Abstract

This study explores one of the most interesting and least studied issues in Brazil: the consequences of complex and contradictory experiences by replacing the traditional drinks by cachaça, introduced through interethnic contact. Given the rarity of the study of Maxakali alcohol consumption in research, this study aims to understand, from the native’s point of view, the negative aftereffect of alcohol consumption. Although anthropological studies emphasize functions of traditional and contemporary drinking as social “lubricants”, social perceptions of the Maxakali highlight the problems of cachaça bought through interethnic contact. Symbols and meanings of these consequences were interpreted through their daily life histories, recorded by 21 leaders in focus group. Through the interethnic contact, some adaptations have occurred in the Maxakali alcohol use, with negative consequences for those who drink, their families, their villages and their community. In the world-of-life, these changes these changes can be seen through accidents, insults, marital disharmony, neglects, violent behavior, illness and death. This study’s findings highlight the importance of producing comprehensive and in-depth knowledge in search of to identify vulnerable groups and to develop participatory solutions.

Key words
South-Amerian indians; Alcoholic beverages; Social problems; Qualitative research

Introduction

The impact of the consequences concerning the introduction of distilled alcoholic drinks into indigenous peoples culture, during Western expansion and now offered through interethnic contact, is one of the most interesting and least studied issues in Brazil¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.^,22 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004.. Whether it may be through the ambiguity and superficiality with which all questions of deviant behavior are treated, or through the philosophical aspects and world views used to approach them, this issue needs to be further explored. Among the 305 Brazilian Indigenous peoples, the use of alcoholic beverages, fermented, distilled and / or mixed, is considered a social and public health problem, with negative consequences for their families, their villages and their communities¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.

2 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004.

3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.

4 Souza MLP, Garnelo L. Quando, como e o que se bebe: o processo de alcoolização entre populações indígenas do alto Rio Negro, Brasil. Cad Saude Publica 2007; 23(7):1640-1648.

5 Ferreira LO. O "fazer antropológico" em ações voltadas para a redução do uso abusivo de bebidas alcoólicas entre os Mbyá-Guarani, no Rio Grande do Sul. In: Langdon EJ, Garnelo L, organizadores. Saúde dos Povos Indígenas: Reflexões sobre antropologia participativa. Rio de Janeiro: Contra Capa; 2004.

6 Souza JA, Oliveira M, Kohatsu M. O uso de bebidas alcoólicas nas sociedades indígenas: algumas reflexões sobre os Kaingang da bacia do rio Tibagi. Paraná. In: Coimbra C, Santos R, Escobar AL, organizadores. Epidemiologia e Saúde dos Povos Indígenas do Brasil. Rio de Janeiro: Fiocruz; 2003.

7 Ghiggi Junior A, Langdon EJ. Reflexões sobre estratégias de intervenção a partir do processo de alcoolização e das práticas de autoatenção entre os índios Kaingang, Santa Catarina, Brasil. Cad Saude Publica 2014; 30(6):1-10.

8 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.^-99 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121..

With the introduction of this distilled drink, especially the use of cachaça (sugarcane liquor)¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.^,22 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004. which has 3.3 to 10-fold higher alcohol content than fermented fruit or hydromel drinks¹⁰10 Brasil. Decreto nº 6.871, de 04 de junho de 2009. Dispõe sobre a padronização, a classificação, o registro, a inspeção, a produção e a comercialização de bebidas. Diário Oficial da União 2009; 05 jun., Brazilian researchers in this field¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.

2 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004.

3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.

4 Souza MLP, Garnelo L. Quando, como e o que se bebe: o processo de alcoolização entre populações indígenas do alto Rio Negro, Brasil. Cad Saude Publica 2007; 23(7):1640-1648.

5 Ferreira LO. O "fazer antropológico" em ações voltadas para a redução do uso abusivo de bebidas alcoólicas entre os Mbyá-Guarani, no Rio Grande do Sul. In: Langdon EJ, Garnelo L, organizadores. Saúde dos Povos Indígenas: Reflexões sobre antropologia participativa. Rio de Janeiro: Contra Capa; 2004.

6 Souza JA, Oliveira M, Kohatsu M. O uso de bebidas alcoólicas nas sociedades indígenas: algumas reflexões sobre os Kaingang da bacia do rio Tibagi. Paraná. In: Coimbra C, Santos R, Escobar AL, organizadores. Epidemiologia e Saúde dos Povos Indígenas do Brasil. Rio de Janeiro: Fiocruz; 2003.

7 Ghiggi Junior A, Langdon EJ. Reflexões sobre estratégias de intervenção a partir do processo de alcoolização e das práticas de autoatenção entre os índios Kaingang, Santa Catarina, Brasil. Cad Saude Publica 2014; 30(6):1-10.

8 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.^-99 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121. seek to understand the conceptions regarding these cultural practices. Those practices involve the apprehension of and the symbolic values towards the consumption of these strong distillates which result in diseases and the marginalization of Indigenous peoples.

In addition, on top of the well-known impacts of the introduction of the distillates, the stereotypes used by the surrounding population, that of “drunks” for the Bororo Indians¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.^,22 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004. and “alcoholics” for the Maxakali¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64., are dated problems. For both of these communities, these stereotypes originate from the first contacts with colonist in their regions¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.^,22 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004.^,99 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121..

For the Bororo Indigenous people, in 1829, detailed descriptions and pictographic reports of scenes of drunkenness were made. They depict the consequences of the distribution of cachaça in the farms of the region of Cárceres / MT¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.. For the Maxakali, their relation to distillates was first reported in 1918⁹9 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121.. Anthropological Research highlighted that, Kaxmuk (cachaça) not only facilitates a change in euphoria, but this change is experienced quicker and is more intense than the effect of the consumption of fermented beverages. Its consumption also puts the Maxakali in contact with spirits during their rituals. Moreover, in their state of alcoholic trance, they resurrect historical animosities¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.; they fight among themselves, “some breaking the heads of others”¹²12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980., and this trance may even lead to a change in their human condition which leads them to possibly murdering their kinsmen and non-relatives¹³13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.

14 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992.^-1515 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329..

Although these ethnographic studies with other research questions recognize the consequences related to the use of Kaxmuk among the Maxakali, there is a lack of research in this area. This field in Brazil is under development and is being further investigated.

To address some of the negative consequences of distilled drinking, this article presents the question - How do Maxakali perceive the consequences of the use of Kaxmuk? This question seeks to understand, through the native’s point of view, the social perceptions regarding the negative consequences of the use of cachaça.

