The indigenous community Haliti-Paresí has origin based on mysticism and is from the region of Ponte de Pedra, where the men lived. According to them, this stone was opened by the dwarf woodpecker and the macaw for the release of their chief, Wazare, who led the subgroups of this people, namely Waimaré, Kaxiniti, Kozarini, Warere and Kawali. Its culture is based on work in plantations, receipt of informal tolls at the road drive BR-235 - Campo Novo do Parecis à Sapezal - preparation of biju (typical food), tourism, sewing, weaving hammocks, hunting, fishing and handicrafts. Also, some of the work as teachers, indigenous sanitation agents, indigenous health workers and drivers of health units (Silva, 2014).

Figure 1.
Location of the indigenous land Utiariti, and villages Haliti-Paresí and Wazare, State Mato Grosso, Brazil, 2016 (Terças et al., 2016).

For this people, health is conceptualized as being well not only with the body but also with the spirits and all therapy performed in order to obtain healing is based on magic and mysticism, characterized by their entities of good and evil, hutyhaliti and thihanare, respectively. For this purpose, they rely on traditional American Indian medicine, developed mainly through the use of medicinal plants and rituals from the shamans, healers and midwives (Ferreira, 2013).

For the Paresí, being healthy refers to a state of vitality, being with energy, being able to exercise their activities of the daily living (ADL), being disposed, and also emphasizing prevention, demonstrating the impact of health education, which gradually was introduced in the culture of this ethnic group, providing greater social control in the biomedical assistance model, as elucidated below.

For me, being healthy means you stay… ah ... mainly having hygiene, being clean, having the village clean, cleaning the house, not to take disease right?! Taking the necessary care of the house and with the children (P1).

Health for me is the quality of life that we have, of us being able to accomplish all ... all the activities that we have to do. Developing them and living well, right? (P4).

Hygiene is characterized as a historical process of seeking health through personal care, especially with children and with the environment, in which daily cleaning is crucial for the maintenance of vitality. In the morning, before sunrise and after lunch, women and children take bathes in the river, followed by men and couples with children, who wait for the end of all to go to the river. Still in the morning, they clean the houses and the yard, wash the dishes and clothes, after which they dedicate themselves to the preparation of lunch. Women are the main responsible for these activities and practices are alternated, that is, there is a collective work, while one group is in charge of hygiene, others perform harvesting, preparation of roots, vegetables and other foods for meals (Noda et al., 2003).

Community work is determined because family nuclei are made up of larger numbers of people when compared to traditional families, which is also evidenced in other activities carried out by indigenous people, such as water care, cleaning and garbage collecting, thus resulting in satisfaction and achievements, besides being recognized as methods of health promotion, given they understand the relationship of poor diet and hygiene with the contraction of diseases (Falkenberg, Shimizu, & Bermudez, 2017).

Combined to this initial perception about health, some determinants and conditions for the achievement of this state were highlighted.

Health is to eat well, sleep well, work well, sweat to take away the bad sweat from the body [laughs], play soccer [laughs] (P2).

These factors are in line with those advocated by the National Policy for Health Promotion (PNPS in Portuguese), namely working conditions, living habits, housing, education, culture, environment, access to goods, leisure and basic services, referring to their actual influence on population’s health (Vendruscolo, Trindade, Rech, Ferraz, & Krauzer, 2015). Studies describing the perception of health under different optics have elucidated that this meaning is related to physical aspects, such as the state of illness or sensation of pain; economic aspects, emphasizing the possibility of exercising labor activity and acquisition of financial resources; and social aspects, where it is cited the freedom that permeates the relations, in which the individual chooses and builds their own social circle (Vargas-Santillán et al., 2017).

This perception was also observed in the indigenous ethnic group Deni, living in the Amazon, who attributes to the activities performed in the environment means to meet the daily living needs and maintenance of health conditions, highlighting the food, housing and cultural aspects, which materialize as forms of subsistence, resulting in physical survival and ethnic life. For the Deni, the spaces of cultivation are seen beyond spaces of agricultural production and use of natural resources, under a social, leisure and family education context (Noda et al., 2003).

