Taxonomias das doenças entre os índios Baniwa (arawak) e desana (tukano oriental) do alto rio negro (Brasil)

Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: 'Every Life Has Equal Value'

Snakebites are more frequent in the Brazilian Amazon than in other parts of Brazil, representing a high cost for the health system since antivenoms are only available through medical prescription from central municipal hospitals in most cases. The need for a cold chain and physicians usually restricts access to the only effective treatment of a snakebite, the antivenom. The complex topography of the rivers contributes to delays in treatment, and consequently increases the risk of severe complications, chronic sequelae and death. Thus, decentralization of antivenom treatment to primary healthcare facilities in the interior would increase access by indigenous population groups to proper healthcare. To standardize and evaluate the decentralization to low complexity indigenous healthcare units, we suggest the (i) development and validation of standardized operational procedures, (ii) training of professionals in the validated protocol in a referral health unit, (iii) implementation of the protocol in an indigenous healthcare unit, (iv) assessment of perceptions towards and acceptability of the protocol, and (v) estimation of the impact of the protocol's implementation. We expect that antivenom decentralization would shorten the time between diagnosis and treatment and, as such, improve the prognosis of snakebites. As health cosmology among indigenous populations has an important role in maintaining their way of life, the introduction of a new therapeutic strategy to their customs must take into account the beliefs of these peoples. Thus, antivenom administration would be inserted as a crucial therapeutic tool in a world of diverse social, natural and supernatural representations. The information presented here also serves as a basis to advocate for support and promotion of health policy initiatives focused on evidence-based care in snakebite management.

Entre játa y waweamu: VIH/SIDA en las comunidades awajún de la Amazonía Peruana

Resumen Este artículo tiene por objetivo presentar las nociones y experiencias awajún de vivir con VIH/SIDA. Los Awajún del distrito de El Cenepa, expresa su comprensión del VIH/SIDA como condición apách (no indígena) por medio de las expresiones “játa SIDA” y “waweamu con síntoma de SIDA” que designan sus nuevas nociones de enfermedad y daño (brujería). Estas concepciones awajún conjugan dimensiones corporales, sociales y espirituales que se entrelazan en la multiplicidad de lo que es “estar enfermo”. Con base en el análisis de dos historias de vida (Elvis y Ricardo), propongo mostrar los caminos de búsqueda de salud y la compleja relación desplegada por las familias awajún, especialmente por las madres de las personas afectadas por esta epidemia.

Antimalarial plants used by indigenous people of the Upper Rio Negro in Amazonas, Brazil

ETHNOPHARMACOLOGICAL RELEVANCE

This is the first intercultural report of antimalarial plants in this region. The aim of this study was to document the medicinal plants used against malaria by indigenous people in the Upper Rio Negro region and to review the literature on antimalarial activity and traditional use of the cited species.

MATERIALS AND METHODS

Participant observation, semi-structured interviews, and ethnobotanical walks were conducted with 89 informants in five indigenous communities between April 2010 and November 2013 to obtain information on the use of medicinal plants against malaria. We reviewed academic databases for papers published in scientific journals up to January 2014 in order to find works on ethnopharmacology, ethnobotany, and antimalarial activity of the species cited.

RESULTS

Forty-six plant species belonging to 24 families are mentioned. Fabaceae (17.4%), Arecaceae (13.0%) and Euphorbiaceae (6.5%) account together for 36.9% of these species. Only seven plant species showed a relatively high consensus. Among the plant parts, barks (34.0%) and roots (28.0%) were the most widely used. Of the 46 species cited, 18 (39.1%) have already been studied for their antimalarial properties according to the literature, and 26 species (56.5%) have no laboratory essays on antimalarial activity.

CONCLUSIONS

Local traditional knowledge of the use of antimalarials is still widespread in indigenous communities of the Upper Rio Negro, where 46 plants species used against malaria were recorded. Our studies highlight promising new plants for future studies: Glycidendron amazonicum, Heteropsis tenuispadix, Monopteryx uaucu, Phenakospermum guianensis, Pouteria ucuqui, Sagotia brachysepala and notably Aspidosperma schultesii, Ampelozizyphus amazonicus, Euterpe catinga, E. precatoria, Physalis angulata, Cocos nucifera and Swartzia argentea with high-use consensus. Experimental validation of these remedies may help in developing new drugs for malaria.

[Mythical stories and the construction of the individual: ambiguity of the bodies and indigenous youth in a context of transformation]

Representations about youth vary historically and culturally. In the Upper Rio Negro, there are indigenous groups with over three centuries of contact with the non-indigenous world. In recent years, male initiation rites were suppressed and formal schooling was introduced. These events led to a redefinition of significance in forms of representation at different stages of life. This work sought to understand the construction of the Indian representation of youth; how they correlate with the other life cycle phases and how they contribute to configuring structured social practices in this social group. Several mythical stories dealing with intergenerational relationships have been reviewed; these were correlated with significant stages of life, with other local narratives, and with data gathered from direct observation. The study concludes that the representations about youth have been configured by the social roles of the initiating/initiated, in a currently contradictory fashion, under a generic and lengthy student phase, deprived of its own sociological markers, prolonging the threshold condition of this phase of life.

[Sociocultural aspects of vaccination in an indigenous region]

The article analyzes interactions between the Baniwa, an indigenous group from the Alto Rio Negro region, and the multi-disciplinary healthcare teams that conduct vaccination there. Approaching from the perspectives of the anthropology of disease, studies of Rio Negro ethnology, and the theory of social representations, the study endeavors to comprehend indigenous interpretations of vaccination and the diseases these seek to prevent. Results show that biomedical ideas about vaccines are re-interpreted through Baniwa cosmology. It is concluded that the vigor of Baniwa thought encourages these indigenes to interpret biomedical action in accord with cultural features and that the clash between Baniwa outlooks and those of healthcare providers has negative repercussions on the vaccination process.