Earth Rights for the Advancement of a Planetary Health Agenda.

This article discusses Earth's Rights as an environmental justice mechanism of reparation, protection, and justice for indigenous communities, environmental defenders, and other populations in Latin America. We argue that Earth's rights encompass and include the right to health and can be integrated into international human rights frameworks to protect all forms of life, responding to colonial legacies of discrimination and violence. We respond to the scarcity of literature discussing Earth's rights in relation to situations where human rights and Earth's rights are violated. We ground our argument in the theoretical conceptualization of Latin American proposals of Earth's rights and its potential for actionable policy approaches that include human health as inevitably interconnected to our planet's well-being. We address the environmental injustices that affect the right to health and argue that an Earth's rights framework can support reparations for historically marginalized communities.

The willingness to forgive among the Wayuu and among people from other indigenous communities in Colombia

Introduction/Objectives: Willingness to forgive has been studied in different situations, however, there are no published studies in Colombia with indigenous populations and taking into account their worldview. The present research was aimed at examining the willingness to forgive of people from various ethnic minorities in Colombia such as the Embera, Nasa, Pijao and Kaamash-Hu communities and focusing in particular on the Wayuu community. Method: An experimental design was used and a cluster analysis was performed. The sample was composed of 159 indigenous adults (30% male) between the ages of 18 and 76, who were shown a series of scenarios describing a common situation in which an orchard was damaged by domestic animals belonging to a neighbour. Three factors were manipulated in the scenario: the severity of the damage, the level of carelessness of the animals' owner, and the animals' owner's explanations and apologetic behaviour. Results: Cluster analysis yielded five qualitatively different positions: Never forgive under any circumstances (6% of the sample, primarily participants from the Embera community), Depends on apology and neglect (15%), Depends on apology, consequences, and neglect (30%, primarily participants from the Kaamash-Hu community), and Almost always forgive (36%, primarily people from the Wayuu community). Conclusion: Thus, there is a convergence between the results of this study and the anthropological observations of the participating ethnic communities. Forgiveness is closely linked to the cosmovision of each indigenous group.

Introducción/Objetivos: La voluntad de perdonar ha sido estudiada en diferentes situaciones, sin embargo, no existen estudios publicados en Colombia con población indígena y teniendo en cuenta su cosmovisión. La presente investigación tuvo como objetivo examinar la voluntad a perdonar de personas de diversas minorías étnicas en Colombia como la comunidad Embera, Nasa, Pijao, Kaamash-Hu y centrándose en particular en la comunidad Wayuu. Método: Se presentaron una serie de escenarios a una muestra de 159 adultos indígenas (30% hombres) de entre 18 y 76 años. Dichos escenarios describían una situación común en la que una huerta era dañada por animales domésticos de un vecino. Se manipularon tres factores en cada escenario: la gravedad del daño, el nivel de descuido del dueño de los animales y, las explicaciones y el comportamiento de disculpa del dueño de los animales. Resultados: El análisis de clústeres arrojó cinco posiciones cualitativamente diferentes: Nunca perdona bajo ninguna circunstancia (6% de la muestra, principalmente participantes de la comunidad Embera), Depende de las disculpas y del descuido (15%), Depende de las disculpas, las consecuencias y el descuido (30%, principalmente participantes de la comunidad Kaamash-Hu), y Casi siempre perdona (36%, principalmente personas de la comunidad Wayuu). Conclusiones: Por tanto, existe una convergencia entre los resultados de este estudio y las observaciones antropológicas que condujeron a la decisión de la Unesco de considerar el sistema de justicia restaurativa de la comunidad Wayuu como un patrimonio inalterable.

Lucha y reconciliación en Nasa Wesx. Análisis del conflicto armado, procesos de paz y diferenciación étnica en el sur del Tolima / Struggle and Reconciliation in Nasa Wesx. Analysis of the Armed Conflict, Peace Processes and Ethnic Differentiation in the South of Tolima

Resumen: El resguardo indígena de Nasa Wesx, al sur del Tolima, ha sido reconocido por su capacidad para establecer diálogos y acuerdos de paz locales con el grupo gue rrillero FARC, a pesar de tener profundas diferencias étnicas, territoriales y onto- lógicas. A pesar de esto, lograron reconocer que la violencia no era una alterna tiva viable para su pueblo, y superaron una confrontación armada de más de 36 años. Para comprender este proceso, es importante dar cuenta de los contextos étnicos y la etnografía como experiencia de conocimiento que analiza la parti cipación de las comunidades indígenas en el conflicto armado y en la construc ción de paz. Al centrarse en la relación crítica entre la comunidad Nasa Wesx y el conflicto armado en Colombia, se destaca cómo esta comunidad ha sido tanto participante del conflicto como agente de Lucha y reconciliación.

