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Conteúdo (article):

CULTURA POPULAR E CUIDADO EM SAÚDE: PRÁTICAS DE BENZEÇÃO EM TERRITÓRIOS ATENDIDOS POR EQUIPES SAÚDE DA FAMÍLIA

POPULAR CULTURE AND HEALTH CARE: BENZEÇÃO IN TERRITORIES SERVICED BY FAMILY HEALTH TEAMS

CULTURA POPULAR Y CUIDADO EN LA SALUD: PRÁCTICAS DE CURANDERÍA EN TERRITORIOS ATENDIDOS POR EQUIPOS DE SALUD DE LA FAMILIA

Luiza Maria de Assunção
Universidade do Estado de Minas Gerais
Email: luassunc@gmail.com
ORCID: 0000-0001-6106-1200

Rosimár Alves Querino
Universidade Federal do Triângulo Mineiro
Email: rosimar.querino@uftm.edu.br
ORCID: 0000-0002-7863-1211

RESUMO
Introdução: O ofício de benzedeiras compõe a cultura religiosa brasileira. Objetivos: Intenta-se compreender como o ofício das benzedeiras, em município mineiro, pode impactar o processo saúde-doença-cuidado nos territórios atendidos pela Estratégia Saúde da Família do Sistema Único de Saúde. Busca-se também identificar como os trabalhadores da atenção básica se posicionam em relação à presença da prática de benzeção. Metodologia: Trata-se de pesquisa qualitativa onde, a partir de entrevistas semiestruturadas, resgata-se as percepções de benzedeiras, usuários e enfermeiros. Para o tratamento do conteúdo das entrevistas foi utilizada análise temática reflexiva. Tomou-se Pierre Bourdieu como norte teórico para refletir sobre a autonomia dos campos de saber e suas disputas. Resultados: Identificou-se as seguintes categorias: Representações sobre a prática; Saúde e Religiosidade/Espiritualidade; Relações com a benzeção. Conclusões: A relação entre os campos não é apenas de conflito. Existe uma disponibilidade dos sujeitos que deles fazem parte que os tem colocado em comunicação. Nesse diapasão, o saber biomédico e o saber da benzeção, ainda que distintos e cumprindo funções específicas, podem ser aliados no processo saúde-doença-cuidado.
Palavras-chave: Atenção primária à saúde. Family Health Strategy. Medicina tradicional. Espiritualidade. Humanização da assistência.

ABSTRACT
Introduction: Benzeção is an integral part of Brazilian culture and religiosity. Objectives: The aim of this study was to understand how the practice of benzeção impacts the health-disease-care process in territories served by the Family Health Strategy in a municipality in Minas Gerais and explore primary care workers’ attitudes towards the practice. Methodology: We conducted a qualitative study using semi-structured interviews to capture the perceptions of benzedeiras, patients and nurses. The content of the interviews was analyzed using reflexive thematic analysis, drawing on Pierre Bourdieu’s theory of conflict between fields of knowledge. Results: The following categories were identified: representations of practice; health and religiosity/spirituality; relationship with benzeção. Conclusions: The relationship between the fields is not just one of conflict. The findings show that the openness of the subjects involved in the fields have placed the latter in communication. Thus, while biomedical knowledge and the knowledge of benzeção are different and fulfill specific functions, they can be used in combination in the health-disease-care process.
Keywords: Primary health care. Family Health Strategy. Traditional medicine. Spirituality. Humanization of care.

RESUMEN
Introducción: El oficio de las curanderas hace parte de la cultura religiosa brasileña. Objetivos: Se intenta comprender como el oficio de las curanderas, en un municipio de Minas Gerais, puede impactar en el proceso de salud-enfermedad-cuidado en los territorios atendidos por la Estrategia de Salud Familiar del Sistema Único de Salud. Se busca también identificar como los trabajadores de la atención básica se colocan con relación a la presencia de la práctica de la curandería. Metodología: Se trata de una investigación cualitativa donde, a partir de entrevistas semiestructuradas, se rescatan las percepciones de curanderas, usuarios y enfermeros. Para el tratamiento del contenido de las entrevistas fue utilizado un análisis temático reflexivo. Se tomó Pierre Bourdieu como norte teórico para reflexionar sobre la autonomía de los campos de saber y sus disputas. Resultados: Se identificaron las siguientes categorías: Representaciones sobre la práctica; Salud y Religiosidad/Espiritualidad; Relaciones con la curandería. Conclusiones: La relación entre los campos no son apenas de conflicto. Existe una disponibilidad de los sujetos que hacen parte de ellos que los colocan en contacto. En este sentido, el saber biomédico y el saber de la curandería, aunque distintos y cumpliendo funciones específicas, pueden ser aliados en el proceso salud-enfermedad-cuidado.
Palabras-clave: Atención primaria de salud. Estrategia de Salud Familiar. Medicina tradicional. Espiritualidad. Humanización de la asistencia.

