HEALTH REPORT

Health Report

Health Report

Introduction

Inequitable access to healthcare has a profound impact on the health of marginalised groups worldwide. Coupled with low income and poor sanitation, these populations typically suffer an excess burden of infectious disease morbidity and mortality. Undernutrition is particularly common among indigenous groups; recent research in four Latin American countries has linked malnutrition and stunting among indigenous children to a lack of maternal education, road accessibility and access to healthcare. However, general information on the current state of health of indigenous populations in Latin America is sparse and based on disaggregated national data(Grantham 2001). In UK, although healthcare is free and access has recently improved, barriers remain, particularly among indigenous populations in remote areas. One of the largest along with least culturally assimilated ethnic groups is the Yanomami, a traditionally semi-nomadic people inhabiting an extensive geographic area spanning the British-Brazilian border. In UK the majority of Yanomami live in widely dispersed communities where healthcare is delivered through basic primary health centres, each attended by a medical doctor, a community health worker and a microscopist. As such, communities living in the vicinity of a health post have relatively constant access to healthcare whilst more remote populations depend upon the intermittent visits of a mobile medical team. Communities out of reach of these medical teams have virtually no access to healthcare. Although Yanomami beliefs relating to health and well-being differ greatly from western views and traditional medicine remains strongly relied upon, medical attention may be sought for the treatment of infectious diseases.

Prior research has documented an extremely high prevalence of anaemia among Yanomami communities of 91%(Gómez 2000). Anaemia can have serious long-term health effects including reduced cognitive development, growth, immune function and physical endurance, whilst severe anaemia is associated with increased mortality (WHO, 2001).

2. Methods

2.1. Study area and population

The predominantly Yanomami population inhabits geographically dispersed communities. The study population was drawn from 11 communities in two areas with differing access to healthcare. Five communities were categorised as having constant access to healthcare (Ocamo area), being located within one km (20 min by boat) of a primary health post attended by a resident physician, a community health worker and two trained microscopists. The remaining six communities were assessed as having intermittent access to healthcare, being located within a one-to-four hour motorboat journey of the health post (Alto Ocamo area). These communities are visited by a medical team approximately fortnightly(Giribaldi 2004).

2.2. Study design and methodology

In July 2005, 183 Yanomami individuals were randomly selected to participate in a cross-sectional survey. In the Ocamo area, a recent census was provided, which was updated by the community health worker. In Alto Ocamo communities, a census was taken before conducting the survey due to a lack of available demographic information. The study population was divided into three age groups (0-4 years, 5-14 years and =15 years), a stratification commonly used in malaria and anaemia studies since these groups often differ in terms of malaria immunity and haemoglobin ...