Author: Aisha Fraites, SAEDI Consulting (Barbados) Inc. 

Despite having one of the largest growing economies due to an unprecedented oil discovery, Guyana’s poverty rates were startlingly high compared to the rest of Latin America and the Caribbean, according to the World Bank’s 2022 updated fact sheet. Sparsely populated interior or hinterland communities are the hardest hit due to limited access to economic opportunities, health care and public services.” (1)  

Guyana is highly vulnerable to the effects of climate primarily due to flooding; with the majority of the population (90%) residing on the Coastal Plain which lies approximately 0.5 to 1 meter below mean sea level (2).  Flooding, droughts and lack of access to clean water (due to mining) compound pre-existing challenges Indigenous women face in receiving adequate antenatal and delivery care. The remoteness of communities, lack of access to health services and equipment, poor transportation infrastructure and extremely costly modes of transportation are some of the factors that contribute to Guyanese Indigenous women’s experiences when it comes to safe birth and delivery.  The COVID-19 pandemic compounded these issues as many communities were forced into lockdown to prevent community spread; many communities relied heavily on Non-Governmental Organisations (NGOs) and the private sector to provide medical, sanitary and other supplies to curb the spread.  

Disaster and climate impacts exacerbate gender inequalities, particularly for indigenous women living in remote communities. For instance, though national rates of antenatal care have been improving, Indigenous women are overwhelmingly less likely to have received antenatal care or received skilled attendance at birth and have significantly higher adolescent birth rates than other women. Sadly, these disparities are experienced by indigenous women and adolescent girls in industrialized countries around the world. Indigenous women and adolescent girls face considerable barriers to accessing medical treatment especially acute during emergencies, despite typically experiencing higher health risks. (3)

In addition to these challenges, some estimated 12,000 migrants have been arriving from Venezuela due to that country’s economic crises to remote areas in Guyana, alarmingly the International Organization for Migration (IOM) and United Nations High Commissioner for Refugees (UNHCR) projected that 40,000 to 60,000 Venezuelans could enter Guyana on a short-term basis if the situation does not improve (4).  This situation stretches already thin resources in the surrounding communities.

Guyana’s development arc appears to be focused on infrastructural, education and health investments with promises to cut the cost of power, improve transport infrastructure, create sustainable hospitals; providing free healthcare and education primarily for those living on the coast (5).  However, there is little mention of how it intends to address the many gendered social issues women face; including high rates of adolescent pregnancy and domestic violence.  

Social Protection for Indigenous Women

In addition to a Ministry of Amerindian Affairs, the Ministry of Social Protection implements social protection programmes to assess risk and support vulnerable populations, both directly and through partners. The three main social assistance programmes are Public Assistance and the Old Age Pension both through the Ministry of Social Protection and the school feeding programme through the Ministry of Education (6).  With the exception of the school feeding programme, the other forms of assistance are centered on the populations on the coast, while Indigenous communities rely heavily on NGOs focused on natural resource management and conservation for economic and social support interventions in their zone of influence. However, there is no national social protection strategy bringing together the programmes through an overarching framework and no strategy addressing the specific and multiple intersecting needs of Indigenous communities.

Though the government of Guyana has distributed cash grants nationally to parents for children to attend school and for COVID-19 relief, these programmes have not become regularized and have no clear qualifying standards. As other countries in the region examine the viability of strengthening or increasing cash grant systems and making other funding available for shock recovery from natural disasters including health epidemics for vulnerable populations, is this the answer for Guyana’s Indigenous people? Will it suffice for tackling mental health concerns. While cash grants offer necessary support, more expansive and extensive gender-responsive relief for these communities is also needed. 

“Historically, women have given birth in the company of other experienced women in the family or the community. This custom, handled by what are called midwives or traditional birth attendants, continues to be common among many indigenous populations in Latin America and other parts of the world. High rates of maternal and neonatal mortality that persist among these populations have sometimes been attributed to what is considered the informal support provided by these persons. In reality, those rates are generally due to economic and social exclusion, the absence of adequate sanitary conditions and nearby medical personnel, or lack of access to emergency services that can prevent or mitigate possible complications.” (Johannsen, 2021)

One recommendation therefore is a national Indigenous "doula" training programme, the “doula” – a Greek word that means “servant woman” or “women’s servant”, where women are paid to provide care to their communities throughout pregnancy and after birth (7). In some cases, this person may already act as a midwife and can receive some formal instruction to enhance their skills, providing a combination of experiential as well as local traditional knowledge and more formal education. These "doulas" could monitor pregnancy while a visiting specialist could be commissioned to advise on special cases which may require treatment at a regional hospital or in Georgetown. In addition, there is a need for improved access to family planning information and contraceptives so that women have increased sexual reproductive health options, a service that could also be provided by the "doula". 

Disaster impacts affecting Indigenous communities will become an increasing reality which explains the urgent imperative that Indigenous women amplify their voices and advocate for improved social protections as Guyana’s economy becomes more stable. It is also key that their knowledge and experience be leveraged in the solutions presented and supported, making them part of the process and agents of change, who ultimately can exercise agency and resilience where needed in the face of multiple risks.  The power should be in their hands. 

Sources:

1. https://newssourcegy.com/caribbean-international/world-bank-flags-guyana-as-having-one-of-the-highest-rates-of-poverty-in-the-region-almost-half-of-population-living-on-us5-per-day/. 
2. https://climatechange.gov.gy/en/index.php/about/facts/effects 
3. https://www.unfpa.org/sites/default/files/resource-pdf/factsheet_digital_Mar27.pdf  
4. https://reliefweb.int/report/guyana/study-shock-responsive-social-protection-latin-america-and-caribbean-guyana-case-study  
5. https://dpi.gov.gy/in-four-years-guyana-expects-oil-revenues-twice-the-size-of-its-2022-budget/#:~:text=Over%20the%20years%2C%20starting%20in,President's%20expanded%20Low%20Carbon%20Development  
6. https://docs.wfp.org/api/documents/WFP-0000116973/download/#:~:text=Social%20protection%20in%20Guyana&text=Two%20main%20social%20assistance%20programmes,by%20the%20Ministry%20of%20Education/. 
7. https://blogs.iadb.org/salud/en/want-doulas-during-childbirth/.