Abstract: The Nasa Wesx indigenous reservation in southern Tolima has been recognized for its ability to establish dialogues and local peace agreements with the FARC guerrilla group, despite profound ethnic, territorial, and ontological differences. Despite this, they managed to recognize that violence was not a viable alterna tive for their people, and they were able to overcome an armed confrontation of more than 36 years. To understand this process, it is important to account for ethnic contexts and ethnography as a knowledge experience that analyzes the participation of indigenous communities in the armed conflict and in peace building. By focusing on the critical relationship between the Nasa Wesx com munity and the armed conflict in Colombia, it highlights how this community has been both a participant in the conflict and an agent of struggle and recon ciliation.

Identificación del virus de hepatitis delta genotipo 3 en comunidades andinas y amazónicas del Perú

Introducción. El virus de la hepatitis delta (VHD) es el causante de la forma más severa de la hepatitis viral humana, se asocia con un riesgo alto de fibrosis al hígado y carcinoma hepatocelular (HCC). Existen 8 genotipos del VHD con diferente distribución geográfica. Objetivos. Identificar los genotipos del VHD circulante en Huanta y tres pueblos indígenas de la Amazonía peruana. Métodos. Estudio observacional y transversal, realizado en 582 muestras reactivas para anti-HBc del VHB. Por el método nRT-PCR se procesaron todos los anti VHD positivos, el genotipo fue determinado mediante secuenciamiento directo tipo Sanger y análisis filogenético del fragmento R0. Se utilizaron 111 secuencias de referencia del GenBank. Las 42 secuencias del estudio fueron editadas y ensambladas con programas bioinformáticos. El análisis filogenético y evolutivo se realizó con los programas: Beast V2.5.2, Jmodeltest v2.1.10, Tracer v1.7.1, Tree Annotator y Figtree v1.4.4. Se utilizaron los modelos Bayesianos Yule y Birth Death skyline serial, el MCMC en 30 y 80 millones respectivamente, con el relaxed uncorrelated Exponential molecular clock. Se calcularon las medidas de resumen y de tendencia central utilizando el programa en STATA 14.0. Resultados. La media de la edad fue de 38 años, el 52,8% fueron mujeres. 101 muestras fueron positivas para anticuerpos anti-VHD. El ARN del VHD fue detectado en el 49,5% de las muestras reactivas a ELISA anti-VHD. El análisis filogenético determinó la presencia del genotipo 3. Conclusiones. Se evidencia la presencia del genotipo 3 del VHD en comunidades andinas y amazónicas del Perú.

Introduction. The Hepatitis Delta Virus (HDV) is the cause of the most severe form of human viral hepatitis and is associated with a high risk of liver fibrosis and hepatocellular carcinoma (HCC). There are 8 HDV genotypes with different geographic distribution. Objectives. To identify the genotypes of VHD circulating in Huanta and three indigenous peoples of the Peruvian Amazon. Methods. Observational and cross-sectional study, from 582 reactive samples for anti-HBc-HBV. Anti-HDV positive samples were processed with the nRT-PCR method, genotype was determined by direct Sanger-type sequencing and phylogenetic analysis of the R0 fragment. 111 reference sequences from GenBank were used. The 42 sequences of the study were edited y assembled with the bioinformatics programs. Phylogenetic and evolutionary analysis was performed with the following software: Beast v2.5.2, Jmodeltest v2.1.10, Tracer v1.7.1, Tree Annotator and Figtree v1.4.4. The Bayesian Yule and Birth Death skyline serial models were used, the MCMC at 30 and 80 million respectively, with the relaxed uncorrelated Exponential molecular clock. Summary and central tendency measures were calculated using the program in STATA 14.0. Results. The mean age was 38 years, 52.8% were women. 101 samples were positive for anti-HDV antibodies. HDV RNA was detected in 49.5% of the anti-HDV ELISA reactive samples. Phylogenetic analysis determined the presence of genotype 3. Conclusions. The presence of HDV genotype 3 in Andean and Amazonian communities of Peru is evidenced.

Epidemiology and Genetic Diversity of Hepatitis B Virus and Hepatitis Delta Virus Infection in Indigenous Communities in Colombia.

