ABSTRACT

Objective:

To identify the repercussions of mining practices on Indigenous Territories on health.

Method:

A qualitative documentary study was conducted, based on online news articles from Brazilian and international newspapers published between March 2020 and December 2022. Data collection took place between December and January 2023. A content analysis was performed.

Results:

A total of 28 news articles from online newspapers were identified, revealing two core themes: Mining and Threats to Indigenous Peoples; and Exposure of Indigenous Peoples’ Health.

Conclusion:

The expansion of illegal mining is evident, posing a threat to the isolation of indigenous peoples and weakening the control of health-related issues by epidemiological services. This research contributes to raising awareness about mining activities and indigenous health, enabling nurses to better understand emerging health issues and adapt their care practices.

KEYWORDS:
Indigenous Peoples’ Health; Mining; Environmental Pollution; Indigenous Peoples; Public Health

RESUMO

Objetivo:

identificar as repercussões das práticas de mineração em terras indígenas na saúde.

Método:

estudo documental de abordagem qualitativa, a partir de matérias jornalísticas de jornais brasileiros e internacionais online registrados entre março de 2020 e dezembro de 2022. A coleta foi realizada entre dezembro e janeiro de 2023. Foi realizada análise de conteúdo.

Resultados:

foram identificadas 28 notícias vinculadas a jornais nas versões online, emergindo dois núcleos: Garimpo e as ameaças aos povos indígenas; Exposição da saúde dos povos indígenas.

Conclusão:

é notória a expansão do garimpo ilegal, ameaçando o isolamento dos povos indígenas e fragilizando o controle dos agravos à saúde pelos serviços epidemiológicos. A pesquisa contribui para conscientização sobre atividades de garimpo e saúde indígena, permitindo que os enfermeiros compreendam melhor as questões de saúde emergentes e adaptem suas práticas de cuidados.

DESCRITORES:
Saúde das Populações Indígenas; Mineração; Poluição Ambiental; Povos Indígenas; Saúde Pública

RESUMEN

Objetivo:

identificar las repercusiones para la salud de las prácticas de minería en tierras indígenas.

Método:

estudio documental con enfoque cualitativo, basado en artículos periodísticos de periódicos online brasileños e internacionales registrados entre marzo de 2020 y diciembre de 2022. La recolección se llevó a cabo entre diciembre y enero de 2023. Se realizó análisis de contenido.

Resultados:

Se identificaron 28 noticias vinculadas a la versión online de periódicos, y surgieron dos categorías: La minería y las amenazas a los pueblos indígenas; Exposición de la salud de los pueblos indígenas.

Conclusión:

es evidente la expansión de la minería ilegal, que amenaza el aislamiento de los pueblos indígenas y debilita el control de los servicios epidemiológicos de los problemas de salud. La investigación contribuye a crear conciencia sobre la actividad minera y la salud indígena, para que los enfermeros puedan comprender mejor los problemas de salud emergentes y adaptar sus prácticas de atención.

DESCRIPTORES:
Salud de las Poblaciones Indígenas; Minería; Contaminación Ambiental; Pueblos Indígenas; Salud Pública

HIGHLIGHTS

Mining activities expanded during the pandemic.

The weakening of regulatory agencies has driven mining activities.

Increased vulnerability to health issues among indigenous peoples.

INTRODUCTION

The health of indigenous peoples is an inalienable right, achieved through public policies, culminating in the creation of the Indigenous Health Subsystem (SASISUS). However, this condition, while significant, carries echoes of persistent colonialism, as predominantly biomedical approaches are identified¹, neglecting the diversity and uniqueness of indigenous peoples. The relevance of this debate cannot be overlooked, considering the multiple issues surrounding health territories and their surroundings, balancing the intercultural context²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785...

3 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... ^-44 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... in the face of persistent historical inequalities and social impacts faced by these peoples.

One of the most pressing challenges is the impact of mining on Indigenous Territories (IT)²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785... . Illegal mining practices and exposure to mercury (Hg) directly affect the health of indigenous peoples, highlighting the need to implement surveillance programs to mitigate the already identified impacts of metal exposure among indigenous populations²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785...

3 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... ^-44 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... .

Hg is a toxic metal used in gold extraction to facilitate the collection of the precious metal. However, exposure to Hg can lead to acute intoxication with high concentrations and chronic intoxication (long-term), which can result in dysfunctions in the central nervous, renal, and pulmonary systems. Due to the neurotoxicity of Hg, individuals may experience muscle tremors, emotional instability, sleep disturbances, hallucinations, memory loss, headaches, muscle weakness, anorexia, and loss of sensitivity. In the lungs, symptoms such as shortness of breath, fever, fatigue, and chest pain have been reported. A metallic taste in the mouth and gingivitis have also been observed⁵5 Barbosa VFB, Caponi SNC de. Direitos humanos, vulnerabilidade e vulneração dos povos indígenas brasileiros no enfrentamento à Covid-19. Physis [Internet]. 2022 [cited 2023 Mar 10];32(2):e320203. Avaliable from: https://doi.org/10.1590/S0103-73312022320203
https://doi.org/10.1590/S0103-7331202232... ^,66 Abrunhosa MA, Machado FR de S, Pontes AL de M. Da participação ao controle social: reflexões a partir das conferências de saúde indígena. Saude soc [Internet]. 2020 [cited 2023 Mar 10];29(3):e200584. Avaliable from: https://doi.org/10.1590/S0104-12902020200584
https://doi.org/10.1590/S0104-1290202020... .

