Several cities are becoming centres of viral transmission in the Amazon. An overview of the Amazonian regions of Brazil, Colombia, Peru and Ecuador.
Try to imagine living in a small community in the heart of the Amazon. You might have a one-room wooden house. Or you might live in a maloca, one of the large communal structures where many Colombian indigenous families live together. There would probably be just one health centre in your community, and sometimes not even that. If there is one, it would stock only the most essential medicines. To reach the nearest hospital you would have to travel by river for many hours, or sometimes days.
Now imagine all of this in the midst of the global coronavirus pandemic.
"The Amazon is in the midst of an emergency," said Gregorio Díaz Mirabal, president of Coica, the Coordination of Indigenous Organisations of the Amazon Basin, which represents the more than three million native inhabitants who share this territory across nine states. According to Coica, more than 40,500 coronavirus cases and at least 2,500 deaths have been recorded in the region. "We are asking for international help. If we keep waiting for governments to act, our people will continue to die. And we do not want to become extinct," said Díaz Mirabal during the virtual launch of the Amazon Emergency Fund, which was attended by several indigenous leaders. The Zoom background shows ethnic headdresses representing the different communities.
The emergency fund was established by Coica, several national indigenous organisations and at least 19 non-governmental organisations, including Amazon Watch, Rainforest foundation US, Amazon Frontlines and Rainforest action network. The goal is to raise at least three million dollars in two weeks, with a final target of five million. The funds raised will be used to purchase and distribute essential goods such as food, protective equipment and medicines among indigenous communities.
The largest city in the Amazon, Manaus, has featured in newspapers around the world for the high number of coronavirus infections and deaths. It has been compared to Guayaquil in Ecuador, arguably the worst-affected area in all of Latin America. The first case in the Brazilian region was recorded on 25 February, and to date the municipality of Manacapuru, part of the metropolitan region of Manaus, has the highest concentration of Covid-19 infections and deaths in proportion to its population.
President Jair Bolsonaro has openly downplayed the crisis, and several public health experts agree that this behaviour is one of the causes of the high number of cases in Manaus. "People do what the president says, spreading the infection and causing deaths," says Pedro Rapozo, secretary of Sbpc, the Brazilian Society for the Advancement of Science, which recently called on the federal government to pay attention to the situation in the Amazon. "People are continuing with their daily lives almost as if nothing has happened."
"Around ten per cent of Covid-19 deaths in Brazil are in the Amazon region. The healthcare system has simply collapsed, and the same can be said of funeral services. The high mortality rate reflects the inefficient health policies in the state of Amazonas. We are seeing the results of years of underinvestment in healthcare services," Rapozo adds. Mass graves have been dug and hospitals in Manaus can no longer cope. Moreover, many people are unable to reach hospitals and simply die in their communities, are never tested and will probably never be counted in the coronavirus death toll statistics.
Rapozo also points out that indigenous people are the most vulnerable, because they have a higher incidence of other health problems, live far from healthcare facilities and often in poverty. Even more vulnerable are populations living in voluntary isolation, because diseases from the outside world pose a genuine threat to their existence. Rapozo considers the doubling of cases within the space of a week in the region of Amazonas and in the regions of Loreto in Peru and Amazonas in Colombia to be particularly worrying. Furthermore, given the vastness of these territories and the low population density, many cases will never be discovered, let alone recorded.
"We have no way of reaching most of the population," says José Joaquín Carvajal Cortés, biologist and researcher at the renowned Fiocruz Amazonia institute in Manaus, regarded as one of the most important public health research institutions in the world. "The area has almost no healthcare infrastructure and indigenous populations are more vulnerable to this type of respiratory disease. History shows us how diseases like this can destroy entire native populations. Hospital beds ran out within a week."
In Colombia, the virus reached the state of Amazonas relatively late, on 17 April. "At first we thought that Amazonas's natural isolation would protect us," explains Ángela López Urrego, a doctoral student in Amazonian studies at the National University of Colombia at Leticia (the capital of Amazonas) and a member of the indigenous organisation Capiul. "But we were wrong, and now we are seeing exactly the opposite."
Urrego describes the chaos that overwhelmed Leticia when the virus arrived: "Our healthcare system collapsed practically at the first case. There were something like five beds and the healthcare staff were not prepared for Covid-19. Not at all." At one point all hospital staff resigned, including ambulance drivers, in protest at the lack of equipment and facilities. After reaching an agreement with management, they returned to work. Now in Amazonas the percentage of Covid-19 cases relative to the population is eighteen times higher than the national average, and there have been days when the number of cases exceeded that of Bogotá, the capital. "We will take control immediately," was the comment of Health Minister Fernando Ruiz after visiting Leticia.
"We are the corruption capital of Colombia," López added. "With the money theoretically earmarked for hospitals, not a single facility has been built. If there is a silver lining to the Covid-19 epidemic in Leticia, it's that many gaps have been exposed. Many cases of corruption have come to light."
"We do not intend to repudiate the state, but we are calling for coordination," announced Coica president Díaz Mirabal at the launch of the emergency fund. "In the Amazon the state has intervened up to a point, but there have been cases where military and medical personnel themselves have spread the infection. Aid should arrive following strict prevention protocols."
Peru has responded more robustly than Brazil, and President Martin Vizcarra's positions are far removed from those of Bolsonaro. Yet Iquitos, the capital of Loreto and the country's "Amazonian capital," famous for being the largest city in the world unreachable by road, is on the list of the highest-contagion areas in Latin America. The BBC reports that the governor stated the city can cremate up to four bodies a day, but the daily death toll is already higher. Basic medical supplies are lacking and hospitals have completely collapsed, with the number of patients far exceeding the number of beds.
According to the Peruvian communications agency Servindi, in a delegation from the municipality of Trompeteros in Loreto, four people tested positive for the coronavirus after visiting at least 18 indigenous communities along the Corrientes river to distribute food. On 20 April the distribution work was halted, as part of the crew was showing acute symptoms. Among those involved is also the mayor of the municipality.
In Ecuador the government's attention has been completely absorbed by the extreme emergency in Guayaquil. The Inter-American Commission on Human Rights has released a statement expressing serious concerns about Covid-19 infections among the Seikopai people, a small indigenous group in the Amazon. Out of a total population of 744 people, 15 cases have been recorded and two elderly people have died. This is a worrying example of the vulnerability of indigenous peoples in the Amazon during the pandemic.
And there are many other similar cases. "I have been informed of cases among the Shuar and the Ashuar in areas such as Pastaza and Napo," says Roberto Narvaez, an anthropologist and human rights specialist with more than twenty years of experience studying and working with indigenous communities in Ecuador. "Access to healthcare is absent in the Amazon. The authorities responsible may be committing the crime of genocide, since it has already happened historically that entire populations have been wiped out by epidemics like this one. This could lead to the imposition of national and international penalties against the government," Narvaez states, expressing his concerns.
There are many similarities between the various areas of the Amazonian region inhabited by indigenous populations that display a great variety of cultural traits. Geographically it is a zone that is very difficult to control. Many illegal activities are still being carried out, such as oil and mineral extraction, logging and timber transport, and coca cultivation. This means that all the people working in these activities risk bringing the virus into remote areas. In addition, healthcare infrastructure and access to health services and information are scarce, while corruption is rife. Alongside the creation of the Emergency Fund, indigenous organisations in Brazil have recently called on the World Health Organisation for help. "Our governments are buried in debt," Díaz Mirabal notes. "We need international help to face this emergency that concerns the whole world. Because we must protect the Amazon."
Translated by Elettra Tsikoudis