Despite the universal vaccination program, there are still regions and territories with a high prevalence of Hepatitis B Virus infection (HBV), such as the Amazon basin, where several indigenous communities live. Additionally, Hepatitis Delta Virus (HDV) is a defective that requires the hepatitis B surface antigen (HBsAg) for the assembly and release of de novo viral particles. Therefore, hepatitis D could be the result of HBV/HDV coinfection or HDV superinfection in individuals with chronic hepatitis B. Among the high prevalence HDV populations are indigenous communities of America. This study aims to describe and characterize the frequency of HBV and HDV infection, viral genotypes and HBV immune escape mutants in indigenous populations from different regions of Colombia. The diagnosis of hepatitis B and hepatitis D was confirmed by serological markers. Moreover, the HBV and HDV genome were amplified by PCR and RT-PCR, respectively, and, subsequently, the phylogenetic analysis was performed. We characterized 47 cases of chronic hepatitis B, 1 case of reactivation and 2 cases of occult hepatitis B infection (OBI). Furthermore, a high prevalence of HDV infection was identified in the study population (29.33%, 22/75) and the circulation of several HBV genotypes and subgenotypes (F1b, F3, F4, and D). Interestingly, this is the first report of the HDV genotype I circulation in this country. These findings demonstrated that HBV and HDV infections are still public health problems in indigenous communities in Colombia.

Chagas Disease: Seroprevalence and Associated Factors in Indigenous Communities of the Southern Limit of Argentine Chaco.

Chagas disease is more prevalent in socially vulnerable communities in the Gran Chaco Eco-region. The study evaluated the seroprevalence of Chagas disease and associated factors between May 2014 and September 2015, in indigenous communities of Santa Fe, Argentina, in the southern Chaco. Lysate ELISA and indirect hemagglutination tests were used to detect antibodies against Trypanosoma cruzi, and recombinant ELISA was used in the case of disagreement. Household surveys were conducted with the head of household about risk factors for the disease. Serological tests were conducted on 298 people from three indigenous communities, 127 male and 171 female. Seroprevalence was 18.5%. A total of 64 surveys were conducted; 82.8% of the heads of household were male, with a median age of 39 years, and 61.0% had not completed primary school. In 35.9% of the households, there was at least one member of the cohabiting group infected with T. cruzi. The level of education of the head of household showed a statistically significant association with Chagas disease (OR = 3.43), among all the risk factors studied. The prevalence of infection is lower than that of other indigenous communities of the Gran Chaco, probably because environmental conditions are moderating and disfavoring the establishment of the insect vector in homes, but also because of socioeconomic differences with the rest of the eco-region. Beyond this, serological controls are needed to prevent vertical transmission.

'An incorporeal disease': COVID-19, social trauma and health injustice in four Colombian Indigenous communities.

Worldwide, medical doctors and lawyers cooperate in health justice projects. These professionals pursue the ideal that, one day, every individual on Earth will be equally protected from the hazards that impair health. The main hindrances to health justice are discrimination, poverty and segregation, but we know that beyond concrete, quantifiable barriers, symbolic elements such as beliefs and fears also play a significant role in perpetuating health injustice. So, between March 2020, when the World Health Organization declared COVID-19 a global pandemic, and June 2021, when vaccines against the virus were globally available, we collected original information about the ways in which four Colombian Indigenous communities confronted COVID-19. Knowing that Colombian Indigenous communities often face health injustices, our goal was to understand the role of symbolic elements in the situation. Our main insight is that historical genocidal processes, in which the powerful have betrayed the trust of Indigenous communities, have created a trauma in the latter, resulting in reluctance and suspicion regarding the acceptance of 'gifts' from external sources, including potentially beneficial health treatments.

Tecnologia digital como instrumento de saúde em uma comunidade indígena no Vale de São Francisco / Digital technology as a tool for health promotion in an indigenous community in the Vale de São Francisco

Resumo: Introdução: As comunidades tradicionais são grupos de indivíduos socialmente organizados que partilham comportamentos econômicos, socioambientais e culturais comuns. Entre elas, destacam-se as comunidades indígenas no Brasil, que vêm sofrendo o impacto da urbanização, do crescimento de doenças crônicas e epidemias e do aumento da insegurança alimentar. Relato de experiência: Este estudo teve como objetivo descrever as experiências da equipe de saúde, quanto ao uso de uma ferramenta de gestão de dados na assistência, em uma comunidade indígena no Nordeste brasileiro. Trata-se de um relato de experiência do uso de uma ferramenta digital nas ações assistenciais em uma comunidade tradicional. A equipe de saúde foi dividida em dois grupos: agentes comunitários de saúde e estudantes de Medicina. Discussão: A descrição das experiências e a análise das narrativas resultaram na identificação de 258 citações, que foram classificadas em 12 categorias, relacionadas ao objeto de estudo. Dentre estas, as questões ligadas aos benefícios da ferramenta foram as mais mencionadas (43,41%), em que os subgrupos abordaram diferentes reflexões. A segunda categoria mais citada se referia às limitações da ferramenta (15,11%), sendo a necessidade do sinal de internet o ponto crítico. Ou seja, esta pesquisa mostra vantagens da ferramenta na atenção à saúde, mas também explicita fragilidades inerentes ao seu uso, de modo a trazer questões importantes dessa vivência e estimular práticas semelhantes. Conclusão: Esse relato de experiência, como método científico, traz importantes questões vivenciadas, relacionadas à aplicabilidade prática de uma ferramenta digital em uma comunidade indígena. Apesar de ser inegável que há pontos de fragilidade evidentes, eles não comprometeram o resultado afirmativo da vivência, melhorando a assistência.

