Militarization in the Special Indigenous Health District of Maranhão: from the “announced disaster” to the epicenter of the pandemic

Abstract

This case study used a historiographical methodology to investigate the trajectory and performance of the  Special Indigenous Health District of  Maranhão, having as a parameter what  the National Policy for Health Care for Indigenous Peoples, still officially in  force in 2021, recommended. It has the general context of health policies in  successive federal governments as  background. The period analyzed and discussed ranges from 2010 to 2021, covering: the crisis in the management  of the National Health Care Policy for  Indigenous Peoples, implemented by  the National Health Foundation; the subsequent creation of the Special  Secretariat for Indigenous Health and  the transfer, to its scope, of the role of manager of this policy, in 2010; the  challenges faced by the Special Secretariat for Indigenous Health in its  first years of management, in the  context of the political crises that led to  the impeachment of President Dilma  Rousseff and the administration of  Michel Temer; the administration of Jair  Messias Bolsonaro, with the consequent systematic attack on  principles and guidelines inscribed in the 1988 Brazilian Constitution and the  dismantling and/or sabotage of the  National Health Care Policy for  Indigenous Peoples; the advent of the covid-19 pandemic in this context and  its specific impacts on the indigenous population, in Brazil and Maranhão,  until 2021.