Alba Lucy Giraldo FigueroaBrazil • Fellow since 1986
Alba is working at the interface between communications and health by trying to put into place an approach to health care that will work for Brazil's remaining, very much at risk, indigenous people.
The Person
An undergraduate philosophy major, Alba went to work early with the Nambiquara. She has since studied anthropology, communications, and public health while continuing to work as an engaged activist in the field. She married a Tucano Indian and has a five-year old daughter.
The New Idea
An undergraduate philosophy major, Alba went to work with the Nambiquara, a tribe whose population has declined from 14,000 to 500 since the 1940s. After a long career working with another tribe, the Tucano, she now has a clear vision of what's needed built up from this long period of learning and experimenting. She is working over the next several years to make this vision work for the Tucano tribes just south of the borders of Columbia and Venezuela. Her approach could prove important well beyond this region as a workable model for restructuring the failed relationship between modern medicine and traditional health care systems and thought.
The Problem
It is now widely appreciated that once indigenous peoples are exposed to unfamiliar social conditions and diseases, proper health care is essential to make even physical survival possible. In the remote Tucano area, for example, efforts to exploit area minerals and to garrison a strategic national frontier have introduced malaria and other diseases for the first time -- diseases against which the Tucano generally have no biological or health care defenses.Given the dispersed and mobile lifestyles of indigenous peoples like the Tucano, preventive health care is especially critical. However, it requires the population's active understanding and participation. This is precisely what Alba perceives existing health care models fail to make possible.
The Strategy
Modern health care workers think and work in a linear, Aristotelian way that is largely incomprehensible to indigenous peoples who are far more likely to think by analogy, anecdotes, and myths. Alba has consequently developed a series of methods to communicate modern health concepts using thought processes familiar to the Tucano. She has also developed techniques to help both sides learn how to communicate effectively with these tools. In doing this, she makes extensive use of traditional tribal health workers in training both imported technicians and new tribal barefoot health workers. Communication alone will not save the Tucano. There must also be a substantial investment in modern health care. Alba has designed a three tiered system ranging from primary care outreach using indigenous barefoot workers up to a central curative and technical backup center.Working from her very firm base as tribal health advisor, she is leading a remarkable effort to win the substantial (and quality) investment needed. For example, she has convinced the army it will be severely criticized if development goes ahead without health protection steps being taken, given how predictable the consequences will be. She serves as a bridge between the army and the health and university communities, where there is substantial mutual distrust left over from the period of military rule. She is also mediating between the military and the government's Indian agency.