Health Care Should Improve For Indigenous Communities- Study

Recently, the Ministry of Health inaugurated a Reference Center on Indigenous Health in Yanomami territory, in the State of Roraima; 14 out of 117 professionals from the Mais Médicos Program were sent to the region to join the staff of the Special Health Districts for Indigenous Health. In a recent statement, the secretary of Indigenous Health, Ricardo Weibe Tapeba, warned about the need to go beyond the “primary care” offered to indigenous people in Brazil.

The increase in medical care for indigenous peoples is analyzed critically by José Miguel Nieto Olivar, professor at the Faculty of Public Health at USP: “The Brazilian collective health model has focused on avoiding what is called centralization in the figure of the doctor, medicine and of medical care, understanding that the field of health is very wide, diverse, multi-professional and with a very wide range of specialties, knowledge about care, cure and prevention”.

This stance involves valuing native understandings of health and treatment, treating them as a priority and seeing indigenous communities as autonomous in their knowledge, as Olivar reiterates: “It is not health technicians, nor university professors, that we work with health, that we are going to define what is good and what is bad in the field of indigenous health […] community groups have a gigantic and fundamental capacity for knowledge, reflection and action to take care of their health processes, so it is not up to us to say how it should be articulated, what should be expanded or what should be done”.


Anthropology is also a tool that can guarantee success in actions for indigenous health, as Marina Vanzolini Figueiredo, professor at the Department of Social Anthropology at the Faculty of Philosophy, Letters and Human Sciences at USP, explains: “Anthropology is dedicated to approaching the perspective of local communities, the perspective of indigenous peoples in this case, then, is to understand how these diseases are being experienced. Within these communities, seek to approach the way this is experienced, understood and interpreted”.

This understanding is based on the assumption that “the way health care is organized and offered can also be violent, in the sense of not respecting native understandings of health and not respecting local interpretations of what care means and what needs to be done”. , what are the measures that need to be taken”, says Marina.

territorial issue
Indigenous health is directly linked to the territory, and this is a determining factor both for the proliferation of diseases and for access to care offered by the Unified Health System: “Many cases of food problems, diabetes problems or illnesses related to water , malaria and other diseases transmissible by vectors are strictly related to environmental conditions and the organization and disorganization of territories”, explains Olivar. “The intensification of mining has a very high relationship with the variations and intensifications of malaria, different types of malaria, and the presence of greater consumption of soft drinks, for example, sugar and bread in many communities, linked to processes of loss of territory and expulsion.”

The territory is also decisive in the reception of indigenous people in health centers: “The bottleneck is a separation, which today makes no sense at all, between indigenous people in communities and indigenous people in cities. The indigenous health subsystem has focused on working with communities, in many cases in an exclusive way. So, who is an indigenous person who is in a city does not have access to the possibilities and strengths of the indigenous health system and with its institutions and devices and only has the local SUS”, he completes.

Marina also warns that “[Diseases] can have a long-term effect of profound psychosocial disorganization, of people and communities as collectivities, an effect of profound weakening of traditional ways of living”.

Claims
The researcher from the Faculty of Public Health at USP and an indigenous woman of the Baré ethnic group, Elizângela da Silva Costa, in Alto Rio Negro (AM), explains some of the needs observed in the territory where she lives:

“We have small indigenous towns called districts. These districts are composed as if they were a mini-municipality. As a result, we, indigenous peoples, are demanding that there be also small hospitals, in addition to the UBS, that can care for our relatives.” Elizângela also brings an overview of indigenous health in practice: “Indigenous health is more focused on first aid. So, for example, there are no X-rays in the communities, there are no such things to do to prevent uterine or prostate cancer, these diseases that are not part of our experience as indigenous peoples. In Pink October, often within the UBS, there is not adequate space to carry out the PCCU . Sometimes a person falls and breaks [a limb] and there is no way to do an X-ray.”

For her, indigenous health is still “a much-questioned topic and it is very difficult to convince Brazilian society that traditional indigenous medicine is a way for indigenous peoples to protect themselves, to take care of themselves”. Elizângela also exemplifies some of the care that was taken during the covid-19 pandemic: “We knew how to take care of ourselves and protect ourselves through the teas of our communities, inside our house, smoke with pitch resins, blessing. We used what nature offers us and, when we say that, society itself does not understand”.