Finally, we will present the context in which the ethnographic knowledge was presented in this research. The first author of this study, a sanitary dentist, previously delivered health care to the Maxakali Indigenous communities for 19 years. Since then, during the past nine years he has worked in a management position in Maxakali Primary Health Care (MPHC). As said by Minayo¹⁶16 Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 12ª ed. São Paulo, Rio de Janeiro: Hucitec, Abrasco; 2010., this experience is an important attribute for the insertion of a researcher in the field to collect data¹⁶16 Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 12ª ed. São Paulo, Rio de Janeiro: Hucitec, Abrasco; 2010.. We believe that, with his multi-professional experience in the Subsystem of Indigenous Health Care, working with the four teams of health professionals from MPHC as well as with those in the Maxakali Mental Health, it contributed positively to the way in which data from this qualitative research was gathered.

Methodology

The Tikmũ’ũn are recognized by the Brazilian State through the Maxakali ethos⁹9 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121.^,1111 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.^,1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.^,1414 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992.. It includes the Makoni, Monoxó, Kapoxó, Malali, Maxakali, Cumanaxó, Panhame Indigenous peoples who all speak Maxakali. Although, they each have their own respective songs and rituals which are all celebrated in their respective Houses of Chants¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.^,1717 Marcato SA. O indigenismo oficial e os Maxakali (séculos XIX e XX). In: Rubinger MM, Amorim MS, Marcato SA, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.. They live on 6,543 hectares of land comprising of three Indigenous reserves¹⁵15 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329., distributed around four Mining municipalities (Figure 1), bordering the State of Bahia¹⁵15 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329..

The Maxakali is the second largest ethnic group in Minas Gerais¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.; they originated from the Atlantic Forest areas¹²12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980. and are traditionally semi-nomadic, hunter, and gather people¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.

12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.

13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.^-1414 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992.. These peoples maintain a group connection and a distinct ethnic-cultural identity because they kept their language and their ancestors passed down their rituals. These customs are not disfigured nor forgotten¹²12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.

13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.^-1414 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992.^,1717 Marcato SA. O indigenismo oficial e os Maxakali (séculos XIX e XX). In: Rubinger MM, Amorim MS, Marcato SA, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980..

Given the scarcity of qualitative and quantitative studies on the phenomenon currently under study in literature, we sought to broaden the spectrum of theorists that contributed to a theoretical framework on social action. We have identified concepts in Schutz¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979. that contribute to the understanding of the principles of a comprehensive approach regarding the social action¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979.. The current relevance of these theoretical notions lies in its ability to understand and (re) interpret the reality based off the action and subjectivity of the social actor¹⁹19 Souza MNC. Algumas considerações sobre a sociologia de Alfred Schütz. Revista Eletrônica dos Pós-Graduandos em Sociologia Política da UFSC 2012; 9(1):1-26.. Schutz’s exposure to the basic methods of Hursel’s phenomenology and Weber’s¹⁹19 Souza MNC. Algumas considerações sobre a sociologia de Alfred Schütz. Revista Eletrônica dos Pós-Graduandos em Sociologia Política da UFSC 2012; 9(1):1-26. comprehensive sociology was crucial in defining the theoretical framework as the focus of the present study when collecting and analyzing interview records.

According to Schutz¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979., “action” is the previously planned human conduct whose meanings are produced mentally. It is also understood that only a small part of a person’s world knowledge originates from his or her own experience, most of someone’s world knowledge is transmitted to him or her by others through their socio-cultural life¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979..

Accordingly, we recognize that the social action of the interviewed Tikmũ’ũn is a result of their interaction in different intra and interethnic contexts. Those involved in the interactions mobilize most of the knowledge previously acquired by their ancestors and at the same time, the knowledge produces meanings for action in a reflective process¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979.^,1919 Souza MNC. Algumas considerações sobre a sociologia de Alfred Schütz. Revista Eletrônica dos Pós-Graduandos em Sociologia Política da UFSC 2012; 9(1):1-26.. It is unique to understand the reality of the socio-cultural interaction of the Maxakali leaders interviewed. Through their experiences, we identified the pragmatic reasons that guide Tikmũ’ũn in their daily life. We consider that “motive” means the state of things, the objective wished to be achieve through the action undertaken¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979.; in this study, the use of Kaxmuk.

In order to understand this reality and to describe its characteristics from a native perspective, we added some cultural issues to the comprehensive phenomenology. The Maxakali cosmological aspects were included in the (ethno) biopsychosocial characteristics described by Schutz¹⁶16 Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 12ª ed. São Paulo, Rio de Janeiro: Hucitec, Abrasco; 2010.^,1818 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979.^,1919 Souza MNC. Algumas considerações sobre a sociologia de Alfred Schütz. Revista Eletrônica dos Pós-Graduandos em Sociologia Política da UFSC 2012; 9(1):1-26. , assuming in this research that, culture is as a fluid system open to Geertz’s reinterpretation²⁰20 Geertz C. A interpretação das culturas. Rio de Janeiro: Livros Técnicos e Científicos Editora; 1989.^,2121 Geertz C. O saber local. 5ª ed. Petrópolis: Vozes; 2002..

Through this point of view, the consequences of the use of Kaxmuk are no longer perceived as a set of immutable physical and biological symptoms observed in the empirical world. They have now become better understood as a subjective process constructed through socio-cultural contexts³3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004., which are experienced intersubjectively by contemporary Tikmũ’ũn (Figure 2), who share a specific web of meanings¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979.

19 Souza MNC. Algumas considerações sobre a sociologia de Alfred Schütz. Revista Eletrônica dos Pós-Graduandos em Sociologia Política da UFSC 2012; 9(1):1-26.

20 Geertz C. A interpretação das culturas. Rio de Janeiro: Livros Técnicos e Científicos Editora; 1989.^-2121 Geertz C. O saber local. 5ª ed. Petrópolis: Vozes; 2002..

In addition to Schutz¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979.^,1919 Souza MNC. Algumas considerações sobre a sociologia de Alfred Schütz. Revista Eletrônica dos Pós-Graduandos em Sociologia Política da UFSC 2012; 9(1):1-26. and Geertz²⁰20 Geertz C. A interpretação das culturas. Rio de Janeiro: Livros Técnicos e Científicos Editora; 1989.^,2121 Geertz C. O saber local. 5ª ed. Petrópolis: Vozes; 2002., the contributions of Latin American researchers¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.

2 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004.

3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.

4 Souza MLP, Garnelo L. Quando, como e o que se bebe: o processo de alcoolização entre populações indígenas do alto Rio Negro, Brasil. Cad Saude Publica 2007; 23(7):1640-1648.

