Delays, corruption and misinformation thwart Covid-19 vaccination efforts across Amazon region
With almost 60,000 deaths and 2.4 million confirmed cases of Covid-19, the nine-nation Pan-Amazon region has become an epicenter of the coronavirus pandemic in South America. The Amazon’s traditional peoples—its indigenous, quilombola, riverside and subsistence agriculture communities—have been included among the priority groups for vaccination in most countries of the Amazon, but those distinct immunization campaigns have several obstacles to overcome.
In February, the Pan-Amazonian Ecclesial Network (known by its Spanish and Portuguese abbreviation R.E.P.A.M.) issued a letter asking the region’s national governments to “spare no effort in buying and distributing vaccines for the Amazonian region.”
In a virtual conference, “The cry of the jungle, voices of the Amazon,” held at the end of February, several civic organizations and church groups discussed urgent measures that should be taken to tackle the current emergency in the region. At the top of the list, acknowledging their unique vulnerability, was universal access to reliable vaccines for the people of the Amazon.
The document mentions the need to “promote transparent information on the vaccines, halting the campaigns of fear about them, which fraudulently disseminate religious and political fanaticisms.” It also notes other threats to the effective distribution of vaccines: corruption, discrimination and the lack of adequate infrastructure and vaccination equipment.
Not enough vaccines, too much misinformation
All such concerns are well-founded. In communities across the Amazon, the lack of vaccines and an avalanche of fake news generating fear about vaccines have been creating uncertainty about the effectiveness of vaccination campaigns. Covid-19 immunization campaigns must also overcome enormous difficulty in reaching remote indigenous groups, isolated riverside communities and the villages of quilombola people, the descendants of African slaves who fled captivity during the slavery era in Brazil (1500-1888), establishing communities in the forest interior.
Covid-19 immunization campaigns must overcome enormous difficulties in reaching remote indigenous groups, isolated riverside communities and the villages of quilombola people, the descendants of African slaves.
The most serious challenge is the dangerously limited vaccine supply. In Ecuador, especially hard-hit by Covid-19, only the first phase of the national immunization program has been concluded. Health care workers and the elderly were among the priority groups that received the first doses, but the number of Ecuadorians vaccinated by March 21 was just 141,000 in a country of 17.5 million.
The next stage, in which 2 million Ecuadoreans are expected to be vaccinated, began earlier this month. But the campaign is advancing slowly, according to the apostolic vicar of Puyo, Bishop Rafael Cob García. “The church has infrastructure in the Amazonian region, including health care centers where we’ve been running Covid-19 tests. We can help in vaccination, but we’re waiting for the government’s plan,” he told America.
The situation is much the same in Bolivia and Peru. Amazonian Bolivians are not confident that vaccines will arrive any time soon, according to the Rev. Juan Elías Ciripi from Cobija, a city in the Amazon basin on the border with Brazil.
“Indigenous peoples are part of the priority group, but nobody knows when the doses will come. We’re waiting for the government,” he told America.
According to Father Ciripi, at least 300 people died of Covid-19 in his city. There is only one public hospital in the region, he said. The pandemic crisis has been intensified by the rainy season and floods that accompany it, which make it difficult to travel to bigger cities to find medical care.
“People used to travel to Rio Branco [in Brazil] when they needed any treatment, but now the border is closed. We’ve been helping peasant and indigenous communities any way we can, with food and medicines,” he said.
In Bolivia “indigenous peoples are part of the priority group, but nobody knows when the doses will come. We’re waiting for the government.”
In Iquitos, Peru, vaccines also seem to be a distant promise. According to the apostolic administrator, Miguel Fuertes, O.S.A., the local church is concerned that the government is not doing enough to raise awareness about the importance of becoming immunized.
Refusing the vaccine
“Part of the society opposes the vaccination, and some people say that they will refuse to take a shot when the doses arrive,” Father Fuertes said. He added that because of the impact of misinformation he has been emphasizing the need for informational campaigns about the safety of vaccines to government officials.
Months ago, an evangelical church in the region began administering ivermectin, deploying a version typically used in veterinary medicine, as a “preventive” measure against the virus. A well-known vermifuge, an anti-parasitic, it has been fraudulently presented as an effective medicine for Covid-19 in other countries of the region, including Brazil, where it is one of the basic components of the “Covid kit” promoted by President Jair Bolsonaro.
“We’re ready to incentivize the vaccination any way we can,” Father Fuertes said.
