An application and a health center: the tough battle of the Brazilian Kuikuro against covid-19

Amid the fires raging through the Pantanal and threatening to expose the area's indigenous peoples to covid-19, good news is rare.

One of them comes from the Ipatse village ―one of the 109 indigenous communities of the Xingu―, which six months ago set a goal: that the new coronavirus does not take any lives.

Subjected to a very fragile health system - without the daily presence of a medical team or nearby hospitals - the Kuikuro people have created their own strategy to curb the disease.

The Kuikuro adapted a mobile application to track suspicious cases.

They also erected a large goose (a typical Brazilian indigenous house) to isolate the patients, while the community determined their quarantine.

These actions delayed the spread of the disease for a few months, but in July the cases began to grow.

It was when the Kuikuro inaugurated their own health center, with oxygen bottles to stabilize the patients, and hired a doctor and a nurse to stay in the territory.

All with donation money.

The village - in which some 400 indigenous people live and which has about 77 infected - has so far been successful in its goal of avoiding deaths from coronavirus.

The fear now is the impacts of the hell that spreads through the Pantanal and the Xingú Park for the health of the indigenous people, in the midst of a pandemic.

The fire begins to approach Ipatse, and the smoke is constant.

At least, the situation in the area is not as serious as that of other villages in the Pantanal area, which had to be relocated due to the fires.

“At the moment, no villages have been evacuated.

We are working with the IPAM Amazônia institute to coordinate with the brigade members of the IBAMA (Brazilian Institute of the Environment) to try to mitigate the situation, ”says researcher Bruno Moraes, who works with the Kuikuro.

But the situation is alarming.

Indigenous people and indigenistas affirm that the constant smoke is worsening the respiratory condition of patients infected by the new coronavirus in some villages, such as Mayene, 20 kilometers away.

In Ipatse, it is feared that such complications could come very soon.

“The virus entered the village, but no one has died yet.

I believe our plan has worked, it has controlled it, ”says indigenous leader Yanama Kuikuro, president of the Kuikuro Indigenous Association of Upper Xingu.

He says that the concern about how the village would cope with the pandemic began in March, when the newscasts - to which the communities have access through televisions powered by a generator - gave the news that the virus was spreading through the Brazilian territory.

At that moment, Chief Afukaka warned about the need to take care of himself and began to speak with the community to start a voluntary quarantine

The most common tasks of the community - which basically lives off the countryside and fishing - pose great risks.

The indigenous people who live in Ipatse usually travel about 160 kilometers to the nearest cities (such as Gaúcha do Norte and Canarana) to buy food that they do not produce in the village, fuel for their boats and fishing equipment.

These constant movements were recorded and analyzed using an application developed by a transnational group of researchers and social scientists.

The Kuikuro already used this tool to map archaeological sites and cultivated areas, as well as to monitor regions at risk of deforestation and forest fires.

And they decided, with their partners, to adapt it to alleviate the health crisis.

The application finally served to produce a large census in the community.

The indigenous community agents registered the number of houses and the men, women and children who lived in them.

They also entered into the system from profiles with comorbidities to the reasons that led to the departure of “indigenous travelers”.

They also organized deliveries of food and equipment to the village, reducing movement needs and increasing confinement rates.

The indigenous people themselves also produced videos in Karib, the local language, to encourage people to stay home.

“We wanted to understand the reason for leaving the village to reduce circulation.

70% of the indigenous people went to the city to buy food and fuel.

We started to distribute those genres and, in effect, we saw a drastic reduction: of 20 people who traveled a week, three went to do it.

The trips that followed were for health treatments, for pregnant women who had to go to prenatal care, ”explains researcher Bruno Moraes, who works on monitoring from his home in the city of Belém.

Geospatial technicians also feed the system with information on the people who travel from each family and if they had symptoms during the last 14 days - crucial data to isolate those who are in contact with suspected cases and thus break the chain of contagion

A goose for quarantine

Even when the coronavirus was already moving through the Xingu region, the Ipatse village lived through the first months of crisis with relative ease.

That first phase was of surveillance and preparation of a response for when the cases arrived.

While three indigenous people fed the application daily with information from the patients, they built a huge goose in case a space was needed to isolate the infected.

The strategy did not take into account that when a Kuikuro falls ill, he also watches for a spiritual ailment and tries not to leave home to protect his spirit.

For this reason, the isolation house ended up being the most used for the quarantine of those who had to go to the city.

The travelers stayed there before returning to the coexistence of the community as one more measure of protection.

The money from the donations - about 200,000 reais, about $ 38,200 - was used to buy medicines, beds and oxygen cylinders.

A small clinic was organized to treat and isolate the infected, with the authorization of the Federal Government.

The center is run by a doctor and a nurse who were hired for a period of six months so that the village could fight the pandemic.

“Having a doctor here every day makes us feel safer.

The SESAI (Indigenous Health Secretariat) also sends us a doctor, who stays for a week and then goes to another community, "says Yanama. The new health facility offers oxygen therapy to patients with respiratory complaints. This week, it received two indigenous people they were stabilized and did not have to be transferred to a hospital.

The structure of the Ipatse has become a benchmark for nearly six surrounding villages.

Every day, the doctor Giulia Parise Balbão communicates by radio with other communities to give them instructions and carry out telemedicine consultations.

“When I arrived, it was already very clear that the objective was not to lose any life in the village.

People were already working tirelessly.

I just came to join this team ”, says Balbão.

This strategy is also expanding to other locations, where they collect data for the same application used by the Kuikuro.

“We have also started monitoring these neighboring villages.

We are exporting the idea.

Regarding the treatment, it will be concentrated in Ipatse, but we hope to be able to hire more doctors to offer this assistance to 12 villages, which make up 13% of the population of Parque do Xingú ”, affirms Moraes.

Until the beginning of this week, the APIB (Articulation of Indigenous Peoples of Brazil) counts 806 deaths from covid-19 among the indigenous population throughout Brazil.

The Government reports 419 victims, since it does not count indigenous people in urban areas.

In the last month, coronavirus cases among indigenous people have rebounded.

In early July, the Ipatse village confirmed its first cases, those of two indigenous people who were probably infected at the city's health center and who were discharged before being tested.

Weeks later, other villagers developed symptoms after participating in a burial.

The geospatial technicians - who daily monitor the situation of the families - promptly identified these people, who were followed up by the medical team.

Tests carried out in the village confirm that at least 77 people have already contracted the virus.

The chief and a 90-year-old woman fell ill and recovered.

The death of the elderly is of great concern to the community, whose history is preserved and transmitted especially by the elderly.

Surveillance remains firm with the same objective assumed six months ago: zero mortality from coronavirus.

Information about the coronavirus

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- Guide to action against the disease

- In case of symptoms, these are the phones that have been enabled in each Latin American country.