5 Ferreira LO. O "fazer antropológico" em ações voltadas para a redução do uso abusivo de bebidas alcoólicas entre os Mbyá-Guarani, no Rio Grande do Sul. In: Langdon EJ, Garnelo L, organizadores. Saúde dos Povos Indígenas: Reflexões sobre antropologia participativa. Rio de Janeiro: Contra Capa; 2004.

6 Souza JA, Oliveira M, Kohatsu M. O uso de bebidas alcoólicas nas sociedades indígenas: algumas reflexões sobre os Kaingang da bacia do rio Tibagi. Paraná. In: Coimbra C, Santos R, Escobar AL, organizadores. Epidemiologia e Saúde dos Povos Indígenas do Brasil. Rio de Janeiro: Fiocruz; 2003.

7 Ghiggi Junior A, Langdon EJ. Reflexões sobre estratégias de intervenção a partir do processo de alcoolização e das práticas de autoatenção entre os índios Kaingang, Santa Catarina, Brasil. Cad Saude Publica 2014; 30(6):1-10.

8 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.^-99 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121.^,2222 Langdon EJM. O abuso de álcool entre os povos indígenas no Brasil: uma avaliação comparativa. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 27-46.

23 Souza MLP, Schweickard JC, Garnelo L. O processo de alcoolização em populações indígenas do Alto Rio Negro e as limitações do CAGE como instrumento de screening para dependência ao álcool. Rev. Psiq. Clín. 2007; 34(2):90-96.

24 Oyacer AM, Nanco J. Alcooholismo y etnia: criticas y propuestas. In: Salgado MS, Mella IJ, organizadores. Salud, cultura y território: bases para uma epidemiologia intercultural. Santiago de Chile: Lincanray; 1998. p. 43-58.^-2525 Menendez EL. El processo de alcoholizacion: revision critica de la producion socioantropologica, histórica y biomédica en America Latina. Rev. Centroam. Cienc. Salud 1982; 8(22):61-94. and the ethnographic literature on the Maxakali⁹9 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121.

10 Brasil. Decreto nº 6.871, de 04 de junho de 2009. Dispõe sobre a padronização, a classificação, o registro, a inspeção, a produção e a comercialização de bebidas. Diário Oficial da União 2009; 05 jun.

11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.

12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.

13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.

14 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992.^-1515 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329.^,1717 Marcato SA. O indigenismo oficial e os Maxakali (séculos XIX e XX). In: Rubinger MM, Amorim MS, Marcato SA, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980. have also guided the data collection and analysis strategies of this research.

What was done: we started with understanding the Maxakali lived realities. This data was collected in focus groups through the use of a herein called Stories Wheels regarding Alcohol use in my village (SWA). Through SWA we gathered the significant descriptions of Maxakali leaders in regard to their experiences with Kaxmuk, which could be understood and unveiled in its essence.

SWA can be understood and conducted as a model for discourses and conversations about everyday life²⁶26 Lunt P, Livingstone S. Rethinking the focus group in media and communications research. J Commun 1996; 46(2):79-98.. It generates discussion by revealing the meanings assumed by the interviewee during the discussion phase, by showing the way in which people negotiate those meanings. SWA also generates diversity and difference, both within and between groups, thus allowing researchers to describe the lived experiences of respondents based on their actions and subjectivity²⁶26 Lunt P, Livingstone S. Rethinking the focus group in media and communications research. J Commun 1996; 46(2):79-98.^,2727 Kitzinger J. Qualitative Research: Introducing focus groups. BMJ 1995; 3(1):311-299..

Purposeful selection of participants was used to obtain a community representation²⁸28 Turato ER. Tratado da metodologia da pesquisa clínico-qualitativa: construção teórico-epistemológica, discussão comparada e aplicação nas áreas da saúde e humanas. Petrópolis: Vozes; 2003.. The first author and a research assistant conducted on-site visits in villages of the two Maxakali communities, from where the leaders come from. The defined inclusion criteria: she / he has to: represent both communities, be an adult of either gender, be or hold a leadership position; also, she / he should still be implicated and approved by her / his community. Using these stakeholder criteria, it provided SWA a relevant heterogeneity among the participants characteristics²⁷27 Kitzinger J. Qualitative Research: Introducing focus groups. BMJ 1995; 3(1):311-299..

Seven leaders did not attend SWA on account of their other social agendas. We worked with 21 stakeholders, five women (26 to 40 years) and 16 men (24 to 51), all of whom live on the reservations. Some held one or more positions such as: teacher (07), village leader (04), indigenous health provider or (04), sanitation officer (03), two shamans and a councilwoman. They were divided into three SWA; together, they represented two communities and 11 of the 19 villages.

Data collection began after all participants provided written informed consent. The SWA were conducted and coordinated by the first and last authors of this study assisted by an observer, using an interview guide.

Following the SWA phases, we read the story “A Kaxmuk in my village” (Chart 1), it was created from the theoretical framework¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.

2 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004.

3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.

4 Souza MLP, Garnelo L. Quando, como e o que se bebe: o processo de alcoolização entre populações indígenas do alto Rio Negro, Brasil. Cad Saude Publica 2007; 23(7):1640-1648.

5 Ferreira LO. O "fazer antropológico" em ações voltadas para a redução do uso abusivo de bebidas alcoólicas entre os Mbyá-Guarani, no Rio Grande do Sul. In: Langdon EJ, Garnelo L, organizadores. Saúde dos Povos Indígenas: Reflexões sobre antropologia participativa. Rio de Janeiro: Contra Capa; 2004.

6 Souza JA, Oliveira M, Kohatsu M. O uso de bebidas alcoólicas nas sociedades indígenas: algumas reflexões sobre os Kaingang da bacia do rio Tibagi. Paraná. In: Coimbra C, Santos R, Escobar AL, organizadores. Epidemiologia e Saúde dos Povos Indígenas do Brasil. Rio de Janeiro: Fiocruz; 2003.

7 Ghiggi Junior A, Langdon EJ. Reflexões sobre estratégias de intervenção a partir do processo de alcoolização e das práticas de autoatenção entre os índios Kaingang, Santa Catarina, Brasil. Cad Saude Publica 2014; 30(6):1-10.

8 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.^-99 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121.^,2222 Langdon EJM. O abuso de álcool entre os povos indígenas no Brasil: uma avaliação comparativa. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 27-46.

23 Souza MLP, Schweickard JC, Garnelo L. O processo de alcoolização em populações indígenas do Alto Rio Negro e as limitações do CAGE como instrumento de screening para dependência ao álcool. Rev. Psiq. Clín. 2007; 34(2):90-96.

