Health Itineraries and Care in the Yvopey Renda Indigenous Community within the framework of the Mutual Aid Hospital System (AMH) in Filadelfia, Paraguay

Abstract

This study examines the health and care itineraries in the Yvopey Renda indigenous community of the Western Guaraní people, within the framework of the Mutual Hospital Aid (AMH) system in Filadelfia, Paraguay. The research focuses on the care experience at the Filadelfia Indigenous Clinic and explores how the AMH insurance is implemented, its impacts on indigenous medical care, and how the lack of this insurance affects those without access. Through a qualitative methodological approach with an ethnographic perspective, participant observations and semi-structured interviews were conducted. The results reveal that self-care is the first option for ailments, followed by the AMH system for those with insurance. Limitations in access and care were identified, including lack of coverage for most community members, limited attention at the clinic, and restricted hours. The study also highlights the tension between the AMH's biomedical approach and traditional indigenous health practices, evidencing an asymmetrical relationship that affects the cultural identity and autonomy of indigenous people. It concludes that, despite criticisms, the AMH system represents a privileged service compared to the lack of access to quality public health services. The work underscores the need for a public health system specific to each indigenous community, with a comprehensive approach that respects and adapts to their traditional cultures.