THE SANITARY SITUATION OF TREMEMBÉ (FROM FOX AND ENGINEER) INDIGENOUS PEOPLES AND AKROÁ GAMELA IN FRONT OF THE COVID-19 PANDEMIC.

The Tremembé (from Raposa and Engenho), located in the municipality of Raposa and São José de Ribamar, and the Akroá Gamela, located in the municipalities of Penalva, Viana and Matinha, in the state of Maranhão, are indigenous peoples who are in the process of struggle for the demarcation of their territories. This requires saying that, at the governmental level, it is necessary to open an administrative process with a view to identifying, delimiting and demarcating such indigenous lands. In general, the demarcation of an indigenous land seeks to guarantee a geographical space for the enjoyment and social reproduction of indigenous peoples. However, it is not only territorial rights that are being claimed by these peoples, but, above all, access to justice as a whole. The struggle for the demarcation of their territories, which were usurped during the violent colonization process (still ongoing), is also a struggle for indigenous collective rights, such as education and health.

In the context of the Covid-19 pandemic that arrived in the country in early 2020, and, in March of the same year, in the state of Maranhão, these peoples suffer yet another violence: the lack of specific and differentiated care by the Special Secretariat for Indigenous Health (SESAI), through the Special Indigenous Sanitary District (DSEI-MA).

The justification given by SESAI is that Tremembé and Akroá Gamela are “non-inhabited” or “urban” peoples (categories used by SESAI itself) and, as such, should be served by municipalities in the SUS network and not by DSEI-MA, as stated in the DSEI's indigenous health contingency plan (2020) [1] .

However, Indianity is not defined solely by the process of land tenure regularization of indigenous lands, nor is it characterized by a way of life confined to the limits of “villages”. Indianity makes references to the past, lives in the present and projects the future. It is, therefore, linked to ancestry, social and affective memory, kinship, relations with the territory, political struggle and indigenous (re) existence. It therefore has a broad and multiple meaning. Furthermore, this SESAI stance is not supported by any legal precept, but, on the contrary, it denies the rights of indigenous peoples guaranteed in the Federal Constitution of 1988, articles 230 and 231, ILO Convention 169 and Commission Resolution 01/2020 Inter-American Convention on Human Rights.

The lack of assistance from SESAI in relation to indigenous people in an urban context has been denounced by indigenous movements and their supporters in the search for the fulfillment of rights, such as the Articulation of Indigenous Peoples of Brazil (APIB). On July 30, 2020, the Supreme Federal Court (STF) decided, in a historic action, that SESAI should extend the services of the Indigenous Health Subsystem to village peoples located in unapproved lands and to non-village indigenous people (STF) , 2020) [2] .

SESAI's omission, through DSEI-MA, with regard to the “health care of indigenous peoples in urban areas”, was reported in an action carried out by the Indigenist Missionary Council (CIMI) and handed over to the Public Defender's Office of the Union, with copy to the OAB / MA Human Rights Commission. In that same document, there are reports by Rosa Tremembé where she states that members of her family (totaling 10 people) did not receive care from the DSEI-MA, as well as did not take a test for Covid-19, even manifesting the symptoms, and, also, they did not obtain the drugs prescribed by doctors. The DSEI's only action, after charging the Tremembé family, was to travel to the SUS Basic Health Unit (UBS), in the DSEI-MA car, without any kind of monitoring by the multidisciplinary health team in the health district.

The same exclusionary policy by the DSEI-MA was adopted with the Akroá Gamela people. Inaldo Kum'Tum Gamela, an important Akroá Gamela leadership, reported to Coletivo Mururu / Rede (CO) VIDA that among his people there were several people with symptoms of Covid-19. However, they were not served by DSEI-MA. Compelled by the cultural homogenization policy adopted by the federal government, they did not carry out tests or receive medicines from the health district. Thus, they sought the SUS service network. In the SUS network, they were not registered as Akroá Gamela indigenous, but as “browns”, even though they affirmed their Indianity, which violates the constitutional principle of self-declaration and ILO Convention 169.

According to the survey carried out by the Maranhão Statistical Committee, with updated data up to August 3, 2020, six (06) suspected cases were reported among Tremembé da Raposa and another six (06) among Tremembé do Engenho. There is one (01) confirmed case among the Tremembé do Engenho and thirty (30) suspected cases among the Akroá Gamela. In the latter, one (01) death is recorded. The lack of specific and differentiated service by DSEI-MA increases the vulnerability of these peoples.

Below, data from Covid-19 between the Tremembé and Akroá Gamela peoples, made available by the Maranhão Statistical Committee (2020) and by the indigenous leaders of the respective peoples.

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Still in dialogue with Inaldo Kum'Tum Gamela, he reported that a team from the Maranhão State Health Force (FESMA), which makes up the Statistical Committee, was present at the beginning of August in the villages Taquaritiua, Centro do Antero, Nova Vila Tabocal and Cajueiro. At the time, 172 tests were carried out (this number corresponds to 10% of the indigenous population in that region, according to Inaldo Kum'tum Gamela [1] ), of which 38 were positive. However, tests were not carried out in the other Gamela villages, such as Barreiro, Porto Velho, Vila Firmino, Piraí, Santeiro, Santa Luzia, Clara, Prequeú, Tabarel, Pocú and Meia Légua.

Inaldo Kum'tum Gamela points out that this action by FESMA is important, but punctual. "If there is no continuity of prevention, treatment, monitoring, what is the use?" question. Another point raised by the leadership is the absence of representatives of its people and of the Tremembé people in the District Council for Indigenous Health (CONDISI), in which there should be the participation of all indigenous peoples located in the state.

It is worth mentioning that such peoples started to be identified and accounted for only through the Statistical Committee, since neither DSEI-MA nor the Municipal Health Secretariats (SEMUS) has been reporting the cases of Covid-19 among these peoples, as we can see in the epidemiological bulletins of the Rede (CO) VIDA project, carried out by Coletivo Mururu (See: https://www.redecovida2020.com/ ).

Thus, this note aims to present, even with the decision of the STF for the immediate assistance of indigenous peoples in unapproved lands and non-villagers, the medical-sanitary limbo that the Tremembé indigenous peoples (of Raposa and Engenho), in the municipalities of Raposa and São José de Ribamar, and the Akroá Gamela, in the municipalities of Penalva, Matinha and Viana, are fighting for not having their territorial rights recognized or their Indianity. The omission in specific and differentiated health care practiced by SESAI, through DSEI-MA, cannot persist. Legal protection for indigenous peoples is not limited to the geographical space characterized by the definition of indigenous land. Despite any government intervention that defines fractions of Brazilian territory, the right to exercise a differentiated socio-cultural way of life, that is, the right to be indigenous, cannot be denied them.

We continue in an attempt to make Covid-19 data visible among indigenous peoples in Maranhão, based on the Indianity of these peoples and adding strength to the struggles they face. Indigenous lives matter!

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[1] Available at http://docs.bvsalud.org/biblioref/2020/04/1095139/plano_de_contingencia_da_saude_indigena_preliminar.pdf. Last accessed on August 14, 2020.

[2] Available at: http://portal.stf.jus.br/noticias/verNoticiaDetalhe.asp?idConteudo=448997&ori=1 Last accessed on: 20.08.2020.

[3] According to the census carried out by the indigenous people in 2015, the population was estimated at around 1,200 people.