24 Oyacer AM, Nanco J. Alcooholismo y etnia: criticas y propuestas. In: Salgado MS, Mella IJ, organizadores. Salud, cultura y território: bases para uma epidemiologia intercultural. Santiago de Chile: Lincanray; 1998. p. 43-58.^-2525 Menendez EL. El processo de alcoholizacion: revision critica de la producion socioantropologica, histórica y biomédica en America Latina. Rev. Centroam. Cienc. Salud 1982; 8(22):61-94.^,2929 Souza MLP. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013.

30 Edwards G, Marshall EJ, Cook CCH. O tratamento para o alcoolismo: um guia para profissionais de saúde. 4ª ed. Porto Alegre: Artmed; 2005.^-3131 Woititz JG. Adult children of alcoholics. Deerfield Beach: Health Communications, Inc; 1990. and through the nine-years of experience of the first author with MPHC. After that, we asked the following questions: “What did you feel when you heard the story? How was it for you to listen to this story? I want to hear the story of Kaxmuk from your village.” After that, the leaders told their stories.

The reports were produced in Portuguese and / or in the Maxakali language. Some leaders spoke in Maxakali language. When the group signaled the exhaustion of the discussion about their stories, the second session of questions began aiming to deepen or clarify any doubts about the aspects discussed²⁷27 Kitzinger J. Qualitative Research: Introducing focus groups. BMJ 1995; 3(1):311-299.. The narratives were recorded in both audio and video format, which were then listened to and transcribed giving rise to a report. The report also included the notes from the conductors and the observer of the SWA.

Following the assumptions of the thematic analysis of Boyatzis³²32 Boyatzis RE. Transforming qualitative information: thematic analysis and code development. California: Sage Publications Ltd; 1998., two researchers began the analysis of narratives through floating reading. With the fragmentation of the contents of the stories and debates, they developed a coding system. After individual analysis, the researchers discussed and refined the findings in consensus. This method served as a basis for the following analyses where the codes were reformulated throughout when new themes arose. The coding and grouping of the data, including the identification of categories, which developed into themes, evolved until reaching the theoretical saturation of the data. The final themes with their respective units of meanings are shown in Figure 3.

This research was approved by the Research Ethics Committee of the Federal University of Minas Gerais and by the National Commission of Ethics in Research.

Results and discussion

The leaders, through telling their stories, acknowledged the negative consequences of Kaxmuk use. Their perceptions stemmed from different points of view, sometimes as authors, sometimes as spectators. They saw and experienced the consequences in their relatives or non-relatives, at home, in the village or in the city. Figure 4 presents the set of dimensions and analytical categories of the experiences lived subjectively and intersubjectively in the Maxakali-world-of-life. According to Schutz¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979.^,1919 Souza MNC. Algumas considerações sobre a sociologia de Alfred Schütz. Revista Eletrônica dos Pós-Graduandos em Sociologia Política da UFSC 2012; 9(1):1-26., these realities are expressed in a biopsychosocial synthesis. Using this theoretical methodological stance, we grouped the experiences of each interviewee under the contexts of the family and of the community spaces of action which represents this biopsychosocial being. Although some consequences can be experienced in more than one dimension, as Edwards et al.³⁰30 Edwards G, Marshall EJ, Cook CCH. O tratamento para o alcoolismo: um guia para profissionais de saúde. 4ª ed. Porto Alegre: Artmed; 2005. noted, we believe that those dimensions provide relevant information to think, using the Maxakali’s point of view, about possible prevention of the consequences rooted in drinking.

Individual dimension

Regarding the abusive drinking and the dangers associated with drinking alone, drinking until falling, amnesia and death by accident among the Maxakali who consume alcohol, the Maxakali consider the amount consumed dangerous to their health. As reported: When [a] tihik goes to the city to buy cachaça and drink, I think it is dangerous, he will fall (drink until falling) and die. If he goes to lie down, he will sleep ... all day long, so he will die because of the hot sun and no one will see [him] at the time. These perceptions corroborate with the findings of other studies³3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.^-44 Souza MLP, Garnelo L. Quando, como e o que se bebe: o processo de alcoolização entre populações indígenas do alto Rio Negro, Brasil. Cad Saude Publica 2007; 23(7):1640-1648.^,88 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.^,2222 Langdon EJM. O abuso de álcool entre os povos indígenas no Brasil: uma avaliação comparativa. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 27-46.^-2323 Souza MLP, Schweickard JC, Garnelo L. O processo de alcoolização em populações indígenas do Alto Rio Negro e as limitações do CAGE como instrumento de screening para dependência ao álcool. Rev. Psiq. Clín. 2007; 34(2):90-96., who all demonstrated that the alcohol consumption is different in the Maxakali from the national population’s patterns.

The Maxakali are aware of the consequences of drinking, as they know the potential risks of “drinking and falling”. It is also evident in Maxakali’s speech the predictability of outcomes after drinking, when individuals put themselves in situations that could have fatal risks, as reported: My father died at the age of 25. He went to the city and drank lots of cachaça. There was a lot of Kaxmuk inside his belly. He drank and lay, [in the city] … and it was a very hot sun day, so, the cachaça burned his heart; he died. Cachaça is dangerous. This extreme intoxication can be a cause of death, induce an alcoholic coma and other illnesses. However, amongst the Maxakali people, this intoxication does not simply destroy their health through the effects seen above, the Indians can die of sunstroke by being under those conditions for hours on end¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64..

The Maxakali recognize the links between other diseases (hypertension, diabetes) caused by the use of cachaça, a beverage that they never manufactured³³33 Maxakali R, Maxakali P, Maxakali I, Maxakali M, Maxakali T. Hitupmã'ax: curar. Belo Horizonte: Cipó Voador; 2008.. This data was confirmed in this study as reported: In the past, [a] tihik Maxakali had no high blood pressure, today there are many tihik[s] who are taking medicine for high pressure. Even [when] taking medicine for high blood pressure he continues to drink Kaxmuk.

In addition to the noninfectious diseases, leaders also pointed out signs of illness caused by cachaça use, one informant said: And also cachaça will ruin the belly. Then the belly looks like this (puts his hands increasing the size of the belly) and turns yellow (passing his hands on the face).

They also realize the danger of drug interaction between the consumption of Kaxmuk and prescribed medication continuously used, as reported: The doctor passes a controlled medicine, [if] that patient takes that medicine and drinks the cachaça, he can die. Another participant added: it can brings death too, because he lies on the bed quietly, without anyone, and so, the death comes.

