Indigenous psychology in disasters: lines of care construction for the “Buen Vivir” of original peoples

Noal, Débora da Silva; Lacerda, Luiz Felipe Barboza; Medeiros, Camila Pinheiro; Santos, Renato Antunes dos; Cardoso, Ytanajé Coelho; Coelho, Lara Gonçalves; Schmidt, Beatriz

doi:10.1590/1982-0275202441e230096en

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Brasil

Estudos de Psicologia (Campinas)

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Sumário

DOSSIÊR - Perspectives on Indigenous Psychology in Brazil: ethical and epistemological challenges • Estud. psicol. 41 • 2024 • https://doi.org/10.1590/1982-0275202441e230096en copy

Indigenous psychology in disasters: lines of care construction for the “Buen Vivir” of original peoples

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

In 2021, the indigenous communities Pataxó, Pataxó Hãhãhãe and Tupinambá, in the state of Bahia, Brazil, were hit by intense floods. The situation required immediate response from local health professionals, with advice from experts in public health disasters and emergencies. This case study focuses on the development of lines of care for the “Buen Vivir” of affected original peoples through collaborative work between indigenous ethnic groups and public health policy professionals.

Method

Analysis of the records of meetings, a training course for indigenous health professionals and three reference documents was carried out.

Results

Possibilities and challenges for assuring the “Buen Vivir” in the post-disaster and public health emergency response phase were addressed, guaranteeing the specificity and protagonism of the communities served.

Conclusion

Contributions were presented along the lines of care construction processes for the “Buen Vivir” of indigenous peoples, pursuing subsidies for public policies in accordance with the socio-historical-cultural particularities of each ethnic group.

Keywords
Disasters; Emergencies; Indigenous peoples; Psychosocial intervention; Mental health in ethnic groups

Date		Meeting Summary
1^st meeting 6/1/2022		Expanded meeting, with the participation of 42 representatives from the following institutions: DSEI-Bahia, SESAB, Universidade Federal do Sul da Bahia, Núcleo de Saúde Mental e Atenção Psicossocial (NUSMAPS, Center for Mental Health and Psychosocial Care) of Fiocruz and the Pan-American Health Organization (PAHO). Aim: to begin the process of participatory construction of the care strategy for populations affected by floods, based on the IASC Pyramid (2007)Inter-Agency Standing Committee. (2007). IASC Guidelines on mental health and psychosocial support in emergency settings. IASC. https://interagencystandingcommittee.org/iasc-task-force-mental-health-and-psychosocial-support-emergency-settings/iasc-guidelines-mental-health-and-psychosocial-support-emergency-settings-2007 https://interagencystandingcommittee.org... ^a a Pyramid composed of four levels, from the most basic to the most specialized: , indicating actions and responsibilities at each level. Psychologists from DSEI-Bahia expressed their concern about the focus exclusively on shelters and accommodations. Referral: a specific document ought to be developed, aligned with the matrix document, focusing on mental health and psychosocial care for affected indigenous peoples.
2^nd meeting 7/1/2022		Five participants, including the Head of the Indigenous Health Care Division of DSEI-Bahia, mental health professionals from DSEI-Bahia and representatives from NUSMAPS-Fiocruz. Aim: to begin the process of formulating a document to address mental health and psychosocial care for affected indigenous peoples.
3^rd meeting 7/1/2022		Sixteen participants, representatives of NUSMAPS-Fiocruz and DSEI-Bahia (psychologists, social workers, nutritionist, pharmacist and health advisor, four of whom were indigenous professionals). Aim: to address response strategies in mental health/Buen Vivir for indigenous peoples affected by floods in Bahia, targeting the participatory mapping of the following issues: (a) What could not be missing in a care strategy for indigenous populations, in the phase of response, and which partners to articulate?; (b) What are the strengths of the affected indigenous communities that would facilitate the implementation of this strategy?; (c) What are the weaknesses of the affected indigenous communities that would make it difficult to implement this strategy? The discussions allowed to raise central demands; articulate public policies and their relevant institutions; structure the first version of the document, which was subsequently presented to the expanded group for evaluation and additions (called, at the end of the process, Recommendations on Mental Health and Psychosocial Care/Buen Vivir for Indigenous Peoples Affected by the Floods in Bahia); list aspects of vulnerability in the post-disaster response (e.g., restoration of water, housing and roads) and recovery (e.g., food security) phases (Noal et al., 2022Noal, D. S., & Rabelo, I. V. M. (2022). Desastres relacionados às mudanças climáticas e seus impactos na saúde mental. In C. Barcellos, C. Corvalán, & E. Silva (Eds.), Mudanças Climáticas e seus impactos na saúde mental (pp. 117-134). Editora Fiocruz. https://doi.org/10.7476/9786557081679 https://doi.org/10.7476/9786557081679... ; United Nations Office for Disaster Risk Reduction, 2015United Nations Office for Disaster Risk Reduction (2015). Sendai Framework for Disaster Risk Reduction 2015-2030. https://www.undrr.org/quick/11409 https://www.undrr.org/quick/11409... ).
4^th meeting 11/1/2022		Four participants: three members of NUSMAPS-Fiocruz and an indigenous psychologist of national reference, a professional linked to DSEI-Bahia and member of the Brazilian Articulation of Indigenous Psychologists. Aim: explore historical aspects of indigenous peoples in the Northeast of Brazil and the importance of the territorial struggle for indigenous Buen Vivir; emergency and medium-term approaches, seeking to mitigate the impact of floods in Bahia. Referrals: proposal for an online training course aimed at DSEI-Bahia workers (which will be discussed later in this article), as well as the creation of a video with psychologist NitaTuxá^b b Citation of name authorized by the professional, to whom the authors are grateful. , with support from Fiocruz, for the Acolhe Bahia series, entitled Acolhe Parente (Welcome Relatives): Buen Vivir and Psychosocial Care (https://youtu.be/63QViroLsYM).
5^th meeting 14/1/2022		Two participants: a representative of NUSMAPS-Fiocruz and a representative of the Head of the Indigenous Health Care Division of DSEI-Bahia. Aim: discuss the process of developing activities; present the proposal for the online training course; present the preliminary version of the reference document Recommendations on Mental Health and Psychosocial Care/Buen Vivir for Indigenous Peoples Affected by Floods in Bahia. The follow-up of activities was approved.

