A ferrovia do diabo e o pioneirismo da enfermagem na floresta Amazônica no século XX: um resgate histórico.

Abstract

Public health in the Amazon region emerged in a critical context, marked by the rise mortality during forest clearing and latex exploitation. During construction of the Madeira-Mamoré railway, approximately six thousand workers died due to endemic diseases. Known as the “Devil’s Railway”, the railway exemplifies the challenges imposed by diseases such as malaria and yellow fever. This study aims to describe the pioneering of nursing in this historical context, emphasizing the importance and challenges faced by health professionals at the time. This is a historical review of literature for describe the pioneering role of nursing at the beginning of the 20th century in the construction of the railway Madeira-Mamoré. Using indexed databases such as MEDLINE (Medical Literature Analysis and Retrievel System Online), LILACS (Latin American and Caribbean Literature in Sciences da Saúde) and SciELO (Scientific Electronic Library Online), and descriptors such as "Nursing", "History of Nursing" and "Health Nursing" the research focuses on the analysis of historical sources and related documents, including consultation in institutions such as ABEn (Brazilian Nursing Association)and USP (University of São Paulo). The attacks on construction of the railway opened space for machines and tracks, but also for illness due to endemic diseases that ravaged the Amazon rainforest region. Housing conditions on the margins of construction show the vulnerability of workers to diseases tropical diseases in the forest, mainly due to malaria. The late arrival of doctors and nurses highlighted the urgent need for medical assistance on site. The Candelária Hospital was the first hospital designed exclusively to treat infectious diseases in Brazil in service of the railway, reflecting the growing demand for specialized care on site. We concluded that the nursing staff was essential at Hospital da Candelária, for the treating diseases and promoting prophylaxis. Historical records are limited, and the The exact contribution of nurses and their qualifications remain uncertain. The fate of nurses on the Madeira-Mamoré railway is also uncertain, with possible returns or integration into the Brazilian health service. The nursing staff at the time operated in a hospital-centric and curative model in a scenario of infectious diseases, with highlighting North American nurses, pioneers in the northern region of Brazil. This model evolved with the Amazon Rural Prophylaxis Program after the closure of the Hospital da Candelaria.