COVID-19 in Isolated Amazonia

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In April, in Brazilian Amazonia near the Venezuelan border, a 15-year-old Yanomami boy became the third indigenous Brazilian to succumb to COVID-19. Buried an hour after his death without parental consent or the traditional Yanomami cremation practice, this young man’s death highlights the unique challenges faced by patients and health-care practitioners as the virus spreads deeper into the most isolated parts of the globe.

Rural South America, from the Andes to the Amazon, was among the last places on Earth to be touched by the SARS-COV2 virus. Yet, with Brazil’s slow response to suppression of the virus and ever-growing disease prevalence, even the most isolated indigenous groups have been affected. According to the Articulation of Indigenous Peoples in Brazil, by May 9th, there were over 220 infections and 55 deaths from COVID-19 from 30 different indigenous groups.

 

Three Yanonami people in informal settlements in the streets of Boa Vista

Photo: Brazil, family in improvised home.

Brazil is home to nearly 900,000 indigenous people making up over 300 different ethnic groups. In the most remote parts of the Amazon rainforest, an Austria-sized area called the Javari Valley, 16 of the 26 resident groups choose to remain completely isolated from Brazilian nationals. This decision was made in the 1980s in conjunction with the National Indian Foundation of Brazil (FUNAI) after sociopolitical disruptions and measles and pertussis outbreaks nearly decimated tribal populations.

These tribes, FUNAI, and Brazil’s national government now find themselves at a crossroads between respecting the long-standing no-contact agreements, which in part may aid in preventing further spread of the virus, or overruling the agreements to deliver more appropriate testing and medical care. In other places in Latin America including Peru and Bolivia, indigenous territories normally open to receiving outsiders have been closed for fear of contamination. These restrictions have been violated both by tourists and by hydrocarbon extraction companies that continue to expand into indigenous land, acts which many feel compromise the health of vulnerable populations.

The number of accessible physicians in the rural Javari Valley has plummeted since late 2018 when the Mais Medicos (More Doctors) program which brought Cuban physicians to rural Brazil, was abruptly ended, disproportionately impacting indigenous populations. Indigenous representatives and FUNAI officials have called upon the Brazilian government to send healthcare professional and sanitation equipment to these rural areas. Brazil’s indigenous peoples are among the most vulnerable to SARS-COV2 infection as their immune systems are often compromised due to limited contact with outside groups, unimproved sanitation structures, and high prevalence of malnutrition and diabetes, a major risk factor for COVID-19. In some groups such as the Yanomami, it is traditional for people to live in collective houses, or Xanapo, making self-isolation and quarantine difficult.

The rates of testing, infection, and deaths among indigenous peoples have proven difficult to track. Indigenous people are marked as “white” by the Brazilian census, an act that some tribal members have called “a denial of our existence, an erasure,” and that makes it difficult for people to track down ill friends and family and for epidemiologists and public health researchers to determine the true burden of disease among Amazonian groups. From the available numbers, native people appear to be dying at a disproportionate rate. 125 of the 980 native people who have tested positive for COVID-19 have died, a 12.75% mortality rate that eclipses the 6.4% national average.

Facing a growing threat to the preservation of their populations, languages, and cultures, many Amazonian peoples such as the Yanomami have taken measures into their own hands. While some Yanomami families sheltered near healthcare posts have opted to stay put, many with less access to care have fled into the rainforest to escape contamination, following in the footsteps of their ancestors when faced with measles and sociopolitical threats. Those who have fled communicate their news and whereabouts to the Hutukara radio, a centralized foundation of information for the Yanomami people.

Local shamans are working hard to find a cure for the xawara, or epidemic, hoping traditional healing modalities will find a treatment that still evades Western biomedicine.

For the most up-to-date information on the state of the indigenous Brazilians during the pandemic, visit Amazônia Real.

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