni), Eight (Potaro/Siparuni) and Nine (Upper Takutu/Upper Esse-quibo). These regions are currently low HIV/AIDS prevalence cases. However, a number of factors render Amerin-dians vulnerable to HIV/ AIDS: they are the poorest group; have a high teenage pregnancy rate; and do not easily access services due to remoteness of locations as well as certain cultural traditions, the bank said.

It was stated that the government, through a participatory process with Amerindian communities and various other stakeholders, will support and or implement a number of activities to address specific HIV/AIDS-related issues in the indigenous population.

The programme will see enhanced knowledge about STIs and HIV/AIDS and methods of prevention, care and treatment and access to resources for community-based priority STI/HIV/AIDS activities. Amerindians will also be empowered through a participatory process, particularly for the village councils and local organisations to plan, implement and evaluate local activities, and their health care system capacity will be strengthened to conduct tests (laboratory services), refer and treat persons infected with HIV or suffering from AIDS.

The current data on HIV/ AIDS indicates that prevalence rates among the indigenous populations are still low. However, the government recognises that under-reporting of HIV/AIDS cases is a severe problem since the Ministry of Health (MOH) estimates 60% underreporting of cases, the World Bank said. It was pointed out that although HIV/AIDS prevalence is still low in the interior regions, the potential exists for the problem to escalate if actions are not taken now to prevent the spread of the disease in the indigenous populations. Factors that contribute to the vulnerability of HIV in the interior locations include poverty and the lack of employment opportunities, which lead to out-migration for jobs in urban areas or mines. Risky behaviours abound in such environments, and returning workers may carry the HIV virus back to their home area. There are already high rates of STIs in some communities and inadequate or lack of information and knowledge about HIV/AIDS and how to prevent it. Prostitution among women and alcoholism are also evident.

The proximity of Amerindian communities to neighbouring countries - Brazil, Venezuela and Suriname - can also pose a problem since men and youths are lured over in search of jobs.

"With the opening up of Guyana's hinterland for development, the proposed Guyana/Brazil road, and the subsequent increase in the transient population, a further increase in the prevalence of HIV/AIDS in the interior regions is anticipated," the World Bank said.

Various consultations were held with a number of organisations and community-based entities and the findings of the consultations suggested that there has been inadequate community sensitisation in hinterland communities regarding HIV/AIDS. It was found that many of the health workers and teachers who are expected to disseminate HIV/AIDS information lack the capacity and knowledge to do so. And there is a dearth of culturally and language-appropriate communications materials, resulting in low levels of understanding of the disease.

The Ministry of Amerindian Affairs will assist in the implementation of the programme and will undertake specific activities for indigenous peoples. The ministry will also serve as a catalyst for ensuring that civil society organisations are encouraged to undertake activities for indigenous peoples through the demand driven component. It will liaise with other ministries, especially health and education, to ensure that the activities they undertake focus on the special needs of Amerindians.

According to the bank, Guyana has an estimated Amerindian population of eight per cent of the total population, which is estimated at 800,000.

It was stated that the indigenous people of Guyana are disproportionately disadvantaged socially, and economically. "Amerindians have some of the lowest health indicators in Guyana. Social development indicators for health and education reveal significantly higher levels of disease, as well as mortality, and higher illiteracy rates when compared to other non-indigenous groups in the country."

Few Amerindians have access to potable water and, since the early 1980s; traditional sources of potable water (creeks and rivers) are under threat of pollution resulting from the rapid growth of mining industries in the interior.

And poverty is rife with close to 80% of the Amerindian population in the country falling below the poverty line with the women especially affected; women are paid lower wages and salaries than men, and cannot easily access credit facilities. Over 70% of Amerindians are engaged in subsistence activities such as agriculture, hunting and forestry. The high incidence of poverty in the hinterland is largely the result of geographic isolation (the economic reforms of the 1990s did not benefit many Amerindians), and limited economic activity.

Other statistics published on the bank's website revealed that the overall poor state of health is reflected in low life expectancy, with less than five per cent of Amerindians living to be 55 years or older compared to the average life expectancy for Guyana of around 64.8 years (61.5 for males and 68.2 for females.

Malaria was listed as being endemic and the leading health problem in the interior and it was noted that at one time, almost a third of the tuberculosis cases were found in the Amerindian population. Regions One, Four (Demerara/ Mahaica), Seven, Eight and Nine have the highest rates of tuberculosis.

"Worm infestation is also endemic in most interior regions. Other poverty-related diseases afflicting Amerindian communities include diarrhoeal diseases and acute respiratory infections."

The Amerindians are also significantly affected by substance abuse, dental caries and snake bites and although the country's immunisation programme is considered successful, the hinterland regions have the lowest coverage rates as a result of inadequate management, transport, communication and other difficulties.

Amerindian women are at higher risk of poor maternal health as fewer births (43%) in the hinterland are attended by trained health care workers.

In the area of education, the bank stated that until recently, there were no mechanisms to ensure a coordinated approach to education programmes for the Amerindian communities. It was said that hinterland schools lack trained teachers and suffer from scarce supplies and not surprisingly, school attendance rates tend to be low. Less than 13% of poor households in the interior regions have received secondary education, and one per cent of Amerindians have received post-secondary education.