On Indigenous people´s Day, Secretary evaluates SESAI´s work during the pandemic
Created in 2010 to attend the indigenous people living in villages, the Special Secretariat of Indigenous Health (SESAI) is currently responsible for the care of 755,000 indigenous people in more than 6,000 villages throughout the country. There are more than 14,000 health professionals to provide primary care to indigenous people from 305 ethnic groups who speak 274 languages.
The difficulties to carry out the services are diverse: rainy weather, difficult access areas, and the dissemination of fake news are some examples. Even in the face of so many adversities, vaccination against Covid-19 continues to advance rapidly. Currently, 75% of the indigenous people eligible to take the vaccine in the 34 Special Indigenous Sanitary Districts (DSEI) have already received the first dose of the immunization. The rate of the second dose of the vaccine is at 59%.
In an exclusive interview, the Special Secretary of Indigenous Health, Robson Santos da Silva, tells us about SESAI´s daily work and how the pandemic and vaccination period are going. Check it out!
How does SESAI relate to the indigenous people today? Is there a relationship of trust? Do the indigenous people trust on SESAI´s work?
As the indigenous people themselves refer to the Secretariat, SESAI is an achievement of the indigenous peoples. Although it was created in 2010, the history of SESAI goes back to 1910, with the creation of the Indigenous Peoples Protection Service, then with the creation of the National Indigenous Foundation (FUNAI), in 1967, and the National Health Foundation (FUNASA).
SESAI is largely responsible for managing the Indigenous Health Care Subsystem. Our job is to provide primary care services in the villages. SESAI is family health, it is in the everyday life of the people. So it is responsible, for example, for primary exams to check diabetes, check the situation of pregnant women, of children, and everything that falls under the direct care of the family´s health.
When the indigenous person needs specialized attention, we need then of the support of medium and high complexity. What does this mean? That all three entities of the Federation: Municipalities, States, and the Federal Government have a responsibility towards this population.
You have been at the head of SESAI for a little over than a year, as a manager, what have been your feelings regarding your experiences?
I took over SESAI at the time of Covid-19. I was appointed on February 12, and from then on we have lived through all this rush, all this desperation. Maybe the older people have heard about some similar situation, but this new generation of children, young people, adults and even managers never experienced this. So there was a lot of running around, a lot of needs arose, and the Federal Government acted promptly.
Even before the World Health Organization (WHO) declared the pandemic, the Ministry of Health, on January 28, issued the first document and, since then, everything that should be done has been done. Of course we have lost people and important leaders, but the Ministry of Health/SESAI and the DSEI have acted quickly and efficiently, including the purchase of personal protective equipment, tests, and the sending of more resources so that the districts could work.
We also made several important partnerships with Non-Governmental Organizations. Another great partner during the pandemic was the Ministry of Defense. Together we carried out 20 inter-ministerial missions and took care, not only of Covid-19 with testing and active search, but also with other specialties such as gynecology and pediatrics. There are other needs besides the pandemic. So we are aware that everything that could have been done was done.
What are the challenges regarding the vaccination of indigenous peoples?
The Federal Government sent, in the first batch received, the two doses of the Covid-19 vaccine for the entire indigenous population that is served by SESAI.
There were more than 910,000 doses to serve approximately 400,000 people who are over 18 years old, that is, they are within the target public. The government made this population the number one priority. Vaccination is at a very high rate. We have been able to reach the goals, but we have some interferences, mainly in relation to the weather. In the Midwest and North regions, it has been raining a lot. SESAI has boats, cars and airplanes, and even so, there are difficulties. SESAI is in the daily life of 6 thousand villages and it is not easy to take care of more than 755 thousand people in so many communities.
SESAI only attends to indigenous villagers. What does this mean?
We have different realities throughout Brazil. There are 305 ethnic groups and 274 different languages.
SESAI does a job very close to what a city hall does. It has Base Poles and health posts, which are the Basic Indigenous Health Units (UBSI) in the territories covered by the Special Indigenous Sanitary Districts (DSEI). It is not a privilege, it is a necessity in view of the difficulties of locomotion and the cultural specificities.
How many workers are needed to provide this service?
Considering public employees and outsourced workers, we have approximately 20 thousand professionals. Of these 20 thousand professionals, 14,200 are health professionals. Of this universe, approximately 6,800 are indigenous. Let´s take, for example, the Xavante District. Considering that I work there and I am an indigenous person, I am from that ethnic group.
So I belong to this. We have heard many people with bad intentions saying that there is a genocide. There is no genocide. When you say this, you are saying that the indigenous themselves are killing their own people. This is an absurd! An empty speech!
How is the vaccination against Covid-19?
We have already reached 90% in some districts. Our goal has been fully met and continues. In other districts, the rates are between 57% and 75%. What disturbed us a little were the fake news that the vaccines would have some kind of consequence. We are doing several awareness campaigns.
There are also several initiatives of the DSEI with active search, that is, going from house to house and talking to leaders, and so we are advancing.
We also have those problems that we have already mentioned, such as the climate and the difficulty of getting there, with distances that can be up to a few days by boat. The perspectives are good and the restrictive measures of not crowding and wearing masks should continue. The vaccine protects, but we need to do our part.