News-Letter Nr. 440

Outsourcing Indigenous Health Presents Problems

Gathered together at the Cimi National Health Meeting held on 24-26 November, missionaries belonging to the entity released a document complaining that the official policy with regard to the health of the indigenous population complies with neo-liberal interests and reflects the government's adoption of stranglehold tactics. In 1993, the 2nd National Indigenous Health Conference established as its guideline the Policy to Attend for Indigenous Health by setting up a Health Subsystem based on Special Indigenous Sanitary Districts (DSEIs), with administrative, financial and budgetary autonomy. The government implemented 34 districts and outsourced health attendance by signing agreements with state and municipal governments and Non-Governmental Organizations (NGOs). The District Councils created in the regions to inspect and plan actions and define the volume of resources used fulfill a purely figurative role. The government proceeded to control the actions of the outsourced services, performing what should be the function of civil society.

In the document prepared at the National Health Meeting, Cimi denounced that the policy of agreements leads to centralizing the powers of coordinating, defining and deciding on health priorities in the hands of third parties rather than in indigenous communities through local and district councils, as defined at the 2nd National Indigenous Health Conference. The councils have lost their function and find it difficult to participate in drawing up the health policy within the districts.

The official health policy has inverted the logic of the collective and participative proposal elaborated in Indigenous Health Conferences. The document argues that "the model implemented by the government conditions indigenous health care to the "good will" of those who set the terms of the agreement, defines actions that come from above, and calculates inside official bureaus the budget to be allocated to implementing the services, including budget cuts." The functioning of the DSEIs is submitted to the political situation and the struggle for power inside the government.

Cuts in resources

The financial problems began one year after the agreements were implemented. The National Health Foundation (Funasa) admits that the budget requested for the first year was R$ 106 million intended for structuring the DSEIs and for permanent care for the indigenous population. This amount, however, was lowered to R$ 80 million in the proposal sent by the Ministry of Health for the National Congress's approval of the General Budget for the Union in 2001. The Director of the ministerial Department of Indigenous Health, Ubiratan Pedrosa Moreira, claims that this budget will be approved without any more cuts and that there will be no further contingency blocking of part of the resources, which is a common practice in the federal government. According to Funasa, the remainder of the funds (R$ 26 million) is guaranteed.

The Pró-Yanomami Committee (CCPY) claims that Funasa asked the agencies for a work plan that projected financial cuts of around 45% to attend to the Yanomami Sanitary District (DSY), the "Casa da Cura Hekura Yano" (Hekura Yano Health Care Center) and the "Casa do Índio" (Indian House) in Roraima. The entities are to submit their work proposals by 15 December. According to the CCPY, the cuts make it impossible to ensure minimum activities for the functioning of the present health system, and place the survival of the Yanomami in jeopardy.

Senate Committee Approves Ratification of Convention 169

The Committee on Constitution and Justice of the Federal Senate approved on Wednesday, 6 December the report delivered by Senator Romeu Tuma (PFL-SP) in favor of the bill for Executive Law nº 34, which deals with ratification by Brazil of Convention 169 of the International Labor Organization (ILO). The bill is to be discussed at a plenary meeting of the Senate.

This matter has been in process at the National Congress since 1991. The bill was approved by the House of Representatives in 1993, and since that date has been in circulation in the Senate. Convention 169 is an import international treaty that rules on international law as regards indigenous affairs. It was adopted at the 76th International Labor Conference in Geneva in June 1989, revising the prior ILO norms, especially Convention nº 107 (1957), already signed by Brazil. It deals with indigenous territories, contracting and working conditions, professional training, welfare, health and education, as well as guaranteeing the participation of the indigenous population in matters relating to questions of direct interest to them.

Although ratification of the Convention by the Brazilian government is a demand of the indigenous peoples, approval of the bill by the Committee was only possible due to an amendment made by Senator Romeu Tuma to articles 2 and 3 of the international treaty, which clarify the rights to dominion and possession set down in the Brazilian Constitution.

Brasília, 7 December 2000.
Indianist Missionary Council - Cimi




For more details on the text you may want to contact Cimi directly under e-mail:



Webmaster Pro REGENWALD

We're happy to receive your comments or answer your questions. now, if you want to contribute to this work