Grace Soares (Fiocruz Amazonia)
There is little data available on the mental health of young indigenous people. In this context, between December 2020 and January 2021, scientists from the Research Center Leônidas & Maria Deane (Fiocruz Amazonia) carried out a diagnostic study that involved eight regions of the Amazon and that resulted in a better understanding of the effects of COVID-19 in this population group. “The study focused on the understanding of the knowledge, the attitudes and the practices (KAP) of young people on mental health during this pandemic period. The results show that indigenous families have been heavily hit by the pandemic, which has caused deaths and insecurity on the social well-being of the community”, commented the KAP activity coordinator and researcher of the Laboratory of History, Public Policies and Health in the Amazon of Fiocruz Amazônia, Júlio Schweickardt.
Although 98% of the respondents have reported using protection measures, including face masks, hand sanitizer and restricted travelling, about 37% were infected and 68% stated someone in their family has had COVID-19. However, only 17.3% reported having access to some kind of psychological care offered by health services during the pandemic. Amongst traditional practices, home-made medicines were the main measures adopted by them. “These figures highlight the need to strengthen the social protection and mental health networks for these populations. This system was already fragile before the pandemic and will continue to be a path to be built even after the most critical moment of the pandemic is over”, highlights the general coordinator of the project by Fiocruz Amazônia, Michele Rocha El Kadri.
The action was part of the project Indigenous Peoples of the Amazon Against COVID-19 (PIACC in the Portuguese acronym), attended by the Coordination of Indigenous Organizations of the Brazilian Amazon (Coiab) and by Unicef, in addition to Fiocruz. The project was financed by the United States Agency for International Development (USAID). It is estimated that a total of 94 populations, about 2,000 communities and 27,000 families were helped by the activities of the project.
The PIACC encompassed five states: Amazonas, Acre, Pará, Roraima and Amapá, covering mainly eight regions: 1) Tumucumaque and Paru D’Este (PA); 2) Guamá Tocantins (PA); 3) Eastern Roraima (RR); 4) Alto Rio Negro (AM); 5) Alto Rio Solimões (AM); 6) Alto Purus (AM, AC); 7) Médio Purus (AM); 8) Yanomami/AYRCA (AM). The survey allowed access to relevant information on the profile and practices of different indigenous groups in different communities and in small urban centers. Overall, 533 young people, between 15 and 22 years of age, participated in the activity, responding to a questionnaire with 48 questions, organized in Part A - Sociodemographic information, Part B - Knowledge on Mental Health, Discrimination and violence, Habits and Costumes, and Part C - Information on COVID-19.
A network of local supporters was created to help in the process of filling out the questionnaire. They adopted different strategies to ensure a representative number of responses. It was necessary to make meetings with leaderships, teachers, pajés, parents, and a direct action with the young people themselves. A successful action that was undertaken was texting the link to the questionnaire, on google.forms, to their cell phones.
Even with logistic problems regarding access to communities and communication issues caused by low connectivity and by the risks imposed by the pandemic, the KAP team obtained samples from all eight regions. The Alto Solimões region was the one that concentrated the higher number of respondents, 111 overall, followed by Eastern Roraima, with 106 valid questionnaires.
“The young supporters identified that various strategies of traditional knowledge were used to fight COVID-19, but this did not mean neglecting to use the recommended measures of social distancing, wearing masks and using hand sanitizer. They also reported personal experience with many problems regarding alcohol consumption and violence; it is, therefore, necessary to invest in projects that involve leisure, sports, income generation and education alternatives. The survey will help institutions plan their work with indigenous young people”, analyzed the KAP coordinator.
Valdemar Pereira Lins was a study supporter in the region of Maturacá, São Gabriel da Cachoeira (AM). He was born in the community that is home to Yanomami people. For him, the work led to learning. “Our goal is to raise awareness among people and contribute to the well-being of the Yanomami communities. Our goal is also to improve the way health professionals see our reality, so that we, indigenous people, can have the different assistance we need”, highlighted the supported. Lins was part of the first class of Intercultural Degree in Physics offered by the Federal Institute of Education, Science and Technology of Amazonas (Ifam), campus of São Gabriel da Cachoeira.
Daughter of another land and living in another reality, supporter Wauana Sheeva Costa Silva Manchineri also worked as a supporter, investing her efforts so that the KAP tool was successful in the Alto Rio Puris region. She is indigenous, a member of the Manchineri people, and has a degree in Agricultural Management from the University of Brasília.
For the articulator, some of the main difficulties faced in the process of applying the questionnaire were access to the Internet (rare and, when present, limited), an important point. “It was, therefore, necessary to use other contact methods, such as phone calls, so the tool had a higher distribution among ethnicities, villages and age groups”, says Manchineri.
The second difficulty pointed by Manchineri was related to geographical distances and to communication with people of the communities. “The Alto Purus region is home to seven peoples distributed in various communities, mostly isolated, with no access to telephones, let alone to Internet access. Among those that belong to the Jamamadi and Kulina peoples, for instance, there are very few that speak Portuguese”, she concludes. In addition to the KAP survey, another Fiocruz Amazonia action was the offering of the course Living well: Indigenous Mental Health, to respond exactly to this need for professional training as pointed by the survey as a sore spot in the health care offered to these communities.