“Two Cultures in Favor of a Dying Patient”: Experiences of Health Care Professionals Providing Snakebite Care to Indigenous Peoples in the Brazilian Amazon
Author:
Murta Felipe123ORCID, Strand Eleanor4, de Farias Altair Seabra12ORCID, Rocha Felipe12, Santos Alícia Cacau12ORCID, Rondon Evellyn Antonieta Tomé12, de Oliveira Ana Paula Silva2, da Gama Hiran Satiro Souza12, Vieira Rocha Yasmim12, Rocha Gisele dos Santos12ORCID, Ferreira Mena12, Azevedo Machado Vinícius12, Lacerda Marcus123ORCID, Pucca Manuela5ORCID, Cerni Felipe5, Nickenig Vissoci João Ricardo4, Tupetz Anna4, Gerardo Charles J.4, Moura-da-Silva Ana Maria6ORCID, Hui Wen Fan6ORCID, Sachett Jacqueline127, Monteiro Wuelton12ORCID
Affiliation:
1. Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69065-001, Brazil 2. Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil 3. Instituto Leônidas and Maria Deane, Fundação Oswaldo Cruz, Manaus 69057-070, Brazil 4. Department of Emergency Medicine, Duke University School of Medicine, Durham, NC 27708, USA 5. Curso de Medicina, Universidade Federal de Roraima, Boa Vista 69310-000, Brazil 6. Instituto Butantan, São Paulo 05503-900, Brazil 7. Diretoria de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus 69065-130, Brazil
Abstract
In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health system for snakebite treatment. A qualitative study was conducted to understand the experiences of health care professionals (HCPs) who provide biomedical care to indigenous peoples with SBEs in the Brazilian Amazon. Focus group discussions (FGDs) were carried out in the context of a three-day training session for HCPs who work for the Indigenous Health Care Subsystem. A total of 56 HCPs participated, 27 in Boa Vista and 29 in Manaus. Thematic analysis resulted in three key findings: Indigenous peoples are amenable to receiving antivenom but not to leaving their villages for hospitals; HCPs require antivenom and additional resources to improve patient care; and HCPs strongly recommend a joint, bicultural approach to SBE treatment. Decentralizing antivenom to local health units addresses the central barriers identified in this study (e.g., resistance to hospitals, transportation). The vast diversity of ethnicities in the Brazilian Amazon will be a challenge, and additional studies should be conducted regarding preparing HCPs to work in intercultural contexts.
Funder
National Council for Scientific and Technological Development Fundação de Amparo à Pesquisa do Estado do Amazonas Ministry of Health Oswaldo Cruz Foundation
Subject
Health, Toxicology and Mutagenesis,Toxicology
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