Could you talk about access to health services in the Amazon, why the region has been disproportionately
affected, and also the accelerated rate of
deforestation that’s presently occurring
and how that’s impacting the spread of the
virus?
Yeah, that’s a very important point, Amy.
So, what we have is, the region already has
the worst indicators in terms of health services.
So, it is the place in Brazil where you have
the lowest numbers of hospital beds per person,
physicians per person. Many municipalities
don’t have hospitals and ICU beds; then
it’s even worse. So, you already start the
pandemic having fewer resources in those places.
In addition, we have several communities in
the region that have the other inequalities
that I mentioned. Overall in the Amazon region,
43% of the population don’t have access
to water. But in some states, it’s even
higher than that. Then there is a completely
separate healthcare for the Indigenous populations,
and those have lost a lot of the physicians
in the past few years when a large program
that existed in Brazil that brought foreigner
physicians to work in those underserved areas
was completely dismantled. So, again, you
keep adding those layers, right?
So, since this new president took term, there
is not a lot of attention in terms of preserving
the environment. In fact, last year, we saw
rampant deforestation, a horrible fire season.
And this year, we already overpassed the deforestation
from last year, and we still have about a
month and a half to go of the cutting season.
So, whenever you have this deforestation,
you have contacts of those people that want
to exploit the land with Indigenous areas.
We see that it’s exactly in the Indigenous
reserves where we are seeing most of the damage.
And those areas are supposed to be preserved,
and then they used to be. So, you have Indigenous
people dying because of this encounter, but,
on top of this, now they are being infected
because those — the people that come into
the area may bring the virus, as well. They
can bring any pathogen. And it’s not just
deforestation, we have to remember. There’s
also mining, which is another activity that
exposed Indigenous people to that.
So, over all Brazil, we have 110 Indigenous
areas that have been affected with COVID.
We have about 7,200 Indigenous people that
have been infected, and the number keeps rising,
and about 330 deaths that already have been
reported.
Now, what happens also is that because a lot
of municipalities don’t have hospitals,
don’t have beds, the health system work
with a sort of regionalization scheme. So,
whenever people need hospital care, need to
be hospitalized, there is a reference municipality
that takes all those people. What we saw in
Manaus, which was the first capital in the
Amazon region that really had a completely
overloaded of the health system, is that once
the capital is completely overloaded and they
cannot even provide hospitalizations for people
living in the capital, they can’t serve
all the municipalities that depend on them.
So, the very high number of deaths that we
observed in those areas, part of them could
have been avoided if we had enough hospital
services available.
But, above all, they could have been avoided
if we provided a better response. So, the
community health agents, they are all over
Brazil. They basically act on the community.
They know the people they serve. And each
team has about one physician, one nurse and
around six community health workers. They
go to house by house to provide care. And
they have very good coverage in the poor and
vulnerable areas, so in the north and northeast.
But again, once the pandemic started, those
community health agents were not provided
with protective equipment, so they can’t
go on the street. And they were not provided
with training, either. So, those people that
could be right there on the ground helping
to identify symptoms, helping to isolate people,
and therefore helping to do contact tracing,
and therefore helping to flatten the curve
so we could have avoided this overload in
the hospital system, they were not working.
So, it’s not just about the inequalities.
They do play a role. It’s not just about
the low provision of health services in the
area. They also play a role. But it’s about
the completely chaotic response that basically
exacerbated all those inequalities, all of
them combined, and created the situation we
saw in Manaus, then we saw in Belém. And
right now Porto Velho, another capital in
the Amazon, it has more than 90% occupancy
of hospital beds, so we can start hearing
from this capital pretty soon.
Now, I also want to make a point that the
fire season is about to start in about a month
or so. And if we had this high level of deforestation,
the fires will come, because that’s usually
the process. The wood now is on the floor.
Whatever they couldn’t sell, they are going
to burn. And whenever we have the fire season,
we have an increase in respiratory conditions.
We have an increase in the demand for hospitalizations
because of respiratory conditions. And we
have an increase in the mortality of children
under the age of 10. Now, this is a very — it’s
a horrible combination. Increasing respiratory
conditions may make people more susceptible
to a severe COVID-19 infection.
So, we can have an overlay of two huge problems
that will create, again, another collapse
in the hospital system. So, we’ve been trying
to raise awareness of this and try to avoid
a fire season like we had last year, because
this would be devastating. And the effects
wouldn’t stay just in the Amazon. What happens
in the Amazon does not stay in the Amazon.
And as we saw last year, the smoke, and therefore
all the particulates that comes from the forest
fires, they can travel. And they can go to
other areas, and
therefore affect other people in Brazil as well.
