pancap/gis/epos improving the access to hiv services for mobile and ...

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
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