1250 ARTIGO ARTICLE

Reflections on intervention strategies with respect to the process of alcoholization and self-care practices among indigenous people in State,

Reflexões sobre estratégias de intervenção a partir do processo de alcoolização e das práticas de autoatenção entre os índios Kaingang, Santa Catarina, Brasil

Reflexiones sobre estrategias de intervención en relación al proceso de alcoholización y las

prácticas de auto-atención entre los Kaingang, Ari Ghiggi Junior 1 Santa Catarina, Brasil Esther Jean Langdon 1

Abstract Resumo

1 Universidade Federal This article, based on ethnographic research on Este texto, baseado em pesquisa etnográfica rea- de Santa Catarina, Florianópolis, Brasil. the Xapecó Indigenous Reservation in Santa Ca- lizada na Terra Indígena Xapecó em Santa Ca- tarina State, Brazil, examines the sociocultural tarina, Brasil, trata do contexto sociocultural Correspondence context of the use of alcoholic beverages among relacionado ao uso de bebidas alcoólicas entre os A. Ghiggi Junior Universidade Federal de Santa the Kaingang indigenous people. The authors índios Kaingang. Complementarmente, aborda Catarina. also discuss the experience with an intervention uma experiência de intervenção institucional, Rua Sebastião Laurentino involving government agencies and nongovern- envolvendo órgãos governamentais e não go- da Silva 365, apto. 1004, Florianópolis, SC 88037-400, mental organizations that attempted to deal vernamentais, que tentou se estabelecer na lo- Brasil. with alcohol-related problems on the reserve. calidade para atuação frente aos problemas re- [email protected] Based on the concepts of alcoholization and self- lacionados ao uso de álcool. Assim, a partir dos care practices, the study analyzes the possibili- conceitos de processo de alcoolização e práticas ties for organizing health intervention practices de autoatenção, analisaremos as possibilidades with indigenous peoples, in light of the principle de articulação de práticas intervencionistas em of differentiated care under Brazil’s National saúde junto a povos indígenas, tendo em mente Healthcare Policy for Indigenous Peoples. o princípio de atenção diferenciada presente na atual Política Nacional de Atenção à Saúde dos Alcoholic Beverages; Health of Indigenous Povos Indígenas no Brasil. Peoples; Qualitative Research Bebidas Alcóolicas; Saúde de Populações Indígenas; Pesquisa Qualitativa

Cad. Saúde Pública, Rio de Janeiro, 30(6):1250-1258, jun, 2014 http://dx.doi.org/10.1590/0102-311X00108613 intervention, process OF alcoholization and self-care practices 1251

