Health in the context of a sustainable development reserve: the case of Mamirauá, in the Brazilian Amazon


  • Marcílio Sandro de Medeiros Fundação Oswaldo Cruz; Instituto Leônidas e Maria Deane; Departamento de Pesquisas
  • Lia Giraldo da Silva Augusto Fundação Oswaldo Cruz; Centro de Pesquisas Aggeu Magalhães
  • Stefania Barca Universidade de Coimbra; Centro de Estudos Sociais
  • Daniel Souza Sacramento Secretaria Municipal de Saúde de Manaus
  • Inez Siqueira Santiago Neta Universidade Aberta da Terceira Idade; Escola Superior de Ciências da Saúde
  • Isabela Cristina Gonçalves Universidade do Estado do Amazonas; Escola Superior de Ciências da Saúde
  • André Monteiro Costa Fundação Oswaldo Cruz; Centro de Pesquisas Aggeu Magalhães



Protected Areas, Health, Vulnerable Populations, Amazon


This article aims to analyze the living and health conditions of riverside inhabitants from eight communities within the Mamirauá Reserve, through the category of analysis of Social Reproduction by Juan Samaja. The chosen method was descriptive, and it was used a structured questionnaire, direct observation and documental analysis. The research has identified low involvement of the riverside inhabitants in social control and community support, which indicates issues regarding bio-communal and political interaction. The response to social demands is organized in a conflicting way, since various institutions that operate in this territory are not articulated. The interaction between political and techno-economic dimensions presented a Prevalence Ratio <1.0, especially in communities where the Mamirauá Institute promoted a greater diversification of its activities. However, the people’s subsistence income suffers strong variations and does not reach the sum of one minimum wage in 60.6% of the families. We observed high frequencies in health complaints (78.8%) and occupational accidents (70.9%), and 54% of judged the provided health services with scores under 2. We concluded that the social processes that determine the health situation of the communities are due to the structure of power that is configured by territorial practices of environmental and indigenous policies, and by overlapped health public programs, that create conflicting situations concerning competences and responsibilities with health attention. The support to the co-management of the Reserve was punctual and, in this way, it barely affected the negative results of this social structure on the most vulnerable groups.


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How to Cite

Medeiros, M. S. de, Augusto, L. G. da S., Barca, S., Sacramento, D. S., Neta, I. S. S., Gonçalves, I. C., & Costa, A. M. (2018). Health in the context of a sustainable development reserve: the case of Mamirauá, in the Brazilian Amazon. Saúde E Sociedade, 27(1), 128-148.