Introduction
The Family Health Strategy (FHS) was introduced across Brazil in 1998. Its expansion in geographical and staff terms is irrefutable, meaning it is essential to consider diversity across the regions and municipalities where the family health teams operate. Brazil’s regions are unequal in many aspects (demographically, economically and culturally), making primary care and the FHS equally heterogeneous1,2,3. It is therefore essential to consider the diversity of municipalities in Brazil in order to understand the real world of health teams in the daily provision of care to meet patients’ health needs4.
It is important to take into consideration the singularities and pluralities of a given territory, as it is in this area that people form their individual and collective identities. Territory is the locus of material and symbolic exchanges, marking it as "used territory" or "everyday territory"5. "Living territory" is a space in which subjects are seen in their entirety (work, leisure, care, relationships and affects), thus requiring a broader approach to health care and the life process6.
The "living territory", of which family health teams are part, embraces different forms of health care. It is within this space that benzeção, or the act of praying for and blessing a person, emerges as a popular culture of care and listening. This practice, which was criminalized for some time, has been regulated/legitimated in some regions of the country7, and now has the possibility of being declared intangible heritage in the state of Minas Gerais thanks to Bill 2024/20248.
The institutionalization of the craft of benzedeiras (women who pray for and bless people) is strongly linked to the Movimento Aprendizes de Sabedoria (Apprentices of Wisdom Movement – MASA), from the state of Paraná. The aim of the movement is to coordinate strategies of resistance and confrontation implemented by traditional peoples and communities in the state9. Attitudes towards blessing vary from the recognition of its practices and acceptance in communities7 to approval by health professionals, as is the case of Maranguape in the state of Ceará10. However, benzeção and the use of this practice by the community is not legitimated within the law10. It is also important to note however that both the National Indigenous Peoples Health Care Policy (PNASP, acronym in Portuguese) and National Policy for Popular Education in Health (PNEP, acronym in Portuguese) include popular practices such as those performed by traditional midwives, benzedeiras, raizeiros (herbal healers) and pajés (shamans)11.
Drawing on Bourdieu’s12,13 theory of conflict between fields of knowledge, the aim of this study was to examine the relationship between religiosity/spirituality and health. By emphasizing the necessary autonomy of fields, the Bourdieusian perspective understands that tension between different domains is inevitable.

Methodology
We conducted a qualitative study with 15 family health teams (FHTs) working in the urban area of a municipality with 102,217 inhabitants14 in the of Pontal do Triângulo Mineiro region, in the state of Minas Gerais. There are no FHTs in the municipality’s rural area.
Data collection began in September 2023, when the lead researcher met with members of all the municipality’s FHTs at the municipal department of health to explain the study purpose and procedures and invite them to participate. While the invitation was made to all FHT members, there was a particularly strong presence of nurses.
Those attending the meeting suggested that the mapping of benzedeiras should be carried out by nursing professionals, who deliver care in the community daily together with community health workers (CHWs). It was also decided that the questions on the form regarding the presence of benzedeiras in the catchment area and identification of patients who used their services should be filled in during a meeting between professionals enrolled in the study and CHWs. During the data collection process, changes were being made to health center management, team composition and hiring of CHWs. The nurses were in general the longest serving team members and met the inclusion criteria, making them key interlocutors in the study.
The form results showed that benzeção was practiced in eight of the 15 territories covered by the FHTs. The form also contained the following open-ended question: "What do you think about the use of benzeção by patients?". The responses were analyzed using reflexive thematic analysis15.
In the second phase of the study, semi-structured interviews were conducted with patients, benzedeiras and nurses from the FHTs in the eight territories. The following inclusion criteria were used: health professionals who had been working in the health center for at least a year; patients living in the municipality who had been using the health center’s services for at least a year and used benzeção; and benzedeiras living in the municipality who had been practicing in an area covered by a FHT for at least a year. Informants under the age of 18 and professionals on sick leave were excluded.
The sample was originally intended to be made up of 24 participants. However, one of the benzedeiras was hospitalized during the study and one patient decided not to take part in the study. The final study sample therefore consisted of 22 participants: eight nurses, seven benzedeiras and seven patients. The recorded interviews were conducted between October and December 2023 in health centers and at the patients’ and benzedeiras’ homes.
The data were analyzed using reflexive thematic analysis15, in which the researcher plays an active role in identifying patterns in data as part of a process that is not linear but rather recursive and iterative, moving backwards and forwards between phases as necessary16.
The study was approved by Minas Gerais State University’s research ethics committee (reference code 6.438.838) and conducted in accordance with the ethical norms and standards set out in National Health Council Resolution 466/117. All participants signed an informed consent form. To protect their identity, study participants are named using a letter for each category followed by the order in which they were interviewed: benzedeiras (B1, B2, etc..); nurses (N1, N2, etc..); patients (P1, P2, etc..).