Various studies have shown that health profes- Brazil 13,14 have drawn on the work of Menén- sionals frequently refer to “alcoholism” as a dez 15 and his concept of “alcoholization pro- problem among indigenous peoples 1,2. Litera- cess”. The concept of alcoholization focuses on ture review from different fields that analyze this the discourse and use of alcoholic beverages question among Brazilian indigenous peoples from the point of view of the actors themselves. reveals a lack of consensus on the meaning of The process of drinking is perceived as based on “alcoholism” and the ways to identify it. The cat- social processes and sociocultural codes that egory, which refers to an individual disease with express collective recognition of positive and an invariable clinical presentation and a natu- negative aspects related to the use of alcoholic ral and chronic prognosis, has proven problem- beverages. atic and anachronistic even for some sectors of This article focuses on strategies employed by biomedicine 3. Studies show that the term “al- Kaingang people to control what they perceive as coholism” emerged in Brazil in the 19th century negative in relation to alcohol consumption. We through a process that turned a popular custom thus adopt the concept of “self-care” 16 to identify into a “disease” in order to raise social, political efforts by the community to prevent or control and economic standards. During this process, what they view as threatening to collective well- biomedical knowledge constructed a solid basis being. Self-care refers generically to representa- for the hygienist order to disseminate bourgeois tions and practices that social groups use to deal values 4. Much more than the diagnosis of a dis- with health and disease processes in a way that is ease, “alcoholism” currently serves to justify the autonomous to professional medical treatment. accusatory marginalization and stigmatization This concept shifts the view from the biomedical of certain groups 5. notion of disease and focuses on meanings that In light of such limitations, this study pres- social groups assign to their ailments, problems, ents an anthropological perspective concerned and feelings. Self-care practices operate at two with the complexity and heterogeneity of the use levels: in a restricted sense that refers to inten- of alcoholic beverages as a collective phenome- tional acts based on people’s decisions in dealing non. The circumstances of alcohol consumption with misfortunes, and in a more ample sense that reveal sociocultural particularities important in refers to practices that ensure the group’s bioso- the emergence of specific meanings assigned to cial reproduction as a whole. alcoholic beverages that require an understand- ing of drinking strategies in unique contexts 6. Not all groups manifest intoxication in the same Methods way, since cultural contexts and values are deter- minant factors in differences of drinking styles The article is based on a study conducted in the and of acting when drinking 7,8. Xapecó Indigenous Reservation in 2009 accord- The contemporary uses of alcoholic beverag- ing to anthropological methodology for quali- es among indigenous peoples hardly reflect the tative data collection through observation and traditional representations and practices marked participation in the local context that is recorded by sociocultural control and limits on the use of in a field diary. The study identified settings for indigenous fermented beverages 6. Indigenous the local population’s consumption of alcoholic societies are inserted in contexts marked by in- beverages, such as dances and soccer games. We terethnic relations of domination and contact also recorded complaints and control strategies that are not always peaceful, as shown by studies related to alcohol abuse. Semi-structured inter- that relate the use of alcoholic beverages to the views were conducted, and given that it is a con- processes of European colonization around the troversial topic, the identifying features of the world 9,10,11. To understand alcohol-related prob- narratives and statements have been changed lems 3 among indigenous peoples requires shift- in order to maintain individual anonymity, al- ing the issue from the physical/individual to the lowing preservation of the group’s confidence 17. collective/social domain, in which drinking prac- The study is part of a broader research project tices are viewed as a phenomenon constructed entitled Evaluation of the Model of Differential through social and historical processes with the Care for Indigenous Peoples: the Cases of the dominant society 11,12. The anthropological per- Kaingáng (Santa Catarina) and spective thus focuses on observation of the in- (Amazonas), approved by the National Council tersection between expectations, attitudes, and on Research Ethics (case review no. 546/2008). other social and cultural factors associated with The study is also part of a longer joint research the use of these substances. program on indigenous people’s health among Recent anthropological studies on the use the Kaingang 18,19,20. of alcoholic beverages by indigenous peoples in

