Vignettes - Mrs Fatima and her family, current experience

Mrs. Fatima is in her late 70s and lives with her daughter’s family in a riverside community located in a remote area in the midst of the Amazon forest. They all live together in the same small wood made house. Mrs. Fatima is descendant of the Tikuna indigenous tribe, with restricted Portuguese knowledge or fluency. Mrs. Fatima is well respected in her community as she has tried to keep her tribe’s culture ‘alive’ over the years. Mrs. Fatima has become increasingly withdrawn and has stayed alone inside her house most days in the past months. Her daughter is concerned as Mrs. Fatima has been having visual hallucinations, has become aggressive towards her small grandchildren, and has been forgetful. People who have been in her house have spread the news around the community that she is becoming ‘possessed’ with malevolent spirits. Mrs. Fatima’s family has consequently tried to keep Mrs. Fatima inside their house as much as possible, which has made her even more unwell. Her daughter has started to give her traditional herbal infusion hoping to calm Mrs. Fatima down. The city’s family health team visits the community once a month by boat, but Mrs. Fatima’s daughter fears that her mother will not accept help and so she has postponed/avoided talking to the health team about this.


Mrs. Fatima would be entitled to a consultation with the general practitioner (medic) through the public health system which provides universal healthcare that is free at point of access. However, general practitioners often do not have enough knowledge to diagnose dementia. In a remote setting such as the Amazon forest, the health priorities are likely […]

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