Abstract: Introduction: Traditional communities are groups of socially organized individuals with common economic, socio-environmental, and cultural behaviors. Brazil's indigenous communities are a prime example of these groups, suffering the impact of urbanization, the growth of chronic diseases, epidemics, and increased food insecurity. Experience report: To describe the health team's experiences in the use of a data management tool for care in an indigenous community in northeastern Brazil. Methodology: This is an experience report on the use of a digital tool to assist actions in a traditional community. The health team was divided into community health agents and medical students. Discussion: The description of the experiences and analysis of the narratives resulted in identifying 258 citations, classified into 12 categories related to the study scope. Of these, issues related to benefits of the tool were the most commonly mentioned (43.41%), where the subgroups addressed different reflections. The second most cited category referred to the tool's limitations (15.11%), with the need for an internet connection being the critical point. This research, therefore, shows the tool's advantages in health care but also explains weaknesses inherent to its use, raising important issues of this experience and stimulating similar practices. Conclusion: This experience report, as a scientific method, addresses essential experienced issues related to the practical applicability of a digital tool in an indigenous community. Although it is undeniable that there are obvious points of weakness, these did not compromise the positive result of the experience, and care was improved.

Nutritional Assessment of the Infant Population of the Chirikyacu Indigenous Community of Peru.

Malnutrition is one of the main public health problems affecting early childhood development, compromising the health and quality of life of thousands of Peruvian children. The main contribution of this work is the analysis of the nutritional status of the infant population of the Chirikyacu Indigenous Community of Peru in order to evaluate current and future food policies. It is a cross-sectional study with a sample of 19 children between 6 months and 6 years of age. Sociodemographic, anthropometric, clinical variables and dietary habits were analyzed from 7 January to 4 February 2018. The mean age of the children was 29.74 months (SD = 23.91). We found statistically significant differences between the BMI values of boys and girls (p < 0.05; Mann−Whitney test). According to the z-scores, 35.29% suffer from malnutrition, although in no case is it severe. Hair, nails and skin were in good condition in general, except for some cases showing signs of nutritional deficiency. Dietary patterns are based on legumes, vegetables, dairy products, ice cream, cookies and sweets, and are considered insufficient to cover basic needs; water intake was also insufficient. Breastfeeding lasted an average of 14 months (SD = 2.9). We found a prevalence of malnutrition higher than that established by the WHO in Latin America among the children of Chirikyacu. The dietary pattern is insufficient to cover basic needs, so it is necessary to continue with nutritional educational interventions to improve it.

Bird conservation status and cultural values in Indigenous Mexican communities: towards a bioculturally informed conservation policy.

BACKGROUND: We summarize comparative ethnoornithological data for ten Mexican Indigenous communities, an initial step towards a comprehensive archive of the avian diversity conserved within Mexico's Indigenous territories. We do so by counting highlighted species listed for bird conservation status on widely recognized "red lists" and their cultural value to build biocultural policies in Mexico for their conservation. METHODS: Indigenous bird names for each study site were determined to allow calculation of the "Scientific Species Recognition Ratio" (SSRR) for high cultural value birds obtained across communities. This demonstrated patterns of cultural prominence. A matrix of 1275 bird versus seven biocultural values was analysed using a correspondence analysis (InfoStat/L-v2020) to illustrate patterns of concordance between bird conservation status and cultural values. RESULTS: This paper contributes to quantitative and qualitative data on the role of ethnoornithology and ethnobiology in biocultural conservation. The areas studied provide refugia for almost 70% of the Mexican avifauna within a fraction of 1% of the national territory, that is 769 bird species recorded for all communities. The global correspondence of regions of biological and linguistic megadiversity is well established, while linguistic diversity is widely accepted as a good proxy for general cultural diversity. Our correspondence analysis explained 81.55% of the variation, indicating a strong relation between cultural importance and bird conservation status. We propose three main categories to establish a bioculturally informed public policy in Mexico for the conservation of what we described as high, medium, and bioculturally prominent bird species all include cultural value in any material or symbolic aspect. High are those species appearing on any threatened list, but also considered in any endemic status, while medium include threatened listed species. The last category included species not necessarily listed on any threat list, but with a wide range of social and cultural uses. We suggest that the concept might be extended to other species of biocultural importance. CONCLUSIONS: We argue that bird conservation policies should be biocultural, that is they should recognize birds of cultural value on a par with bird species "of special interest" because they are most critical for biodiversity conservation. The desire of local people to protect their traditional community lands and livelihoods can be an effective biodiversity conservation strategy, which should be recognized in national biocultural policies.

