49 50.97. As a consequence of these conditions, the members of the Indigenous Community who are in this settlement suffer malnutrition, anemia, and widespread parasitism.161 50.98. The hospital that is closest to the area of settlement of the Yakye Axa Community is roughly 70 kilometers away. To reach the regional hospital for the President Hayes Department, the members of the Community have to travel over 200 kilometers and they have no special transportation for this, and public transportation is scarce and inadequate. The Community has no health center or post, and it is not visited regularly by health promoters.162 50.99. Currently the Yakye Axa Community has a school with a regular attendance of 57 boys and girls. However, given the characteristics of the Community’s current settlement, the school’s structure is not adequate and it does not have sufficient materials and facilities, which are provided mainly by State. The health, nutrition and clothing conditions of the boys and girls of the Community severely affect their attendance and their performance in class.163 50.100. The precarious living conditions of the members of the Yakye Axa Community settled alongside the road from Pozo Colorado to Concepción were acknowledged on June 23, 1999 by the President of the Republic of Paraguay, who issued Decree No. 3789 that declared a state of emergency regarding the Yakye Axa and Sawhoyamaxa indigenous Communities, of the Enxet-Lengua People. The presidential decree acknowledged that the Yakye Axa Community lacked “access to the traditional means of subsistence associated with their cultural identity, because the owners do not allow them to enter the habitat that they claim as part of their traditional territory;” and it ordered the INDI “together with the Ministries of the Interior and of Public Health and Social Welfare to carry out the necessary actions to immediately provide medical care and food to the families of said communities, during the time required by the judicial proceedings regarding legislation in connection with the land claimed as part of their traditional habitat.”164 50.101. Esteban López visited the INDI on a regular basis to request food, medicine, opinion of Pablo Balmaceda rendered before the Inter-American Court during the public hearing held on March 4, 2005. 161 See public health medical report on the Yakye Axa Community prepared by Pablo Balmaceda (file with appendixes to the brief with pleadings and motions, appendix 1, volumes 1555 to 1563), and expert opinion of Pablo Balmaceda rendered before the Inter-American Court during the public hearing held on March 4, 2005. 162 See public health medical report on the Yakye Axa Community prepared by Pablo Balmaceda (file with appendixes to the brief with pleadings and motions, appendix 1, volumes 1555 to 1563); expert opinion of Pablo Balmaceda rendered before the Inter-American Court during the public hearing held on March 4, 2005, and book entitled “Atlas de las Comunidades Indígenas en el Paraguay”, Presidency of the Republic, Technical Planning Secretariat. Paraguay, 2002 (file with documents submitted during the public hearing held on March 4 and 5, 2005, Volume II, page 404). 163 See statement by Albino Fernández rendered before a notary public on February 10, 2005 (file on the merits, reparations, and costs, Volume III, volume 637), and testimony of Inocencia Gómez rendered before the Inter-American Court during the public hearing held on March 4, 2005. 164 See Presidential decree No. 3789 of June 23, 1999 (file with appendixes to the application, appendix 10, volumes 1278 to 1280).