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The Xapexó Indigenous Reservation and health post and is crossed by state highway SC-480, resulting in heavy automobile traffic be- The lands that today comprise the Xapecó Indig- tween Ipuaçu and Bom Jesus. enous Reservation were claimed by Chief Vanh- It is important to recognize the presence of krê as payment for the labor of clearing a path Christian affiliation on the Reservation with al- through the forest to lay a telegraph line from legiance to one of two groups 22,25. The first group 1890 to 1893 21. The definitive deed to the lands identifies as “Catholic” and is the result of mis- in the mid-1940s resulted in the forced transfer sionary efforts implemented from the late-19th of indigenous people from the State of Paraná to the mid-20th centuries. The other group is to this location 22. The Reservation’s territory composed of Kaingang belonging to Evangelical initially measured 50,000 hectares between the denominations organized in the area since the Xapecó and Xapecozinho rivers, but was reduced mid-20th century and these followers are locally to 15,000 hectares in the 1960s 22,23. As shown called “believers” (crentes). Visitors to the Reser- by Almeida 22, the reduction occurred together vation cannot fail to notice the numerous Evan- with deforestation and sale of native Araucaria gelical churches and variety of denominations (Araucaria angustifolia) and Imbuia (Ocotea po- established in all the villages. For reasons that rosa) forests. The Indian Protection Service (SPI) will become obvious in the course of this article, itself was responsible for lumber extraction and we will focus on the attitudes of the believers in the fraudulent sale of parts of Xapecó territory relation to alcoholic beverages. to descendants of Italians from the neighboring State of . Only in 1978 were measures taken to remove the intruders, “leaving Abuses related to alcoholic beverages behind a trail of co-paternity (compadrio), alli- according to the Kaingang ance, and marriage between settlers and Indians, the marks of which are visible on the faces of those Alcoholic beverages play positive roles in the who stayed in the area” 22 (p. 15). modes of sociability of local indigenous and The Reservation is currently located in the non-indigenous people; they appear as motivat- municipalities of Ipuaçu and Entre Rios in the ing factors for participation in soccer games and west of the State of Santa Catarina, The two dances that occur on the Reservation, mediate municipalities had 6,798 (Instituto Brasileiro relations with merchants in the local towns, and de Geografia e Estatística. http://www.cidades. are consumed during collective work groups, ibge.gov.br/xtras/perfil.php?lang=&codmun=4 called “puxirão”. 20768&search=santa-catarina|ipuacu, accessed For the purposes of this article, we emphasize on May/2014) and 3,018 (Instituto Brasileiro de that the Kaingang use a term for a specific type Geografia e Estatística. http://www.cidades.ibge. of drinker when referring to negative aspects as- gov.br/xtras/perfil.php?lang=&codmun=42051 sociated with alcoholic beverages: the “bêudo” 7&search=santa-catarina|entre-rios, accessed (drunkard). As an accusatory category for certain on May/2014) inhabitants, respectively in 2010. individuals, the term signals abusive drinking or According to the last census, the Reservation’s immoral conduct, associating the individual in indigenous population was 4,056 24. Ipuaçu, in question with incidents viewed locally as unde- which the largest part of the Reservation belongs, sirable. Various discourses associate bêudos with had a total of 3,436 indigenous persons 24. episodes of public and domestic violence, theft, The Reservation is arranged internally in or other transgressions. 10 villages. The study that served as the basis This category is also often used didactically for this article concentrated on the two largest to lecture children, especially concerning plac- villages, Sede and Pinhalzinho, both located in es where they should not go: “there are bêudos Ipuaçu municipality. The Sede village has some there”; or to scare them when they are misbehav- 1,500 inhabitants and several important agencies ing: “Don’t do that, or I’ll call the bêudo.” Children such as the National Indian Foundation (FUNAI) use the category to tease a child who has a family post, the Chief Vanhkrê Primary and Junior High member labeled as such: “... your father is a bêu- School, an armadillo-shaped gymnasium, a cul- do!” They also imitate, in moments of diversion, tural center, a daycare center/preschool, and a the performance of bêudos, especially the way relatively well-equipped health post. An unpaved they walk, gesticulate, and speak. road connecting the municipality of Entre Rios The recognition of a specific public bodily to Bom Jesus cuts through this village. Pinhalzi- performance as the result of consuming alcohol nho village, with some 1,200 inhabitants, is lo- is crucial for the characterization of the bêudo, in cated approximately seven kilometers from the which stigma and accusation emerge from the in- municipal seat of Ipuaçu. It has a primary school terpretation of certain signs shared by the larger

