Tierney is correct in stating that the last 500 years of contact between Native Americans and people of European descent have had disastrous consequences, with epidemics being responsible for killing millions of people. Typically, first face-to-face contacts result in the deaths of between one third and one half of the native populations within the first 5 years of contact (see Hill and Hurtado 1996). The majority of South American Indian groups were exterminated in this way during the first two centuries after European arrival in the Americas (see J. Hemmings book, Red Gold). Unfortunately, the lessons of half millennium have not resulted in any significant improvements. If a group of native South Americans who have been living in isolation for some period of time were to make contact today, the result is likely to be equally catastrophic.

In Brazil alone, there are still some 30-50 groups who are still living isolated from face-to-face contact with peoples of European descent (Funai estimated 55 uncontacted tribes two years ago, Veja: June 10, 1998). Others exist in Peru and Bolivia, and perhaps in Venezuela, Equador and Colombia as well. Yet, there are no contingency plans for managing the medical, economic and social consequences of contact. Such contacts are inevitable, since global economic, social and population forces are driving increasing numbers of people into remote areas for the purposes of colonization and resource exploitation. If the last five hundred years of depredations and virtual extinctions of peoples are not to be repeated, a concerted effort is necessary.

Remote peoples in South America face three major threats. First, wood-cutters, miners, colonists, missionaries and even government-sponsored bodies are entering their traditional ranges in increasing numbers. Face-to-face contacts with some members of remote groups will occur as a result of those incursions. Eventually one or more of those contacts will result in the transfer of disease organisms to individuals with little resistance to those diseases. Epidemics will then ensue, even among individuals who never actually come into contact with people of European descent, since the natural response to disease among mobile peoples is to flee to neighboring villages or camps. Second, the habitats of remote peoples are shrinking rapidly. As more areas are colonized, the available habitat to support subsistence is increasingly circumscribed. In some cases, the habitat is not sufficient to support the nutritional needs of the group. This loss of habitat creates problems over both the short and long term. In the short term, the resource pressure can lead to nutritional stress, disease, and both inter- and intra-group conflict. Over the long run, even after peaceful contact is established, those peoples may lose access to their traditional territories because colonists and others will have established either de facto are legal ownership of those areas. Third, many local groups have become isolated from other members of their larger ethnic groups, due to incursions into their territory. Those isolated groups can be small enough that they do not constitute viable breeding populations. As a result, small demographic shocks can lead to their physical extinction, even without significant disease epidemics (see recent case of how the El Nino and La Nina weather patterns may be exterminating the uncontacted Jarawas in the Andaman Islands).

In order to avoid such disastrous consequences, several steps need to be taken in the immediate future. First, a commission needs to be established to evaluate the status of existing isolated peoples. There is a great deal of information already available through reports from private individuals and government bodies who have visited or live in remote areas. That information needs to be analyzed and the status of each group evaluated. Which groups are in immediate threat of contact? What are the likely sources of contact (miners, wood-cutters, colonists, etc.)? Which groups face probable extinction due to small population size in isolation? Such a commission should include experts in anthropology, physicians and public health administrators, and government officials who are responsible for policy development among native peoples. Second, policies regarding contact need to be developed. Which groups can be protected from contact? Which groups should be approached and offered contact due to their probable extinction in the immediate future? How should contacts be managed in both the long and short term? Third, medical contingency plans must be developed and financed. Rapid vaccination and outreach medicine could potentially bring contact-related mortality to less than 2-3% in the first year (eg. see Hill and Hurtado 1996). Since newly contacted peoples have no experience with health posts and western medicines, a nontraditional medical program needs to be developed. It is necessary to deliver medical treatment when and wherever it is required without relying on the people themselves to seek and to follow prescriptions. Since isolated peoples remain highly susceptible to foreign antigens for a decade or so, such programs need to be sustained over a period of several years.

Many anthropologists and indigenous rights activists believe that uncontacted Indians should be left alone. These people are well-meaning, but they are wrong because they base their position on three incorrect assumptions. First, they assume that the Indians have chosen to remain isolated. They have not. What they have chosen is to avoid those who they believe would kill, enslave and abuse them. There is little doubt that most would immediately opt for contact if instead they expected trade, affection,help and support. Human's are a social species by nature and enjoy productive interactions with neighboring groups. Most isolated tribes have difficult lives that includes very high rates of child mortality (see Hill and Hurtado 1996). All Indians that we have ever spoken to gladly accept improvements in their physical conditions and health situation if offered by true friends. None are content with the typical 30-50% child mortality rates that they experience without Western medicine. As soon as it becomes clear to isolated natives that those attempting to contact them are peaceful and friendly, and can provide them with technology to ease some of the burdens of their lives, they virtually always initiate a contact.

The second incorrect assumption by those who oppose contact is that the Indians will inevitably be decimated by virgin soil epidemics. This is not true. I have been present at contact sites within days of first contact and am good friends with others who have carried out first contacts in three different South American countries. If competent medical care is available and consistently present during the first five years following contact, few contact related deaths need occur. The last band of Northern Ache foragers of Paraguay was contacted in April of 1978 and I began medical care of that group in collaboration with two other missionary organizations within days of contact. Only 2 small children out of a group of 22 died within the first five years of contact, and both were in poor health at contact. In 1979 another band of Ache contacted a missionary family who then lived with them in their traditional home range from that time until the present. Only 1 child from a group of 37 died within the first five years after contact. The key to survival after contact for these two groups was competent medical care 24 hours a day, 365 days a year for several years after contact.

The third incorrect assumption by those who oppose contact is that the isolated native groups will survive if not contacted. Population genetics and demographic models clearly show this is not true. Most isolated populations of less than several hundred people are destined to go extinct through accidental population fluctuations. This process is much more rapid in small groups and in situations where traditional territories have recently decreased in size. Almost certainly many isolated groups went extinct in the 20^th century without ever making contact. In some cases one or two final survivors may be rescued at the end of such a decline.

Although there is a body of scientific literature on virgin soil epidemics among native peoples, a long period of missionary and governmental experience, and well-informed articles that provide specific advice on contact situations (eg. Hill and Kaplan 1989), individuals and organizations making contact with isolated native groups at the end of the 20^th century seem as uninformed as those a hundred years earlier. Even well meaning groups and individuals continue to ignore this accumulated body of knowledge. For example, the planned Funai contact of the Korubo in Brazil in October 1996 included 26 individuals who were not screened or quarantined including 8 journalists and their assistants, but no medical personel! When outsiders suggested that the original team may have infected the Korubo, government officials returned to the contact site again for a few hours, but without qualified medical personel. (see http://www.nationalgeographic.com/features/96/contact/index.html). The previously contacted group appears to have turned hostile at a later date (due to deaths caused by the contact crew?) and has not been monitored since. Funai has not allowed any qualified medical team into the area to investigate the Korubo situation since the 1996 contact. All the Korubo at the 1996 contact could be dead from diseases introduced by the contact team and accompanying foreign journalists.

There is now sufficient documentation of the consequences of first contacts that we can no longer plead ignorance. The remaining isolated peoples in South America and other places in the world should not suffer the same fate as those of the previous 500 years. The American Anthropological Association should form a panel of experts now to develop policy on this issue and advise pertinent government and missionary organizations. Failure to act will invariably lead to the destruction of the last human societies without permenant peaceful contact with the world's larger human community.