Discrepancies in infant feeding recommendations between grandmothers and healthcare providers in rural Mexico.

BACKGROUND: Infant feeding practices are rapidly changing within rural areas in Mexico, including indigenous communities. The aim of this study was to compare infant feeding recommendations between grandmothers and healthcare providers, to better understand the factors that may influence these practices within these communities. This study builds on research that recognizes the legacy of colonization as an ongoing process that impacts the lives of people through many pathways, including the substandard healthcare systems available to them. METHODS: Qualitative study based on secondary data analysis from interviews and focus groups guided by a socioecological framework conducted in 2018 in two rural, Indigenous communities in Central Mexico. Participants were purposively selected mothers (n = 25), grandmothers (n = 11), and healthcare providers (n = 24) who offered care to children up to two years of age and/or their mothers. Data were coded and thematically analyzed to contrast the different perspectives of infant feeding recommendations and practices between mother, grandmothers, and healthcare providers. RESULTS: Grandmothers and healthcare providers differed in their beliefs regarding appropriate timing to introduce non-milk foods and duration of breastfeeding. Compared to grandmothers, healthcare providers tended to believe that their recommendations were superior to those from people in the communities and expressed stereotypes reflected in negative attitudes towards mothers who did not follow their recommendations. Grandmothers often passed down advice from previous generations and their own experiences with infant feeding but were also open to learning from healthcare providers through government programs and sharing their knowledge with their daughters and other women. Given the contradictory recommendations from grandmothers and healthcare providers, mothers often were unsure which advice to follow. CONCLUSIONS: There are important differences between grandmothers and healthcare providers regarding infant feeding recommendations. Healthcare providers may perceive their recommendations as superior given the neocolonial structures of the medical system. Public health policies are needed to address the different recommendations mothers receive from different sources, by harmonizing them and following an evidence-informed approach. Breastfeeding programs need to value and to seek the participation of grandmothers.

Barriers to cutaneous leishmaniasis care faced by indigenous communities of rural areas in Colombia: a qualitative study.

BACKGROUND: Neglected tropical diseases (NTDs) such as cutaneous leishmaniasis (CL) are often associated with rural territories and vulnerable communities with limited access to health care services. The objective of this study is to identify the potential determinants of CL care management in the indigenous communities in the rural area of the municipality of Pueblo Rico, through a people-centered approach. METHODS: To achieve this goal, qualitative ethnographic methods were used, and a coding framework was developed using procedures in accordance with grounded theory. RESULTS: Three dimensions that affect access to health care for CL in this population were identified: (1) contextual barriers related to geographic, economic and socio-cultural aspects; (2) health service barriers, with factors related to administration, insufficient health infrastructure and coverage, and (3) CL treatment, which covers perceptions of the treatment and issues related to the implementation of national CL treatment guidelines. This study identified barriers resulting from structural problems at the national level. Moreover, some requirements of the national guidelines for CL management in Colombia impose barriers to diagnosis and treatment. We furthermore identified cultural barriers that influence the perceptions and behavior of the community and health workers. CONCLUSIONS: While the determinants to CL management are multidimensional, the most important barrier is the inaccessibility to CL treatment to the most vulnerable populations and its inadequacy for the socio-territorial setting, as it is not designed around the people, their needs and their context.

Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention.

