{"id":479244,"date":"2023-06-09T19:14:24","date_gmt":"2023-06-09T22:14:24","guid":{"rendered":"https:\/\/revistapesquisa.fapesp.br\/?p=479244"},"modified":"2023-06-09T19:17:17","modified_gmt":"2023-06-09T22:17:17","slug":"indigenous-researchers-reveal-preventive-medicine-in-which-well-being-depends-on-preservation-of-the-environment","status":"publish","type":"post","link":"https:\/\/revistapesquisa.fapesp.br\/en\/indigenous-researchers-reveal-preventive-medicine-in-which-well-being-depends-on-preservation-of-the-environment\/","title":{"rendered":"Indigenous researchers reveal preventive medicine in which well-being depends on preservation of the environment"},"content":{"rendered":"

\"\"Jaider Esbell, O Paj\u00e9 Curando Com Tabaco<\/em>, 2020 \u00a9 Jaider Esbell Contemporary Indigenous Art Gallery<\/span><\/a>In 2009, 12-year-old Luciane, the niece of anthropologist Jo\u00e3o Paulo Lima Barreto, a member of the Tukano indigenous people, was bitten by a poisonous snake in her community deep in the Amazon. She was initially treated with traditional indigenous remedies, including herbal medicine, to manage the pain and swelling in her foot. At the suggestion of the local indigenous health agent, she was taken to a health clinic in Pari-Cachoeira, in the municipality of S\u00e3o Gabriel da Cachoeira, to continue her treatment. \u201cThere, she was attended to by a nurse who happened to be menstruating, as my family later discovered when questioning the medical team. In our culture, a person who has been bitten by a poisonous snake cannot have any contact with menstruating women,\u201d recalls Barreto. \u201cThis worsened Luciane\u2019s condition.\u201d<\/p>\n

The girl was then transferred to a hospital in Manaus, where the medical team suggested amputating her left foot. The family, however, were against it. \u201cMy father and two uncles were adamant that amputation was unnecessary. They believed that a combination of indigenous practices and allopathic medicine would suffice. Unfortunately, the doctors at the hospital were less than receptive,\u201d Barreto recounts. With the support of the Federal Public Prosecutor’s Office, Luciane was moved to another healthcare facility where she received treatment from a medical team willing to collaborate with indigenous specialists. \u201cThe treatment was successful. Luciane is now doing well, although she does have some minor lingering effects, such as reduced mobility in her foot,\u201d says Barreto.<\/p>\n

This incident inspired Barreto to research the subject for his doctoral dissertation in anthropology, which he defended in 2021 at the Federal University of Amazonas (UFAM). In his dissertation, titled \u201cKumu\u00e3 na kahtiroti-ukuse<\/em>: Uma \u2018teoria\u2019 sobre o corpo e o conhecimento pr\u00e1tico dos especialistas ind\u00edgenas do alto rio Negro\u201d (Kumu\u00e3 na kahtiroti-ukuse<\/em>: A \u2018theory\u2019 on the body and the practical knowledge of indigenous specialists in the Upper Negro River region), Barreto challenges prevailing notions in public health and anthropology, calling for their reevaluation. He also advocates for the use of classifications and terms borrowed directly from indigenous languages. Last year, his paper was selected as the best thesis in archaeology and anthropology by the Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES), and was published as a book by the Brazilian International Institute of Education (IEB).<\/p>\n

One commonly used term that Barreto addresses is paj\u00e9<\/em>. \u201cThe paj\u00e9<\/em> is often portrayed as an elderly person with the ability to commune with the gods, the deceased, animals, plants, or minerals to acquire supernatural powers. This is an overly exotic depiction that the media, textbooks, and even the scientific community often portray to nonindigenous society,\u201d he wrote in a 2017 article. According to Barreto, even in the Tupi-Guarani language, the word paj\u00e9<\/em> fails to capture the diversity of roles performed by indigenous health specialists. \u201cAmong the Tukano, there are three different types: yai<\/em>, kumu<\/em>, and baya<\/em>,\u201d he told Pesquisa FAPESP<\/em>. \u201cThey all share the same core training, but each has their own healing specialty. In broad terms, a yai<\/em> is responsible for diagnosis, while a kumu<\/em> administers treatments. A baya<\/em>, in addition to being a master of ceremonies and dances, is also a kumu<\/em>.\u201d Barreto also believes the translations of indigenous terms need to be decolonized from their religious connotations. \u201cConcepts such as \u201csacred,\u201d \u201cfaith,\u201d \u201cspirits,\u201d \u201cprayer,\u201d \u201chealer,\u201d \u201cgood,\u201d and \u201cevil\u201d are imported from a Christian and colonizing theological model. The health and healing practices of indigenous peoples are not within the realm of religion or theology; the kumu\u00e3<\/em>, the plural form of kumu<\/em>, are not religious.\u201d<\/p>\n

