What is the urban in contemporary Amazon? Implications for health surveillance in the biome

Bertha Becker's provocation 1 made in 1995, when referring to the Amazon as an Urbanized Forest, was a milestone.It was the recognition, by an important non-Amazonian and active voice in the debates that characterized the Amazon as a frontier of capitalist accumulation, that the forest was an urban frontier 2,3 .This perspective emerged from the developmentalist narrative for that vast rainforest landscape as a wellspring of exploitable resources (minerals, logging, energy, land), one that obscured the human presence prior to colonization.Recent studies 4 add new and important evidence that long before the 16th century the region was vibrant and would have housed at least ten million inhabitants, organized into peoples and territories who mastered soil, water and biodiversity management technologies.From the native standpoint, there were no large agglomerations that differed from the agricultural productive environment, but rather settlements dispersed along rivers separated by gradients spanning from the inhabited area to the farm, the orchard and the forest, articulated between each other, and with the larger centers, forming networks that made housing and production viable.This paradigm reoriented colonial agriculture, but was disregarded by the urban-industrial paradigm which blindly and in an authoritarian manner reorganized urbanization strategies in Brazilian territories.Native urbanization, which completely assimilated the forest, and the urban specificities in the Amazon, were not only not understood as such, but were in fact absent from the national agendas of governments, academia (outside the region) and the third sector for most of Brazil's history.And, as Bertha Becker argued, "what is not on the agenda, does not exist".The production of worrying landscapes and indicators under the climate-environmental agenda and its repercussions on the economic agenda, resulting from the imposition of urbanization patterns according to the urban-industrial logic, revived this debate.On the other hand, these urbanization processes were intrinsically associated with health-disease processes.Urbanization has altered the distribution of diseases relevant to public health along occupation gradients in transformed landscapes.For public policies associated with health surveillance and control actions, the use of normative definitions of "city" and "countryside" or "urban" and "rural" helped to distinguish between urban and rural health and, consequently, to design actions.Adopting dichotomous categories to explain the differences in risk of exposure as well as disease prevention seemed sufficient.But not for the Amazon

Amazon rainforest · Biology · Biome · Environmental health · Environmental planning · Geography · Child Nutrition and Water Access · Ecology · Indigenous Health and Education · Medicine

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