BACKGROUND: Abusive and disrespectful treatment of women during childbirth is a critical global issue that threatens women's sexual rights and reproductive rights and access to quality maternal care. This phenomenon has been documented in Colombia. However, little emphasis has been placed on identifying the drivers of and potential interventions against disrespect and abuse against particularly vulnerable populations in the country, including internally displaced indigenous women. METHODS: This report is a sub-analysis of a larger project. Semi-structured interviews were conducted with indigenous (Embera) women with childbirth experience (n = 10), maternal healthcare workers (n = 6), and community stakeholders (n = 5) in Medellín, Colombia. Qualitative analysis techniques, consisting of inductive and deductive approaches, were used to identify and characterize the drivers of disrespect and abuse against indigenous women during childbirth and points for intervention. Existing frameworks were adapted to thematically organize drivers and potential solutions into four interrelated subsystems: individual and community factors, clinician factors, facility factors, and national health system factors. RESULTS: Participants highlighted disrespect and abuse as stemming from (within the individual and community level) its normalization, lack of autonomy and empowerment among indigenous women, lacking antenatal care, (within the clinician level) prejudice, linguistic or cultural barriers to communication, lack of understanding of indigenous culture, medical culture and training, burnout and demoralization, (within the facility level) inadequate infrastructure, space, and human resources, and (within the national systems level) lack of clear policies and the devaluing of respectful maternity care. They called for interventions specific to these drivers, grounded in dignity and respect for indigenous culture. CONCLUSION: This paper expands upon the growing literature on global mistreatment during childbirth by highlighting drivers of mistreatment and identifying points for intervention in a previously unstudied population. Our data show that indigenous women are especially vulnerable to mistreatment due to cultural and linguistic barriers and prejudice. Broad and meaningful action is urgently needed to realize these women's rights to respectful maternity care. Interventions must be multifaceted and locally specific, taking into account the needs and wants of the women they serve.

RESUMEN: CONTEXTO: El trato abusivo recibido por mujeres durante el parto es un problema mundial que amenaza los derechos de las mujeres y el acceso a una atención materna de calidad. Este fenómeno ha sido documentado en Colombia, pero poco énfasis se ha hecho en poblaciones vulnerables, como las mujeres indígenas desplazadas. METODOLOGíA: Se presentan resultados derivados de un proyecto macro. Se realizaron entrevistas con mujeres indígenas Emberas que tuvieron experiencia de parto en Medellín (n = 10), profesionales de salud (n = 6) y líderes comunitarios (n = 5). Se utilizaron técnicas de análisis cualitativo de enfoques inductivos y deductivos, para identificar aspectos que generan el maltrato contra las mujeres indígenas durante el parto y posibles intervenciones para evitar su ocurrencia. Los modelos teóricos existentes se adaptaron para organizar temáticamente los generadores del maltrato y soluciones en cuatro subsistemas: factores individuales y comunitarios, factores clínicos, factores relacionados a los hospitales y factores asociados al sistema nacional. RESULTADOS: Los participantes destacaron como factores a nivel individual y comunitario la normalización de tratos irrespetuosos y abusivos de parte de los profesionales de salud con las mujeres indígenas, así como su falta de autonomía y empoderamiento. A nivel clínico, se identificó la falta de atención prenatal, barreras para la comunicación, falta de comprensión de la cultura indígena, la cultura y formación médica, la desmoralización de los médicos. Sobre los servicios de salud, se encontraron infraestructuras, espacios y recursos humanos inadecuados. En el nivel del sistema, se identifican la falta de políticas y poca valoración de la atención respetuosa. Los participantes señalaron la importancia de realizar intervenciones sobre estos generadores, basados en la dignidad y el respeto por la cultura indígena. CONCLUSIONES: Este artículo amplía la creciente literatura global sobre el maltrato dirigido a las maternas durante el parto y muestra que las mujeres indígenas son especialmente vulnerables debido a las barreras y prejuicios culturales y lingüísticos. Se necesitan urgentemente acciones amplias para hacer realidad los derechos de las mujeres frente a la atención materna respetuosa. Las intervenciones deben ser multifacéticas y específicas a nivel local, teniendo en cuenta las necesidades y deseos de las mujeres a las que sirven.

Healthcare professionals' experiences and perceptions regarding health care of indigenous pregnant women in Ecuador.

BACKGROUND: Pregnancy is an important life experience that requires uniquely tailored approach to health care. The socio-cultural care practices of indigenous pregnant women (IPW) are passed along the maternal line with respect to identity, worldview and nature. The cultural differences between non-indigenous healthcare professionals (HPs) and IPW could present a great challenge in women's health care. This article presents an analysis from a human rights and gender perspective of this potential cultural divide that could affect the health of the IPW in an Andean region of Ecuador with the objective of describing the health challenges of IPWs as rights holders through the experiences and perceptions of HP as guarantors of rights. METHODS: We conducted 15 in-depth interviews with HPs who care for IPW in Chimborazo, Pichincha provinces of Ecuador. We utilized a semi-structured interview guide including questions about the experiences and perceptions of HPs in delivering health care to IPW. The interviews were recorded, transcribed and subjected to thematic analysis in Spanish and translated for reporting. RESULTS: We found disagreements and discrepancies in the Ecuadorian health service that led to the ignorance of indigenous cultural values. Common characteristics among the indigenous population such as illiteracy, low income and the age of pregnancy are important challenges for the health system. The gender approach highlights the enormous challenges: machismo, gender stereotypes and communication problems that IPWs face in accessing quality healthcare. CONCLUSIONS: Understanding the diverse perspectives of IPW, acknowledging their human rights particularly those related to gender, has the potential to lead to more comprehensive and respectful health care delivery in Ecuador. Further, recognizing there is a gender and power differential between the provider and the IPW can lead to improvements in the quality of health care delivery and reproductive, maternal and child health outcomes.