Illegal mining is also often associated with a web of violence and exploitation, including weapons, drugs, and even prostitution, which can result in an increase in sexually transmitted infections⁷7 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271... . There is also vulnerability among indigenous peoples regarding food and river contamination by Hg, as approximately 20% of the Hg used in gold extraction is discharged into the rivers⁸8 Escobar AL. A interiorização da pandemia: potenciais impactos em populações em situação de vulnerabilidade na Amazônia. NAU Social [Internet]. 2020 [cited 2023 Mar 19]; 11(20):137-143. Avaliable from: https://periodicos.ufba.br/index.php/nausocial/article/view/36614
https://periodicos.ufba.br/index.php/nau... . Fish easily absorb Hg and accumulate it in their tissues as methylmercury (MeHg), but they exhibit gradual elimination. Therefore, the higher the trophic level, the higher the concentrations of this metal, causing harmful effects on human health since fish constitute the primary protein source for indigenous peoples⁵5 Barbosa VFB, Caponi SNC de. Direitos humanos, vulnerabilidade e vulneração dos povos indígenas brasileiros no enfrentamento à Covid-19. Physis [Internet]. 2022 [cited 2023 Mar 10];32(2):e320203. Avaliable from: https://doi.org/10.1590/S0103-73312022320203
https://doi.org/10.1590/S0103-7331202232...

6 Abrunhosa MA, Machado FR de S, Pontes AL de M. Da participação ao controle social: reflexões a partir das conferências de saúde indígena. Saude soc [Internet]. 2020 [cited 2023 Mar 10];29(3):e200584. Avaliable from: https://doi.org/10.1590/S0104-12902020200584
https://doi.org/10.1590/S0104-1290202020... ^-77 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271...

The situation is exacerbated by the vulnerability of indigenous peoples to the impacts of the dominant economic model¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... ^,99 Rocha DF da, Porto MFS. A vulnerabilização dos povos indígenas frente ao COVID-19: autoritarismo político e a economia predatória do garimpo e da mineração como expressão de um colonialismo persistente. Observatório Covid-19 Fiocruz, 2020 [cited 2023 Mar 19]. Avaliable from: https://www.arca.fiocruz.br/handle/icict/41407
https://www.arca.fiocruz.br/handle/icict... ^,1010 Langdon EJ, Diehl EE. Participação e autonomia nos espaços interculturais de saúde indígena: reflexões a partir do sul do Brasil. Saude soc [Internet]. 2007[cited 2023 Mar 31];16(2):19-36. Avaliable from: https://doi.org/10.1590/S0104-12902007000200004.
https://doi.org/10.1590/S0104-1290200700... and by health crises that demand urgent control of health risks, such as the COVID-19 pandemic, which amplified the vulnerabilities of indigenous peoples. Invasions by illegal loggers, land grabbers, missionaries, and miners acted as “vectors” for the spread of the virus¹¹11 Porto MF de S, Rocha D. Neoextrativismo, garimpo e vulnerabilização dos povos indígenas como expressão de um colonialismo persistente no Brasil. Saúde debate [Internet]. 2022 [cited 2023 Mar 31];46(133):487-500. Avaliable from: https://revista.saudeemdebate.org.br/sed/article/view/6580
https://revista.saudeemdebate.org.br/sed... , and with the weaknesses in public policies, environmental surveillance, and health issues were exacerbated during this pandemic period due to social isolation and the implementation of sanitary barriers in villages, further magnifying the vulnerabilities of indigenous peoples⁷7 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271... _.

In this scenario, the ongoing presence and flexibility of mining and prospecting activities alarmingly threaten the livelihoods and health of indigenous peoples²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785...

3 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... ^-44 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... . These activities not only endanger the physical well-being of the inhabitants of these areas but also violate the sacred constitutional rights of these communities, including the right to control their territories, resources, cultures, and traditions, including their rights to health¹⁰10 Langdon EJ, Diehl EE. Participação e autonomia nos espaços interculturais de saúde indígena: reflexões a partir do sul do Brasil. Saude soc [Internet]. 2007[cited 2023 Mar 31];16(2):19-36. Avaliable from: https://doi.org/10.1590/S0104-12902007000200004.
https://doi.org/10.1590/S0104-1290200700... .

Due to weaknesses in environmental legislation, indigenous peoples have been subjected to recurrent attacks on their territories in recent years⁷7 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271... . This debate has been noticed in widely circulated journalism. Recognition and open discussion of these issues in these vehicles are important for fostering critical reflection on the topic and expanding awareness of the situation in society. This, in turn, can assist healthcare professionals in developing a deeper understanding of the specific needs of indigenous peoples, taking into account the impacts of mining, interculturality, and the importance of documenting facts to comprehend specific vulnerabilities.

Health records can highlight conflicts that undermine the effectiveness of the system, hindering the implementation of effective actions within the Health Care Network (Rede de Atenção à Saúde - RAS) and having a negative impact on the monitoring and control of diseases among indigenous peoples. Nursing, as a part of this team, plays a fundamental role in promoting the health and well-being of indigenous peoples, recognizing the complexities of their cultural, social, and health realities, with a focus on identifying conflicts that affect the RAS.

Thus, it is understood that information about these events has been disseminated and discussed but has been studied relatively little as a source of information. This can provide elements for a broader debate on the health and vulnerabilities of indigenous peoples. This study aimed to identify the repercussions of mining practices in IT on health.

METHOD

This is a documentary study with a qualitative approach, and it was conducted using newspaper articles that had not yet been analyzed by scientific committees, meaning that the materials were considered primary sources ¹³13 Sá-Silva JR, Almeida CD, Guindani JF. Pesquisa documental: pistas teóricas e metodológicas. RBHCS [Internet]. 2009 [cited 2023 Mar 19];1(1). Avaliable from: https://periodicos.furg.br/rbhcs/article/view/10351
https://periodicos.furg.br/rbhcs/article... . The research was carried out through a clipping service, which involves research and data collection to monitor, analyze, and archive information from various media sources, providing an overview of what is being reported ¹⁴14 Moreira BR da C, Cordeiro TB da S, Carvalho CM da S. Proposta de modelos de relatórios de clipping diário e semestral. Conexões: revista de relações públicas e comunicação organizacional. 2018[ cited 2023 Mar 19];01(01):48-67. Avaliable from: https://periodicos.ufam.edu.br/index.php/conexoes/article/view/3810
https://periodicos.ufam.edu.br/index.php... . It took place during the months of December 2022 to January 2023. In the initial search, the keywords “Mining,” “Indigenous,” and “Health” were used.