Through the interactional processes, they reported emotional and health consequences with relatives of those who drink: Because the drink brings a lot of illness, it is not only the cachaça that will bring the disease. People who are [mothers] think, sometimes [their] son, who does not have the problem, thinks about his relative, about his brother… and thinks about his aunt, [who are all drinking]. As the relative is talking, her people drink, but she does not know what happens because she leaves. Because she has a problem, she became very ill, she has high blood pressure. These consequences are in line with those described by Edwards et al.³⁰30 Edwards G, Marshall EJ, Cook CCH. O tratamento para o alcoolismo: um guia para profissionais de saúde. 4ª ed. Porto Alegre: Artmed; 2005. in his work on the treatment of alcoholism.

Regarding the dangers concerning accidents and traumas, Rubinger¹²12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980. reports that a shaman’s wife had part of her foot amputated from a fire, because the Indian became so intoxicated by cachaça that she did not feel her foot on fire. Although Kaxmuk’s greatest consumption is by men, accidents and injuries also occur among women: I have a sister, which I do not hide. Saturday [their was] a party [at my house], she drank so much [she] hit [her] foot and fell and broke it here (clavicle); even [if] she’s hurt, she still drinks!

Family dimension

Eitlle et al.³⁴34 Eitle TM, Johnson-Jennings M, Eitle D. Family structure and adolescent alcohol use problems: Extending popular explanations to American Indiansc. Soc Sci Res 2013; 42(6):146-1479. says that, the family, as a dynamic and unique context for children’s development, is a neglected topic in studies of alcohol use among indigenous peoples. In order to understand the roles and responsibilities of the members of a family, Dessen and Silva Neto³⁵35 Dessen MA, Silva Neto NA. Questões de Família e Desenvolvimento e a Prática de Pesquisa. Psic.: Teor. e Pesq. 2000; 16(3):191-292. emphasize that it is necessary to study the interactions and relationships between different family groups and to situate families in relation to the historical, social, cultural and economic contexts that they cross.

Popovich¹³13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980., studying the marriage and kinship relationships, noted that any level of Maxakali kinship carries a set of definitions, roles, and responsibilities for behavior. Each level has an information store of principles as well as an instrument that leads to action, bringing with it many expectations regarding behavior.

According to the author¹³13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980., the “father” is expected to provide the necessary food: the meat, through hunting, in former times; manioc, potato, corn and currently through plantations. The father should teach his son how to make bows and arrows and how to hunt, as well as the Maxakali’s myths, legends, and rituals.

The woman who is called “mother” should cook the staple foods for her family. She also weaves the handicrafts and washes the clothes; her daughter learns to be a true Maxakali woman by observing and imitating her. The mother-daughter dyad is probably the most intimate of relationships in this society¹³13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980..

A study regarding the consequences of alcohol use among Venezuelan Indians³⁶36 Seale JP, Shellenberger S, Rodriguez SC, Seale JD, Alvarado M. Alcohol use and cultural change in an indigenous population: a case study from Venezuela. Alcohol Alcohol 2002; 37(6):603-608. showed that the most frequently reported problems were the lack of money for essential family needs such as food, medicines and payments, as well as neglect of the family unit. Wives reported that their husbands spend all their money in one night or on drunken days in the city, returning home with little or none of the money they received³⁶36 Seale JP, Shellenberger S, Rodriguez SC, Seale JD, Alvarado M. Alcohol use and cultural change in an indigenous population: a case study from Venezuela. Alcohol Alcohol 2002; 37(6):603-608.. A similar situation is reported by the Maxakali: I go in the city to make fair. My family is hungry. [He] stays there straight and child stays waiting all night; (the child) sleeps and his / her father does not appear. What happened: the father drank and fell on the sidewalk, fell asleep. [He] Just arrived the other day and brought nothing.

Two other Maxakali described this phenomenon in more detail: And there is something else, when [a]tihik does not have money, he goes to the street, exchanges his son’s food”, completes the other: oh this is not good, you went out to do groceries [the son] bought beans, oil, sugar, rice, but he was [ex]changing. He gave [the groceries] to the white in exchange for cachaça. That is why today the card [is called] Bolsa Cachaça.

The exchanges carried out by the Indians in the commercial centers of the region are frequent¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.

12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.

13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.^-1414 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992. and constitute one of the most interesting and least studied aspects of so-called inter-ethnic contact¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.. The towns, around the villages, economy and commercial activities depend directly on the Maxakali when they seek to acquire goods indispensable to life¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.^,1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980., among them, the cachaça⁹9 Pena JL. Os índios Maxakali: a propósito do consumo de bebidas de alto teor alcoólico. Revista de Estudos e Pesquisas, FUNAI 2005; 2(2):99-121.

10 Brasil. Decreto nº 6.871, de 04 de junho de 2009. Dispõe sobre a padronização, a classificação, o registro, a inspeção, a produção e a comercialização de bebidas. Diário Oficial da União 2009; 05 jun.

11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.

12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.^-1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.: When you drink cachaça you spend a lot of money. When it’s over, you [take] the most expensive thing [you own] (like a TV, DVD, Sound), you pick it up and negotiate with the others; [you end] up selling [it for] cheaper and losing the good things. This is not right, you are hurting yourself and your family.

Regarding the expenditure of money on beverages, the results of this study corroborates with the findings of a survey conducted with the Tenharim⁸8 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966. Indians from Brazil. Due to the cachaça, some Tenharim fail to provide their family with life’s basic necessities for sustenance. However, for the Tenharim, this does not mean that the Indian cannot drink. For some interviewees, if the Tenharim consumes alcohol, but does not neglect his family, his relatives do not interfere with his drinking habits⁸8 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.. A contrary situation was reported in the study conducted with the Venezuelan Indians³⁶36 Seale JP, Shellenberger S, Rodriguez SC, Seale JD, Alvarado M. Alcohol use and cultural change in an indigenous population: a case study from Venezuela. Alcohol Alcohol 2002; 37(6):603-608.. Some of them, when they go to the city to receive the money, they drink, and they do not bring anything home or to their children, so the children get hungry³⁶36 Seale JP, Shellenberger S, Rodriguez SC, Seale JD, Alvarado M. Alcohol use and cultural change in an indigenous population: a case study from Venezuela. Alcohol Alcohol 2002; 37(6):603-608.. One interviewee reported the same situation: Malnutrition starts from the question of alcoholic drinks because [when] the father drinks, sometimes [he] does not remember [his] children.

Now, if both parents are alcoholics, the family may have reached a point where social complications make life even less predictable³¹31 Woititz JG. Adult children of alcoholics. Deerfield Beach: Health Communications, Inc; 1990.. He has a brother who drinks a lot, along with his wife. They go straight to town and take [their] son. It is not very good when they both drink, because when they bring their child, they fall with the child in the garden. When the staff of SESAI (indigenous health care providers) passes through, they pick up the child and take the child to the village and hand it over to him (who is the uncle).

