Deep in the Amazon,
The Best Doctors
Arrive by Air Mail
To Treat Machete Cuts, Bites,
Brazil Flies Medical Team
To Isolated Parts of Jungle
By MATT MOFFETT
Staff Reporter of THE WALL STREET JOURNAL
October 13, 2005; Page A1
ITAMARATI, Brazil — Enock Cavalcante hadn’t been well since lightning struck the outhouse he was in during a violent storm in this Amazon jungle town not long ago. In August, he began losing feeling in his legs and suffering blackouts. Mr. Cavalcante’s family didn’t think he’d survive the 15-day boat ride to the nearest large hospital, in the city of Manaus.
Fortunately, the Brazilian Air Force’s National Air Mail squad was nearby. National Air Mail isn’t a letter-carrying service — it’s an airborne medical unit making rounds in the most isolated parts of the jungle. Briefed on Mr. Cavalcante’s condition, Air Mail doctors concluded the man’s only chance was to be evacuated to a neurological specialist in Manaus. National Air Mail’s single-engine Cessna had to fly through a thick haze created by fires raging in the rain forest, but the aircraft picked up the patient on a ramshackle landing strip and whisked him away to the neurologist. Mr. Cavalcante’s condition has stabilized, town officials say.
Chalk up another successful mission for the flying medical specialists known by locals as “the Angels of the Amazon.”
National Air Mail started flying in the Amazon in the 1930s when its rickety planes not only ferried in doctors and mail, but also explored new territory and made contact with Indian tribes. With daredevil pilots legendary for using the river as a navigation guide, as well as an emergency-landing zone, National Air Mail’s role in regional development was enshrined in Brazil’s constitution in the 1940s. By the late 1980s, though, National Air Mail had been grounded by military reorganizations and budget cuts.
Last year, the government restarted airborne medical missions, reviving the storied Air Mail name, as part of a push to more closely link the Amazon with the rest of the country. Three times a month, teams of half a dozen or so Air Force physicians and nurses fly week-long medical missions to small towns in the western Amazon. If a sick person needs more specialized care, doctors have the patient flown out by Air Mail pilots, who are old Amazon hands accustomed to changeable weather and potholed airstrips.
“Few people visit us, so when we hear that Air Mail plane engine, it is the most comforting sound you can imagine,” says Joao Campelo, a local political leader in Itamarati.
Plenty of outback inhabitants can vouch for the skill of Air Mail fliers and doctors. When Carlos Jamamadi, a Jamamadi Indian, was bitten by a deadly jararaca snake not long ago, the Air Mail service saved his life by swiftly evacuating him to a hospital that had snakebite serum. Air Mail doctors also tended to the stab wounds and broken arms of rubber-tapper Elizário Lopes after he’d gotten the worst of a machete fight with a colleague. Two of the tapper’s friends had carried him 10 miles on a litter to the doctors.
Sometimes even the Angels run out of miracles. Early this year, Air Mail doctors treated 7-year-old Josué Rodrigues for tetanus after he’d gotten a large wooden splinter lodged in his foot. The boy joked and posed for photos on the flight to the hospital in Manaus. But several days later the medical team found out that he had died of complications from the infection.
Brazilians appreciate the Air Mail’s can-do spirit, especially at a time when many of the country’s politicians are being discredited by a massive corruption scandal. Just two decades after the end of a repressive military dictatorship, a recent public-opinion poll revealed that the armed forces were the most trusted institution in Brazil.
A seven-member Air Mail mission in August treated hundreds of cases, from malaria, to an emergency Caesarean section delivery, to simple tooth extractions.
The first town on the route, Juruá, recently saw its only two doctors, Peruvian immigrants, pull up stakes for better-paying jobs in a larger and more livable city. Capt. Marcus Aurelio Bezerra de Andrade, a 44-year-old pediatrician who headed the Air Mail mission, saw the void left by the absent doctors when he treated an acutely malnourished 8-month-old baby girl, who had a distended belly and who weighed about half the norm for her age.
Upon arriving in Itamarati, the Air Mail team encountered Raimundo da Souza, a former rubber-tapper who is enduring the physical scars and isolation from an old case of leprosy. All of his fingers have been amputated. He also has sores on his feet, a consequence of nerve damage that prevents him from feeling anything when he’s bumping into objects. Even though the leprosy has been cured, local social workers won’t go near Mr. da Souza’s cabin and the man’s brother won’t allow his nephews and nieces to visit. “I’ve been looking out for myself a long time,” says Mr. da Souza, who is so isolated he doesn’t know what month it is.
Air Mail doctors bandaged the man’s foot wounds and ordered him medicine for a skin infection he’d gotten from spending so much time on his back. The Air Mail team also tried explaining to Mr. da Souza’s brother that his children couldn’t contract leprosy from their uncle since he no longer has the disease. It’s clear the brother is going to take some convincing, the doctors say. Brazil is second only to India in the number of cases of leprosy, but the stigma is still fierce.
In the next town of Eirunepe, doctors had to move quickly when a badly bloodied and bruised fisherman was brought in for emergency treatment. The fisherman had been undercutting his competitors on price and the other fishermen settled matters with their fists, says Eduardo Fuji, his Air Mail doctor.
Moving on to the hamlet of Envira, the medical team was first relieved by what it didn’t find: There were no overdoses involving ayahuasca, a hallucinogenic drink prepared from a vine and used by a religious sect in the area. But while the doctors were breaking for lunch at a fish restaurant, a motorcyclist crashed into a bulldozer on the street outside. The physicians scrambled onto the street and put the biker’s fractured leg in a splint, before having him flown out for orthopedic treatment.
Throughout the journey, Dr. Andrade said he was struck by the kindnesses showered on the medical team by people who had so little. In one town, they were serenaded by a guitarist and in another treated to a tour of a resident’s makeshift zoo with a baby jaguar and giant turtles. The team was fed such bounteous meals of spicy Amazon dishes that by the end of the week some doctors had put on a couple of pounds. But Dr. Andrade was aware of the limitations of their efforts. “There are social problems here that are beyond a doctor’s ability to solve,” he said.
In Ipixuna, one of the poorest towns on the route, three babies had died recently from diarrhea caused by impure water. The doctors did what they could to save another child, Micael Conceicao, a 1-year-old who had a tennis-ball-size lump on his head from a fall in his jungle hut.
Dr. Fuji told Micael’s mother, Maria de Souza da Conceicao, that it was imperative the baby be flown out to a city hospital for surgery on the growing lump. “There is very little time,” he explained. Clearly uneasy about sending her baby away, Mrs. Conceicao, said she’d think about it. But when the doctors went to the airport for their flight out that afternoon, there was no sign of Mrs. Conceicao or the baby. The Air Mail team waited for a while, but it had patients to attend to in the next town, and eventually flew off.
A couple days later, though, the doctors discovered that Mrs. Conceicao had had a change of heart and put her baby on a commercial flight to the hospital. A surgeon drained blood from the lump and Micael was later returned to his village in good health.
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