Munduruku Indigenous people; medicalization; cosmography; intermedicality; Indigenous community health workers


This article analyzes the role of Munduruku indigenous community health workers (CHW) with the expansion of biomedical services as part of state presence and territorial control in Brazil. Centuries of interethnic contacts among the Munduruku have resulted in a plurality of health practices. Since 1999, Primary services have increased significantly, when the Indigenous Health System (SASI) was created. CHWs were incorporated as part of the health teams serving the indigenous lands. Munduruku CHWs have not only assumed an important role in the delivery of biomedical services, but also are key in the articulation between different traditions of care. Although there is a clash between the hegemony of biomedicine and the Mundurucu cosmographical perspective that links health to territory, the CHWs are protagonists and important actors in the negotiations and appropriations that occur in the contact zone of medical pluralism. They have emerged as local leaders, collaborating with village caciques in health service issues and dialoguing with and supporting families in therapeutic itineraries that include various medical traditions. In addition, they have become political actors in the new participatory spaces created for indigenous representation, such as local and district health councils that are part of the Indigenous Health System.