Malaria Entangled: Ribeirinhos, Plants, Mosquitoes, and Public Health Interventions in the Brazilian Amazon

Abstract

This ethnographic study was conducted among the riverine people, also known as Ribeirinhos, in the state of Amazonas, Brazil, during four months of field research. The study focused on learning from Ribeirinhos’ experiences and practices of malaria. In this thesis, I argue that paying attention to Ribeirinhos’ experiences and diagnostic, treatment, and control practices of malaria can provide useful insights into blind spots in the current interventions to control the disease in Brazil. As this is a thesis by publications, the findings are presented in three manuscripts. The first manuscript focuses on how malaria is experienced by Ribeirinhos. It explores the embodiment of malaria, empirical strategies to distinguish it from other febrile sicknesses, misalignment between bodies and current biomedical diagnosis methods, “becomings” of bodies and experiences, and the vicissitudes of having the disease. The second manuscript examines experiences and treatment practices for vivax malaria highlighting the uses of pharmaceuticals, side effects of antimalarial drugs, and traditional treatments for malaria. The third manuscript describes Ribeirinhos’ perceptions of malaria-carrying mosquitoes, their everyday practices to manage these beings, and their experiences with control interventions, such as time monitoring recommendations (TMR), indoor residual spraying (IRS), and insecticide-treated nets (ITN). The three manuscripts clearly show that Ribeirinhos' lives are thoroughly entangled with Amazonian rivers and forests; malaria also takes part in these entanglements. Learning from their experiences and practices of malaria has provided information about the nuances, improvisations, and continuous negotiations required to coexist with the parasite and disease vectors.