The inclusion criteria encompassed international, national, and regional digital newspapers with free access, containing articles published between March 2020 and December 2022, addressing the topics of “indigenous health” and “repercussions of mining in IT.” The articles were cataloged in a Microsoft Excel spreadsheet to facilitate organization by the author.

According to the inclusion criteria, articles published in digital newspapers with international coverage (El País), national coverage (G1, O Globo, Brasil de Fato, UOL Notícias, BBC News Brasil), and regional coverage (Correio Braziliense, Folha de Pernambuco, Carta Capital, Folha Boa Vista, G1 Roraima, and Amazônia Real) were selected.

The analysis of the results was based on Bardin’s content analysis method¹⁵15 Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011.. Therefore, the articles were read in their entirety for eligibility purposes, and interpretations of the content were made, resulting in sets of core meanings with similar ideas and expressions that were related to each other: “Mining and Threats to Indigenous Peoples” and “Exposure of Indigenous Peoples’ Health.”

No ethical approval from a Research Ethics Committee was required since the contents are in the public domain.

RESULTS

The final sample consisted of 28 news articles linked to online headlines, available between March 2020 and December 2022, during the COVID-19 pandemic period. The information is presented in Table 1.

Headlines 16, 19, 21, and 25 highlight the consequences of gold prospectors’ invasion and their encroachment on IT, while headlines two, four, six, 12, 15, and 17 depict the risks of gold mining invasion, emphasizing environmental and social impact, increased violence, sexual exploitation, and risks to indigenous health.

Headlines one, five, 11, and 14 portray mining as detrimental to indigenous health, causing the transmission of diseases to which they have no immunity, such as COVID-19. Meanwhile, headlines eight, nine, 13, 18, 23, 24, and 26 cover political topics, highlighting the lack of public policies for indigenous people, as well as government neglect towards indigenous communities. They also criticize the federal government’s conduct in combating illegal mining.

Headlines three, seven, 10, 20, 22, 27, and 28 highlight the violence caused by gold prospectors, particularly illegal ones, against the Yanomami and other ethnic groups, emphasizing the federal government’s neglect regarding calls for help from organizations.

The content analysis of the articles in the investigated newspapers allowed for the classification of three core themes: (1) Mining and threats to indigenous peoples; (2) Health of the indigenous population.

Core Theme 1: Mining and Threats to Indigenous Peoples

Identifies the consequences of environmental disasters and health issues among indigenous people related to exposure to Hg and describes cases of physical and sexual violence against children, adolescents, and women, particularly in Yanomami communities.

Based on the analyzed newspapers, it was possible to highlight the recruitment carried out by gold prospectors among indigenous people, mercury contamination of indigenous populations, and the social and cultural impacts.

Core Theme 2: The health of the indigenous population

The health of indigenous people is highlighted in the analyzed reports, as the advancement of mining and the proximity of isolated peoples to gold prospectors contribute to the spread of contagious diseases, to which indigenous people have no immunity, such as malaria and COVID-19.

Another point highlighted is the cases of malnutrition, resulting in the health collapse of the Yanomami. The reports also criticize the performance of government agencies responsible for implementing health policies in the villages.

DISCUSSION

Territorial conflicts in Brazil, linked to ethno-environmental issues, have their roots in European colonization, a process that still persists, with changes only in its strategies of domination¹⁶16 Tsosier R. Os povos indígenas e a justiça ambiental: o impacto das mudanças climáticas. Revista Direitos Fundamentais e Alteridade. [Internet]. 2022[cited 2023 May 27];5(2):36-82. Avaliable from: https://periodicos.ucsal.br/index.php/direitosfundamentaisealteridade/article/view/1023/825
https://periodicos.ucsal.br/index.php/di... ^-1717 Mondardo M. Em defesa dos territórios indígenas no Brasil: direitos, demarcações e retomadas. GEOUSP [Internet]. 2022 [cited 2023 May 27];26. Avaliable from: https://www.revistas.usp.br/geousp/article/view/176224
https://www.revistas.usp.br/geousp/artic... . The investigation of mining impacts on IT reveals a worrying trend: protective institutions are losing strength, while neoliberal interests advance, disregarding the rights of indigenous peoples¹¹11 Porto MF de S, Rocha D. Neoextrativismo, garimpo e vulnerabilização dos povos indígenas como expressão de um colonialismo persistente no Brasil. Saúde debate [Internet]. 2022 [cited 2023 Mar 31];46(133):487-500. Avaliable from: https://revista.saudeemdebate.org.br/sed/article/view/6580
https://revista.saudeemdebate.org.br/sed... .

As indigenous culture and their territories are intrinsically linked to the ecosystems they inhabit, environmental degradation can directly affect traditional indigenous territories¹⁸18 Vedovatto M. Povos indígenas e injustiça etnoambiental na formação territorial brasileira. Revista Interdisciplinar em Estudos de Linguagem. 2019 [cited 2023 May 27];1(1). Avaliable from: https://ojs.ifsp.edu.br/index.php/riel/article/view/1140
https://ojs.ifsp.edu.br/index.php/riel/a... . Such conditions are related to major financial, extractive, agro-industrial, and commodity entities that exploit and privatize public lands, disregarding the negative impacts that result¹⁹19 Busso C. Svampa, M. (2019). As fronteiras do neoextrativismo na América Latina: conflitos socioambientais, virada ecoterritorial e novas dependências. Guadalajara: CALAS, 144 pp. Rel. Int. [Internet]. 2020 [cited 2023 Mar 19]; 45):469-71. Avaliable from: https://revistas.uam.es/relacionesinternacionales/article/view/12884
https://revistas.uam.es/relacionesintern... .