Despite the social complications of parental alcohol consumption, studies regarding alcohol use in some indigenous peoples from Brazil emphasize that protein-calorie malnutrition in children is partly linked to their parent’s alcohol consumption⁶6 Souza JA, Oliveira M, Kohatsu M. O uso de bebidas alcoólicas nas sociedades indígenas: algumas reflexões sobre os Kaingang da bacia do rio Tibagi. Paraná. In: Coimbra C, Santos R, Escobar AL, organizadores. Epidemiologia e Saúde dos Povos Indígenas do Brasil. Rio de Janeiro: Fiocruz; 2003.. Although, we must recognize that there are several types of families and that the maternal and paternal roles are multidimensional and complex. Above all, those fathers and mothers have different roles in different cultural contexts³⁷37 Kreppner K. Developing in a developing context: Rethinking the family's role for children's development. In Winegar LT, Valsiner J. Children's development within social context. New Jersey: 1992. p. 161-182.. This demonstrates the need for more in-depth studies on alcohol use with an emphasis on the family context and its impact on the child’s individual development. Such studies would help to understand how different ways of parenting affects the development of the Maxakali child.

In regard to the violent behavior and the loss of the family bond, it was observed that, like the jaguar character in “My uncle the Iauaretê,”³⁸38 Rosa JG. "Meu tio o Iauaretê". Estas estórias. 3ª ed. Rio de Janeiro: Nova Fronteira; 1985. the Maxakali, when they drink, may be subject to a similar kind of trance¹⁵15 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329.. They feel transmuted into a jaguar and can kill people or animals. When they return to normal, they cannot clearly remember what happened to then or what they did¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.^,1515 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329..

In an ethnographic essay, Vieira¹⁵15 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329. performed an integrated analysis of cosmology and Maxakali kinship. Vieira observed that Kaxmuk consumption is one of the vectors of bodily transformation that implies the loss of the human condition. According to the author, a drunken Maxakali becomes capable of assault, to the point of killing a relative¹⁵15 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329.. This kind of transformation was reported by one interviewee: Oh my God, that person does that (fight, beat, strike to the point of being able to kill a relative), but it is not that person who is doing this, is the demon who is doing [it]. Then you stay there, take it all, you have to take it all! Until he gets better, reinforced by another leader: Cachaça does not respect another person, it kills, either a father, or brother, or woman. There is a Maxakali who’s killing even a woman because of drinking.

People with drinking problems sometimes seem to have lost all links with their family. Yet they can nurture strong emotions about relationships which are harmed by death, disharmony, or neglect, and their relatives are likely to have similar feelings³¹31 Woititz JG. Adult children of alcoholics. Deerfield Beach: Health Communications, Inc; 1990.: Today, when he drinks, he sits quietly, he does not mess with me; because if the woman goes down to man, he does it! Now if the woman does not go down he does not do that! Because the man, he wants to show himself, he is very male chauvinist, he wants to hit you, you know? In the contexts of MPHC, to understand this wife’s ability to deal with the stress and the feelings brought about by her intimate relationship with an alcoholic enables the process of helping and the treatment of the entire family³⁰30 Edwards G, Marshall EJ, Cook CCH. O tratamento para o alcoolismo: um guia para profissionais de saúde. 4ª ed. Porto Alegre: Artmed; 2005.^,3131 Woititz JG. Adult children of alcoholics. Deerfield Beach: Health Communications, Inc; 1990..

Community dimension

Kaxmuk intake was historically encouraged and highly exploited by local traders. This consumption has a direct impact on the social organization of the Maxakali villages, causing fragmentation among their families¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.

12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.^-1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980... The narrated stories portray this fragmentation: I left the village where I lived. Now I am living only with my family and my brother because of a problem with cachaça. [A] Tihik from the village was drinking, [he was] going crazy, I was scared. I left there to take care of my family, the children.

Another report confirms the above quote when an interviewee demonstrates his drinking behavior in his village or does not reach other villages when he is drunken: When I drink a sip, I do not go out to visit another village, I keep quiet down. If I drink too much it is dangerous to go to visit another village because there you can die. Participants also described that some members preferred to consume alcohol alone and concealed their consumption from others to avoid social complications: When I buy Kaxmuk, I drink alone.

Sometimes, drinking alcohol at home does not mean that the individuals were drinking alone. Participants described drinking, where adults drank and went from house to house, usually ending in a fight: The person is single, he has no wife, the other has [one]. The single [one] drinks cachaça, and wants to flirt with the married woman. So, he goes to her house, but her husband is jealous and tells him to leave. The drunkard curses both of them and starts a confusion. The couple gets angry. That’s why it’s very dangerous to have a sip and go out to another village.

Despite the lively and pulsating multiplicity of the Maxakali socialization being historically governed by the search for the alliance¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008., the warlike confrontation has always prevailed. This dominance of confrontation is seen in the contact relations of the peoples that constitute the present Maxakali with their territories, their villages and their residences¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.^,1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.. Under the effects of alcohol, they manifest latent situations of revolt originating from the past conflicts and deaths of their ancestors, before and after the formation of the Tikmũ'ũn¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.

12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.^-1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980..

From this multiplicity, Ribeiro¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008. and Popovich¹³13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980. consider that the formation of the present Maxakali that this only explains a possible source of internal imbalance to its social structure. Thus, generating fragmentations in the social structure is often accompanied by violence with connections peculiar to Kaxmuk consumption.

This internal imbalance in relation to social structure linked to the Kaxmuk intake causes a great mobility of both family(ies). A villager’s displacements may cause many changes among several villages in its three territories. As well, it may imply the configuration of a new village¹³13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.. The reports of the leaders meet the findings of anthropological studies¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.^,1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.. According to these findings, when it comes to allies, revenge ceases to be the motto of or the reasons behind the displacements and the conflict becomes the direct element that leads to mobility. In turn, this leads to the remoteness of every party involved.

Regarding the violent deaths and the right to reparation, there are conflicts that strike even harder at the tribal organization creating serious social problems. Studies¹²12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.^,1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980. conducted in the 1960s, 70s and 80s recorded the occurrence of homicides committed by people under the effect of Kaxmuk consumption against their own relatives. As reported: You fight with your wife, then you hurt your children and your wife, and if you do not have no one to help (the family), that person can kill the woman in the house.