Results and discussion
All the municipality’s FHTs work in urban areas. Eight of the 15 FHTs recognized the existence of benzedeiras in the health area.
Table 1 – Characteristics of study participants (religion, gender, age, skin color, marital status, education level and length of time using or practicing benzeção)
The nurses were predominantly women (87.5%), white (62.5%), Catholic (73%), aged between 30 and 40 (75%), married/in stable union (62.5%) and had completed a specialist training course (75%) (Table 1). Among the nurses who used benzeção (87.5%), 50% were Catholic and 25% were Kardecists, and 62.5% had completed a specialist training course.
The benzedeiras were all women aged 61 years and over. They were predominantly Catholic (57%), brown (43%), married/in stable union (57%) and literate (85.7%), and started to practice benzeção at different ages: between 7 and 10 years of age (43%) and between 11 and 19 years of age (43%) (Table 1).
The patients were also predominantly Catholic, exclusively (28.5%) or together with other religions (42.9%). Most of the patients were aged between 30 and 40 years (43%), single (43%) and black (86%), with 28.5% not having completed primary school and 28.5% having completed a specialist training course. The majority of patients reported that they had been using benzeção since childhood (85.7%) (Table 1).
The analysis of the nurses’ answers to the question "What do you think about the use of benzeção by patients?" revealed the following attitudes towards benzeção: faith-related practice; culture-related practice; a resource that helps in difficult times; respect for religious diversity; a practice that is allied with medical treatment; a practice that is submissive to medical rationality (Figure 1; Box 1).
Figure 1 – Family health team nurses’ attitudes towards benzeção
Box 1 – Subthemes and excerpts illustrating family health team nurses’ attitudes towards benzeção.
The thematic analysis of the interviews identified three categories that are consistent with a study conducted in another municipality in Minas Gerais7: (1) Representations of practice; (2) Health and religiosity/spirituality; (3) Relationship with benzeção. These three categories were divided into two core themes: benzeção in the religious field (Theme I); and the scientific field and the religious field (Theme II). The results of the thematic analysis of the interviews are shown in Box 2.
Box 2. Thematic categories identified in the interviews with FHT nurses, benzedeiras and patients.
The results and discussion section is structured around both the thematic categories identified in the responses to the open-ended question on the form and those identified in the interviews.