Barreto\u2019s father, Ov\u00eddio Lemos Barreto, and two of his paternal uncles, Manoel Lima and Durvalino Moura Fernandes, are kumu\u00e3<\/em> and co-supervised his thesis alongside anthropologist Gilton Mendes dos Santos at UFAM. \u201cThe kumu\u00e3<\/em> are recognized as custodians of indigenous knowledge in the Upper Negro River area. Barreto, Fernandes, and Lima each made a valuable contribution to Jo\u00e3o Paulo\u2019s research, his investigations, discoveries, and formulations,\u201d explains Santos. Their inclusion as co-supervisors, he explains, was Barreto\u2019s decision and was never formally approved by the program or the university, which \u201cunfortunately, like other institutions, has not provided enough space for these individuals and their knowledge within its academic settings.\u201d<\/p>\n

Another concept Barreto explores in this paper is bahsese<\/em>\u2014\u201ca therapeutic resource and a means of communication with the waimahs\u00e3<\/em>. According to our cosmology, when the world was made, a group of waimahs\u00e3<\/em> was chosen to be transformed into humans, while the others, who were rejected, came to inhabit the water, land, and air. They continue to seek revenge for their exclusion by bringing diseases to humans,\u201d explains Barreto, who cofounded the Bahserikowi Indigenous Medicine Center in Manaus, where he previously conducted ethnographic research. \u201cI believe the word \u201cbenzedero<\/em>\u201d (\u201chealer\u201d), with its Christian connotation, is insufficient to express the epistemological meaning of the term as understood by the Tukano.\u201d<\/p>\n

Barreto uses the term \u201cindigenous medicine\u201d rather than conventional expressions like \u201cancestral knowledge\u201d and \u201ctraditional knowledge.\u201d \u201cThese labels need to be challenged because they give the impression that indigenous people possess a less legitimate and inferior form of knowledge simply because it is not scientific. Barreto\u2019s work demonstrates that there are alternative forms of knowledge that should be respected as such,\u201d notes Jo\u00e3o Pacheco de Oliveira, a professor of anthropology at UFAM and at the National Museum of the Federal University of Rio de Janeiro (UFRJ).<\/p>\n

Sanitation expert Sofia Mendon\u00e7a concurs. \u201cI believe the term \u201cindigenous medicines,\u201d in the plural form, is more appropriate as it better reflects the diverse and sophisticated systems and the wide range of preventive and healing practices among different indigenous ethnic groups. The terminology also varies across groups; the word paj\u00e9<\/em>, for example, may hold significance and be utilized by certain indigenous groups, such as those in Xingu,\u201d says Mendon\u00e7a, who is the coordinator of a university extension program called Projeto Xingu at the S\u00e3o Paulo Medical School of the Federal University of S\u00e3o Paulo (UNIFESP). \u201cWhatever the terminology used, what\u2019s important is that we harness and embrace this knowledge to expand our understanding of disease processes.\u201d<\/p>\n

Indigenous researchers face significant barriers to publishing their work and attending health conferences, says Machado<\/p><\/blockquote>\n

\u201cNeither biomedicine nor indigenous medicine holds supremacy over the other; both have their limitations. The ideal approach is to integrate them together,\u201d adds Rubens Belfort Junior, a professor of dentistry at UNIFESP. This was the original idea behind Projeto Xingu, established in 1965 by Roberto Geraldo Baruzzi (1929\u20132016), a professor at the same university, and explorer Orlando Villas-Boas (1914\u20132002), then the director of the Xingu Indigenous Park in Brazil\u2019s Midwest. \u201cPhysicians practicing Western medicine and indigenous medicine specialists can learn from one another,\u201d says Belfort Junior, who joined the Xingu Project in the 1970s and has provided eye care to indigenous peoples and other local communities in northern Brazil since the 1980s.<\/p>\n

The discussion is not a recent one. In 1906, in a thesis titled \u201cO exerc\u00edcio da medicina entre os ind\u00edgenas da Am\u00e9rica\u201d (The practice of medicine among indigenous people in America), completed at the then School of Medicine of Rio de Janeiro (now run by UFRJ), the Brazilian anthropologist, physician, and radio host Edgard Roquette-Pinto (1884\u20131954) wrote that indigenous societies possessed valuable knowledge about diseases that should be investigated and incorporated into nonindigenous society. \u201cHe noted that there were even indigenous techniques for dealing with psychological illnesses, at a time when psychoanalysis was just making its debut,\u201d says Oliveira, one of the pioneers in postcolonial studies in Brazil.<\/p>\n