Throughout the Maxakali, all of the families that had one of its members affected by a violent death have the right and the duty of reparation. The consequence for the revenge of their loved one is the death of the murderer, by the hands of the deceased’s relatives¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.^,1313 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.. That’s situation regard of Kaxmuk consumption; in the case of the woman above, alcohol becomes the predictor of two outcomes, a double homicide. According to Álvares¹⁴14 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992., “conflicts generate a chain of revenge among the members of the groups involved that last for several years, until they move away in a radical way¹⁴14 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992.: The drink goes to your head in such way that you do not even know what is happening. You wake up like this, “Oh, my father in heaven, look [at] what I did! I killed my wife, and now? [How will] my children eat, I am now like that.

Another similarity of the findings to other ethnographic studies¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.

12 Rubinger MM, Amorim MS, Marcato AS, organizadores. Índios Maxakali: resistência ou morte. Belo Horizonte: Interlivros; 1980.

13 Popovich FB. A organização social dos Maxakali [tese]. Arlington: Universidade do Texas; 1980.

14 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992.^-1515 Vieira MG. Virando Inmõxã: uma análise integrada da cosmologia e do parentesco Maxakali a partir dos processos de transformação corporal. Amazônica 2009; 1(2):308-329. is that reports on the repair of violent deaths among the Maxakali collaborates with the findings of this study by claiming that there was no long-standing fighting. If a person were to kill someone, their relatives would give him/her to their dead relatives and the “blood would have returned”, terminating the problem¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.. Such a situation is still experienced today in the Maxakali’s imagination: Once a problem happened in my village; I lost my son-in-law and my nephew in the same day. My other son-in-law killed my nephew. When I look at that, it pains me and I’m thinking about what happened. When my children drink, I say: have you not seen the example? Do you want more trouble? I say this because two coffins have already arrived in my village. It’s not easy!

At the same time, the Maxakali started apprehending the use of Kaxmuk to fight for resistance. This fight for resistance results in the permanence of changes in symbolic and material aspects of their autochthonous forms of becoming¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008.. In the sociohistorical and cultural scenarios of the interethnic contact studied, Maxakali social perceptions point to the total exclusion of the traditional fermented drink.

The consumption of the traditional drink is part of a mythical past. Álvares¹⁴14 Álvares MM. Yãmiy, os espíritos do canto: a construção da pessoa na sociedade Maxakali [tese]. Campinas: Unicamp; 1992. and Ribeiro¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008. report that spirits have their life in the hereafter, very close to that of humans. There, they hunt, fish, gather, collect and plant their small farms and make their handicrafts.

When they gather for the Parrot ritual to sing in Kukex (House of Chants), women make clay pots where they cook their food and make their fermented drinks. Before the ritual, the parrot spirits bring the corn to the women, who chew it and throw it into a large pot of clay. The other day, the spirits of the Parrot took the corn clay pots to Kukex¹¹11 Ribeiro RB. Guerra e paz entre os Maxakali: devir histórico e violência como substrato da pertença [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2008..

As for the indigenous populations of Rionegrinas/AM³3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004., Bororos/MT¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.^,22 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004., Mbyá Guarani/RS⁵5 Ferreira LO. O "fazer antropológico" em ações voltadas para a redução do uso abusivo de bebidas alcoólicas entre os Mbyá-Guarani, no Rio Grande do Sul. In: Langdon EJ, Garnelo L, organizadores. Saúde dos Povos Indígenas: Reflexões sobre antropologia participativa. Rio de Janeiro: Contra Capa; 2004., Kaingang/PR⁶6 Souza JA, Oliveira M, Kohatsu M. O uso de bebidas alcoólicas nas sociedades indígenas: algumas reflexões sobre os Kaingang da bacia do rio Tibagi. Paraná. In: Coimbra C, Santos R, Escobar AL, organizadores. Epidemiologia e Saúde dos Povos Indígenas do Brasil. Rio de Janeiro: Fiocruz; 2003.^,77 Ghiggi Junior A, Langdon EJ. Reflexões sobre estratégias de intervenção a partir do processo de alcoolização e das práticas de autoatenção entre os índios Kaingang, Santa Catarina, Brasil. Cad Saude Publica 2014; 30(6):1-10., Tenharim/AM⁸8 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966. the network of symbols and meanings expressing the negative consequences related to the use of Kaxmuk in the Maxakali culture is interlaced within this population. As Geertz²⁰20 Geertz C. A interpretação das culturas. Rio de Janeiro: Livros Técnicos e Científicos Editora; 1989.^,2121 Geertz C. O saber local. 5ª ed. Petrópolis: Vozes; 2002. suggests, the culture is entangled in a web of meanings that has been woven from generation to generation. This web fits rightly the perverse adjective, since the delivery of a comprehensive and integrated health care with a culturally humanized approach to individuals, families and Maxakali communities was historically denied and is silenced as well as naturalized. Their morbidity and mortality profile is represented by high mortality coefficients and incidents of childhood malnutrition, in addition to intestinal parasites, acute diarrheal, respiratory and scabies diseases³⁹39 Assis EM, Oliveira RC, Moreira LE, Pena, JL, Rodrigues, LC, Machado-Coelho GLL. Prevalência de parasitos intestinais na comunidade indígena Maxakali, Minas Gerais, Brasil, 2009. Cad Saude Publica, 2013; 29(4):681-690., highlight that adjective.

Final considerations

In order to understand the reason for the complete replacement of the fermented beverage by cachaça, it is necessary to understand not only why the Maxakali abandoned the fermented traditional drink, but why do the Maxakali want to continue using Kaxmuk? As reported by a leader; “It is a potato drink, a corn drink. These drinks were always made for religious [purposes] and I have seen it. It also contained coconut water [which was made the day before the religious purpose]. I say this because I have already seen it and consumed it. My father made garapa and put it [the coconut water] with the garapa, and then we consumed it too, this kind of drink was the one that we used. We used to make such a pot from that height”.

In the spatial and temporal perspective of Schütz¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979., it is important to consider the reasons why the contemporary representatives of the Makoni, Monoxó, Kapoxó, Malali, Maxakali, Cumanaxó and Panhame kept the sugarcane liquor use instead of traditional drink. This consideration is mainly to understand Kaxmuk’s positive and functional usages that integrate the social factory of the indigenous peoples. These functions are also part of the manifestations of inter and intragroup sociability (facilitator of shamanic transitions, social “lubricant” and regulator of expressions of violence and enmity) as described by Brazilian researchers in this field¹1 Fernandes JA. Cauinagens e bebedeiras: os índios e o álcool na história do Brasil. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 47-64.