As an example of territorial conflicts, there is the case of the invasion of Yanomami IT, a vast territory of almost 10 million hectares between the states of Amazonas and Roraima, where episodes of intense violence and deaths of indigenous people have occurred⁴4 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... , reflecting the expansion of illegal mining in Brazil. The report “Complicity in Destruction” confirmed a 62% increase in deforestation related to mining in the Amazon in 2021 compared to 2018, as well as deaths of environmental defenders, with 722 conflict cases and 17 deaths in 2020²⁰20 Articulação do Povos Indígenas do Brasil. Relatório cumplicidade na destruição IV: como mineradoras e investidores internacionais contribuem para a violação dos direitos indígenas e ameaçam o futuro da Amazônia. 2021 [cited 2023 Mar 19]. Avaliable from: https://cumplicidadedestruicao.org/cnd4
https://cumplicidadedestruicao.org/cnd4... .

The years from 2019 to 2022 were challenging for defenders of Indigenous Territories (ITs)⁷7 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271...

8 Escobar AL. A interiorização da pandemia: potenciais impactos em populações em situação de vulnerabilidade na Amazônia. NAU Social [Internet]. 2020 [cited 2023 Mar 19]; 11(20):137-143. Avaliable from: https://periodicos.ufba.br/index.php/nausocial/article/view/36614
https://periodicos.ufba.br/index.php/nau... ^-99 Rocha DF da, Porto MFS. A vulnerabilização dos povos indígenas frente ao COVID-19: autoritarismo político e a economia predatória do garimpo e da mineração como expressão de um colonialismo persistente. Observatório Covid-19 Fiocruz, 2020 [cited 2023 Mar 19]. Avaliable from: https://www.arca.fiocruz.br/handle/icict/41407
https://www.arca.fiocruz.br/handle/icict... . Despite constitutional protection and international norms, such as the International Labor Organization’s Convention No. 169, colonial practices persist in Brazil, leading to genocide. The government in power at the time relaxed environmental legislation, exacerbating the situation¹⁷17 Mondardo M. Em defesa dos territórios indígenas no Brasil: direitos, demarcações e retomadas. GEOUSP [Internet]. 2022 [cited 2023 May 27];26. Avaliable from: https://www.revistas.usp.br/geousp/article/view/176224
https://www.revistas.usp.br/geousp/artic... . For example, Bill 191/2020 aimed to authorize mining in IT, weakening the right to prior, free, and informed consultation. Additionally, bills in Congress also threatened the indigenous peoples’ right to their lands, such as Bill 2,633/2020, which expanded the regularization of invaded lands²¹21 Zeneratti FL. O acesso à terra no Brasil: reforma agrária e regularização fundiária. Revista Katálysis. [Internet]. 2020 [cited 2023 May 27];24:564-575. Avaliable from: https://doi.org/10.1590/1982-0259.2021.e79558
https://doi.org/10.1590/1982-0259.2021.e... .

These environmental relaxation measures related to gold extraction have contributed to the contamination of water, soil, and the deterioration of the health of various indigenous peoples and traditional communities²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785...

3 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... ^-44 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... . For example, the Munduruku and Sai Cinza IT have approximately 606 kilometers of rivers affected since 2017. These facts reflect governmental negligence and the “risk society” described by Ulrich Beck, in which the production and distribution of wealth are accompanied by risks²²22 Beck U. Sociedade de risco. São Paulo: Editora; 2010., such as diseases like malaria and various forms of violence.

Finally, these interferences go against the indigenous philosophy of “bem-viver,”(good living) based on complementarity, harmony, and reciprocity with nature, in contrast to capitalist competitiveness¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... . Even as they prioritize harmony with nature, these peoples have their dynamics altered by such enterprises due to neoliberal logic¹¹11 Porto MF de S, Rocha D. Neoextrativismo, garimpo e vulnerabilização dos povos indígenas como expressão de um colonialismo persistente no Brasil. Saúde debate [Internet]. 2022 [cited 2023 Mar 31];46(133):487-500. Avaliable from: https://revista.saudeemdebate.org.br/sed/article/view/6580
https://revista.saudeemdebate.org.br/sed... , which clearly impacts health²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785... ^,33 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... ^,44 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... .

Inclusion of various challenges faced by indigenous peoples

The records in the core themes reflect how the fragility of environmental legislation, government policy, and the pandemic have accelerated problems in indigenous territories in recent years, favoring invasions and an increase in illegal mining. These issues are related to the exposure of indigenous peoples to the risks of infections and violence, which could lead to their extinction. History shows that contact between indigenous and non-indigenous people has contributed to the spread of diseases, causing epidemics and high mortality among indigenous populations²³23 Rodrigues D, Albertoni L, Mendonça SBM de. Antes sós do que mal acompanhados: contato e contágio com povos indígenas isolados e de recente contato no Brasil e desafios para sua proteção e assistência à saúde. Saude soc. [Internet]. 2020 [cited 2023 May 30];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200348.
https://doi.org/10.1590/S0104-1290202020... .

Contact with invaders has led to the transmission of diseases to indigenous peoples²⁴24 Sousa LA de, Zaitune MP do A. Uma revisão de escopo de revisões sistemáticas sobre exposição humana ao mercúrio. Rev bras saúde ocup [Internet]. 2022 [cited 2023 May 27];47:e18. Available from: https://doi.org/10.1590/2317-6369/38120pt2022v47e18
https://doi.org/10.1590/2317-6369/38120p... , contributing to the emergence of health problems related to mining. Among the various consequences, the exposure of indigenous people to factors that contribute to their illness is directly related to the use of Hg by gold prospectors²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785... ^,33 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... ^,44 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... . This is highly detrimental to human health, causing imbalance in the body and neurological symptoms, vomiting, diarrhea, facial tremors, and even death⁴4 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... , symptoms that should be identified and understood by nursing professionals, who have a relevant role within and around IT.

Nursing, through Primary Health Care (PHC), can identify immediate needs, leading efforts in epidemiological surveillance, disease monitoring, and tracking²⁵25 Santos CS, Moreira AD, Silva KL, Lana FCF. Desastre socioambiental: condições de saúde dos atingidos na perspectiva dos profissionais de saúde e gestores. Rev. enferm. UFSM. [Internet] 2023 [cited 2023 Sept 09];13, e25. Avaliable from: https://doi.org/10.5902/2179769274176
https://doi.org/10.5902/2179769274176... , supported by the development of health education actions and case management.

