Uma etnografia das práticas sanitárias no Distrito Sanitário especial indígena do Rio Negro - Noroeste do Amazonas

Abstract

This study is characterised as ethnography of the sanitary practices developed at the Rio Negro Indian Sanitary Special District (DSEI), highlighting the work organization of nursing professionals, such as, nurses, nursing technicians and the Indian health-care agent. Its aims comprise the sanitary practices employed by the Indian Health-Care Multidisciplinary Team (EMSI) nursing corps regarding the provision of differentiated attention to health-care as it interacts with the Baniwa Indian health-care agent (AIS), his forming process and sociodemographic profile; social representations and sanitary practices, seeking to grasp his compatibility and/or incompatibility with the policy of differentiated attention to the Indian health-care subsystem. The present research entails a prospective, descriptive, qualitative type study, directed by the interpretative model of the social representation theory and health evaluative survey. The findings here obtained show that the Baniwa AIS, faces problems regarding his low schooling, along with the fact that his professional forming process has advanced very little since the DSEI was implemented six years ago. The EMSI acting profile is marked by the care treatment model to the spontaneous demand, even though the professionals provide care for diseases of the infectious, chronic-degenerative type to specific population groups (mother-child group), with detriment to health surveillance components presupposed on the design of the National health programs. Among the set of essential activities developed in the DSEI, the travelling logistics consumes a large part of the EMSI time and energy, with negative implications on the health-care agent overseeing and followup as well as on the implementation of the differentiated attention principle presupposed by the National Indian Health-Care Policy. The areas are still greatly patched and the differentiated attention gets mixed up with the extension of the coverage provided by the DSEI Implantation.