2 Fernandes JA. Selvagens Bebedeiras: Álcool, embriaguez e contatos culturais no Brasil Colonial [tese]. Niterói: Universidade Federal Fluminense; 2004.

3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.

4 Souza MLP, Garnelo L. Quando, como e o que se bebe: o processo de alcoolização entre populações indígenas do alto Rio Negro, Brasil. Cad Saude Publica 2007; 23(7):1640-1648.

5 Ferreira LO. O "fazer antropológico" em ações voltadas para a redução do uso abusivo de bebidas alcoólicas entre os Mbyá-Guarani, no Rio Grande do Sul. In: Langdon EJ, Garnelo L, organizadores. Saúde dos Povos Indígenas: Reflexões sobre antropologia participativa. Rio de Janeiro: Contra Capa; 2004.

6 Souza JA, Oliveira M, Kohatsu M. O uso de bebidas alcoólicas nas sociedades indígenas: algumas reflexões sobre os Kaingang da bacia do rio Tibagi. Paraná. In: Coimbra C, Santos R, Escobar AL, organizadores. Epidemiologia e Saúde dos Povos Indígenas do Brasil. Rio de Janeiro: Fiocruz; 2003.

7 Ghiggi Junior A, Langdon EJ. Reflexões sobre estratégias de intervenção a partir do processo de alcoolização e das práticas de autoatenção entre os índios Kaingang, Santa Catarina, Brasil. Cad Saude Publica 2014; 30(6):1-10.^-88 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.^,2323 Souza MLP, Schweickard JC, Garnelo L. O processo de alcoolização em populações indígenas do Alto Rio Negro e as limitações do CAGE como instrumento de screening para dependência ao álcool. Rev. Psiq. Clín. 2007; 34(2):90-96.. Furthermore, these are the dimensions that received little attention and demand anthropological research. However, they have already been studied in relation to other indigenous peoples.

Continuing from the phenomenological perspective¹⁸18 Schutz A. Fenomenologia e relações sociais. Rio de Janeiro: Zahar; 1979., the use of alcoholic beverages has historically contributed as a social lubricant for indigenous peoples²²22 Langdon EJM. O abuso de álcool entre os povos indígenas no Brasil: uma avaliação comparativa. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 27-46.. Today, for many of the Maxakali, the contexts and patterns of consumption have changed corroborating with the dynamics of culture³3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.^,2020 Geertz C. A interpretação das culturas. Rio de Janeiro: Livros Técnicos e Científicos Editora; 1989.^,2121 Geertz C. O saber local. 5ª ed. Petrópolis: Vozes; 2002.. The consequences of this use are largely unexplained by cultural specificities, since control and sociocultural limits cease to exist³3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.^,44 Souza MLP, Garnelo L. Quando, como e o que se bebe: o processo de alcoolização entre populações indígenas do alto Rio Negro, Brasil. Cad Saude Publica 2007; 23(7):1640-1648.^,88 Pereira PPS, Ott AMT. O processo de alcoolização entre os Tenharim das aldeias do rio Marmelos, AM, Brasil. Interface Comunicação Saúde Educação 2012; 16(43):957-966.^,2929 Souza MLP. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013.^,3636 Seale JP, Shellenberger S, Rodriguez SC, Seale JD, Alvarado M. Alcohol use and cultural change in an indigenous population: a case study from Venezuela. Alcohol Alcohol 2002; 37(6):603-608..

The Maxakali drink other substances and often do so in new social contexts with negative consequences for the individual who drinks, their families, villages and communities. The aftermath takes the form of accidents, trauma, illness and death. As well, neglect of parents’ roles and responsibilities to the family, violent behavior, conjugal disharmony, and fragmentation of villages are other repercussions of the consumption of alcohol.

Another important question is whether the Maxakali recognize the difference between the negative consequences of Kaxmuk’s exclusive consumption and those associated with the traditional fermented drinks. This awareness can be seen by comparing the problems related to Kaxmuk use with the problems possibly associated with the exclusive or mixed use of their traditional fermented drinks consumed by their ancestors. For the time being, the lack of this knowledge has had negative and often devastating consequences for Maxakali, their families, their villages and their communities. We believe that, the joint construction of this knowledge may in future be part of a community agenda. As well, this knowledge will help the institutions working with and for the Maxakali by strengthening the culture and rescuing the traditional Maxakali beverage.

The SWA and generous dialogue with the Tikmũ’ũn produced native and innate questions²²22 Langdon EJM. O abuso de álcool entre os povos indígenas no Brasil: uma avaliação comparativa. In: Souza MLP, organizador. Processos de alcoolização indígena no Brasil: perspectivas plurais. Rio de Janeiro: Fiocruz; 2013. p. 27-46.^,2424 Oyacer AM, Nanco J. Alcooholismo y etnia: criticas y propuestas. In: Salgado MS, Mella IJ, organizadores. Salud, cultura y território: bases para uma epidemiologia intercultural. Santiago de Chile: Lincanray; 1998. p. 43-58. on how to organize interventions for and with this population with a less prescriptive character⁵5 Ferreira LO. O "fazer antropológico" em ações voltadas para a redução do uso abusivo de bebidas alcoólicas entre os Mbyá-Guarani, no Rio Grande do Sul. In: Langdon EJ, Garnelo L, organizadores. Saúde dos Povos Indígenas: Reflexões sobre antropologia participativa. Rio de Janeiro: Contra Capa; 2004.^,3838 Rosa JG. "Meu tio o Iauaretê". Estas estórias. 3ª ed. Rio de Janeiro: Nova Fronteira; 1985.. It has the power to think about other sensitivities, with possibilities of existence outside the record of alcohol use³3 Souza MLP. Alcoolização e violência no Alto Rio Negro [tese]. Manaus: Universidade Federal do Amazonas; 2004.^,2323 Souza MLP, Schweickard JC, Garnelo L. O processo de alcoolização em populações indígenas do Alto Rio Negro e as limitações do CAGE como instrumento de screening para dependência ao álcool. Rev. Psiq. Clín. 2007; 34(2):90-96..

If, as Rancière maintains⁴⁰40 Rancière J. A partilha do sensível: Estética e política. São Paulo: Editora34; 2005., there is a relationship between politics and visibility, in the sense that politics would deal with what one sees and what can be said about what one sees, then it designates who has the competence to “see and quality to say”. The findings of the present study also have the power, in the strong sense of the term, to raise a voice and speak about the misfortunes and needs of the Tikmũ’ũn. This power is meant to describe the capability of provoking noise from government agencies and academies to recognize the need to develop interdisciplinary projects aimed at expanding research on the consumption of Kaxmuk.

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