It is known that indigenous exposure to Hg reflects the impact on biodiversity, contaminating rivers and food sources, and on the health of indigenous people, leading to diarrhea, skin lesions, and other health problems²⁴24 Sousa LA de, Zaitune MP do A. Uma revisão de escopo de revisões sistemáticas sobre exposição humana ao mercúrio. Rev bras saúde ocup [Internet]. 2022 [cited 2023 May 27];47:e18. Available from: https://doi.org/10.1590/2317-6369/38120pt2022v47e18
https://doi.org/10.1590/2317-6369/38120p... . In this regard, nursing can advise at-risk groups to undergo regular health exams and make referrals when exposure to Hg is identified²⁵25 Santos CS, Moreira AD, Silva KL, Lana FCF. Desastre socioambiental: condições de saúde dos atingidos na perspectiva dos profissionais de saúde e gestores. Rev. enferm. UFSM. [Internet] 2023 [cited 2023 Sept 09];13, e25. Avaliable from: https://doi.org/10.5902/2179769274176
https://doi.org/10.5902/2179769274176... .

Furthermore, transformations and exploitation in the vicinity of Indigenous Territories intensify violence due to the resistance of indigenous people. This violence is physical, moral, cognitive, and cultural, and is perpetrated by invaders of IT, and it can be identified through actions of expropriation of IT, the suppression of cultural practices, the annihilation of traditional health knowledge, and acts against indigenous life²⁶26 Gonçalves DOD, Espinoza F, Carvalho GBV de. Violência contra terras indígenas no Brasil e a precária punibilidade de seus agentes. Revista Culturas Jurídicas. [Internet]. 2021 [cited 2023 June 15];8(20). Avaliable from: https://periodicos.uff.br/culturasjuridicas/article/view/50018/30436
https://periodicos.uff.br/culturasjuridi... .

Sexual violence in adolescents and adults also had repercussions, and the consequences and traumas vary according to the sociocultural context of each ethnicity²⁷27 Staliano P, Kaneko AY, Mondardo M. Violência sexual infanto juvenil indígena: da vulnerabilidade social à articulaçao de políticas públicas. Estud. pesqui. psicol [Internet]. 2022 [cited 2023 jun 15];22(4). Avaliable from: https://doi.org/10.12957/epp.2022.71745
https://doi.org/10.12957/epp.2022.71745... ^-2828 Oliveira VGC, Oliveira JE. Violência sexual contra crianças e adolescentes na reserva indígena de Dourados, aldeias Jaguapiru e Bororó, Estado de Mato Grosso do Sul, Brasil. Habitus. [Internet]. 2019 [cited 2023 June 15];17(1). Avaliable from: https://doi.org/10.18224/hab.v17i1.7232
https://doi.org/10.18224/hab.v17i1.7232... . It affects the psychosocial development of child victims of sexual violence, leading to extreme and sudden changes in behavior and personality, as well as physical changes such as bruises, genital lacerations, pain, and body injuries, and a lack of understanding of the nature of the act as violence²⁸28 Oliveira VGC, Oliveira JE. Violência sexual contra crianças e adolescentes na reserva indígena de Dourados, aldeias Jaguapiru e Bororó, Estado de Mato Grosso do Sul, Brasil. Habitus. [Internet]. 2019 [cited 2023 June 15];17(1). Avaliable from: https://doi.org/10.18224/hab.v17i1.7232
https://doi.org/10.18224/hab.v17i1.7232... .

Another point is the intensification of Sexually Transmitted Infections (STIs) in these regions. It is evident that mining activities contribute to the emergence of STIs in these indigenous regions due to contact with prostitution, which has raised concerns for health agencies. This is because cases of STIs among indigenous people and populations in mining-affected areas have increased²⁹29 Graeff SVB, Pícoli RP, Arantes R, Cunha RV da. Evolução da infecção pelo HIV entre os povos indígenas do Brasil Central. Cad. Saúde Pública. [Internet]. 2021 [cited 2023 June 23];37(12). Avaliable from: https://doi.org/10.1590/0102-311X00062920
https://doi.org/10.1590/0102-311X0006292... .

These health issues highlight the need for healthcare teams, especially nurses, to identify cases of violence on-site and provide psychological support to communities affected by mining impacts, as there can be significant psychological consequences²⁵25 Santos CS, Moreira AD, Silva KL, Lana FCF. Desastre socioambiental: condições de saúde dos atingidos na perspectiva dos profissionais de saúde e gestores. Rev. enferm. UFSM. [Internet] 2023 [cited 2023 Sept 09];13, e25. Avaliable from: https://doi.org/10.5902/2179769274176
https://doi.org/10.5902/2179769274176... due to threats of territory invasion and health concerns²⁰20 Articulação do Povos Indígenas do Brasil. Relatório cumplicidade na destruição IV: como mineradoras e investidores internacionais contribuem para a violação dos direitos indígenas e ameaçam o futuro da Amazônia. 2021 [cited 2023 Mar 19]. Avaliable from: https://cumplicidadedestruicao.org/cnd4
https://cumplicidadedestruicao.org/cnd4... ^,2424 Sousa LA de, Zaitune MP do A. Uma revisão de escopo de revisões sistemáticas sobre exposição humana ao mercúrio. Rev bras saúde ocup [Internet]. 2022 [cited 2023 May 27];47:e18. Available from: https://doi.org/10.1590/2317-6369/38120pt2022v47e18
https://doi.org/10.1590/2317-6369/38120p... .

