Reflexões sobre questões morais na relação de indígenas com os serviços de saúde

Abstract

ResumoOs sistemas médicos são culturalmente moldados e podem ter impactos negativos naqueles que não compartilham essas bases. Discutimos a perspectiva indígena de questões morais na relação com os serviços de saú-de na região do Alto Rio Negro/Amazonas/Brasil. Trata-se de pesquisa qualitativa que utilizou como técnicas a observação participante e entrevistas em duas comunidades na região do Alto Rio Negro. A transferência para serviços de saúde em área urbana foi identificada como a principal questão moral para os indígenas na região. A diversidade de tradições, culturas e valores dos povos indígenas influenciam na sua moralidade e tomada de decisões clínicas, que eram pouco compreendidas pelos profissionais de saúde. Na relação entre profissionais de saúde e usuários indígenas ficou evidente o choque entre habitus distintos e a configuração de uma relação entre estranhos morais. Essas condições dificultam o diálogo para a resolução de conflitos. Palavras-chave: Saúde de populações indígenas. Ética clínica. Bioética. Noroeste amazônico. ResumenReflexiones sobre cuestiones morales en la relación de indígenas con los servicios de salud Los sistemas médicos son culturalmente moldeados y pueden tener impactos negativos en los que no comparten estas bases. Se discute la perspectiva indígena de cuestiones morales en la relación con los servicios de salud en la región del Alto Rio Negro/Amazonas/Brasil. Fue un estudio cualitativo que utiliza las técnicas de la observación participante y entrevistas en dos comunidades de la región del Alto Rio Negro. La transferencia para servicios de salud en zona urbana fue identificada como la principal cuestión moral para los indios de la región. La diversidad de tradiciones, culturas y valores de los pueblos indígenas tienen influencia en su moralidad y la toma de decisiones clínicas que eran poco comprendidas por los profesionales de salud. En la relación entre los profesionales de salud y los usuarios indígenas se hizo evidente el choque entre los distintos habitus y la configuración de una relación entre extraños morales. Estas condiciones dificultan el diálogo para resolver los conflictos. Palabras-clave: Salud de poblaciones indígenas. Ética clínica. Bioética. Noroeste del Amazonas. Abstract Reflection on moral issues in the relation between indigenous people and health servicesMedical systems are culturally adapted and may have negative impacts on those that do not share these bases. We discussed the indigenous perspective on moral issues in the relation with health services in the region of Alto Rio Negro/Amazonas/Brazil. It was a qualitative research that used participant observation and interviews in two communities in the region of Alto Rio Negro as techniques. The transfer to health services in urban areas was identified as the main moral issue for the Indians in the region. The diversity of traditions, cultures and values of the indigenous people influence their morality and clinical decisions to be made, what used to be little understood by health professionals. In th...

The work process and care production in a Brazilian indigenous health service

“…8 Some investigations have, however, pointed out that the indigenous healthcare knowledge and their traditional healing practices are not included in the professional care provided in the villages. 4,5,8 Since the inception of the National Indigenous Healthcare Policy, the various forms of indigenous care in Brazil have not been evaluated by governmental agencies. 11,12 The National Indigenous Healthcare Policy established 34 Special Indigenous Health Districts covering all Brazilian indigenous territory.…”

“…9,10,13 The forces intrinsic to the work process include: social inequalities, conditions of work, and insecurity and health in the job, as well as the different concepts of the health-illness-care process shared by healthcare providers and indigenous people. 4,8,9,13 Indigenous healthcare encompasses different types of knowledge from Public Health and other areas of expertise, such as Clinic, Epidemiology, Management and Social Sciences, of the public health field. Among other fields of knowledge, Anthropology and Psychology should be mentioned.…”

“…The result is their social marginalization, particularly in relation to access to public health services. [2][3][4] Healthcare for indigenous populations is also affected by cultural, social, historical, economic, and political factors. Health workers involved in indigenous healthcare constantly face perspectives that differ from the classic biomedical model prevalent in Western societies.…”

Dificuldades enfrentadas pelos indígenas durante a permanência em uma Casa de Saúde Indígena na região Amazônica/Brasil

“…Fact also observed in the study performed by Pontes, Garnelo and Rego (2014), in which the Casai's conditions were inappropriate for accommodation of patients and family members, what represents not to be a reality exclusive of the Casai/Santarém, but also of other Casais in Brazil, there being, thus, need of a different sight to this theme.…”

“…According to Pontes, Garnelo and Rego (2014), either the hospitalizations or the stay in the Casai provokes rupture of very restrictive dietary rules that some indigenous groups are used to, according to the following speeches: Among other aspects, the indigenous people's eating habits also differ from the non-indigenous ones. Those have a respect and equilibrium link with the nature, because they acknowledge their food, medicinal herbs and even the tools used to hunt come from it.…”