Underlying premises in medical mission trips for Madiha (Kulina) Indigenous people in the Brazilian Amazon

Abstract

This article proposes two premises that underlie biomedical health care delivery provided through medical missions to Madiha (Kulina) Indigenous Amazonian people living in forest villages. First, that health care is implemented through a set of detached transferable goods and services. Second, that health is a condition that requires the importation of knowledge and resources. The premises were induced through qualitative research on the Brazilian government’s medical missions that provide biomedical care to Madiha (Kulina) in the southwestern Amazon as part of the national health care system. Despite policy rhetoric, delivery practices disregard embedding health and health care in local infrastructure and cultural conditions. There is little or no collaboration with Indigenous healers, capacity building of the local (Indigenous) health care system, education of resident lay health monitors, or extensive and lasting infrastructural development. The article recommends reorientation of delivery to prioritize local health care infrastructure development.