In this context, the convergence of healthcare, psychological, and legal fields becomes essential for interdisciplinary efforts, given the limitations of Primary Health Care (PHC) actions within the villages. Referring cases of violence to medium and high complexity levels of the Brazilian Unified Health System (SUS), located in urban areas, brings about situations involving organizational and cultural differences that pose additional challenges for indigenous users⁶6 Abrunhosa MA, Machado FR de S, Pontes AL de M. Da participação ao controle social: reflexões a partir das conferências de saúde indígena. Saude soc [Internet]. 2020 [cited 2023 Mar 10];29(3):e200584. Avaliable from: https://doi.org/10.1590/S0104-12902020200584
https://doi.org/10.1590/S0104-1290202020... ^,1010 Langdon EJ, Diehl EE. Participação e autonomia nos espaços interculturais de saúde indígena: reflexões a partir do sul do Brasil. Saude soc [Internet]. 2007[cited 2023 Mar 31];16(2):19-36. Avaliable from: https://doi.org/10.1590/S0104-12902007000200004.
https://doi.org/10.1590/S0104-1290200700... .

Professionals working in the Special Indigenous Health Districts (DSEI), in these cases, in addition to their technical skills, would consider the cultural and historical nuances of the peoples they serve¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... . This allows them to identify, address, and properly refer cases of physical violence²⁷27 Staliano P, Kaneko AY, Mondardo M. Violência sexual infanto juvenil indígena: da vulnerabilidade social à articulaçao de políticas públicas. Estud. pesqui. psicol [Internet]. 2022 [cited 2023 jun 15];22(4). Avaliable from: https://doi.org/10.12957/epp.2022.71745
https://doi.org/10.12957/epp.2022.71745... ^,2828 Oliveira VGC, Oliveira JE. Violência sexual contra crianças e adolescentes na reserva indígena de Dourados, aldeias Jaguapiru e Bororó, Estado de Mato Grosso do Sul, Brasil. Habitus. [Internet]. 2019 [cited 2023 June 15];17(1). Avaliable from: https://doi.org/10.18224/hab.v17i1.7232
https://doi.org/10.18224/hab.v17i1.7232... through the National Foundation of Indigenous Peoples (FUNAI), the Center for Reference and Social Assistance (CRAS), the Center for Specialized Reference in Social Assistance (CREAS), mobilizing preventive approaches and support to strengthen a protection network⁶6 Abrunhosa MA, Machado FR de S, Pontes AL de M. Da participação ao controle social: reflexões a partir das conferências de saúde indígena. Saude soc [Internet]. 2020 [cited 2023 Mar 10];29(3):e200584. Avaliable from: https://doi.org/10.1590/S0104-12902020200584
https://doi.org/10.1590/S0104-1290202020... ^,2727 Staliano P, Kaneko AY, Mondardo M. Violência sexual infanto juvenil indígena: da vulnerabilidade social à articulaçao de políticas públicas. Estud. pesqui. psicol [Internet]. 2022 [cited 2023 jun 15];22(4). Avaliable from: https://doi.org/10.12957/epp.2022.71745
https://doi.org/10.12957/epp.2022.71745... ^,2828 Oliveira VGC, Oliveira JE. Violência sexual contra crianças e adolescentes na reserva indígena de Dourados, aldeias Jaguapiru e Bororó, Estado de Mato Grosso do Sul, Brasil. Habitus. [Internet]. 2019 [cited 2023 June 15];17(1). Avaliable from: https://doi.org/10.18224/hab.v17i1.7232
https://doi.org/10.18224/hab.v17i1.7232... .

Regarding cultural and cognitive violence, it is essential to ensure that indigenous people themselves are protagonists in the preservation of their knowledge and traditions¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... ^,66 Abrunhosa MA, Machado FR de S, Pontes AL de M. Da participação ao controle social: reflexões a partir das conferências de saúde indígena. Saude soc [Internet]. 2020 [cited 2023 Mar 10];29(3):e200584. Avaliable from: https://doi.org/10.1590/S0104-12902020200584
https://doi.org/10.1590/S0104-1290202020... . This can be achieved through dialogue channels between indigenous leaders and healthcare professionals to ensure that public policies respect and strengthen the autonomy and cultural diversity of indigenous peoples, as can be addressed through Indigenous People’s Health Conferences⁶6 Abrunhosa MA, Machado FR de S, Pontes AL de M. Da participação ao controle social: reflexões a partir das conferências de saúde indígena. Saude soc [Internet]. 2020 [cited 2023 Mar 10];29(3):e200584. Avaliable from: https://doi.org/10.1590/S0104-12902020200584
https://doi.org/10.1590/S0104-1290202020... .

In the face of moral violence, there is a demand for a psychosocial support network that is immersed in the indigenous worldview¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... and with active collaboration from human rights defense institutions such as the State and Federal Public Prosecutors’ Offices. In these cases, there is a need for alignment with nurses in Indigenous PHC through actions and programs such as the Indigenous Health Knowledge Articulation Program (PASSI), through initiatives for specialized professional training¹⁰10 Langdon EJ, Diehl EE. Participação e autonomia nos espaços interculturais de saúde indígena: reflexões a partir do sul do Brasil. Saude soc [Internet]. 2007[cited 2023 Mar 31];16(2):19-36. Avaliable from: https://doi.org/10.1590/S0104-12902007000200004.
https://doi.org/10.1590/S0104-1290200700... .

Regarding the context of the COVID-19 pandemic, it became evident that the invasion of gold miners and direct contact with non-indigenous people facilitated the spread of the virus²⁵25 Santos CS, Moreira AD, Silva KL, Lana FCF. Desastre socioambiental: condições de saúde dos atingidos na perspectiva dos profissionais de saúde e gestores. Rev. enferm. UFSM. [Internet] 2023 [cited 2023 Sept 09];13, e25. Avaliable from: https://doi.org/10.5902/2179769274176
https://doi.org/10.5902/2179769274176... , and the weaknesses in defending the human rights of indigenous peoples were exposed⁵5 Barbosa VFB, Caponi SNC de. Direitos humanos, vulnerabilidade e vulneração dos povos indígenas brasileiros no enfrentamento à Covid-19. Physis [Internet]. 2022 [cited 2023 Mar 10];32(2):e320203. Avaliable from: https://doi.org/10.1590/S0103-73312022320203
https://doi.org/10.1590/S0103-7331202232... ^,99 Rocha DF da, Porto MFS. A vulnerabilização dos povos indígenas frente ao COVID-19: autoritarismo político e a economia predatória do garimpo e da mineração como expressão de um colonialismo persistente. Observatório Covid-19 Fiocruz, 2020 [cited 2023 Mar 19]. Avaliable from: https://www.arca.fiocruz.br/handle/icict/41407
https://www.arca.fiocruz.br/handle/icict... . This demonstrates that federal institutions responsible for the defense of indigenous peoples neglected and denied resources for the control and combat of COVID-19 in indigenous villages, as evidenced in core theme 1.