\u201cUnfortunately, health professionals are still reluctant to incorporate indigenous knowledge into both practice and academia,\u201d laments Douglas Rodrigues, the director of UNIFESP\u2019s Indigenous Outpatient Clinic. \u201cBreaking this ethnocentric view that underestimates other forms of knowledge, such as indigenous knowledge, is difficult. It is worth noting, however, that while a doctor practicing Western medicine typically undergoes six years of undergraduate studies and four years of residency, the training of a paj\u00e9<\/em> in the Upper Xingu can take up to two decades,\u201d he adds.<\/p>\n

Rodrigues highlights that, within the field of anthropology, there has been extensive discussion in the past two decades toward the integration of diverse medical traditions. Concepts like \u201cintermedicality,\u201d first developed in the 1990s by American anthropologist Shane Greene, have played a role in this discourse. Greene argues that this integration often leads to biomedicine exerting dominance over indigenous medicine. \u201cWe must push these discussions further within the field of biomedicine and other healthcare disciplines,\u201d he suggests. In her chapter of the anthology Vozes ind\u00edgenas na produ\u00e7\u00e3o do conhecimento: Para um di\u00e1logo com a sa\u00fade coletiva<\/em> (Indigenous voices in knowledge production: Towards a dialog with public health; Hucitec, 2022), Di\u00e1diney Helena de Almeida, a historian from the Patax\u00f3 ethnicity, writes that \u201csince colonial times, non-European healing practices have been associated with witchcraft and voodoo, marginalizing them as mere expressions of indigenous and African cultures.<\/p>\n

\u201cDuring the nineteenth century, there was a prevailing view among physicians that medical practices and systems outside the scientific realm were not effective in treating illnesses. However, this view was mainly rhetorical since in practice, doctors observed and even experimented with folk healing practices, especially herbal medicine.\u201d<\/p>\n

The anthology was produced in a collaboration between the Oswaldo Cruz Foundation\u2019s National School of Health Policy (ENSP-FIOCRUZ) and a group of indigenous researchers from different regions of Brazil. \u201cDespite the growing number of indigenous students in Brazilian higher education since the early twenty-first century, they still encounter significant barriers to publishing their work and participating in health conferences,\u201d notes sociologist Felipe Rangel de Souza Machado, a researcher at the school and one of the organizers of the initiative. \u201cThey not only face prejudice, but some encounter difficulties due to Portuguese being their second language, and the lack of indigenous bibliographic references.\u201d<\/p>\n

The editorial board for the book consisted entirely of indigenous researchers, including Barreto himself. In addition, each of the 21 articles in the book is lead authored by indigenous researchers from diverse ethnic groups across Brazil. \u201cThe book includes discussions on education and territory, for example, recognizing that health is a comprehensive concept from an indigenous standpoint. It is a form of medicine in which human well-being is inherently connected to the land and the respectful interaction with the environment,\u201d Machado explains.<\/p>\n

\u201cIndigenous peoples are now actively advocating for the right to healthcare that respects their cultures,\u201d notes Almeida, who has a PhD in the history of science and health from FIOCRUZ and serves as professor at the State University of Santa Cruz (UESC) in Bahia. One related initiative is the book Hitupm\u00e2’ax: Curar<\/em> (Hitupm\u00e2\u2019ax: Cure), produced by students from the Maxacali ethnic group as part of the Intercultural Training Program for Indigenous Educators at the Federal University of Minas Gerais (FIEI-UFMG). \u201cThe book was written as a manual for healthcare professionals who are sent to Maxacali reservations. Among other recommendations, it addresses the negative impact of constant turnover of medical teams on the quality of care provided,\u201d says Almeida. The book was launched in 2008 by N\u00facleo Literaterras, at UFMG\u2019s School of Languages and Literature. \u201cThese ideas offer an immensely valuable intercultural experience and should be incorporated as mandatory reading in training programs for healthcare professionals,\u201d he concludes.<\/p>\n

Scientific article<\/strong>
\nBARRETO, J. P. L. Bahserikowi \u2013 Centro de Medicina Ind\u00edgena da Amaz\u00f4nia: Concep\u00e7\u00f5es e pr\u00e1ticas de sa\u00fade ind\u00edgena<\/a>. Amaz\u00f4nica \u2013 Revista de Antropologia<\/strong>. Vol. 9, no. 2, pp. 594\u2013612. 2017.<\/p>\n","protected":false},"excerpt":{"rendered":"Scholars from different ethnic groups discuss healthcare from the perspectives of different peoples","protected":false},"author":689,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[165],"tags":[201,200],"coauthors":[3453],"class_list":["post-479244","post","type-post","status-publish","format-standard","hentry","category-humanities","tag-anthropology","tag-environment"],"acf":[],"_links":{"self":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/479244","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/users\/689"}],"replies":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/comments?post=479244"}],"version-history":[{"count":3,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/479244\/revisions"}],"predecessor-version":[{"id":482028,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/479244\/revisions\/482028"}],"wp:attachment":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/media?parent=479244"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/categories?post=479244"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/tags?post=479244"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/coauthors?post=479244"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}