INTRODUCTION:
Land regularization is a structural determinant of access to public policies in rural areas. In agrarian reform settlements that have not yet been titled, legal insecurity can exacerbate social and health vulnerabilities, restricting access to water, sanitation, and health services.1,3,4 This study describes living conditions and access to primary care in a rural community that has been organized for two decades but still lacks formal land regularization.

METHODS:
Experience report derived from the pilot study of a doctoral research on health and access to primary care in rural settlements in southeastern Brazil. Home visits were conducted, a structured questionnaire was applied to five residents, and qualitative listening sessions were carried out with seven community members to explore daily life, living conditions, and interactions with public services. The area is rural, sparsely populated, and located about 30 km from the referral health service.

RESULTS:
Precarious housing without basic sanitation was observed, with rudimentary cesspits and limited access to treated water. Educational attainment was very low among residents. Access to health services is hindered by distance and irregular availability of care, with occasional medical attention and rare visits from community health workers. Despite these challenges, residents expressed strong appreciation for interdisciplinary outreach and research activities developed by public universities in the territory.

CONCLUSIONS:
The experience highlights the region's deprivation, the urgency of proper sanitation, difficulties in accessing healthcare, and governmental neglect. The slow pace of land regularization and limited access to essential public policies led many originally settled families to leave the area. It also shows the potential of partnerships between universities and rural communities to mitigate inequalities.