BENZEÇÃO IN THE RELIGIOUS FIELD
Representations of practice
Benzeção is dominated by Catholic18,10 women18,10,19 aged between 64 and 80 years. This profile is consistent with that of the benzedeiras participating in this study.
The practice is seen as a family tradition passed down orally19,7 from generation to generation18,7,10,19,20 and as part of Brazilian culture7,18,20. According to some of the interviewees, benzeção is a gift10,7, meaning that not just anybody has the vocation. Benzeção should therefore be free, and no restrictions should be applied to the times a patient is seen7.
It is an action that requires faith from both parties (the benzedeira and the person receiving the blessing). Faith is therefore a fundamental element of benzeção, and is indispensable for achieving results18,21,22,23. Co-participation in the healing process occurs in the form of knowledge exchange, accompanied by dialogue and mutual listening between the caregiver and the cared for18,22, cultivating “affective labor”24, where both parties are affected.
The most commonly used instruments are prayer and plants. The laying on of hands and use of medicinal plants are integrative and complementary practices (ICPs), and are very similar to prayer with the laying on of hands and use of plants by benzedeiras25. Prayer is a form of complementary and alternative medicine and is intrinsically linked to faith, both of which have been related to improvements in physical and mental health18,21,23.
The use of medicinal plants is a popular care resource20 and common practice in the work of benzedeiras, as shown by a qualitative study18 conducted in municipalities in Minas Gerais. Other scholars also mention the use of plants in benzeção18,7,21,20,23,26,27.
According to the Ministry of Health, ICPs “are therapeutic resources that strengthen the care provided by the SUS [Sistema Único de Saúde or Unified Health System, the country\'s public health system] and broaden the population\'s perception of autonomy and self-care”25(s/p). They are therapeutic approaches aimed at disease prevention, health promotion and recovery and focused on active listening, building a therapeutic bond and promoting “a connection between human beings, the environment and society”25(s/p). Access to these practices was formalized by the National Integrative and Complementary Practices Policy (PNPIC, acronym in Portuguese), and they are currently offered mainly in public primary care services25. However, as Teixeira28 points out, benzeção has yet to be included in complementary health policies in the SUS.
The tensions that lie within the institutionalization of ICPs are a sign of the diversity of understanding and knowledge in the field, which includes conflicts between scientific and popular knowledge. The nature of relationships between fields vary from place to place. In Sobral in the state of Ceará, while benzedeiras are not included in the PNPIC, they are considered non-formal health agents who contribute to community engagement, the identification of potential health needs and patient referral26. In health services in some cities and regions they are also regarded as “healing agents”, and benzeção is considered a health resource and popular therapy29, attesting to its recognition as popular knowledge and an integral part of the health care process10.
The role played by benzeção and the reasons people seek this practice vary. Benzeção is commonly sought by parents for their children, with children accounting for the largest share of the demand for these services and some benzedeiras choosing only to bless children30.
How many times have my girls had a scare that changes the wind? The elders say "change the wind", you give them medicine and it doesn\'t work, go and get them blessed, that’ll sort it out. That rash you get now and again, go and get them blessed, that’ll sort it out.(P2)
According to Avelar Filho31, rural communities have their own language that conveys the way rural people express themselves and promote their values and identity. As can be seen in the words of P2, certain expressions are found throughout the narratives of both patients and benzedeiras, such as: espinhela caída (collapsed sternum) = lumbago or lombalgia (back pain); ventre (or vento) virado (upturned tummy) = diarrhea; cobreiro (rash) = herpes zoster; quebranto (or quebrante) = feitiço or bewitchment; mau-olhado (or olho gordo) or evil eye = envy.
In adults, benzeção releases negative energy and is an active listening tool, providing relief and reassurance. People often seek benzeção when they are not sure what is wrong with them and wish to get better. Thus, people may ask to be blessed for either physical, psychological or social reasons32.

