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If they cannot pay they are still treated. But for HIV/AIDS tests they have to fly to the capital city and the ticket costs must be paid by the non-Surinamers. A ticket is around USD 180 and a lab test is SRD 300 9 , or USD 90 (extended test). An extended test is the first test that is required by Internal Medicine when a doctor found a patient to be HIV positive and has referred the patient to one of the hospitals in Suriname. The test consists of blood test, ex-rays of lungs, liver, hart and other vital organs, sometimes a scan is required. If the Brazilians had registered as living in the areas, they would have received free treatment, but for them to do so, they will need to be in contact with the official government organizations. Since many of them are “undocumented” persons, they will not do so. 9 Gum Air, a local airplane service flying to the designated areas of small scale gold mining. 8
Chapter 2. Funding resources for Mobile and migrant populations in the small scale gold mining sector in Suriname The target population (+/- 40,000) is located in the interior of Suriname. In the interior no policlinics are available, other than those of the Medical Mission in Suriname (MMS), a religious based governmental organization that is financed by the GOS to provide primary health care in the difficult area of the interior. 10 In 2011 the MMS received SRD 24.6 million, equivalent to USD 7.350.838 from the MOH. Other sources of finance are the UNFPA and the Global Fund. According to the MMS they have a registered base of around 60,000 persons living in the interior. 11 These are all Surinamese persons (mostly Marroon, around 10% is Amer-indian), i.e. persons with the Surinamese nationality who are registered as living in designated villages, according to the National Bureau of Citizens Registrations. Condoms are provided free by the UNFPA. The Global Fund provides for ARV’s and lab tests. In 2011 there were 200 Surinamese persons in their work area on ARV’s. This is roughly 0.3% of their data base. All care and services are provided free of costs to nationals. If non- Surinamese persons can prove that they are registered in the villages at the Central Bureau of Citizens Administration, they will be also treated free of costs. Access issues The big challenge therefore, is posed by the large Brazilian community in Suriname (total population in small scale gold mining 40,000; 40,000 minus 15,000 Surinamese = about 24,500 Brazilians, and not more than 1% other nationalities). This subset of the target population is often times “undocumented”, therefore they will not register at the Bureau for Citizen Registration (CBB). If they are not registered, they cannot prove that they have been living in Suriname for 5 years or longer. If they cannot prove that they have lived here for 5 years or longer, they will not be eligible to apply for a Medical card of the Ministry of Social Affairs. This authority requires persons to be a) Surinamese citizens or b) immigrants who have lived in Suriname for a period of at least five years legally and documented. No information exists as to the private resources of this segment of the population. When someone gets very sick, key persons, usually related to the Brazilian churches situated in Paramaribo 12 will collect money from their fellow Brazilians to get this person to Brazil. This is so because admission to a hospital without insurance will require a deposit between SRD 5000 to SRD 6000, which is equivalent to USD 1500. A ticket to Belem/Brazil requires USD 300. Problems arise when the person is not able to travel. There have been reported cases of women who delivered babies and had to leave them in the hospital because they could not pay the bill of SRD 16,000 (USD 4,776). So according to one source person at the Church, they avoid the hospitals as much as possible. 10 Previously (before 2001) the MMS was an organization of the Moravian Church Foundation. Due to escalating costs the Government took over the operations of this ngo. 11 Pls refer to map of working area MMS. 12 Church of God, Baptist Church of Brazil 9
Page 1 and 2: PANCAP/GIS/EPOS IMPROVING THE ACCES
Page 3 and 4: General background Suriname Surinam
Page 5 and 6: Chapter 1. Identifying the Target p
Page 7: The commercial sex workers experien
Page 11 and 12: 7. Doctor visits : 8. A) for a pers
Page 13 and 14: Image: Map of Medical Mission and w
Page 15 and 16: Chapter 4. Financing options For th
Page 17 and 18: 2 years when the dust of restructur
Page 19 and 20: 5. CONCLUSIONS AND RECOMMENDATIONS
Page 21 and 22: Endnotes: 1. Page 7: Note: It must
Page 23 and 24: 2. Promotion a) ads, fliers etc b)
Page 25 and 26: 3. For the political willingness to
Page 27: Literature AVERT HIV/aids, various

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