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group: tipsy walking, shouting, cursing, growling, ervation’s indigenous leaders and the believers. and mumbling. Public appearances of bêudos Both groups produce parameters on the status are a spectacle to be enjoyed by the population. alcoholic beverages according to diverse reasons When someone notices an unusual noise, espe- for regulation of the substances themselves, of cially on the street, they invite all those around the possibilities and ways of their use and of the to watch. The comments are usually made in a individuals that wish to drink. taunting tone. However, public appearances by bêudos are sporadic, considering the local population’s Self-care practices: indigenous leaders daily dynamics. The practice of “drinking on the and “believers” highway”, observed particularly on weekends along state highway SC-480 in the village of Pin- The Kaingang indigenous leaders can be viewed halzinho, is also considered inappropriate. The as a corpus of actors with legitimate power to drunkards often hurl jokes and insults at driv- make decisions and take action pertaining to ers or pedestrians. Regardless of whether they maintenance of the internal organization, to at- are merely carrying their alcoholic beverages or tempt to resolve conflicts, and to represent the actually consuming them, it is common to see group as a whole on political issues vis-à-vis the Kaingang sleeping on the highway shoulder af- surrounding society 26. ter their drinking sprees. When asked about this The highest position in the indigenous lead- practice, the local residents are unanimous in ership hierarchy is the cacique or “chief”, the calling them bêudos. figure that centralizes the power over political The villages have side paths called “carreiros” decisions and mediates the process for the for- that serve as alternatives to the regular roads and mation of this local corpus. The chief’s assistants trails. Such paths cut across fields and yards and in the various Reservation villages are called connect points in the villages by shortcuts. Vari- “captains”, who have legitimate power to make ous carreiros cross the forests or uninhabited ar- certain emergency decisions at the micro-social eas and become prime spots for encountering level. People usually turn to the captains when Kaingang drinking alone. If a stranger comments they have complaints. It is up to the leaders to that he intends to take such a shortcut, he is in- verify the grievances and take the appropriate variably warned to beware of violent attitudes measures. by the bêudos. However, our field experience The leaders work according to an indigenous showed that most of these bêudos avoided con- justice system 27 that guides their handling of tact when we tried to approach them. unwanted situations. This system must follow Field observation showed that drinking or certain steps to guarantee the legitimacy of such getting drunk in public places is not viewed in actions. In the case of a grievance between neigh- a positive light by the Kaingang, particularly if bors or spouses, for example, the leader con- the beverage of choice is cachaça (high-proof venes what is called a “hearing”. He attempts to sugar cane spirits). It is as if there is a spatial and consider all parties involved in order to come to temporal border demarcating styles of drinking a decision. The most basic measure is generally associated with morality, which is transgressed “counseling”, done individually with the parties through appearing intoxicated in public on inap- during the hearing itself seeking a verbal propos- propriate occasions. In addition to dances and al for a peaceful settlement. If the problem per- soccer games, the private space of the home is sists and the misunderstanding causes new harm considered the most adequate place for alcohol to one or both of the parties, they are called on consumption, where “you can drink without be- again by the leaders for more serious measures. ing bothered”. As alcohol users confirmed: “If you One example is to use the stocks or tronco as a don’t raise a fuss and don’t fight, there’s no prob- punitive measure; the delinquent person is tied lem in having a couple of drinks.” by the wrists to a tree trunk located on the land of Given the above, one can say that the con- one of the leaders. sumption of alcoholic beverages and the recog- Indigenous leaders act in the social control nition of specific problems associated with this of alcoholic beverages in two ways: sporadic au- process are points of reflection among the local thorizations for the sale of alcohol on the Reser- population. In this sense, the ethnographic con- vation – at soccer games and dances – and the text leads us to question the stigmatizing West- restraint of unpleasant behavior by individuals ern representations that tend to view alcohol that transgress expected conduct. In the latter consumption on indigenous lands as “unbridled case, when situations of intoxication are consid- licentiousness”. Here we highlight the expressive- ered problematic, tying to the trunk is justified ness of two internal ideological groups, the Res- as a safety measure to prevent serious incidents.

