Images of the Yanomami abound in Puerto Ayacucho, below, but some say Venezuela restricts access to health care.

The Yanomami are treated at hospitals in Puerto Ayacucho.

By SIMON ROMERO

PUERTO AYACUCHO, Venezuela - Three years after President Hugo Chavez expelled American missionaries from the Venezuelan Amazon, accusing them of espionage, resentment is festering here over what some tribal leaders say was official negligence that led to the deaths of dozens of indigenous children and adults.
Some leaders of the Yanomami, one of South America’s largest forest-dwelling tribes, say that 50 people in their communities have died since the expulsion of the missionaries in 2005 because of recurring shortages of medicine and fuel .
Mr. Chavez’s government disputes the claims and points to more spending than ever on social welfare programs for the Yanomami. The spending is part of a broader plan to assert greater military and social control over expanses of rain forest that are viewed as essential for Venezuela’s sovereignty.
“This government makes a big show of helping the Yanomami, but rhetoric is one thing and reality another,” said Ramon Gonzalez, 49, a Yanomami leader from the village of Yajanamateli who traveled recently to Puerto Ayacucho, the capital of Amazonas State, to ask for improved health care.
“The truth is that Yanomami lives are still considered worthless,” said Mr. Gonzalez, who was converted to Christianity by New Tribes Mission, a Florida group expelled in 2005. “The boats, the planes, the money, it’s all for the criollos, not for us,” he said, using a term for nonindigenous Venezuelans.
There are about 26,000 Yanomami in the Amazon rain forest, in Venezuela and Brazil, where they subsist as seminomadic hunters and cultivators of crops like manioc and bananas.
They remain susceptible to ailments for which they have weak defenses, including respiratory diseases and drug-resistant strains of malaria. In Puerto Ayacucho, they can be seen wandering through the busy streets, clad in T-shirts and baggy pants, toting cellphones.
Claims of medical neglect emerged before Mr. Chavez expelled the American missionaries, who numbered about 200. They administered care to the Yanomami with donated medicine from the United States and transported them to clinics on small propeller planes using dozens of airstrips carved out of the jungle.
Mr. Gonzalez and other Yanomami leaders provided the names of 50 people, including 22 children, who they said died from ailments like malaria and pneumonia after the military limited civilian and missionary flights to their villages in 2005. The military replaced the missionaries’ operations with its own fleet of small planes and helicopters, but critics say the missions were infrequent or unresponsive.
Officials here questioned the claims.
“ One cannot forget that the Yanomami and other indigenous groups have learned how to exert pressure on the government in order to receive food or other benefits,” said Carlos Botto, a senior official with Caicet, a government research institute that focuses on tropical diseases.
But the Yanomami leaders point to what they consider to be a broad pattern of neglect and condescension from public officials.
“They put pictures of Yanomami everywhere, on tourist brochures, in airport lobbies, even on ambulances here in Puerto Ayacucho,” said Andres Gonzalez, 38, a Yanomami leader. “That’s where they want us,” he said, “in pictures, not positions of power.”