Table 3 Summary of the indirect causal relationship between the health and well-being of indigenous Wayana people living in the southeast interior region of Suriname and the Inter-American Development Bank's Suriname Land Management Project (SLMP) and the Sustainable Development of the Interior project (SU-T1026) using the five epidemiological criteria

Coherence

Cause and effect association supported by existing knowledge or theory

Existing knowledge and theory: Ref. Nos. [4–6, 16, 49, 51, 69–76]

Coherent

Strength of Association

Strong effect when exposed to cause

The main activity of multilateral investment funds is to provide loans for basic infrastructure projects and the conversion of non-marketed resources into the global market. Land and resource privatization occurs where indigenous people are living and confines them to plots of land that are too small for them to live, and where food sources are contaminated. Dispossessed indigenous people who survive become disabled, dislocated, scattered, impoverished and alienated minorities.

Strong

Time Order

Cause precedes effect in time

In 1958, the Surinamese government, within the context of the post-World War II Bretton-Woods global economic development plan, conducted Operation Grasshopper. The purpose of the project was a geological inventory of the interior region and the creation of economic opportunities for Suriname. Missionaries were the vanguards of economic development, land and resource privatization, and the displacement of indigenous people living in the area.

Cause Precedes Effect

Specificity

Effect traceable to single root cause

The current situation of Indigenous Peoples around the world is the result of a linear programme of “legal” precedent, originating with the Doctrine of Discovery and codified in contemporary national laws and policies [77]. Around the world, Indigenous Peoples are over-represented in all categories of disadvantage. In most indigenous communities people live in poverty without clean water and necessary infrastructure, lacking adequate health care, education, employment and housing. Many indigenous communities still suffer the effects of dispossession, forced removals from homelands and families, inter-generational trauma and racism, the effects of which are manifested in social welfare issues such as alcohol and drug problems, violence and social breakdown. Basic health outcomes dramatize the disparity in well-being between Indigenous Peoples and European descendants.

Effect Traceable to Single Root Cause

Consistency on Replication

Cause and effect association has been repeatedly observed by different persons, in different places, circumstances, and times

Ref. nos. of similar cause and effect associations observed: [4, 16, 26, 27]

Consistent