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Intoxicated individuals never spend more than cessity to form a covenant with Jesus: the Evan- a few hours tied to the trunk “to calm down and gelical pastors’ sermons gain strength through sober up”. This punishment is public and is used intensification of the Pentecostal experience, routinely. both individual and collective. In the case of bêudos as well as other unpleas- The pastors underscore abstinence from al- ant situations, repeat offenses by individuals can coholic beverages during the worship services, lead to further measures by indigenous leaders, focusing on “replacing alcohol with acceptance first as a request to leave the village and then as of the word of God”. Problematic cases are the a “transfer” to another indigenous Reservation. target of testimonials, which always emphasize The believers also intervene in alcohol- threshold experiences that serve to provoke con- related abuses. They represent one of the most version. The converts, in turn, become fervent outspoken voices on moral issues, which is wit- preachers on such issues by the testimony of nessed by the large number of Evangelical sects their own life histories. on the Reservation. Criticisms are also common for individuals One joins the community of believers by birth that have “strayed” from the doctrine and devi- or by conversion, understood as rites of pas- ated from religion by drinking. In moments of sage 22 to a “new life” guided by “the doctrine”. disbelief in the word of Jesus due to drunkenness, During the period that a person belongs to one they get involved in fights and misunderstand- of these churches, a series of rules pertaining to ings. Such actions are associated with “evil spirits” bodily habits, such as wearing specific clothing that follow the individual and take advantage of (trousers and dress shirts for men and skirts for a moment of distraction to over-power the soul. women) and haircuts (long hair tied in a pony- The weakness of those who drink is portrayed tail for women and short hair with well-shaven a process of “disturbance”; evil spirits grasp the faces for men). They must also abstain from person and consume him physically and spiri- certain activities such as participating in games tually. As interpreted by believers, this is a dis- and dances, committing adultery, and, primarily, turbance in which the very substance of alcohol from consuming alcoholic beverages 22. can be the recipient of such destructive agents. In For those who are not born into the religion, reference to the name of a popular brand of cane conversion can occur after a visit to a church liquor, they say “cachaça possesses 51 demons”. motivated by various circumstances: drink- The believers’ discourse is often associated ing problems, a serious illness, or by invitation with moral ideals defended by the indigenous from a spouse or family number. The convert is leaders, since it is assumed that converts cause accepted during the worship service, which is fewer problems due to their strict conduct. Dur- almost a daily ritual for “believers”, and the mo- ing counseling, indigenous leaders may recom- ment when the individual is encouraged to re- mend conversion to the group of believers as a consider his mistakes in life, reinterpreting past way of containing some problematic situation. events through the prism of Evangelical doctrine. The general population commonly emphasizes One characteristic of believers is the task the combined efficacy of the believers’ and indig- of proselytizing to those who have still not ac- enous leaders’ efforts. cepted the “word” of Jesus. They always seek to The Xapecó Indigenous Reservation also has emphasize the correct form of behavior and that practices that are independent of these ideologi- there are no alternatives for salvation other than cal groups and reflect strategies to regulate abu- joining the group 22. This constant pursuit of new sive cases associated with alcohol. In one case followers by the believers has implications for during fieldwork, repeated transgressions com- indigenous social organization. The mode of or- mitted by an individual accused of being a violent ganization and administration of the churches in “bêudo” culminated in his unexplained death: the various villages contributes to the formation “he was simply found dead”. The episode did not of close circles of sociability among groups of result in any major concerns or punishment for worshippers, routinely reinforced in the alliances the perpetrators. The population acknowledged and practices of reciprocity among each congre- that “it was better this way (...), otherwise nobody gation’s members. These circles also structure was safe”. the emergence and empowerment of Evangelical religious leaders (pastors, presbyters, etc.), who have an important influence on the local group, Institutional intervention to deal with despite being subject to the general guidance of alcoholism the indigenous political leaders. The worship service is a special moment that In 2009, the multidisciplinary indigenous peo- constantly focuses on the opportunity and ne- ple’s health team working in the Sede village con-

