Da desterritorialização a territorialização precária: um estudo sobre o adoecimento mental dos povos indígenas da região de saúde Cone Sul – MS

Abstract

The constitution of Indigenous territories in Brazil is marked by historical processes of expropriation, confinement, and denial of rights, expressed through multiple forms of social, economic, political, and symbolic vulnerability. In Mato Grosso do Sul, particularly in the Cone South Health Region of Mato Grosso do Sul, these processes are intensified, resulting in the worsening of mental illness among Indigenous populations. This thesis aims to analyze the interrelations between processes of deterritorialization and precarious territorialization and the psychological suffering experienced by Indigenous peoples in the region, using as an empirical field the care provided at the University Hospital of the Federal University of Grande Dourados (HU-UFGD) between 2021 and 2023. The research adopts a qualitative approach, grounded in critical Health Geography, territorial studies, and Indigenous epistemologies, integrating documentary analysis, participant observation, and the author’s professional experience as a hospital social worker. Data were systematized from twenty cases monitored in the HU-UFGD psychiatry outpatient clinic and Psychosocial Care Unit, combined with secondary information (IBGE, DATASUS) and accounts from professionals in the Indigenous health care network. The results highlight the prevalence of severe depressive episodes, psychotic episodes, and substance abuse, often associated with domestic, sexual, and institutional violence, mourning, loss of territory, and community disintegration. The analysis points to the absence of culturally appropriate public policies, the fragility of the psychosocial care network in the region, and the lack of specialized services aimed at Indigenous mental health. The study reveals that Indigenous women and girls are the most affected, facing additional layers of vulnerability related to gender, ethnicity, and territory. It is concluded that Indigenous mental illness in the Dourados macroregion cannot be understood solely through a biomedical lens but must be analyzed in light of the relationships between health, territory, and social justice. The research reaffirms the centrality of territory, spirituality, and traditional knowledge for Indigenous well-being, indicating the need for public policies and care practices to be formulated in light of Indigenous epistemologies and the analytical contributions of Health Geography.

Brasil-pe umi tekoha indígena ojejapo ha ojejoko heta ára rupi peteĩ tapere ojehecháva ñemosãirõ, ñemboty ha tekombo’e ojehechauka’ỹva rehe, ha péicha ojehecha hetaichagua teko vai rehegua: tekoha, tekoha renda, economía, política ha ñe’ẽ rehegua. Mato Grosso do Sul-pe, ha peteĩchante región de salud Cone Sul-MS-pe, ko’ã mba’e vai oiko hatãve, ha ohechauka mba’éichapa umi tekoha rehegua ñehundi ogueru avei ñande reko asy rehegua umi ava indígena-kuérape. Ko tesis rembiapo oguereko peteĩ tembiapo guasu: ohecha mba’éichapa umi desterritorialización ha territorialización precaria oipytyvõ teko asy rehegua umi ava oikóva upe región-pe. Ojeporu ha g̃ ua peteĩ campo empírico rehegua, ojehecha umi tembiapo ojejapóva Hospital Universitário da Universidade Federal da Grande Dourados (HU-UFGD)-pe, ary 2021 guive 2023 peve.Ko ñembo’e oguereko peteĩ apopyrã ñehendu rehegua, ohechaukáva Geografía de la Salud, umi estudio territorial ha umi arandupy indígena rehegua, ombojoaju umi ñemoñe’ẽ documental, tembiapo ojehecháva ha avei pe autora rembiasakue ha tembiapo peteĩ asistente social hospitalar ramo. Umi mba’e ojehecháva ojejapo veinte caso rehegua ojehecháva psiquiatría ha Unidad de Atención Psicossocial HU-UFGD-pe, oñembojoaju avei umi marandu oúva IBGE ha DATASUS guive ha umi tembiapo rehegua umi profesional kuéragui oĩva red de atención a la salud indígena-pe. Umi resultado ohechauka heta tekokatu vai: ñe’ã rasy vaieterei, teko asy opoko vaíva, ojeipuru vaieterei alkohol ha drogas, umi mba’e ojehecháva violencia doméstica, sexual ha institucional rehegua, ñehundi tekoha rehegua ha jehekýi umi tekoha rehegua. Umi análisis ohechauka mba’éichapa ndoikói umi política pública ohechakuaáva arandupy rehegua indígena-kuéra, ha mba’éichapa pe red de atención psicossocial ndojeporúi porã umi tendápe, ndojeporúi umi servicio especializado indígena-kuéra rehegua. Ojehecha avei kuña ha mitãkuña indígena-kuéra oĩha tenondeve umi ohasáva asy, ha ojehecha avei umi jehasa asy oĩha ambue mba’e rehegua: tekoha, ava rehegua ha kuña rehegua. Ojehechakuaa pe teko asy indígena Dourados rehegua ndaikatúi oñemomba’e año medicina rehegua rupi, síno ojehecha tekohápe, tekokatu ha tekojojápe rehegua. Ko ñemoarandu ohechauka jey pe yvy reko, pe nhandereko arandu ha pe teko porã reko tee ramo guarani rehegua, he’ívo tekotevẽha política pública kuery ha jehasarã rehegua jejapo ojejapo va’erã teko arandupy indígena reheve ha Geografía de la Salud remiandu rehegua rupive.