Yanomami: cases of malaria doubled in the Bolsonaro government – 02/08/2023 – Health

The number of cases of malaria registered at the DSEI (Special Indigenous Health District) Yanomami, in Roraima, skyrocketed during the Bolsonaro government. The increase appears in the report prepared by the Ministry of Health and obtained by Sheet.

According to the document, 9,928 cases of the disease were registered in the region, where the Yanomami Indigenous Land is located, in 2018. The total increased to 20,393 in 2021.

The report also points out that almost a third of the cases occurred in the age group from 0 to 9 years old (30%) and that the place of probable infection that grew the most in the period was precisely in mining areas.

The document was produced after an inspection carried out at the territory’s DSEI from January 15 to 25.

In the report, released by Sheetsituations of extreme precariousness are also reported in the base poles within the Yanomami TI and in the local Casai (Indigenous Health House).

Facilities are described with feces on the floor, use of expired medications, oral syringes reused without proper hygiene and several care units closed due to lack of security, a consequence of the high incidence of illegal activities in the region.

There are also reports of health professionals afraid of prospectors, in addition to a lack of food, gas cylinders and protective equipment for doctors.

On more than one occasion, the document mentions that there is no proper separation between malaria and non-malaria cases.

In 2022, 11,634 cases were registered, but the report warns that the real number must be much higher, since, due to logistical difficulties, “it is considered that the insertion of data in Sivep-Malaria [sistema de controle da doença] by the District can take more than 3 months, with still significant underreporting”.

In many cases, data is recorded on paper documents and sent by courier to Casai in Boa Vista. There, professionals report that they suffer from connection instability, which sometimes prevents data from being entered into the system.

There are also reports of indigenous people who died with symptoms of malaria, but the cases were not entered into the system, since the health team did not have tests to confirm the diagnosis.

“There is a lack of structure in the malaria control program with a lack of testing and treatment, since the locations with the highest number of cases do not have any testing and treatment activity, resulting in a long period of infection and illness that contributes to an increase in transmission and aggravation of cases”, says the document.

The report describes, for example, the situation of an elderly person who was in the Yaritopy community, which, according to the text, “is being affected by a large number of cases of malaria, but there is no access to diagnosis and treatment of malaria, as well as any health intervention”.

The solution, says the report, was to take the patient by helicopter to the Surucucu base pole, which only happened after days of symptoms. Only the most serious cases are displaced, according to the document.

The elderly man arrived in Surucucu on a stretcher, unable to walk, with serious signs of dehydration and malnutrition. When he was tested for malaria, the result was positive. However, the report continues, the base pole did not have adequate antimalarial medication or mosquito nets for patients (the insect transmits the disease).

“The team made boots to warm the feet to control hypothermia”, adds the text.

The report also points out that, during the Bolsonaro government, it was mining that boosted the growth of malaria in the region.

Infections in indigenous areas increased from 26.6% in 2019 to 29% in 2022, with a peak of 34% in 2020. Contamination in mining areas increased from 5.2% to 18.3%.

Alexandre Naime Barbosa, vice president of the Brazilian Society of Infectious Diseases and an infectologist at Unesp, said that malaria is endemic in the region where the Yanomami have lived for centuries.

This is because it is an area of ​​great concentration of primates, creating a reservoir of the disease. However, mining has exacerbated the problem because it ends up removing the vegetation cover and increasing the mosquito proliferation focus. anopheleswhich transmits malaria.

With the greater number of mosquitoes in the region and the population density coming from mining, the disease is transmitted from human to human through the mosquito, without the intermediary of the monkey.

“The main need is to get the prospectors out. The indigenous people have always had malaria, but, in the dynamics of the wild cycle [quando o macaco é o incubador da doença], they are more adapted. When you have the infection in a scenario of malnutrition, the severity increases, because then they are immunosuppressed [com imunidade baixa]”, he said.

To deal with the spike in cases of malaria, the COE (Emergency Operations Center) Yanonami, a task force created at the Ministry of Health to deal with the humanitarian crisis in the region, decided to treat all people present at the site of the disease. This includes both indigenous people and miners, adding up to around 50,000 people.

The problem is that the folder does not have enough medicines for this and has not yet moved to buy them, according to people heard by the report. The treatment is done with a single dose of artesunate (AS) and mefloquine (MQ) in a single dose, which costs about US$ 2 per pill, or R$ 10 approximately.

In addition to the risk inherent to the disease, the delay in treatment can cause the problem to spread across the country. This is because thousands of prospectors left the site spontaneously in anticipation of federal government action.

The disease can pass from an infected person to the mosquito anopheles, present in almost all of Brazil. Thus, the flow of miners to other locations can cause outbreaks in other regions.

Another aggravating factor is that in regions where there is no incidence of malaria, health teams are not necessarily prepared to deal with the disease, which can delay diagnosis and increase the risk of serious problems.

Situations like this happened recently in Bahia, Espírito Santo, Minhas Gerais and Piauí. In the case of prospectors, the main concern is with the interior of Maranhão and Pará, the place of origin of most of the people who were in the area.

For Alexandre Naime, the departure of prospectors without treatment for malaria means that they can take the disease to other regions, aggravating the problem.

“It’s a big problem because the disease usually has an incubation time of up to 14 days, but it can last for months under certain conditions. If the miners went to a forested region where there are mosquitoes that transmit it, they could serve as reservoirs for the disease. Malaria is one of the disease historically linked to mining in Brazil,” he said.