Creencias y actitudes de resistencia a la vacunación contra la COVID-19 en comunidades indígenas de la provincia Cotopaxi / Beliefs and attitudes of resistance to vaccination against COVID-19 in indigenous communities of the Cotopaxi province

La respuesta a la vacunación no es solo un problema sanitario y su caracterización epidemiológica no puede responder únicamente a una perspectiva exclusivamente biomédica sino también de alcances sociales, educativos y económicos de profundo arraigo cultural. El objetivo de este estudio fue conocer las actitudes y creencias en cuatro comunidades indígenas de la provincia Cotopaxi, con respecto al proceso de vacunación. Se estratificaron resultados de los muestreados a fin de explorar si las comunidades indígenas con mayor nivel educativo o mayor asistencia a las charlas educativas sobre vacunación diferían de otras en cuanto a sus actitudes y creencias erróneas sobre este proceso. La comunidad Zq1 mostró ser la de menor nivel educativo, menor porcentaje de asistencia a las charlas educativas y presentó el mayor por ciento de aceptación de la vacunación (75.0%). La mediana de la tasa de creencias erróneas fue mayor para creencias como "Las vacunas no son seguras" (Aq3, Cq4: 9,4 ± 1,1, Gq2: 9,3 ± 1,2, Zq1: 8,8 ± 1,3) y "Las vacunas tienen un propósito oculto" (Aq3: 8,6 ± 1,5, Cq4: 8,7 ± 1,4, Gq2: 9,0 ± 1,3, Zq1: 8,4 ± 1,8)(AU)

The response to vaccination is not only a health problem and its epidemiological characterization cannot only respond to an exclusively biomedical perspective but also to social, educational and economic scopes with deep cultural roots. The objective of this study was to know the attitudes and beliefs in four indigenous communities of the Cotopaxi province, regarding the vaccination process. The results of the sampled were stratified in order to explore whether indigenous communities with a higher educational level or greater attendance at educational talks on vaccination differed from others in terms of their attitudes and erroneous beliefs about this process. The Zq1 community proved to be the one with the lowest educational level, the lowest percentage of attendance at educational talks and had the highest percentage of acceptance of vaccination (75.0%). The median rate of erroneous beliefs was higher for beliefs such as "Vaccines are not safe" (Aq3, Cq4: 9.4 ± 1.1, Gq2: 9.3 ± 1.2, Zq1: 8.8 ± 1 .3) and "Vaccines have a hidden purpose" (Aq3: 8.6 ± 1.5, Cq4: 8.7 ± 1.4, Gq2: 9.0 ± 1.3, Zq1: 8.4 ± 1, 8)(AU)

Chile (Capsicum spp.) as Food-Medicine Continuum in Multiethnic Mexico.

Mexico is the center of origin and diversification of domesticated chile (Capsicum annuum L.). Chile is conceived and employed as both food and medicine in Mexico. In this context, the objective of this paper is to describe and analyze the cultural role of chile as food and as medicine for the body and soul in different cultures of Mexico. To write it, we relied on our own fieldwork and literature review. Our findings include a) the first matrix of uses of chile across 67 indigenous and Afrodescendants cultures within Mexican territory and b) the proposal of a new model of diversified uses of chile. Traditional knowledge, uses and management of chile as food and medicine form a continuum (i.e., are not separated into distinct categories). The intermingled uses of Capsicum are diversified, deeply rooted and far-reaching into the past. Most of the knowledge, uses and practices are shared throughout Mexico. On the other hand, there is knowledge and practices that only occur in local or regional cultural contexts. In order to fulfill food, medicinal or spiritual functions, native communities use wild/cultivated chile.

Shifting cultivation and hunting across the savanna-forest mosaic in the Gran Sabana, Venezuela: facing changes.

