Yanomami: ‘The feeling of powerlessness has diminished’, says doctor – 03/29/2023 – Health

Two months after the declaration of a public health emergency and the arrival of teams from the National Force of the SUS (Sistema Único de Saúde) in Yanomami territory, in Roraima, physician Ana Caroline Marques states that “the feeling of impotence has diminished”. Now, there are more medicines and food and, mainly, recognition from society, she says.

“The Yanomami population is being seen. Before, I used to say that they were a forgotten people and that it didn’t seem to exist for the rest of society. Today we can scream and demand minimum working conditions, claim for improvements”, he evaluates.

A native of the Tupiniquim people, in Espírito Santo, the doctor says that she always wanted to work with native peoples and participated in extension programs and internships for this purpose while she was an undergraduate, attended at UFSCar (Federal University of São Carlos).

“I wanted to work where it was really necessary, where I knew that care would make a difference in someone’s life”, he says. And the reality he found after participating in the selection of the Doctors for Brazil Program and taking office at the Auaris center in May 2022 was very different from anything he had ever experienced.

There were many patients with malnutrition, dehydration, skin lesions, pneumonia, diarrhea and worms. “It’s desperate, because you feel powerless and think that everything is going to have a negative outcome. It’s the challenge of trying to do your best to save a life, and at the same time, knowing that your resources are limited”, he says, his voice embargoed.

Marques reports that there was a lack of basic medications, bandage, adhesive tape, and that the team even performed a delivery with rubber gloves, the kind used for cleaning, because there were no disposable gloves.

To minimize the problem, she began asking for donations and self-purchasing medication to take with each routine, as the trip schedule is called.

Doctors have 15 days off and 15 days in the Yanomami Indigenous Territory. Two days before traveling from Boa Vista to the poles, they begin to organize the basket of groceries and medicines. Each pole has a list of foods that can be taken, according to the availability of refrigerators. Many units do not have electricity, and what is obtained through solar panels is used to refrigerate vaccines.

Employees deliver the food and their luggage for weighing, and this material goes on a first flight with the medications and supplies. Then a second flight is carried out by the contracted air taxi company, this time with the team.

When she noticed that basic items were missing, the doctor started to take antibiotics, antipyretics, analgesics and vermifuge on her own. “There were times when we had a patient with a fever and, if I hadn’t taken dipyrone, we would only have the cooling option, bathing in cold water to see if the temperature lowered”, she says.

“I’ve always been very ‘helpful’, I went out asking colleagues for donations and took them. I even avoided a maternal death because I had taken medication to control postpartum hemorrhage”, she recalls.

There was a moment, however, when it was not possible to minimize the lack of resources. When the malaria outbreak occurred, which killed many indigenous people and left serious sequelae, there was no medication or rapid tests for diagnosing the disease.

The capacity for exams is one of the bottlenecks in service. The malaria test is the only one carried out in the region itself. There is also collection of material for the diagnosis of tuberculosis, usually carried out the day before a trip, to be sent for analysis in Boa Vista. For the rest, everything needs to be done in the capital, at least until the Indigenous Health Reference Center is set up at the Surucucu Base Pole, scheduled for the end of April.

Another challenge, this one in transition, is the number of professionals. Marques says that eight doctors are hired, four every fortnight, to serve the entire territory.

“I experienced three different scenarios in my last fortnight. The new doctors were still in the hiring process, receiving guidance on the operation of indigenous health units, and I had contact with two teams of volunteers from the National Force of the SUS”, he says.

When she arrived at the Surucucu center, Marques was accompanied by a nurse, three nursing technicians and an endemic disease control agent, and there was also a physiotherapist and a nutritionist at the center. “We were insufficient, because in order to assist the communities in the region, the team often has to travel, walk for hours or go by helicopter”, comments the doctor.

The National Force team alleviated the situation, but when the volunteers left two days later, Marques was called in for several rescues and the health unit was left short. The scenario only improved again at the end of the fortnight, with the arrival of a new group.

“The presence of professionals needs to be more continuous. It is something that is on the way to happening”, he believes.

New arrivals will have at their disposal latex gloves, vermifuge, ferrous sulfate for patients with anemia, antibiotics, saline solution and analgesics, as well as vitamin and nutritional supplements for malnourished patients —not just rice, corn flakes, milk and cookie, like months ago.

“With the distribution of basic baskets to the communities, we observe that the nutritional status in general is improving”, he points out. “We are still going to treat cases of malnutrition and diarrhea, but with resources.”