This study aims to analyze the ethno-political, ethical, and health repercussions, for indigenous peoples' organizations involved in agreements with the Ministry of Health, resulting from the implementation of Special Indigenous Health Districts (DSEI) in the State of Amazonas, Brazil. The DSEIs chosen for analysis were those of Manaus and Rio Negro. Data were collected from reports drafted during and after planning and other meetings of the respective indigenous peoples' organizations, participatory observation in events organized to evaluate the health district apportionment process, and interviews with indigenous and non-indigenous managers of DSEIs. The article discusses the ambiguity of indigenous peoples' organizations in having to exercise their own political role while implementing a state policy, assumed as a way to overcome the stigma of their presumed inability to head the process of implementing a DSEI.
Health Policy; South American Indians; Organizations