ETNOENFERMAGEM: CUIDADOS CULTURAIS EM UMA COMUNIDADE MAPUCHE EM PUERTO AGUIRRE, AYSÉN, CHILE

Ojeda, Marisa Angélica Mansilla; Heidemann, Ivonete Teresinha Schulter Buss; Villa, Sergio Eduardo Contreras

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Original article • Texto contexto - enferm. 29 (spe) • 2020 • https://doi.org/10.1590/1980-265X-TCE-2019-0262 copiar

ETNOENFERMAGEM: CUIDADOS CULTURAIS EM UMA COMUNIDADE MAPUCHE EM PUERTO AGUIRRE, AYSÉN, CHILE

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivos:

compreender as crenças, expressões e práticas genéricas de cuidado utilizadas pela comunidade mapuche em Puerto Aguirre e reconhecer o cuidado profissional oferecido à promoção da saúde.

Método:

pesquisa qualitativa baseada na etnoenfermagem, realizada durante sete viagens a Puerto Aguirre, realizadas entre julho de 2018 e janeiro de 2019. Foram entrevistados sete informantes-chave e sete informantes gerais. As informações foram compiladas por meio de observações, anotações de campo, conversas e entrevistas.

Resultados:

confirmou-se a propriedade científica da etnoenfermagem, identificando três temas que estruturam as práticas de cuidado cultural na comunidade estudada: A identidade mapuche como principal valor para preservar o cuidado cultural; A presença de mulheres é essencial para realizar experiências e práticas de cuidado significativas entre os mapuches; e Os mapuches valorizam e usam práticas de cuidado cultural e profissional para promover a saúde.

Conclusão:

a pesquisa reconhece a validade plena da Teoria do Cuidado Cultural, uma vez que a enfermagem e, em geral, as diferentes profissões da saúde, tendem a se popularizar e o conhecimento profissional é complementado, aprendendo e aprimorando o cuidado cultural na comunidade.

DESCRITORES:
Enfermagem transcultural; Cuidado; Grupos étnicos; Antropologia cultural; Pesquisa em enfermagem

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Ivonete Teresinha Schulter Buss Heidemann ivonete.heidemann@ufsc.br

Social structure and holistic health of the Mapuche community
Worldview
Most identify themselves as Mapuche and this was a surprise to me because I thought there was a great rejection, because we are a community that has no identity, copying models (G7). We already do more for the natural. I, on the part of (my) family, come more naturally. The dissemination of my mother’s knowledge, which comes from Chiloé, comes more with the medicinal herb (C7). Chonos was a very advanced city (G7).
Technological Factors	I believe that the arrival of 24/7 light and television antennas has been the most harmful for the population (G2). Something very special happens: although we are so close and far from everything that life has today, we are so close to technology, to connectivity, but at the same time so far, because we are on an island (G3).
Religious or philosophical factors	My God gave me this gift to help others (C6). There is only one Being who has all things. He owns life. Whenever he wants, he gives it and takes it (G1).
Family and social factors	Thank God, although there are differences, we are always together, family support is essential (C2). If families do not care about their daughters or relatives, problems arise. Having healthy children who can work support the family, that is enough (C3). Here the whole family goes fishing, they get stronger as a family, as an institution (G4).
Political and legal factors	The association of residents is responsible for working with communities. There are three neighborhood councils, but this depends on the control exercised by the municipality. Suddenly, there are leaders who mark you, even if they want to do things that stop you. (It is) a negative counterpart (G7). This country is the third country in the world that has (more) islands and does not have adequate legislation (G7). Therefore, the rural health policy for this region is different from the rest of the country. You need to generate resolution locations of what is normally expected from a center in this case (G5).
Educational factors	Young people rarely return with a professional title (C2). One hundred percent of children or people who go out looking for studies or something usually don’t come back for the same reason. Because they feel that they cannot step up their standard of living here (G3).
Economic factors	Most of them are artisanal fishermen. Divers became artisanal fishmongers. Many people left; here the population reaches more or less 1,500 inhabitants among the three communities (G7). There are many marine products, but the red tide does not allow harvesting. There are protected animals, such as the sea lion, the otter. They cannot be hunted (C1).
Holistic Health System
Cultural systems	Nursing care - health promotion	Professional systems
Our family, in one way or another, practices ancient medicine, because we discovered it (G7). I’ll get some hooks from - there’s a wood that says the luma, I’m going to make them boil and I do it with burnt sugar. I take it and it is a sacred medicine (G1). They use sea lion oil, hunting is prohibited and; therefore, is no longer used. Sea lion hunting can be prohibited, because it always happens (C5).	As a former paramedic, I see the potential for interculturality. From the beginning, we are going to do the plant workshop, there is someone who creates soap oil, etc. (G4). Totally willing to work with Mapuche medicine, it would be a contribution. If you can take medicine in your garden, it is accessible and you don’t need to go to a pharmacy (G5). “Overweight and obesity occur in all age groups. In children of all age groups. The relationship that La Posta has with educational institutions is through vaccines/control. Everything goes to La Posta. They are done in days. Childhood and adolescence health control is made by appointment, and with kindergarten, informative lectures are coordinated throughout the year. (These are) certain activities that are carried out (G4).	Most people who go to consultations are women, children and older adults, men are not. The men who go to consultation are those on board. In fact, the men of the island do not go to consultation, they do not come much to La Posta (G4). Well, for example, here in La Posta, since I listen to reason, I spoke to him about 45 years ago, because even a 15-year-old boy realizes several things. La Posta, in a way, has been strengthening in the sense that today we can count on doctors (G1).