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sisted of 2 nurses, 1 nutritionist, 1 dentist, 1 phy- at that which is primarily individual. AA focuses sician, and various nurse technicians. The indig- its work on weekly meetings in which members enous persons in this team were restricted to the share their idiosyncratic experiences anony- positions of nurse technicians and indigenous mously, while the Hudolin method works in the health agents. The latter are local residents and opposite direction by forming clubs. act as facilitators between the actions offered by Ideally, these clubs are conceived as spaces the Indigenous Health Care Subsystem and the for contact among families with alcoholic rela- local sociocultural realities. tives. The families are articulated in a multifamily Another important place occupied by a Kain- network through the involvement created by the gang in the health team was that of “health di- functioning of the administrative system main- rector”. He was affiliated with the Health Depart- taining the club. The club has a teacher as the ment of the Ipuaçu Municipal Government. In central mediator who may or may not be from practice, he worked to mediate communications the community, and who engages the families among the various local health spheres, that is, according to the methodological orientation. watching over the indigenous community’s inter- Club participation should create a space for sys- ests and needs and those of the official agencies, tematic surveillance intended to reformulate the ranging from the health team to the National alcoholic’s bonds of interaction and sociability. Health Foundation (FUNASA) and occasionally Theoretically, knowledge of the family member’s FUNAI. The Kaingang who occupied this posi- specific problems creates a collective health re- tion was not a health professional, but was highly sponsibility among club members, changing the active in local political dynamics. entire family’s behavior and lifestyle, as well the The non-indigenous members of the health general culture of the local community. team frequently expressed the idea that the The method was organized on the Xapecó In- “Kaingang have high incidence of alcoholism”, digenous Reservation on two fronts: one through an affirmation which displayed a lack of clar- the multidisciplinary indigenous people’s health ity in relation to the local problems of drinking. team, in which the health director and another The health professionals who developed the Kaingang were invited to participate in method- programs to treat hypertension on the Reserva- ological training courses in Italy, and the second tion 28 complained frequently that alcohol con- through the “mothers’ group” in Pinhalzinho vil- sumption interfered with allopathic medication lage for identification of families to participate among Kaingang patients. in the project. In addition to the women in the The strategies of such programs were based group and health team staff spreading the project on educational efforts to change habits during through word of mouth, the project and invita- monthly meetings with their patients. The health tions to participate were announced on posters professionals tirelessly explained the ill effects of displayed at various locations where the Kain- salt and lard and urged users to comply rigor- gang circulate, such as health posts, schools, and ously with their medication and to avoid alcohol. churches. At one point, FUNAI took the initiative to de- The first step was to organize the clubs. velop a specific program with users of alcoholic FUNAI scheduled several meetings during the beverages through a partnership with a non- latter half of 2009, attempting to coordinate them governmental organization (NGO), Outro Olhar with visits to the Reservation by members of the (Another View), from the city of Guarapuava, in Another View NGO. FUNAI relied on crucial as- the neighboring State of Paraná. The plan was sistance from one of the founders of the moth- to implement a mutual help model based on the ers’ group, a key community figure known as a Hudolin method for what the NGO referred to as remedeira (herbal healer). This Kaingang woman “problems related to alcohol consumption” rath- helped schedule meetings in the Catholic Church er than FUNAI’s designation of “alcoholism” 29. in the village of Pinhalzinho and at the house that The method is an Italian initiative with less hosted the mothers’ group. visibility in Brazil than Alcoholics Anonymous Several attempts to schedule meetings were (AA). Its overall objective is “to help families in made, but they failed to attract interested people trouble, through a family (systemic) approach, a and in the end did not happen. This led to ten- multi-family community of 2 to 12 families, to sion between the various parties involved in the reach sobriety and a change in behaviour and life intervention and resulted in placing the health style” 30. The basis for the method is a “social- director and his work in check. There was a cer- ecological” approach, in which individuals are tain insistence that he was not really interested seen as interdependent. Thus, problems related in the issue, which eventually led to accusations to alcohol consumption are approached at the that his activities were merely for self-interest. collective level and not, as in the methods of AA, His trip to Italy for training in the Hudolin meth-

