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Racial and Ethnic Health Disparities"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This article is an ethnography of the Hitn\u00fc, a nomadic Indigenous people who, due to killings and threats, sought refuge in the city of Arauca, on the border with Venezuela (northeastern Colombia). It examines the urban experience of poverty and exclusion in a context of Indigenous rights and differentiated policies offered to the displaced and Indigenous peoples and demonstrates how different forms of violence affect their health and limit effective responses to illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>A four-month ethnographic study (2023\u20132024) was carried out, during which one of the authors lived with 68 members (12 families) of the El Alcarav\u00e1n settlement in Arauca, Colombia. The data provide insight into the settlement\u2019s living conditions, the experience of illness in the urban context, the search for medical care, and the manifestations of violence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Respiratory infections and diarrhea are common among the Hitn\u00fc, and cases of tuberculosis and Chagas disease were also identified. So-called \u201cmild illnesses\u201d are managed through family-based self-care and treatment provided by the cacique, whereas \u201cdifficult illnesses\u201d require biomedical intervention. Structural violence shapes both the burden of disease and the ways the Hitn\u00fc treat their ailments, particularly due to food insecurity, lack of drinking water, and inadequate sanitation. Venezuelan migrants, despite being foreigners, receive greater humanitarian assistance, generating tensions with the Hitn\u00fc. Physicians\u2019 practices tend to be hegemonic, highly medicalized, and revictimizing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Health services must be grounded in the actual needs of the Hitn\u00fc and guided by an intercultural approach based on the findings of this study. Ensuring a safe territory would prevent the reproduction of direct, structural, and symbolic violence, and reduce health inequities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40615-026-03043-6","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T14:23:34Z","timestamp":1781101414000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Illnesses, Violence, Forced Displacement and Differentiated Citizenship Among the Hitn\u00fc People from Arauca, Colombia"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-2226","authenticated-orcid":false,"given":"Claudia","family":"Amaya-Castellanos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5883-3000","authenticated-orcid":false,"given":"Esther Jean","family":"Langdon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5039-9449","authenticated-orcid":false,"given":"Francisco","family":"Ortega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"3043_CR1","unstructured":"Lobo-Guerrero M, Herrera X. 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Bogot\u00e1: Siglo Veintiuno Editores; 1991.","edition":"1.a ed"}],"container-title":["Journal of Racial and Ethnic Health Disparities"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40615-026-03043-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40615-026-03043-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40615-026-03043-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T14:23:46Z","timestamp":1781101426000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40615-026-03043-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":57,"alternative-id":["3043"],"URL":"https:\/\/doi.org\/10.1007\/s40615-026-03043-6","relation":{},"ISSN":["2197-3792","2196-8837"],"issn-type":[{"value":"2197-3792","type":"print"},{"value":"2196-8837","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"assertion":[{"value":"28 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the principles of the Declaration of Helsinki, the Belmont Report, and the Council for International Organizations of Medical Sciences report, based on the recognition of the free self-determination and leadership of Indigenous peoples to participate in research. The study was approved by the Ethics Committee of the Universitat Rovira i Virgili (CEIPSA-2023-TD-0065).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Informed consent was obtained from the participants, considering the customs and practices of the Hitn\u00fc Indigenous people. Consent was given by the cacique and each of the heads of households in the El Alcarav\u00e1n settlement.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Participants agreed to publish their reported data; anonymity was maintained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}