Theme 1 - Mapuche identity as the main value to preserve cultural care
Importance of acknowledgment as an ethnic group (Mapuche) to continue with cultural care. (Mapuche identity, care, meanings and expressions of care, women’s role).	Most of the population identifies as Mapuche, and for me that has been a surprise because I thought there was a great rejection, because we are a community that has no identity, copying models (G7).
	This island is inhabited by the Chilote; they went down the channels looking for work and they brought the Mapuche culture all the culture and knowledge of herbs. That is innate and typical of the Mapuche. That is constant, it is part of life. I see that reflected here (G4).
	Our family, in one way or another, practices ancient medicine, because we discovered it (G7).
Theme 2 - The essential presence of women to carry out meaningful care experiences and practices among the Mapuche
Women’s role as the main family caregiver and responsible for providing health and illness care (family support, Mapuche identity, care, meaning and expressions of care).	There is the presence of women, the maternal, labor, cultural and religious role, empowered women. Here, women are very strong; they are super empowered, they do the same as men. Women have a role in all aspects, economic, social. Men are more shy, but more violent. (They are) inserted in the way of living (in which) women are heads of household (G5).
	One of the ingredients has herbs, grass and urine. When you are a child, you have no fever and are healthy. I learned it myself, I don’t know if God gave me to help people, it’s not so much to charge 2 or 3 thousand pesos per person, because they spend more when they go to Coyhaique (C6).
	Most people who go to consultations are women, children and older adults, men are not. The men who go to consultation are those on board. In fact, the men of the island do not go to consultation, they do not come much to La Posta (G4).
Theme 3 - Mapuche value and use of cultural and professional care practices to promote health
Popular care and use of cultural practices to promote health and well-being. (family support, care, meanings and expressions of care, Mapuche identity, women’s role). Professional Care is oriented to recognize Interculturality, to promote health and well-being. (care, meanings and expressions, professional health care, no care).	They use sea lion oil, hunting is prohibited and; therefore, is no longer used. Sea lion hunting can be prohibited, because it always happens (C5).
	Well, for example, here in La Posta, since I listen to reason, I spoke to him about 45 years ago, because even a 15-year-old boy realizes several things. La Posta, in a way, has been strengthening in the sense that today we can count on doctors (G1).
	I try to mention it as complementary medicine, since they are compatible. Today there is a revolution in the way of living, returning to the most natural. A deal was made anyway. Some went too far. I think we need to complement it (G5).
	As a former paramedic, I see the potential for interculturality. From the beginning, we are going to do the plant workshop, there is someone who creates soap oil, etc. (G4).