Indigenous Support House suspends services due to overcrowding in the Amazon

By Fred Santana – From Cenarium

MANAUS (AM) – The Indigenous Health Support House (Casai) in Manaus has suspended, since last Wednesday, the 24th, the admission of new patients. The measure was announced by the Ministry of Health, through the Special Indigenous Health District (Dsei) Manaus, after finding that the unit exceeded its planned capacity by almost 80%, according to official documents to which CENARIUM had access.

According to the official document, on September 22, 354 Indigenous people were accommodated between patients and companions, while the maximum capacity of Casai is 202 users. In addition, another 70 Indigenous people remain hospitalized in the capital’s hospitals and are expected to return to the unit after discharge, which further increases the overcrowding situation.

During a meeting held on September 16, with the presence of representatives from the Special Secretariat of Indigenous Health (Sesai), the management of Casai Manaus, the Division of Indigenous Health Care, and coordinators of Dsei in the region, it was decided that the admission of patients would be restricted to referrals through the Indigenous Health Care Information System (SISTER). In cases considered false emergencies, the unit will notify the district of origin, which will be responsible for the patient’s return.

Collapse of Indigenous health in Amazonas

CENARIUM found, through a source who works in the defense of Indigenous peoples, under condition of anonymity, that the situation is marked by the silence of Indigenous organizations in Amazonas, such as the Articulation of Indigenous Organizations and Peoples of Amazonas (Apiam).

“Some organizations and leaders agree with the current scenario and prevent documents like this from coming to light to expose the collapse of Indigenous Health in Amazonas, especially at Casai Manaus, which serves Indigenous patients from all over the state,” the source told the report.

“The temporary suspension directly impacts the right of Indigenous peoples to health, guaranteed by the Constitution and by international treaties such as the ILO Convention 169. In Amazonas, where more than 180,000 Indigenous people from over 60 different peoples live, many depend on CASAI to access medical treatment in the capital,” they continued. “Without adequate care, they run the risk of having their treatment interrupted or even denied, which violates the principle of human dignity and the right to continuous and equal access to the SUS,” they warned.

João Sateré, a leader of the Andirá/Maraú Indigenous Territory (IT), stated that the directors of the Indigenous Health Support House (Casai) in Manaus do not comply with the legal requirement to conduct screening for all patients before referral. According to him, the absence of this procedure compromises access to health and harms the patients served at the unit.

“First, it is necessary to remove all the directors at CASAI Manaus for not complying with the law, which requires screening all patients before referral. This is the main problem. Now, because of the directors’ negligence, the patients are harmed without proper health care,” complained João Sateré, leader of the Andirá/Maraú IT.

João also reported that, at the local service base, there is a lack of medication for emergency situations. According to the leader, this shortage leaves patients without immediate alternatives in the face of treatment needs.

“Here at the base it is much worse. There are no emergency medicines, and patients are left not knowing what to do. It is sad, but it is reality. The health project is being poorly managed,” he said.

Other determinations

The ruling, according to the document, seeks to halt the admission of new users until the number of those accommodated is reduced to the planned capacity. The official dispatch emphasizes that, in case of non-compliance with the protocol, responsibility for the irregular admission of patients will fall entirely on the Dsei of origin.

During the restriction period, each district must strengthen partnerships with the municipal Secretariats of Health in their territories to serve Indigenous people in local units of the Unified Health System (SUS). The measure aims to ensure the continuity of care without overloading Casai Manaus. The official letter also states that Casai Manaus will continue to house the patients already admitted, seeking solutions to deal with the excess users.

CENARIUM sought the Ministry of Health for a statement on the closure of the unit in Manaus, but there has been no response so far. The report is also attempting to contact Apiam for a statement on the reports that the association remains silent in the face of the situation described in this edition.

Edited by Jadson Lima
Translated from Portuguese by Gustô Alves