Capitalization of MSF Marajó project

The MSF Marajó project operated from March 2023 to June 2025 in Portel, a remote Amazonian municipality characterized by extreme territorial duality between urban areas with significant capabilities and isolated rural communities facing structural vulnerability. While initially designed as a Primary Health Care and Sexual and Reproductive Health intervention within Brazil's Unified Health System (SUS), the project underwent a fundamental strategic reorientation toward specialized sexual violence response after identifying systematic barriers that forced survivors to obtain police authorization before accessing medical care.

The intervention's central achievement was transforming Portel's response to sexual violence from a system centred on judicialization to a humanized approach focused on the survivor. Through strategic advocacy, institutional capacity building, and operational changes, MSF influenced local policy frameworks and established mechanisms that seek to institutionalize humanized care principles beyond the organization's direct presence.

This capitalization report analyses the project's strategic evolution, operational methodologies, and transferability potential, with particular emphasis on lessons learned for humanitarian interventions within formal health system contexts where legal frameworks can be reinterpreted rather than replaced.