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odology became the target of internal allegations The experience examined was based on a among members of the health team who claimed proposal of intervention originating from out- that it had been nothing more than a “tourist side the indigenous community and oriented by trip”. Other research colleagues that visited the non-consensual preoccupations with the prob- area in this period heard the same accusations by lem held by the institutions involved. In prac- other residents of the Reservation. tice, it sought to identify the alcoholics and their Meanwhile, from the health director’s per- families, organizing them in groups in order to spective, the initiative failed because of a meth- educate and to modify behavior and lifestyles ac- odological misalignment stemming from a ba- cording to Hudolin directives. sic demand by the Guarapuava NGO that the The project overlooked or ignored the use clubs meet in public and not in closed meeting of alcoholic beverages from a sociocultural per- rooms. According to the director, his knowledge spective, that is, the process of alcoholization of the community assured that “the best thing in the community. The intervention efforts thus would be to hold closed meetings in the health failed to consider the Kaingang’s own thoughts post or school”. on adequate and inadequate forms of consum- Thus, during the field research conducted in ing alcoholic beverages according to local moral- the second semester of 2009, the impasses had ity. The efforts also failed to articulate with self- still not been resolved. No real progress had been care practices developed by community mem- made in implementing the intervention project, bers to deal in relatively autonomous ways with which was “at a standstill” according to some of problems related to alcohol consumption. the Kaingang involved. It was based on a generalization of the prob- lem without taking into consideration the unique aspects of the Reservation’s social organization. Final remarks The attempted intervention ended up provoking a social drama in which latent conflicts emerged The Brazilian National Healthcare Policy for In- among the actors. Similar to what Diehl 35 has digenous Peoples 31 has promoted the principle demonstrated, accusations and disagreements of differentiated care for indigenous peoples. about the problems of the proposal’s implemen- The policy specifies the need to respect the tation cut across internal disputes that emerged communities’ cultural practices and traditional from preexisting schisms that revealed political knowledge, including them whenever possible processes in the local health field. in routine health work 32. The policy also stipu- We are aware of experiences in Brazil that lates that primary care provided by health units have achieved better results with the same should articulate with indigenous health prac- question. Ferreira 34 shows how participation tices. In other words, Brazilian legislation explic- in discussion groups on alcohol abuse by Gua- itly manifests a concern for the need to articu- rani leaders and shamans, together with the late official health intervention with the various FUNASA team, resulted in a better understand- indigenous forms of self-care. This is a difficult ing of the problem experienced by the commu- task for health professionals, since it requires re- nity. Through the traditional dialogic practice of thinking their biomedical understanding of dis- “good words”, group dynamics fostered reflec- eases and the respective treatments, as well as tions on coping strategies and generated posi- being receptive to dialogue. Thus, labeling some tive effects, not only through reduction of alco- forms of drinking as “alcoholism” overlooks the hol abuse but also through the reaffirmation of indigenous people’s thoughts on their own be- Guarani identity. haviors 6,33,34. We attempted here to analytically situate the This case study on an intervention program intervention experience within an ethnographic designed by governmental and nongovernmen- context, with the goal of making a contribution tal institutions allows us to reflect on the strate- for the expansion of the comprehension of the gies for articulating with indigenous communi- question starting from the community’s own ties based on the concepts of alcoholization 16 concerns in relation to alcohol abuse on the Res- and self-care practices 18. These concepts high- ervation. This kind of exercise can present im- light the importance of sociocultural processes in portant tools against the reproduction of wide- the biosocial reproduction of groups, emphasiz- spread stigmas towards Brazilian indigenous ing the contributions of anthropological research peoples, such as generalizations of “alcoholism” for the development of approaches to complex or “alcohol-related problems”, providing greater health problems – such as mental health and al- consistency for health action in relation to na- cohol abuse. tional policy.

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Resumen Contributors

Este texto se fundamenta en una investigación etnográ- A. Ghiggi Junior contributed to the elaboration of the fica realizada en la Tierra Indígena (TI) Xapecó, Santa field research, data analysis, writing of the article, re- Catarina, Brasil, y aborda el contexto sociocultural re- vision of the content, and submission of the article. E. lacionado con el consumo de bebidas alcohólicas entre J. Langdon collaborated in the orientation of the field los indígenas Kaingang de la región. De forma comple- research, data analysis, writing of the article, and revi- mentaria, se observa una experiencia de intervención sion of the content. institucional que intentó desarrollarse en la zona y en la cual participaron órganos gubernamentales y no gubernamentales, con la intención de hacer frente a los Acknowledgments problemas relacionados con el consumo de alcohol. A partir de los conceptos de proceso de alcoholización y The authors wish to thank Prof. Dr. Flávio Braune Wiik prácticas de auto-atención, analizaremos las posibili- for the joint supervision of the thesis that served as the dades de articulación de prácticas intervencionistas en basis for the article, the National Research Institute: el ámbito de la salud para grupos indígenas, teniendo Brazil Plural (IBP), and the Nucleus for Studies on Indi- en consideración el principio de atención diferenciada genous Health and Knowledge at the Federal University presente en la actual Política Nacional de Atención a la of Santa Catarina (NESSI/UFSC) for networking with Salud de los Pueblos Indígenas en Brasil. other researchers interested in the theme. They also wish to thank Capes and CNPq for research and study Bebidas Alcohólicas; Salud de Poblaciones Indígenas; grants and the Graduate Program in Social Anthropo- Investigación Cualitativa logy/UFSC for the opportunity to develop the study. In addition, they thank the Kaingang of the Xapecó Indi- genous Reservation for their hospitality and essential support.

References

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