The nursing response to health emergencies, such as COVID-19, has been observed throughout history, and it was no different as identified in the findings regarding the healthcare team’s role. Therefore, considering the facts, nursing care can be comprehensive and interdisciplinary, addressing issues of physical, mental, cultural, and environmental health, by monitoring the spread of diseases²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785... ^,33 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... and health issues, with efforts through health education to mitigate the impacts of mining²⁵25 Santos CS, Moreira AD, Silva KL, Lana FCF. Desastre socioambiental: condições de saúde dos atingidos na perspectiva dos profissionais de saúde e gestores. Rev. enferm. UFSM. [Internet] 2023 [cited 2023 Sept 09];13, e25. Avaliable from: https://doi.org/10.5902/2179769274176
https://doi.org/10.5902/2179769274176... .

Non-protective measures at the federal level in the last five years and their impact on the worsening of diseases due to the fragility of the SASISUS.

It is essential to highlight ineffective procedures and actions in the face of the pandemic. These ineffective actions, which should have been coordinated with municipalities and states, resulted in weakened reporting, leading to the worsening of diseases⁹9 Rocha DF da, Porto MFS. A vulnerabilização dos povos indígenas frente ao COVID-19: autoritarismo político e a economia predatória do garimpo e da mineração como expressão de um colonialismo persistente. Observatório Covid-19 Fiocruz, 2020 [cited 2023 Mar 19]. Avaliable from: https://www.arca.fiocruz.br/handle/icict/41407
https://www.arca.fiocruz.br/handle/icict... . Monitoring cases by the nursing team, especially those working within ITs, facilitates local decision-making that has an impact on actions directed by government authorities through official records. This demonstrates the essential role of professionals working within these territories²⁴24 Sousa LA de, Zaitune MP do A. Uma revisão de escopo de revisões sistemáticas sobre exposição humana ao mercúrio. Rev bras saúde ocup [Internet]. 2022 [cited 2023 May 27];47:e18. Available from: https://doi.org/10.1590/2317-6369/38120pt2022v47e18
https://doi.org/10.1590/2317-6369/38120p... in combating diseases such as malaria, which has seen a significant increase in cases.

To achieve this, it is necessary to strengthen intersectoriality and interculturality as a crucial component in intervening in the determinants of health⁶6 Abrunhosa MA, Machado FR de S, Pontes AL de M. Da participação ao controle social: reflexões a partir das conferências de saúde indígena. Saude soc [Internet]. 2020 [cited 2023 Mar 10];29(3):e200584. Avaliable from: https://doi.org/10.1590/S0104-12902020200584
https://doi.org/10.1590/S0104-1290202020... ^,1010 Langdon EJ, Diehl EE. Participação e autonomia nos espaços interculturais de saúde indígena: reflexões a partir do sul do Brasil. Saude soc [Internet]. 2007[cited 2023 Mar 31];16(2):19-36. Avaliable from: https://doi.org/10.1590/S0104-12902007000200004.
https://doi.org/10.1590/S0104-1290200700... , with the aim of developing broader and more effective initiatives, as well as the active participation of indigenous peoples in the process¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... ^,77 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271... . This is the key to ensuring the continuity and sustainability of indigenous medicinal practices¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... , which can be integrated with healthcare professionals, especially nursing, and incorporated into care practices.

The limitation of specific actions in the territories to mitigate the effects of mining is also highlighted in the news articles. Headline 11 illustrates the devastating impact of a government that went against the public interest and favored neoliberal initiatives⁹9 Rocha DF da, Porto MFS. A vulnerabilização dos povos indígenas frente ao COVID-19: autoritarismo político e a economia predatória do garimpo e da mineração como expressão de um colonialismo persistente. Observatório Covid-19 Fiocruz, 2020 [cited 2023 Mar 19]. Avaliable from: https://www.arca.fiocruz.br/handle/icict/41407
https://www.arca.fiocruz.br/handle/icict... . This situation was exacerbated by the newspapers, which showed the government’s negative contribution to monitoring measures due to political authoritarianism⁹9 Rocha DF da, Porto MFS. A vulnerabilização dos povos indígenas frente ao COVID-19: autoritarismo político e a economia predatória do garimpo e da mineração como expressão de um colonialismo persistente. Observatório Covid-19 Fiocruz, 2020 [cited 2023 Mar 19]. Avaliable from: https://www.arca.fiocruz.br/handle/icict/41407
https://www.arca.fiocruz.br/handle/icict... .

This implies, initially, the fragility of the SASISUS due to a decrease in resources for indigenous health and the deterioration of the sector⁹9 Rocha DF da, Porto MFS. A vulnerabilização dos povos indígenas frente ao COVID-19: autoritarismo político e a economia predatória do garimpo e da mineração como expressão de um colonialismo persistente. Observatório Covid-19 Fiocruz, 2020 [cited 2023 Mar 19]. Avaliable from: https://www.arca.fiocruz.br/handle/icict/41407
https://www.arca.fiocruz.br/handle/icict... . It affects the work of healthcare professionals, especially nurses, who are in the villages working in PHC, which in turn reflects on the effective monitoring and responses to events⁷7 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271... ^,88 Escobar AL. A interiorização da pandemia: potenciais impactos em populações em situação de vulnerabilidade na Amazônia. NAU Social [Internet]. 2020 [cited 2023 Mar 19]; 11(20):137-143. Avaliable from: https://periodicos.ufba.br/index.php/nausocial/article/view/36614
https://periodicos.ufba.br/index.php/nau... , such as the healthcare center for the Yanomamis⁴4 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... .

