Paulo Trindade: the Indigenous nurse working to vaccinate Indigenous communities in Brazil
Paulo Trindade: the Indigenous nurse working to vaccinate Indigenous communities in Brazil
April 2025
On an April morning, nurse Paulo Trindade, 45, was walking through the corridors of an old city hall building in Cachoeira do Sul, a municipality in the central region of Rio Grande do Sul with 80,000 inhabitants. He had a mission: to collect 36 influenza vaccines to administer to Guarani Mbya Indigenous people living in the Guabiju Indigenous Land, located in a remote rural area of the municipality.
Indigenous nurse Paulo Trindade seeks vaccines in the municipality of Cachoeira do Sul to take them to an indigenous village.
Predominant in South America, the Guarani Mbya are spread across Brazil, Argentina, Uruguay, and Paraguay. They usually live close to nature, in areas far from urban centers. The Guabiju Indigenous Land is home to about 40 people and lies 60 kilometers from downtown Cachoeira do Sul, in a forest with difficult access—reaching it via a bumpy dirt road takes about an hour.
Despite the distance, the Guarani Mbya do not need to leave the village to get vaccinated: Brazil’s Indigenous Health Care Subsystem (SasiSUS), part of the Unified Health System (SUS), ensures comprehensive health care for Indigenous peoples, including vaccines, nutritional treatment, dental care, and sanitation. According to the 2022 census by the Brazilian Institute of Geography and Statistics (IBGE), there are 1.69 million Indigenous people in the country—representing 0.83% of the population.
Nurse Paulo is used to working with traditional communities: he himself is Indigenous, from the Kaingang ethnic group. Years ago, he left the Guarita Indigenous Land in Tenente Portela, a town of fewer than 15,000 people in Rio Grande do Sul, to study nursing at a university in Porto Alegre, thanks to a scholarship. Adapting to the big city was a challenge he faced with determination, driven by a goal: “When I was a child in the 1980s, access to health care in the villages was very limited. That motivated me: ever since I entered university, I’ve wanted to work with Indigenous communities and give back.”
Cultural Specificities
To provide care for Indigenous populations, one must consider the specificities of each group. “Each ethnic group has a different culture, so the team must be knowledgeable in order not to mix them up. In Rio Grande do Sul alone, we work with Guarani Mbya, Kaingang, Charrua, and Xokleng,” Paulo explains.
Indigenous family gets vaccinated against influenza: Sabrina da Silva Gomes (mother), Rafael Martines (father), and Henrique, Ítalo, Rafaela, Brenda, and Thalles (children)
The Guarani Mbya, for instance, often turn to traditional medicine before Western medicine. They seek help from Karaí—spiritual leaders who carry out shamanic rituals to protect the community.
After navigating the forest in a 4x4 vehicle, Paulo and his Ministry of Health colleagues were welcomed by the village chief, Sergio Martines, 60. For over two decades, the chief has known the importance of vaccination: he is a community health agent and connects the village to the public health system. “We know the vaccine is important for protection. For us, it's good that the vaccine comes to the village, along with other health services,” says Sergio.
Ministry of Health team responsible for providing healthcare in indigenous territories. From left to right: psychologist Gabriela Zuchetto; nursing technician Giziani Bonugli; nurse Paulo Trindade; dentist Frederico Couto; and chief Sergio Martines.
The Guarani Mbya don’t usually invite strangers into their homes—so vaccination takes place at the Indigenous school. As soon as Paulo and his colleagues set up an improvised vaccination station, dragging tables into place, a long line of children and adults formed. Indigenous residents speak Guarani Mbya among themselves and Portuguese with health professionals. In other villages, many do not speak Portuguese at all.
Indigenous school becomes health center for vaccination of the Guarani Mbya community
Sabrina da Silva Gomes, 33, and Rafael Martines, 27, brought four of their five children to receive the flu vaccine—the youngest, under six months, must wait a bit longer. “It’s important to vaccinate so we don’t get sick,” says Sabrina. Rafael, a teacher at the village’s Indigenous school and the chief’s son, believes vaccinating children means protecting them. “This way they don’t catch diseases and the flu doesn’t spread,” he explains.
Health worker holding a bottle of influenza vaccine
In Brazil, the Ministry of Health is responsible for Indigenous health care. It organizes vaccination campaigns and defines the essential vaccines to be given. For Leandro da Silva Euzébio, 31, who brought his 9-year-old son Enzo for vaccination, keeping up with the vaccine schedule is a priority. “I think it's very important to prevent the flu, especially for those of us who are more vulnerable, like Indigenous populations,” says Leandro.
Nurse Giziani Bonugli vaccinates Enzo, aged 9
Personal fulfillment
Ensuring Indigenous communities receive health care brings personal fulfillment for Paulo. “Thanks to SUS, everyone has the right to free vaccination. But Indigenous populations, because of their high vulnerability, are prioritized. When I started nursing school, it was really tough—I had to quit my job to study and started selling crafts to support my wife and three children. It’s hard for everyone. But from the start, I knew I wanted to give back to Indigenous people,” he recalls.
Thanks to the work of Paulo, fellow health workers, and authorities across the Americas—with support from the Pan American Health Organization (PAHO)—millions of people have access to vaccines and quality health care. And it is thanks to this collective effort that the Region has regained its status as free of endemic measles—an achievement aligned with PAHO’s Elimination Initiative, which aims to eliminate more than 30 communicable diseases and related conditions by 2030.