The organization process of this ethnicity reflects on cultural techniques and experiences that go through generations, resulting in an agroforestry productive system based on the preservation of environmental resources, which is part of the cultural precepts of this people and of adaptation to the ecosystems and geographic spaces inhabited (Noda et al., 2003). This reality was also evident during studies on indigenous history through aspects related to the political organization, food, labor, housing and other health determinants provided in Law No. 8.080/90, being associated with the European and imperialist gaze, expressing the country's economy (Lamas, Vicente, & Mayrink, 2016).

According to the Haliti-Paresí group, as soon as there is no aptitude to perform the activities described above or when they are harmed, the disease installs due to carelessness arising from the lack of control over the individual himself or those under his responsibility - as children -; from climate change, which mainly favors the occurrence of respiratory illnesses; and from the working routine, characterized as heavy and sometimes overloading.

From the moment you are not healthy, you do not feel like leaving home, you stay there at home, without doing your activities, or doing your activities at home. But you do not have the willingness to perform tasks, get along with other people, go out, talk, this type of things, because a person who is sick becomes almost always lying there, just wants to be quiet in their place (P4).

The state of being healthy, according to this population, is related to the possibility of social insertion and interaction, permeated by communication and collective participation (Vargas-Santillán et al., 2017). Social representations in health are understood as forms of thought where properties and roles are associated with changeable processes of life and social communication, defining the identity and particularity of individuals and the genesis of the relationships they maintain. They integrate opinions, beliefs and knowledge about a certain object of central interest, in this case, health, and are constructed in such a way as to reshape the reality experienced by a specific group (Silva & Menandro, 2014).

Studies have shown this association by different life cycles, such as the elderly, adolescents and adults, defining the transition and interaction with society as a health act, relating them to working and living with other people that do not belong to their core family, exercising autonomy and independence and integrating an active state of preservation of quality of life and social value (Silva & Menandro, 2014). These factors are addressed in the PNPS through the guidelines that advocate cooperation, respect for singularities, intersectoriality, commitment to comprehensive care, combined management and strengthening of social participation, thus promoting quality of life and reducing health vulnerabilities and risks (Malta, Silva, & Jaime, 2014).

The main health problems found in the speeches are diarrhea, low child weight, common flu, infections due to falls and/or routine accidents, viral infections, allergic rhinitis, bronchitis, fever and hantavirus infection, which is the most worrying.

Well, the most severe thing that happened was the contact that my mother-in-law had with hantavirus, you know? (...) We are sure that many people here had contact with hantavirus and ... this is more serious. But the most common is flu; the children have it at lot, because they are always in the river (P7).

A concern we had and still have is with hantavirus; in this last case, my husband’s grandmother had it and almost died. They had this concern in getting rid of the rats and other important precautions to prevent this from occurring again but apart from that, there is almost no concern about it (P4).

Hantavirus infection is a serious viral disease that can progress to death in 50% of cases (Ferreira, 2003) (Vial et al., 2013). It affects people mainly due to the human occupation of areas of environmental transformation, such as the one observed in the Wazare village, which was founded in 2012. It affects mainly rural populations, river dwellers, maroons, settlers, squatter, prospectors and natives (Ayres, Calazans, Saletti Filho, & França-Junior, 2006) (Nichiata et al., 2011) and this exposure is accentuated by the relationship of the indigenous people with the environment, which occurs intensely (Gouveia, 1999) (Weihs & Mertens, 2013). In Brazil, the first cases of hantavirus infection were detected in 1993 after a family outbreak that resulted in two deaths in the state of São Paulo. After this, it became endemic in the country, with distribution in 15 Federated Units, in the five regions of the country (Marcos, Junior, & Rosa, 2016).

The fact that hantavirus infection is a major health problem and present in most indigenous discourses may be related to the severity and speed of clinical evolution (Lemos & Silva, 2013), demonstrating the need for health surveillance actions in areas of vulnerability to broaden the view on emerging diseases and thus diagnose them and enable fast interventions in order to reduce morbidity and mortality in these communities.

According to Ferreira (2013), indigenous medical systems must be articulated with Western medicine, providing a higher quality care to these peoples and aiming for comprehensive health care. For this purpose, the healer of the Paresí territory acts in the diseases of the spirit and sporadically of the body, being responsible for treating the ‘diseases of indigenous people’, whereas the health professionals treat of the diseases of the body, considered by this ethnic group like ‘diseases of non-indigenous people’.

I think that here in the village we look more at the spiritual look of the body itself. If we are not sick, we are very worried if we are with God, let's put it this way, and He who rules us, right? If we are not well with Him, we will become sick, that is why we make our offerings, we pray, so that there is a balance, not only in the body, but also in the spirit (P5).

