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For Amazon indigenous facing COVID-19, distance to ICU beds poses dire threat

  • Remote indigenous communities deep in the Brazilian Amazon lack access to the ICU beds and pulmonary ventilators that have become essential during the COVID-19 pandemic, a new mapping initiative shows.
  • More than half of the 3,141 villages analyzed are more than 200 kilometers (120 miles) from an ICU bed, and 10% of these villages are more than 700 km (435 mi) away.
  • A case in point: The Yanomami people of Maturacá village would need to travel three hours by plane to a health facility that has a ventilator; in some of the most distant villages, travel by river can take more than a week.
  • Even when they reach a health facility, there are fewer than 5,000 ventilators across Brazil’s entire Amazon region, and more than half of municipalities — home to more than 8 million inhabitants, including 203,000 indigenous people — don’t have one at all.

COVID-19 in the Amazon

COVID-19 represents a particularly insidious threat for remote villages in the Amazon, where the nearest ICU bed is, on average, 315 kilometers (nearly 200 miles) away. The distance for some can be more than three times greater, and even then most Amazonian municipalities lack pulmonary ventilators.

In these regions, keeping entire villages socially distant from outsiders is essential, but the encroachment of illegal loggers, miners and land grabbers, as well as travelers to and from the cities, poses a looming threat.

As of May 18, 537 COVID-19 cases and 102 deaths have been reported by 38 indigenous groups in Brazil.

The nonprofit InfoAmazonia has generated a series of graphics illustrating the distances from villages to ICUs and ventilators using data from the National Registry of Health Facilities of the Brazilian Health Ministry and the location of Amazonian villages available in the SisAldeia registry run by Funai, the federal agency responsible for indigenous affairs. InfoAmazonia says this is a collaborative mapping project and is not inclusive of all Amazonian villages.

Over half (58.9%) of the 3,141 villages analyzed are located more than 200 km (120 mi) from an ICU bed, and 10% of these villages are between 700 and 1,079 km (435-670 mi) away.

Distance from villages to ICU beds

Indigenous health care in Brazil is provided at base centers within Special Indigenous Health Districts (known as DSEIs) but the system only covers low-complexity cases, so ventilators or ICU beds must be shared with the general population, served by the Brazilian public health system, or SUS.

Some, such as the Yanomami people from Maturacá village, would need to travel three hours by plane to a base center with a ventilator. No land or river connections exist between the village and Boa Vista, the capital of Roraima state. In the most distant villages in the Rio Negro region of Amazonas state, travel by river can take more than a week.

For people in these regions, distance is not the only challenge. Areas such as Manaus, the capital of Amazonas, have seen hospitals overloaded, and the risk of long wait times for an ICU bed or a lack of beds is a serious possibility.

Yanomami indigenous community. Photo: CB V. Santos/Brazilian Air Force

Concentration of ventilators

“Serious COVID-19 cases mean patients are feeling short of breath and, therefore, immediately needing a ventilator to help air circulate through the lungs. The data analyzed also reveal a lack of ventilators as one of the major bottlenecks in indigenous people’s access to health care in the Amazon,” InfoAmazonia wrote in an article about the analyses.

Only 4,760 ventilators are available through the SUS in Brazil’s Amazon region, which makes up nine states. As of March 2020, almost 8% were non-functional according to data from the Ministry of Health.

More than half of the municipalities in the Amazon (66.5%) do not have ventilators at all. These municipalities are home to more than 8 million inhabitants, including 203,000 indigenous people, according to 2020 data from IBGE, the national statistics agency.

Banner image of young Kayapó Matsi Waura Txucarramãe in the Piaraçu village/Brazilian State of Mato Grosso (andreoliveira.cebola) courtesy of InfoAmazonia.

Liz Kimbrough is a staff writer for Mongabay. Find her on Twitter @lizkimbrough_

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