Indigenous, Immigrant Groups Often Excluded
By Amanda Schoenberg
Tico Times Staff
aschoenberg@ticotimes.net

Seven out of 10 indigenous Costa Rican residents have no electricity. Three out of ten indigenous people in the country are illiterate.

And not a single student graduated from either of the country's two indigenous high schools last year.
Those were some of the alarming statistics compiled by health officials and released last week.

Minister of Health Rocío Sáenz acknowledged a consistent "social exclusion policy" of the country's indigenous and immigrant residents, which has led to a dire health and development situation for both groups.

Suicide and accident rates in indigenous communities are on the rise, as are cancer and chronic illnesses, following a national trend. Death due to infectious disease has decreased among indigenous residents, but still remains higher than the general population, according to the study.

Up to 34% of indigenous residents living on reservations have no health insurance, and 20% are excluded from all health services, according to the study, "Develop-ment and Health in Indigenous Communi-ties in Costa Rica," sponsored by the Ministry of Health, the Pan-American Health Organization (PAHO) and the World Health Organization (WHO), and based in part on the 2000 census.

Sáenz said the indigenous community has been pushed aside by a national health system she called "bureaucratic, urban, impersonal and non-bilingual."

Indigenous residents usually access health care only in emergencies, she said, although the Ministry is trying to implement a more preventive healthcare model.

Other government health priorities for indigenous populations include sensitization training, regular preventive visits by doctors fluent in indigenous languages and increased use of traditional medicine within existing health models.

According to the study, Costa Rica's 63,876 indigenous residents represent 1.7% of the total population. As many as 58% of indigenous residents live outside national reservations. An estimated 43% of land in indigenous reservations is owned by non-indigenous people.

The reality for different indigenous groups within Costa Rica varies widely, according to the report.

The Talamanca Bribrí, with 13% of the total indigenous territory, maintain a cosmological belief system, the majority speak Bribrí and the community hosts one high school.

However, the 958-member Matambú community, descendants of the Chorotega in what is now Guanacaste, have lost traditional medicinal practices and language and most consider themselves Guanacastecos.

Donald Rojas, member of the Boruca community and coordinator of the National Indigenous Board, said the board has denounced insufficient government response to community needs for years.

Rojas said there has been a "30-year government policy of paternalism and isolation."

"We have been asking for a better-quality development plan, but it has fallen on deaf ears. The government makes their plans at their desks, instead of consulting the community," he said.

Rojas said the creation of a Indigenous Education Subsystem of the Ministry of Education has not resolved problems in indigenous education, including the lack of a truly bilingual program beyond isolated language and art classes.

According to the Ministry of Edu-cation, the first Boruca-language teacher began instruction in 1997, and by 2002 there were 53 indigenous language teachers in 120 schools, covering 71% of the indigenous population.

Minister of Education Manuel Antonio Bolaños said he was working on a new plan to expand preschool, alternative and adult education in indigenous territories.

Health Minister Sáenz also released dismal statistics on the Costa Rican immigrant population in a separate study, "Migration and Health in Costa Rica: Elements for Analysis," produced by the Health Ministry, the WHO, PAHO and the Latin American Social Studies Faculty (FLACSO).

According to the report, 7.8% of Costa Rican residents were born outside the country, with Nicaraguans representing 75% of foreign-born residents.

Of families whose heads of households are Nicaraguan, 24.9% of households were considered poor, compared to 20.9% of the country's total households considered poor. The study said 13% of poor families do not have basic sanitation, and 29% have deficient sanitation.

Only 60% of Nicaraguans in the country have health insurance, compared to 83.4% of Costa Ricans. Eight of every 10 uninsured Nicaraguan is less than 12 years old.

According to FLACSO interviews, the majority of immigrants in the country's northern zone do not have health insurance and have trouble finding medical care.

In the Atlantic region, participants said they had faced discrimination, while in the Central Valley paperwork was cited as the biggest problem in getting health care.

FLACSO sociologist Guillermo Acuña said the study found changes in immigration patterns are affecting public health, with work-related accidents on the rise. He said local clinics usually provide immigrants access to basic medicine because they are not required to submit legal documentation.

The study acknowledged an urgent need for more complete information of immigrant populations to better serve the population. Acuña said census results did not properly account for migrant workers, and hospitals only began to collect nationality data in 2000.