THE SCIENTIFIC FIELD AND THE RELIGIOUS FIELD
Health and religiosity/spirituality
This theme highlights the wider relationship between health and religiosity/spirituality, revealing health professionals\' knowledge of and familiarity with the territory on the one hand and mutual respect for religious diversity among professionals (as sometimes different beliefs are not respected by co-workers), the absence of religious discrimination and openness to religious pluralism among peers and patients on the other. The analysis shows that nurses respect patients’ religion and that while the focus in the health center is patient health, there is no religious discrimination when it comes to care and assistance. However, studies have shown the existence of "cordial" discrimination, where certain religious practices are invisibilized and looked down on33.
It is therefore important to respect patients\' beliefs, and health workers should be aware of patients\' religious beliefs, especially when it comes to older patients. The latter often have religious needs, which need to be supported and accommodated ethically and with respect. In this respect, a study emphasizes the importance of considering the influence of religion on care practices and meeting patients’ specific religious needs33.
According to the authors33, individual life experiences and knowledge should not be disregarded by a colonial mindset (conventional medical knowledge) that look downs on, avoids and ignores other unestablished knowledges regarding healthcare, demonstrating a lack of lack of cultural competence. Health equity requires an understanding of the influence of religiosity/spirituality on health care and therapeutic practices33.
Learning to deal with the religious/spiritual dimension comes from practice. The accommodation of religious needs occurs on a day-to-day basis, through active listening during care. There is no preparation to deal with this reality. In addition to the fact that there is no specific training for dealing with religiosity/spirituality, not all health workers are sensitive to these aspects. Evidence shows that addressing patients’ religious/spiritual needs in clinical practice is linked to reduced mortality and improved quality of life and mental health. However, lack of training is an obstacle. These dimensions are not even mentioned in the national medicine curriculum guidelines, showing a lack of openness to religiosity/spirituality in the documents that govern medical knowledge in Brazil32,34.
While not all CHWs are trained to deal with religious/spiritual issues, they hold a significant amount of knowledge about a given territory and deeply identify with the area, having intimate knowledge of the community and their religious and spiritual beliefs. According to a previous study35, despite attempts to characterize CHWs as professionals without technical training, these workers possess a unique identity inclined towards community leadership, social belonging, active listening and building bonds with the community.
It is believed that there is a relationship between health and religiosity/spirituality. Faith, regardless of religion, combined with scientific knowledge, can help. It is not only the patient\'s faith that matters, but also the health worker\'s, since the impact of religiosity/spirituality on health care can affect both parties. Faith may not necessarily provide the cure, but it can ease suffering. As one study suggests, beyond concrete solutions to health problems, there is a hidden human quest for the valorization of subjectivity36.
The pursuit of religiosity/spirituality is a very individual thing. The discovery of an illness sensitizes the individual, encouraging them seek treatment (which may include, for example, benzeção). In limit situations such as palliative cancer care, patients may request spiritual support in tandem with medical treatment, because religion can often provide comfort33.
Finally, according to one of the interviewees, while the biomedical model fails to consider the individual as a holistic being, one of the diagnoses in the Nursing Diagnosis Handbook (NANDA) is impaired spirituality. Despite the handbook, based on their own experiences in their everyday practice, nurses believe that religiosity/spirituality has an impact on health7,33. Nurses make an effort to respect the parallel pursuit of medicine and religiosity/spirituality, always questioning certain potentially harmful practices (for example, herbal baths for infants using picão, a medicinal plant widely used in local communities to treat jaundice in newborns (N1); and the use of herbal teas to treat wounds in adults)29,7,37. P1 explains that it is possible that patients rely on both fields of knowledge without conflict:
Sometimes we go to the doctor looking for a cure to a health problem, but sometimes it\'s spiritual. So we go to the doctor and it doesn\'t go away, and so we go to the benzedeira, and the situation gets better. I think it\'s good to try both options, right? Because you never know where the problem comes from, right? (P1)
Thus, alternative medicine does not seek to question scientific knowledge as knowledge per se, but rather the pathologization, medicalization and commercialization of life. Popular care, like the biomedical model, is just one of an array of healing systems and approaches that can complement each other, without one system imposing an ideology of validity and superiority over the other38. They are complementary in that they can be used together, but the approach to care employed by alternative medicine differs from that of the biomedical model39.

Relationship with benzeção
It\'s important, isn\'t it? Because you seek real medicine, right, but you also seek the resources [that are available] in the area, benzeção, which helps, right? (B6)

