Humildade cultural no compartilhamento de decisões individuais e coletivas em saúde

Abstract

This ethnography was performed during my work as supervisor and tutor in the More Doctors’ Program for Brazil in the indigenous communities of Guarani Mbya in the Ribeira Valley in São Paulo and in the Quilombola Community of Cafundó in the municipality of Salto de Pirapora. The objective was to understand how these communities interpret: (1) the therapeutic plans offered by the health teams, (2) the current public health policies and how they associate them with their traditional therapeutic model, and (3) how the School of Medical Sciences and Health (PUCSP) could contribute to the formation of professionals fit to work in rural communities. The hypothesis of the study is that health professionals focus the therapeutic plan on the disease and consider only evidence-based medicine neglecting the primary care attribute of cultural competence. The cosmology of the communities, the happiness projects, and the respect for autonomy were not the pivot for either individual or collective health decisions. During the study we had the opportunity to set up the rural internship at the Faculty of Medical Sciences and Health, which is compulsory the for 6 th -year medical students, as an opportunity to train doctors to focus their work on people and communities using medicine based on evidences which respects the autonomy and local culture, and faithful to the happiness projects of people and communities, thus providing health care not only based on scientific evidence but also person-centered and culturally appropriate With this ethnography we understand that a health professional who was not born and lived in these territories will hardly be competent in this culture, whilst universities do not train quilombola and indigenous health professionals the best definition would be the use of cultural humility, a professional in solidarity with the way of life and struggles of these people and their territories