Category		Recommendations
Professionals		Engage interpreters for effective dialogue with the community. Identify the DSEI and the Indigenous Health Houses in the territory, including them in the Contingency Plans of the health establishments at SUS reference network. Ensure ethnic registration in the indigenous person’s screening and/or care form, ensuring reliability of statistics on the impacts of the event on that specific population. Map and join the health actions already carried out by indigenous movements organized in each municipality. Observe the National Policy for the Health of Indigenous Peoples in the construction of strategies. Promote the ambience of the health establishment, according to the ethnic specificities of the indigenous populations served. Enable equitable access and reception criteria, ensuring that strategies are feasible. Ensure comprehensiveness in health care, considering respect and appreciation of cultural aspects, under penalty of socio-emotional suffering resulting from these absences worsening clinical conditions related to other conditions.
Managers		Strengthen intersectoral responses, with federated entities, community leaders and civil society organizations for actions at all levels of the IASC Pyramid. Map risk and protective factors for affected people, drawing on knowledge from community leaders, indigenous health agents and DSEI professionals. Consider local temporality in response strategies. In Primary Care, promote matrix support in mental health in the most impacted territories, in addition to support for training and guidance on how to act in disaster situations. In non-specialized focused support, monitor cases of suicide attempts and self-mutilation, abuse of alcohol and other drugs, liaising with professionals from DSEIs, Psychosocial Care Centers, mental health outpatient clinics, indigenous leaders, etc. Promote listening, supporting and conversation groups, especially aimed at those considered most vulnerable and who demonstrate suffering prior to the disaster; spaces for sharing ancestral narratives and stories, which promote intergenerational dialogue and value cultural practices (singing, dancing, craft production), favoring young people’s feeling of belonging to their collectives; meetings of pajés/shamans to safeguard and disseminate traditional knowledge. Promote spaces for listening to workers (care for caregivers) and also to indigenous leaders, addressing processes of territorial and collective mourning.

Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas Núcleo de Editoração SBI - Campus II, Av. John Boyd Dunlop, s/n. Prédio de Odontologia, 13060-900 Campinas - São Paulo Brasil, Tel./Fax: +55 19 3343-7223 - Campinas - SP - Brazil
E-mail: psychologicalstudies@puc-campinas.edu.br

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[1] Correspondência para: D. S. NOAL. E-mail: noaldebora@gmail.com.