Sometimes the doctor comes (...) with the technician or sometimes the nurse comes with the technician (...). We receive two medical visits, two visits a month. Also, when we need, we call there and they come and pick the person and take them to the doctor and bring again, or else they attend them right here or, when it is needed, they take them to the hospital, right? (P14).

The religious practices of non-indigenous people were disseminated among the indigenous people by the Rondon and Anchieta Mission, who catechized and integrated them into national civilization through literacy based on religiosity, believing in the need for a contact and learning about the true God, according to Catholicism. This model, applied in boarding schools, began to be carried out in the villages around the 70's, strengthening the proximity to the American Indians and the effectiveness of actions. Over the years, these activities have been maintained by other entities, such as Operação Padre Anchieta (Opan), Irmãzinhas do Sagrado Coração de Jesus and Protestant Missions, always being linked to literacy and the religious practice of the whites, presenting the monotheism to the natives (Câmara et al., 2012).

Indigenous religiosity remained open to other religions, sometimes withdrawn but always existing. They are heterogeneous peoples with different languages that share great religious diversity: rituals, sacred calendars, different forms of worship and various names for God, characterized as inclusive and ecumenical, promoting interculturality (Oliveira, 2014).

Due to a cultural issue, whenever possible, health care is provided by indigenous professionals because of this cosmological, symbolic and spiritual internalization that these people have, highlighting the encouragement to the formation and qualification of these professionals in the community. This also materializes as a strategy for creating and offering paid jobs for the community, periodic absence of non-indigenous health professionals in the villages and as mediation in inter-ethnic relations, according to the National Policy for Attention to the Health of Indigenous Peoples (Pnaspi), highlighting the training of the indigenous Health Agents (AIS) (Langdon, Diehl, & Dias-Scopel, 2014).

There is concern about the preservation of other habits. The Haliti-Paresí emphasize activities such as painting, dancing, singing, myths, traditional food such as string beans, free-range chicken, cassava and yams. They assert the discourse that preserving these habits enables controlling what concerns the Western culture, so that this latter does not to become paramount, and preserves the language, teamwork in the search for harmony and good coexistence, instruction of children, dissemination of their culture to the society and preservation of the environment, maintaining an intrinsic relationship with the strength of the forests, which according to them, invigorates the energies.

The environment is seen in a comprehensive way, ranging from the interactions between living beings and climatic phenomena, like catastrophes, to entities, monstrous creatures and deities.

We live in the border and in our water, the water we drink, comes down with pesticides, all these things come down, let's say the chemical waste that comes from the crops, and so we end up consuming this water and it ends up affecting our health status a lot (P25).

Fóller (2004) and Velden (2012) corroborate that the origin of a disease among indigenous peoples can often be found in the relationship between sick human beings and parts of nature, such as plants and trees, or even phenomena, such as winds or water swirls. Nowadays, this kind of explanation can be extended and include ‘modern’ phenomena, such as airplanes passing in the sky and flue gases - contaminations.

In addition to these factors, there is the perception of the Haliti-Paresí on the intervention of health services in the village, through immunizations, sanitation actions and participation in consultations that monitor health care, as also presented in other studies (Silva, Diaz, & Silva, 2015). In the field, we observed the accomplishment frequent meetings in which they discussed themes and ideas that could lead to improvements for the village. They emphasize their concern for children, who are always involved in the activities of this people, adult awareness through lectures of the chief and responsibilities of women in health, since these latter occupy a central role in care, as can be observed in the speeches:

Well, in my family group, my mother is responsible for the health of everyone. She takes care of everyone, all the people in my family, right? She is the one who provides care when someone is sick, something like this. (P5).

In the dry season, in the cold, I always try to keep the children well dressed, not to get too much wind; they drink lots of liquids, that's all. (P3).

The role of indigenous women in Brazilian villages consists of caring for the community's nature, culture, crafts, children and health. In this context, men play a secondary role, primarily assuming the role of provider, while the woman is recognized as a caregiver. It should be stressed that, for a proper and effective social organization of the ethnic group, there must be this division of attributions, in which both have their relevance. Consequently, there is no superiority or inferiority between them, they are crucial for the maintenance of the village and preservation of culture (Grubits, 2014).