Abstract
BackgroundPrevious studies found that while internationally financed economic development projects reduced poverty when measured in terms of per capita GDP, they also caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows when measured in terms of mercury poisoning and the burgeoning rate of suicide. In this study, we developed a needs assessment and a policy-oriented causal diagram to determine whether the impaired health of the people in this region was at least partially due to the role the country has played within the global economy. Specifically, could the health and well-being of indigenous people in Suriname be understood in terms of the foreign investment programs and economic development policies traceable to the Inter-American Development Bank’s Suriname Land Management Project.MethodsInterviews took place from 2004 through 2015 involving stakeholders with an interest in public health and economic development. A policy-oriented causal diagram was created to model a complex community health system and weave together a wide range of ideas and views captured during the interview process.ResultsConverting land and resources held by indigenous people into private ownership has created an active market for land, increased investment and productivity, and reduced poverty when measured in terms of per capita GDP. However, it has also caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows.While the effects of economic development programs on the health of vulnerable indigenous communities are clear, the governance response is not. The governance response appeared to be determined less by the urgency of the public health issue or by the compelling logic of an appropriate response, and more by competing economic interests and the exercise of power.ConclusionThe health and well-being of the indigenous Wayana in Suriname’s interior region is at least partially due to the role the country has played within the global economy. Specifically, the health and well-being of indigenous people in Suriname can be understood to be a result of foreign development bank-funded projects that drive the government of Suriname to trade land and natural resources on the global market to manage their country’s balance of payments.
Highlights
Previous studies found that while internationally financed economic development projects reduced poverty when measured in terms of per capita Gross Domestic Product (GDP), they caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows when measured in terms of mercury poisoning and the burgeoning rate of suicide
While converting land and resources held by indigenous people into private ownership has created an active market for land, increased investment and productivity, and reduced poverty when measured in terms of per capita GDP, it has caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows when measured in terms of mercury poisoning and the burgeoning rate of suicide [18,19,20,21,22,23,24,25]
Open-ended interviews were used to study people’s mental models and to determine how four specific factors relating governance, economic development and indigenous community health are viewed: 1. The conversion of land and resources held by indigenous people into private ownership has caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows when measured in terms of increased death, disease and disability
Summary
Previous studies found that while internationally financed economic development projects reduced poverty when measured in terms of per capita GDP, they caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows when measured in terms of mercury poisoning and the burgeoning rate of suicide. Could the health and wellbeing of indigenous people in Suriname be understood in terms of the foreign investment programs and economic development policies traceable to the Inter-American Development Bank’s Suriname Land Management Project. MDBs provide loans and low interest subsidies on the condition that the developing country agrees to adopt Structural Adjustment Programs (SAPs) that remove excess government controls and promote market competition consistent with the neo-liberal ideology that drives globalization [9,10,11]. Governments of developing countries are forced to open up their economies to foreign direct investment (FDI) and reduce their role in the economy by privatizing the health sector as well as state-owned industries and non-market land and natural resources [7, 12,13,14,15,16]
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