Effects of cultural change on health and fertility in Amazonian Indian societies: Recent research and projections

Abstract

The combined effect of accelerating deforestation and urbanization will change the Amazon Basin from a sparsely settled wilderness rainforest with tiny isolated settlements of indigenous culturally distinct inhabitants to a scrub desert filled with rapidly growing cities. In the next 10 years Amazon Basin countries will add 48.5 million people to their population due to colonization by border countries. Amazonian populations have experienced a reversal in demographic transition and the Omran described epidemiologic transition. Historical estimated data settlement to 6-10000 years ago with population estimated at 8.5 million. This population collapsed at a rate of 20:1 to 35:1 after the Conquest due to the introduction of European disease. Smallpox epidemics first occurred in the early 1600s and spread as the century progressed. Current demographic studies have placed estimates of the Indian population at 500000 with many tribes extinct or absorbed by others but data are fragmented for the overall population. Accurate data collection is hampered by the lack of written languages. A history of health of early inhabitants is unavailable due to lack of paleopathological evidence. The introduced diseases discussed are measles smallpox tuberculosis malaria yellow fever Chagas disease and leishmaniasis onchocerciasis schistosomiasis and helminthiasis. Diabetes is unknown obesity uncommon and cardiovascular disease low. Dental disease is associated with Western culture. Death by drowning or from falls is common among Shipibo children. Since 1964 intervillage and intertribal warfare has been an important cause of mortality as has accidental gunshot wounds homicide and vehicular accidents. Among the Waorani 4% of all deaths were due to snakebite. Currently the Shipibo have excellent health but exhibit a vulnerability to tuberculosis and the acute infectious diseases of childhood. Infant and child deaths are due to acute gastrointestinal infections facilitated by fecal contamination of water and food in spite of the Shipibos obsessive cleanliness. Cervical cancer rates are high. Polygynous women have birth intervals 4.5 months longer than monogamous women and have 1.3 fewer term pregnancies; polygyny is associated with lower fertility and modernization with higher. Traditional culture controls on fertility are disrupted by cultural changes brought about by Western contact and ideas and by the destruction of the environment.