The spread of coronavirus disease 2019 (COVID-19) continues to pose a serious threat to 800,000 indigenous people in Brazil. There are 305 tribes who speak 274 languages spread across the remote national territory, who have faced historical inequities related to poverty, health problems, and limited access to health care.

Monitoring the impact of the pandemic among Brazil’s indigenous communities is a major challenge due to the lack of adequate surveillance systems. The data collected by¹1. Queiroz C. Covid-19 e indígenas: os desafios no combate ao novo coronavírus. Uol; 2020. [cited on May 22, 2020]. Available from: Available from: https://www.uol.com.br/vivabem/noticias/redacao/2020/05/02/covid-19-e-indigenas-os-desafios-no-combate-ao-novo-coronavirus.htm?
https://www.uol.com.br/vivabem/noticias/... Government from March 2021 onward suggested ~50,000 cases and 1,000 deaths among those who live in indigenous lands (except for urban indigenous and those waiting on demarcation of land by the government). Many indigenous people go to urban centers in²2. Cardoso AM. If the coronavirus enters the villages, it is possible that the increase in cases will be explosive. Indigenous peoples in Brazil. Socio-environmental policy and legislation: monitoring of conservation units. Socioambiental; 2020. [cited on May 22, 2020]. Available from: Available from: https://www.socioambiental.org/pt-br/noticias-socioambientais/se-coronavirus-entrar-nas-aldeias-e-possivel-que-aumento-de-casos-seja-explosivo-alerta-especialista
https://www.socioambiental.org/pt-br/not... search of better living conditions³3. Yanomami DK. Plataforma de monitoramento da situação indígena na pandemia do novo coronavírus (Covid-19) no Brasil. Socioambiental; 2021. [cited on Feb. 21, 2021]. Available from: Available from: https://covid19.socioambiental.org/
https://covid19.socioambiental.org/... . The census of the last Brazilian Institute of Geography and Statistics (IBGE) showed that 49% of the total population of Brazilian Indians live in urban centers, outside demarcated indigenous lands⁴4. Instituto Brasileiro de Geografia e Estatística. Indicadores de população [internet]. Rio de Janeiro: IBGE; 2021. [cited on May 22, 2020]. Available from: https://www.ibge.gov.br/apps/populacao/.

There have been several structural initiatives to mitigate the impact of COVID-19 including the Emergency Plan to Combat COVID-19 in Indigenous Territories and the National Contingency Plan for Human Infection with the new coronavirus in indigenous people, but there are no known published reports on their impact⁵5. Oliveira J. Com 77 mortes, povos de 34 etnias indígenas já foram atingidos pelo coronavírus no Brasil [internet]. El País; 2020. [cited on May 23, 2021]. Available from: Available from: https://brasil.elpais.com/brasil/2020-05-13/com-77-mortes-povos-de-34-etnias-indigenas-ja-foram-atingidos-pelo-coronavirus-no-brasil.html
https://brasil.elpais.com/brasil/2020-05... .

Indigenous university students, who returned to their villages after suspension of the university’s face-to-face activities, provided a unique opportunity to learn about lived experiences of COVID-19 in their villages through government-sponsored programs. Semi-structured interviews via WhatsApp were conducted with 26 indigenous students from 19 villages located in the central-west, south, and northeast regions of Brazil, which has a population of about 54,000 indigenous people.

The topics covered included socio-demographic, access to health care, (i.e., description of the village regarding location, housing, form of subsistence, access to health, education, social organization, and impact of the pandemic on the village). The interviews were conducted in May and June 2020, after authorization from the indigenous leaders, from the Special Indigenous Sanitary District (DSEI) and approval of the study by the Research Ethics Committee (CONEP) with opinion 4.279.173.

To enrich the narratives, prior to the interviews, indigenous students conducted informal dialogues with their village leaders and other members of the community to obtain socio-demographic and access to health care information regarding the impact of the pandemic in their villages. The thematic analysis was used to analyze the data. The ethnic groups in 19 villages were as follows: Atikum and Pankararu (northeast); Terena, Guarani Kaiowa, Pankará, Pitaguary, Tuxi and Pataxó (midwest); and Kaingangi and Guarani (south). In general, houses are made of clay or wood. Sustainable livelihoods are based on farming, fishing, hunting, livestock, and handicrafts. Each village is governed by a chief, 88% of the villages had an elementary school (for 6-14 years old), and 35% had a secondary school (for 17 years old), with classes held in Portuguese in 52% of schools. A total of 100% of villages had at least one Community Agent for Indigenous Health whose role is to 26% had a Health Centre (Base Pole) with nurse, dentist, doctor, some Poles with nutritionist, and psychologist.

The narratives, although originating from three distinct geographic regions, were convergent and provided contextual insights into the impact of the pandemic on income loss with consequent food insecurity, lack of access to health services, physical and emotional manifestations, and violence and abuse of psychoactive substances.

With deforestation from illegal loggers and miners and climate change, indigenous communities are already vulnerable to food and nutritional insecurity. The loss of income from social isolation preventing the sale of handicrafts exacerbated food and insecurity. Due to the scarce natural resources, these Indians have a diet similar to that of a non-indigenous person, although they still maintain a preference for foods from hunting and fishing. The food is basically purchased from local stores, distributed by the federal government, or generated from subsistence agriculture and the raising of animals such as chickens and pigs.

The “Base Poles” are manned by significant non-indigenous health professionals and struggled to provide a service with reduced visits from non-indigenous professionals, indigenous health professionals’ self-isolation because of high risk of the existing comorbidities (i.e., diabetes, hypertension, asthma, and chronic obstructive pulmonary disease) or COVID-19 infections, and with the shortage of personal protective equipment. There was a strong emphasis on the negative impact of social isolation on their communities given multi-generational housing and the fear of losing indigenous elders who are integral to the maintenance of indigenous traditional knowledge, culture, and practices and are the custodians of customary law and governance. There was also a perception of an increase in substance abuse and family conflicts.

Unquestionably, these narratives illustrate that the pandemic is deepening profound systemic inequities, but they also give a strong sense of young indigenous students wanting to maintain their indigenous systems and that the interviews given them an opportunity to advocate for a response to safeguard their communities (Table 1).

CONCLUSIONS

Finally, we alluded that each culture has its shape, patterns, expressions, and structures to know, explain, and predict the state of well-being, as well as behavior patterns related to the health-disease process and the social and cultural universes where they occur. Then, the valorization of traditional knowledge and practices are paramount in the establishment of therapeutic relationships.

Although data on the impact of COVID-19 on indigenous groups around the world are still irregular, it is already worrying how the pandemic has affected indigenous communities and how the situation remains unfavorable for all indigenous people, as the fragility of public policies, the absence of health teams in many communities, the distance from some villages to medical centers, and the natural fragility of this population to respiratory diseases are added to other health problems.

An essential aspect of this study was to ensure that indigenous views of the world are reflected which are centered on the connection between people and nature. Without pretending to exhaust this reflection, we proposed to continue seeking scientific results that reflect the impacts of the pandemic on indigenous communities, the strategies that indigenous people and health workers have adopted in responding to the pandemic, particularly in relation to the use of traditional knowledge and practices, and in addition to their perceptions of priorities for policy responses. Finally, the data have repercussions in the defense of the protection of indigenous rights and in the strengthening of the actions of young indigenous people who seek help for their communities.

REFERENCES

Publication Dates

History