BACKGROUND: Human encroachment and overexploitation of natural resources in the Neotropics is constantly increasing. Indigenous communities all across the Amazon, are trapped between a population rise and a hot debate about the sustainability of hunting rates. The Garden Hunting hypothesis states that shifting cultivation schemes (conucos) used by Amazon indigenous communities may generate favorable conditions, increasing abundance of small and medium wildlife species close to the 'gardens' providing game for indigenous hunters. METHODS: Here, we combined camera trap surveys and spatially explicit interview dataset on Pemón indigenous hunting scope and occurrence in a mosaic of savanna and forest in the Gran Sabana, Venezuela to evaluate to what extent the wildlife resource use corresponds to Garden Hunting hypothesis. We applied the Royle-Nichols model and binomial regression in order to: (1) assess whether abundance of small and medium wildlife species is higher close to conucos and (2) evaluate whether hunters select hunting localities based on accessibility to wildlife resources (closeness to conuco) more than wildlife abundance. RESULTS: We find mixed evidence supporting the Garden Hunting hypothesis predictions. Abundance of small and medium species was high close to conucos but the pattern was not statistically significant for most of them. Pemón seem to hunt in locations dominated by forest, where species abundance was predicted to be higher, than in close vicinity to conucos. Hunting scope was focused on the most abundant species located close to the conuco (Cuniculus paca), but also in less abundant and unavailable species (Crax alector, Tapirus terrestris and Odocoileus virginianus). CONCLUSIONS: Our research provided the first attempt of a systematic sampling survey in the Gran Sabana, generating a quantitative dataset that not only describes the current pattern of wildlife abundance, but sets the base-line to monitor temporal and spatial change in this region of highland Amazon. We discuss the applicability of the estimates generated as a baseline as well as, environmental challenges imposed by economic, social and cultural changes such as mining encroachment for wildlife management.

Dataset: Ecosystem services and uses of dune systems of the coast of the Araucanía Region, Chile: A perception study.

The dataset shows the relationship and valuation of the coastal dunes of the Araucanía region in Chile. The valuation of the local population was surveyed using a questionnaire applied to 49 subjects belonging to Mapuche communities and local government. The data consists of eight tables that show a list of questions, the number of times per year that visit the dunes, cultural practices carried out in the dunes, valuation of ecosystem services provided by the coastal dunes, and knowledge about flora and fauna. Lastly, the original questionnaire and its responses in Spanish and English are included in supplemantary material. This dataset was generated within the framework of the manuscript "Ecosystem services and uses of dune systems of the coast of the Araucanía Region, Chile: a perception study" where 23 leaders of Mapuche communities and 26 representatives of the local government were interviewed. The dataset can be used to compare the valuation of ecosystems by local communities, especially when quantitative data are scarce or do not exist.

Land and livelihood in the age of COVID-19: Implications for indigenous food producers in Ecuador.

Like many Latin American countries, Ecuador responded to COVID-19 by restricting trade and travel, a decision that disrupted the prevailing model of regional trade integration. Among some analysts, observations have been made that the lockdown represents a new opportunity to revitalize rural livelihoods and smallholder agriculture. This paper evaluates these claims by exploring the impact of COVID-19 on household food security and smallholder food production in Chimborazo, a highland province that is known for extremely high rates of poverty and the highest concentration of Kichwa-speaking Indigenous people in Ecuador. Drawing upon original empirical research, it makes the case that the prospects for revitalizing smallholder production remain structurally constrained by a legacy of land inequality and failed agrarian reform. According to our findings, the only sectors that thrived during the lockdown were ones that served local markets. For those requiring significant shipping and storage, merchants and traders were able to drive down farmgate prices, squeezing local producers. At the same time, new government legislation made it easier for employers to terminate wage labourers, undermining a vital source of income and employment for low-income households. Far from revitalizing smallholder agriculture, the pandemic appears to have further entrenched an economic model of supporting agribusiness at the expense of family farms and migrant labour.

Microscopic and submicroscopic Plasmodium infections in indigenous and non-indigenous communities in Colombia.

BACKGROUND: The indigenous population is considered a highly susceptible group to malaria because individuals usually live in areas with high exposure to Anopheles and poverty, and have limited access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not been studied extensively. This study aimed to determine the prevalence of Plasmodium infections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia. METHODS: A community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. Inhabitants of all ages willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection. RESULTS: Among 713 participants, 60.7% were from indigenous communities. Plasmodium spp. was detected in 30 subjects (4.2%, CI 95% 2.9-5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6-3.9) and 1.7% (CI 95% 0.9-2.9), respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2-7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the prevalence of infection compared with a non-indigenous population (PR 19.4; CI 95% 2.3-166.7). CONCLUSION: There is a high proportion of Plasmodium infection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.