The relationship between medical practices and benzeção ranges from conflict to dialogue/complementary practice. Dialogue stands out more and is recurrent in the accounts of the different categories of participants (benzedeiras, nurses and patients), with conflict being mentioned when a popular practice is used as a substitute for medical treatment. In contrast, when the alternative treatment is used as an integrative practice, it is viewed as successful (N8). The nurses believe that integrative practices associated with conventional medicine provide benefits (N8).
A previous study suggests that by emphasizing welcoming and active listening (soft and humanized care technologies) ICPs are accordant with comprehensive care. They can therefore be viewed as both alternative and complementary to conventional treatment40. Despite the implementation of the ICPs and the World Health Organization’s traditional medicine strategy41, a study detected setbacks in the recognition of these practices by medical knowledge18.
The substitution of medical treatment mentioned above is exemplified by patient refusal to take prescribed medication and use the popular pharmacy (N3). When it comes to treating wounds, professionals advise against the use of certain potentially harmful popular practices (N3)29,7,37.
Concerning conflict, interviewees report that people may seek benzeção due to lack of support in health services; “medicine didn\'t sort it out, and benzeção did”; “there are illnesses that aren\'t for doctors”. According to the patients, "spiritual medicine" provides answers that scientific medicine cannot offer (P1), and there are problems, spiritual issues for example, that only benzeção can solve (P4). Medicine and religion are therefore viewed differently, with both fulfilling its own function (P6): there are things that are for medicine and things that are for benzeção (P6). This is consistent with the findings of a previous study7.
Thus, from the patients’ perspective, benzeção goes hand in hand with science (P1), and both fields can dialogue with each other, with the latter dealing with physical issues and the former with issues of the soul or spirit. The health center is there to treat matter and the benzedeira to treat the spirit/soul, as illness may sometimes be linked to the spiritual plane, meaning sometimes medicine alone cannot provide the necessary support. It is therefore important to try on both fronts (the scientific and religious/spiritual), meaning that medicine and benzeção can complement each other, as highlighted by other studies29,7,42,43.
According to B5, seeking both types of knowledge is not a problem since not everything is for the doctor and not everything is for the benzedeira. This reflection illustrates the type of dialogue and communication both types of knowledge establish with patients. This is why health workers need to experience cultural diversity, since culture can influence the type of communication and dialogue established. Lack of interaction with different cultures and languages can lead to conflict and adversely affect adherence to conventional treatment, which adopts a technical and rationalist language44.
Our findings also show that benzedeiras and doctors have a good relationship: “Doctors can\'t solve cobreiro (rash) and send the patient to the benzedeira” (B4). Some doctors do not believe in the work of benzedeiras, while others trust them and refer patients to them (B4)7. In the dialogue between doctors and benzedeiras, the latter show greater interest in contributing to the health system, meaning that the exchange remains one-sided45. The following statement by B4 is insightful: [Benzeção] is a science that even we don\'t really understand, but it works.
Benzeção is seen as a "science" in the sense that it has its own logic and rationale, which somehow work. Benzedeiras therefore hold specific knowledge about illnesses that doctors have no grasp of. On the other hand, when the benzedeira realizes that the person needs to go to the health center, she advises them to go to the doctor (B6), as shown by other studies29,7,45,26. This attitude in turn shows the benzedeira\'s interest in reconciling her popular knowledge and science45.
This alludes to a possible complementary relationship/partnership between the two types of knowledge where, according to health workers and patients, the concurrent use of medicine and religion is seen as a solution rather than a problem. It is believed that they can go hand in hand, as long it does not adversely affect the medical treatment7.
Our findings show the importance of engagement between scientific and popular knowledge. While some problems are "just for medicine", other healing processes go beyond science alone. Medicine and religiosity/spirituality are thus not self-sufficient.
Finally, the health professionals highlight that it is important to consider the patient as a whole: as long as the use of medical resources and benzeção is good for the patient; what matters is the patient’s well-being. It is therefore important that health professionals are aware that popular beliefs and practices can constitute care, making a unique contribution to patients and their families and playing an important role in the promotion of health, wellbeing, support and welcoming22.
In contrast to Bourdieu’s12,13 theory of conflict between fields of knowledge, our findings show that the relationship between the fields in this study is not just one of conflict, but rather dialogue, often being possible to bring them into communication, depending on the ideologies shared by the subjects involved.
From this perspective, the participation of benzeção in health can be seen as an additional resource in the promotion of physical, psychological and social health rather than an obstacle to conventional medical knowledge and practice. In this sense, the central issue is the linkage between religiosity/spirituality and health as a process rather than a product, thinking of religiosity/spirituality and its dialogical engagement with other spheres of life.

Conclusions
Benzeção is a practice performed predominantly by Catholic women. It is a family tradition passed down orally from generation to generation that is part of Brazilian religiosity and popular culture. It is viewed as a gift that cannot be practiced by just anybody. Benzeção is free of charge and no restrictions should be applied to the times a patient is seen. It is an action that requires faith from both parties (the benzedeira and the person receiving the blessing) to work. The most commonly used instruments are prayer and plants.
The relationship between benzeção and conventional medicine ranges from conflict to dialogue/complementary practice. According to the interviewees, the concurrent use of scientific knowledge and popular/religious knowledge is viewed as a solution rather than a problem. Dialogue stands out more and is recurrent in the accounts of the different categories of participants (benzedeiras, nurses and patients), with conflict being mentioned when a popular practice is used as a substitute for medical treatment. Future studies should include professionals who do not use benzeção to explore their perceptions and potential conflicts with the practice.
Benzeção is seen as a field of knowledge in the sense that it has its own logic and rationale, which somehow work, with benzedeiras holding specific knowledge about illnesses that health professionals have no grasp of. The allusion to benzeção as a "science" by one of the study participants underlines the breadth of popular knowledge and the extent to which it can impact care practice. The referral of patients to doctors by benzedeiras and vice versa highlights the bridge between popular knowledge and the scientific field and the permeability of their boundaries.
Dialogue and partnership emerge from a perspective of "lack" or “non-self-sufficiency”, both in benzeção and medicine. Contact between these fields of knowledge gives rise to both conflict and dialogue. The findings show that the openness of the subjects involved in the fields have placed the latter in communication. Thus, while biomedical knowledge and the knowledge of benzeção are different and fulfill specific functions, they can be used in combination in the health-disease-care process.

Funding: This study was supported through a research productivity grant provided by Minas Gerais State University (UEMG) - PQ/UEMG.

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