Intended for healthcare professionals


Lessons on planetary health from traditional Quilombola communities of the Brazilian Amazon

BMJ 2023; 383 doi: (Published 05 October 2023) Cite this as: BMJ 2023;383:p2188
  1. Priscila de Morais Sato, PhD in sciences, adjunct professor1,
  2. Leonaldo Brandão, master in Amazon family agricultures and sustainable development, PhD student, articulation coordinator and local representative of the Médio Itacuruçá Quilombo23
  1. 1School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
  2. 2School of Agricultural Engineering, State University of Campinas, São Paulo, Brazil
  3. 3Association of Quilombola Communities of the Abaetetuba Islands (ARAQUIA), Algodoal, Pará, Brazil
  1. Correspondence to: P de Morais Sato: pri.sato{at}

The effects of the climate emergency on people’s health and quality of life are increasingly acknowledged. However, certain groups and regions, including women, racialised and minoritised groups, individuals living in poverty, and those in the global south, are disproportionately affected by the climate emergency despite often having the least responsibility for causing it.1 In this context, solutions to protect planetary health are urgent, and it’s necessary to learn from the knowledge of those who have been caring for the environment for generations, such as native and other traditional populations.

Traditional populations are culturally differentiated groups that self-identify as such, have their own forms of social organisation, and occupy and use territories and natural resources as a condition for their cultural, social, religious, ancestral, and economic reproduction. They rely on the transmission of knowledge, innovations, and practices that have been generated and transmitted by tradition. Examples are the indigenous and Quilombola populations.2 Quilombola communities are reminiscent of Black communities founded by African enslaved people who were brought to Brazil in colonial times, who developed daily practices of resistance in the maintenance and reproduction of their characteristic ways of life and in the consolidation of their own territories.3

The lessons presented in this article draw on the experiences and strategies of the Quilombola communities of the Abaetetuba islands, located in the north east of Pará state, Brazil.

Protecting the environment means fighting environmental injustices

Pollution, loss of biodiversity, and the climate emergency affect the food and water security of communities, contributing to a multitude of health concerns including respiratory and skin diseases, as well as worsening mental health. They also lead to changes in eating practices and lifestyles, as climate breakdown can lead to droughts, flooding, and other extreme or unpredictable weather events, affecting the availability and price of fresh fruit and vegetables and other healthy foods. This is associated with increasing rates of non-communicable diseases.

These factors are also evident in the environmental damage and pollution caused by expansive projects, such as building ports, mining dams, or burning forests to grow African oil palm crops close to community territories. The Quilombola communities in Pará state have experienced the loss of land to make space for palm oil plantations. These forms of environmental racism exacerbate the degeneration of the local environment through deforestation and water and land pollution, leading to worsening health in local and indigenous communities.

Human health depends on the health of a bigger system

Despite being constantly affected by environmental injustices, Quilombola people share belief systems and world views rooted in a profound respect for nature. They possess a wealth of ancestral knowledge that’s traditionally shared orally across generations, which is intrinsically related to their culture and cosmology.

By recognising the importance of nature and biodiversity for preserving life, Quilombola communities use the environment without destroying it. They have an understanding that they are integral parts of the ecosystem, and they fight for its preservation. The health of humans and non-humans is interdependent, indicating the relevance of approaches not based on domination or the commodification of natural habitats for commercial gain.

Living off the natural environment without endangering biodiversity

Quilombola people have a wealth of experience of how to live in, and prosper from, the land without ruining the local environment. One strategy is forest management, which provides economic, social, and environmental benefits while also keeping forests alive by respecting the sustainability of the ecosystem.

An example is the açaí berry, which has been a part of the traditional food culture of these communities for centuries and is now one of the main sources of income for most families.4 In forest management, priority is given to the açaí palm, creating extensive areas of açaí palm groves mixed with other species that are maintained according to their economic, symbolic, and medicinal values, guaranteeing plant diversity. As well as providing nourishment and facilitating access to clean air and water, the preservation of forests contributes to the healthcare of Quilombola communities by providing medicinal resources derived from animals and plants.

The Quilombola communities of the Abaetetuba islands also promote environmental sustainability aligned with food security through Quilombola family farming—a form of food production characterised by growing diversified crops in small fields and home gardens without using pesticides. This is marked by collective efforts in communal work and the exchange of seedlings, seeds, and knowledge. Furthermore, these agroforestry systems incorporate agricultural techniques, such as green manure, controlled burning, crop diversification, and seed and seedling selection.5

Sustainable fishing is another practice employed for biodiversity conservation. It uses traps that allow for the preservation of ecosystems while respecting the reproductive period of fish according to their species—known as “piracema” (closed fishing season).6

Solutions need to confront extractive colonialism and capitalism

It’s important to highlight that the techniques mentioned are not solutions in themselves—they’re potential strategies to promote sustainability when guided by respect for human and non-human lives. It’s necessary to challenge hegemonic forms of exploitation of lands and peoples and to distrust “solutions” that are disguised as “sustainable” but serve only the interests of exploiting nature for profit, without considering other ways of relating to it.

In this sense, the historical resistance to colonial oppression practised by Quilombola people in various forms (such as social movements, political activism, or cultural and intellectual production) challenges and reverses the unequal power relations established during the colonial period.7 However, despite the secular resistance of Quilombola communities, for any actions to have a meaningful impact this burden has to be shared, including general efforts to incorporate the principles of equality and justice into our actions, as well as the validation of traditional knowledge and peoples, to promote planetary health.


  • Competing interests: None.

  • Provenance and peer review: Commissioned, not peer reviewed.