Direitos humanos, vulnerabilidade e vulneração dos povos indígenas brasileiros no enfrentamento à Covid-19 / Human rights, vulnerability and vulneration of Brazilian indigenous peoples coping with Covid-19

Resumo O objetivo deste ensaio teórico é discutir as condições de produção de vulnerabilidade e vulneração dos povos indígenas no Brasil no enfrentamento da coronavirus disease (Covid-19). Iniciamos por um panorama dos processos de negação de direitos e vulnerabilização que se intensificaram no governo Bolsonaro. Por fim, destacamos os componentes da vulnerabilidade e vulneração que afetam os povos indígenas brasileiros no enfrentamento da Covid-19. Os resultados mostraram que os povos indígenas têm múltiplas vulnerabilidades relacionadas aos seus contextos sócio-históricos e culturais que, no Brasil, são agravadas por uma política neocolonialista e autoritária. Concluímos que os povos indígenas brasileiros não estão apenas expostos à condição de vulnerabilidade, mas à vulneração frente à Covid-19. O estudo contribui para a compreensão das implicações da ausência de condições equitativas de proteção contra o coronavírus em relação à alta mortalidade dos indígenas devido à Covid-19.

Abstract This theoretical essay aims to discuss the conditions of production of vulnerability and vulneration of indigenous peoples in Brazil coping with Covid-19. We begin with an overview of the processes of denial of rights and vulnerability that intensified in the Bolsonaro government. We finally highlight the components of vulnerability and vulneration that affect Brazilian indigenous peoples in confronting Covid-19. Results showed that indigenous peoples have multiple vulnerabilities related to their socio historical and cultural contexts, which in Brazil are aggravated by a neocolonialist and authoritarian politic. We clearly concluded that Brazilian indigenous peoples are not only exposed to the condition of vulnerability, but to vulneration facing with Covid 19. The study contributes for understanding the implications of the absence of equitable conditions of protection against the coronavirus regarding to the high mortality of indigenous people due to Covid-19.

Challenges to access health faced by rural population and their perception regarding healthcare

The Brazilian nation has rich population diversity, and this makes it responsible for guaranteeing the social rights of all. In this perspective, this research seeks to categorize which are the main challenges in access to health that the rural populations face and to understand how the execution of this health care is carried out by professionals from the perspective of rural people. This is a cross-sectional study with a qualitative approach, carried out at the Nossa Senhora Aparecida Settlement, located in the municipality of Pesqueira (Pernambuco state) in 2018. The results demonstrate that the challenges facedby settled families are due to the difficulty of access to health services. In view of this, the rural population chooses to keep their cultural practices focused on their health alive. Therefore, it is common to use herbal medicines and mystics related to religious beliefs in self-care practices. It was concluded that the current public policies have gaps in their implementation, especially in terms of accessibility, security, health education, equity and respect for cultural differences. In addition, there is precariousness at the national level of studies focused on the health determinants and determinants of the rural population, which makes it necessary that more research be carried out so that new public policies can emerge.

Conhecimento de gestores e profissionais da rede de atenção psicossocial sobre matriciamento em saúde mental / Knowledge of managers and professionals of the psychosocial care network on mental health matrixing

Objective: To identify the knowledge of managers and health professionals of a municipality in the sertão of Pernambuco State about the support in the matrix of mental health. Methods:This is a descriptive, qualitative study, carried out from October 2017 to January 2018. Ten professionals from the Municipal Psychosocial Care Network were interviewed through a semi-structured script. The analysis of the content of the interviews was developed according to the discursive textual analysis method. Results:There were gaps in knowledge about matrixing and difficulties in recognizing the mental health actions that should be developed in Primary Health Care. The deficient academic training of health managers and professionals negatively influences their conceptual knowledge and their ability to implement mental health matrixing. The main difficulties were the lack of participation of professionals, the stigma of the person with mental disorder, as well as limitations in the size of human resources, workload and infrastructure of the health services. Final considerations:The actions of permanent education are important resources to overcome these problems, enhancing the expansion of matrix practices

Objetivo: Identificar o conhecimento dos gestores e profissionais de saúde de um município do sertão pernambucano sobre o apoio matricial em saúde mental. Métodos:Trata-se de um estudo descritivo,de abordagem qualitativa, realizado no período de outubro de 2017 a janeiro de 2018. Foram entrevistados dez profissionais da Rede de Atenção Psicossocial municipal, por meio de um roteiro semiestruturado. A análise do conteúdo das entrevistas foi desenvolvida segundo o método de análise textual discursiva. Resultados: Evidenciaram-se lacunas de conhecimento sobre matriciamento e dificuldades para reconhecer as ações de saúde mental que devem ser desenvolvidas na Atenção Primária à Saúde. A formação acadêmica deficitária de gestores e profissionais de saúde influencia negativamente o seu conhecimento conceitual e a sua habilidade de implementar ferramentas de matriciamento em saúde mental. As principais dificuldades para matriciar foram a falta de participação dos profissionais, o estigma da pessoa portadora de transtorno mental, assim como limitações no dimensionamento de recursos humanos, carga horária de trabalho e infraestrutura dos serviços de saúde. Considerações finais:As ações de educação permanente são importantes recursos de superação dessas problemáticas, potencializando a expansão das práticas matriciais.