.jpg)
The day trip to Cachoeira revealed that health in Brazil is deeply connected to race, history, culture, and survival. These are not just abstract concepts but lived experiences rooted in land, food, and community ties. Walking through the quilombo community of Kaonge, the Sisterhood House in Cachoeira, and the Santa Cruz Ranch Restaurant highlighted how historical exclusions have shaped not only pathways to wellness, dignity, and economic sustainability but also ongoing health disparities rooted in systemic inequalities. I was struck by how health knowledge, access to care, and systems of survival have been shaped by centuries of colonization, enslavement, and resistance.
At Kaonge, listening to the griô and learning how to make palm oil–based cough syrup reframed my understanding of health knowledge.
Healing here was not separated into clinical versus cultural domains; it was communal, embodied, and intergenerational.
The remedy was not presented as an alternative to biomedical care, but as part of a broader tradition of survival in a context where formal systems were historically inaccessible or hostile.
The Kaonge Quilombo
At Kaonge, the distinction between "medicine" and "culture" dissolved. For example, the use of palm oil-based cough syrup exemplifies how traditional remedies serve as vital health resources. This moment forced me to confront how Western health frameworks often dismiss such practices, despite their deep roots in knowledge, experience, and necessity. This wasn't just a remedy; it was a communal, intergenerational act of survival.
During the Coronavirus Epidemic, while the entire world seemed to be struggling, no one in Kaonge Quilombo was ill or died from COVID. Protected by the wisdom of their elders, specifically Valdelice, better known as Vardê (in the community), their 101-year- old matriarch. As a clinician in training, I had to consider my own position shaped by models that privilege institutional validation over “lived expertise.” I felt challenged to reflect on how biomedical frameworks often dismiss such practices despite their effectiveness and cultural legitimacy.
The Sisterhood House
Visiting the Sisterhood House in Cachoeira further deepened this reflection. The Irmandade da Boa Morte (Sisterhood of the Good Death) stands as a living monument to collective strength. Women organized to preserve cultural, spiritual, and social traditions rooted in Afro-Brazilian history.
In their sanctuary, health is redefined as something far beyond the physical body, encompassing belonging, memory, and mutual care. The Sisterhood House embodied how social cohesion itself functions as a protective health factor, especially for communities historically marginalized by colonial and post-abolition structures.
Ethical Reflections on Tourism, Community, and Systemic Inequality
Later, at the Santa Cruz Ranch Restaurant, we explored licor de maracujá (passion fruit liqueur) as part of a community-based tourism initiative. This experience highlighted how food and drink can serve as both cultural expression and economic strategy. Hosting tourists was presented not as a spectacle but as a way for the community to express itself, sharing knowledge on its own terms. I was struck by how tourism here intersected with health: supporting livelihoods, sustaining cultural identity, and offering an alternative to exploitative labor structures shaped by history.
Throughout the day, I became increasingly aware of how health is shaped by geography and historical displacement. Many communities in this region formed after abolition without land rights, infrastructure, or state support. The conditions, informal housing, limited services, and reliance on communal knowledge are adaptations to systemic neglect, not failings. These conditions are not personal failures but outcomes of historical decisions that continue to determine who has access to clean water, sanitation, education, and stable healthcare. What stood out most was the emphasis on dignity: working, teaching, hosting, and healing as acts that reaffirm worth in a society still marked by racial inequality.
The most enduring realization for me was understanding how health narratives can easily become extractive stories. Listening, rather than interpreting too quickly, felt ethically essential.
The stories shared were not lessons for me to resolve but realities to sit with. I leave Cachoeira with more questions than answers.
Questions about how to honor traditional healing without appropriating it, how clinicians can engage community knowledge without hierarchy, and how health equity must be understood as historical accountability rather than as an isolated intervention.
This day reinforced that health is not simply delivered; it is lived, remembered, and negotiated across generations.
Kayneynia Burney
Student, Doctor of Nursing Practice (DNP)
Clinical Nurse Specialist – Gerontology
4th Semester