Healthcare of Indigenous Amazonian Peoples in response to COVID-19: marginality, discrimination and revaluation of ancestral knowledge in Ucayali, Peru.

Systematic and persistent discrimination against Indigenous Peoples translates into differential health outcomes when analysed through ethnicity and/or mother tongue.1 In Peru, morbidity and mortality rates among Indigenous Peoples for COVID-19 appear to confirm this.2 The COVID-19 pandemic has highlighted the historical structural violence against Indigenous Peoples that currently takes a disproportionate toll in the Peruvian Amazon. This equally applies to Indigenous Andean Peoples and Afro Peruvians. Indigenous Peoples in voluntary isolation and those in initial contact are at highest health risk in this pandemic as they have no previous immunity against common infectious diseases, and lack access to public healthcare services. The Peruvian government introduced a state of emergency early on, but it did not work as theoretically expected because of the deeply rooted inequalities in Peru. Public policies focused on reducing health inequities affecting Indigenous Peoples in peri-urban Amazonian contexts are urgently needed.3 Essentially, Indigenous Peoples (through their legitimate representatives) ought to be incorporated in the planning, monitoring, implementation and evaluation of those public policies to ensure sustainability, equity and inclusion in the short, medium and long run. It is also urgently necessary to rethink Peru’s health system to ensure it has an intercultural approach, designed for and with Indigenous Peoples in terms of prevention, treatment and access during and beyond the pandemic. An intercultural approach to healthcare implies that health services not only respects indigenous medical practices but promotes and enables joint and complementary interactions between biomedical and indigenous medical approaches to prevent and treat healthcare problems.4 In the last 15 years, Peru has produced more than 10 official documents on intercultural health, but very little of this has turned into practice. The problem is not the lack of an approach, as such, but the incapacity to turn it into practice. Transforming the current …