It is important to emphasize that the development of effective strategies, aligned with indigenous health knowledge¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... , needs to encompass various dimensions, such as the promotion, protection, and recovery of health in the face of the impacts of mining²2 Brabo ED, Santos ED, Jesus IM, Mascarenhas AF, Faial KF. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil. Cad Saude Publica. 1999 [cited 2023 Mar 10];15(2):325-31. Avaliable from: https://pubmed.ncbi.nlm.nih.gov/10409785/
https://pubmed.ncbi.nlm.nih.gov/10409785...

3 Santos ECO, Câmara V de M, Brabo E da S, Loureiro ECB, Jesus IM de, Fayal K, et al. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil. Cad Saúde Pública [Internet]. 2003[cited 2023 Mar 10];19(1):199-206. Avaliable from: https://doi.org/10.1590/S0102-311X2003000100022
https://doi.org/10.1590/S0102-311X200300... ^-44 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... , as identified in the newspapers regarding events in the SASISUS, especially regarding malaria, child malnutrition, Hg poisoning, and COVID-19⁴4 Ramos ARA, Oliveira KA de, Rodrigues F dos S. Mercury-based mining in Yanomami Indigenous Territories and accountabilities. Ambient soc [Internet]. 2020 [cited 2023 Mar 10];23. Avaliable from: https://doi.org/10.1590/1809-4422asoc20180326r2vu2020L5AO.
https://doi.org/10.1590/1809-4422asoc201... ^,55 Barbosa VFB, Caponi SNC de. Direitos humanos, vulnerabilidade e vulneração dos povos indígenas brasileiros no enfrentamento à Covid-19. Physis [Internet]. 2022 [cited 2023 Mar 10];32(2):e320203. Avaliable from: https://doi.org/10.1590/S0103-73312022320203
https://doi.org/10.1590/S0103-7331202232... ^,77 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271... ^,1212 Vianna A dos S, Câmara V de M, Barbosa MC de M, Santos A de SE, Asmus CIRF, Luiz RR, et al. Exposição ao mercúrio e anemia em crianças e adolescentes de seis comunidades da Amazônia Brasileira. Ciênc saúde coletiva [Internet]. 2022[cited 2023 Apr];27(5):1859-71. Avaliable from: https://doi.org/10.1590/1413-81232022275.08842021
https://doi.org/10.1590/1413-81232022275... .

Due to the identified weaknesses, nursing can develop initiatives such as advocating for the right to health, promoting intersectoral approaches that encourage intercultural¹1 Krenak A. Reflexão sobre a saúde indígena e os desafios atuais em diálogo com a tese “Tem que ser do nosso jeito”: participação e protagonismo do movimento indígena na construção da política de saúde no Brasil. Saúde Soc [Internet]. 2020 [cited 2023 Mar 10];29(3). Avaliable from: https://doi.org/10.1590/S0104-12902020200711
https://doi.org/10.1590/S0104-1290202020... and interdisciplinary approaches in the provision of healthcare²⁵25 Santos CS, Moreira AD, Silva KL, Lana FCF. Desastre socioambiental: condições de saúde dos atingidos na perspectiva dos profissionais de saúde e gestores. Rev. enferm. UFSM. [Internet] 2023 [cited 2023 Sept 09];13, e25. Avaliable from: https://doi.org/10.5902/2179769274176
https://doi.org/10.5902/2179769274176... , supporting the social participation of indigenous peoples in the development and implementation of health policies⁷7 Guajajara SB, Alarcon DF, Pontes AL de M. Entrevista com Sonia Guajajara: o movimento indígena frente à pandemia da COVID-19. Ciênc saúde coletiva [Internet]. 2022 [cited 2023 Mar 19];27(11). Avaliable from: https://doi.org/10.1590/1413-812320222711.22212021.
https://doi.org/10.1590/1413-81232022271... , monitoring and evaluating the systems involved, and being able to identify diseases and health issues early and intervene effectively²⁵25 Santos CS, Moreira AD, Silva KL, Lana FCF. Desastre socioambiental: condições de saúde dos atingidos na perspectiva dos profissionais de saúde e gestores. Rev. enferm. UFSM. [Internet] 2023 [cited 2023 Sept 09];13, e25. Avaliable from: https://doi.org/10.5902/2179769274176
https://doi.org/10.5902/2179769274176... .

The study is limited by the generalization of results. Due to the cultural, social, and geographical diversity of indigenous peoples, the results obtained in a specific group or region may not be generalizable to all indigenous peoples. These limitations emphasize the need for future studies to address these issues and continue investigating the repercussions of mining in indigenous territories specific to each ethnicity.

FINAL CONSIDERATIONS

In conclusion, the accelerated expansion of mining activities in ITs was driven by the weakening of regulatory bodies under an antidemocratic-leaning government, intensifying the devastation of these areas and increasing the vulnerability of these populations, both from an epidemiological and environmental perspective.

The analyzed headlines, in their reports, highlighted the risks associated with an exclusive government that promotes mining in ITs and uses the authority of its position to engage in actions that contribute to invasions in these territories. Therefore, it is important to identify the repercussions during critical periods to foster discussions about the health and vulnerability of indigenous peoples and the impacts of government policies that disregard the rights of these populations.

Furthermore, the study underscores the need to implement strategies for collective participation, particularly in the formation of DSEI teams. This involves engaging indigenous peoples in discussions and decision-making processes to develop effective measures that integrate their knowledge with the healthcare system and territorial protection.

The research contributes to raising awareness of the relationship between mining activities and indigenous health, enabling nurses to better understand emerging health issues and adapt their care practices. This includes the identification of epidemiological, environmental, and indigenous rights risk factors, which, of course, can provide support for the training and work of nurses in intercultural contexts and their social and political role through inclusive strategies.

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