While health care and pastoral teams in Iquitos wait for the rollout of the vaccination campaign, the struggle to deal with other aspects of the pandemic continues. “The city had a shortage in its oxygen supply, and medical equipment is deficient,” Father Fuertes said. “Some of our parishes are testing people for Covid-19 and helping communities with food and medicines.”
Government officials had to block off the Colombian Amazon after an outbreak of a new Covid-19 strain in nearby Manaus, Brazil. The vaccination of indigenous groups in Colombia has recently begun, and the church is ready to play a role in the process.
“The Colombian episcopate offered the structure of the church in the Amazon for the vaccination campaign,” the Rev. Héctor Henao Gaviria said. “Where there are no health-care facilities, diocesan buildings may be used. That hasn’t been necessary yet.”
Covid-19 has penetrated even the most remote areas of the Pan-Amazon region, infecting and killing subsistence farmers and indigenous people.
According to Father Henao, who heads Caritas Colombia, the church’s social service agency, the government has allocated a first shipment of 45,000 doses to the Colombian Amazon, a significant attempt to reach the region’s 265,000 inhabitants..
Although conditions in the region of Leticia, a city on the border with Brazil and the capital of Amazonas State, have not reached the level of the chaos being experienced in Brazil, Covid-19 has penetrated even the most remote areas, infecting and killing subsistence farmers and indigenous people. “There has been a huge underreport of such deaths,” Father Henao charged.
On the Colombian side of the border there is a higher level of acceptance about vaccines, the Rev. Yilmer Alonso Pérez, who leads the Caritas office in Leticia, said. “Most of the population here is Catholic and understands the need to take a vaccine,” he said. “On the Brazilian side of the border, the Evangelical population is larger and there are more difficulties.” There have been multiple reports of Christian missionaries, particularly in the Brazilian Amazon, convincing communities to resist immunization efforts.
Brazil has so far administered the largest number of doses, with more than 1.9 million people in Brazil’s Amazon region at least partially vaccinated. That figure includes health care professionals, elders, indigenous groups and people in quilombola communities.
Although indigenous peoples are designated among the priority groups for vaccines in Brazil, significant numbers of them are likely to be missed, according to Marcivana Sateré Mawé, who coordinates the Indigenous Ministry of the Archdiocese of Manaus.
“Almost half of the Brazilian indigenous population lives in the city,” she said, not in the interior villages being targeted for immunization outreach. “They should be included in the priority group too. It’s not up to the government to decide that a certain group is ‘less indigenous’ than the other,” she complained.
Missing the urban indigenous people?
Ms. Marcivana, who like many indigenous people prefers to use the name of her tribe, the Sateré Mawé people, as a surname, also directs an association that reaches out to the indigenous groups of the Manaus area. She has been struggling to secure access to vaccines for this urban indigenous population.
There have been multiple reports of Christian missionaries, particularly in the Brazilian Amazon, convincing communities to resist immunization efforts.
The task of convincing people to take the vaccine is frequently a hard one. According to Claudemir Nogueira da Silva, leader of a federation of indigenous organizations in the region of the Purus River, some villagers have been refusing to welcome vaccination teams.
“That’s the case of the Jamamadi people, for instance. Some of them were influenced by a Baptist missionary and just don’t want to take the vaccine,” he said.
In February, a group of 399 Jamamadi carrying bows and arrows forced a group of health care professionals to go back to their small plane and leave without vaccinating anyone in their community.
Mr. da Silva, a member of the Apurinã people, said that a number of the Jamamadi were eventually persuaded to accept the vaccine. But many others have been discouraged by misinformation.
“People say it has a chip that will kill the person over time. They also say it’s demonic,” he said, exasperated.
The Bishops’ Conference’s Indigenous Missionary Council in Brazil (known as C.I.M.I.) is also concerned about the dozens of indigenous groups that live in total isolation in the rainforest. “The Brazilian state must guarantee that [these indigenous communities] remain isolated, particularly during the pandemic,” said Luis Ventura, a lay missionary at C.I.M.I.
Isolation, according to Mr. Ventura, is the best “immunization” in the case of these indigenous communities. But illegal incursions on what should be restricted territories of these indigenous communities by miners and loggers create a continuous risk for them.
Among the quilombola peoples, vaccination rates have been low. In Pará State, members of communities in the region of Acará are anxious about it.
Isolation is the best “immunization” for some indigenous communities. But illegal incursions by miners and loggers create a continuous risk for them.
“People continually ask me when the vaccines will be sent to us. But the state government is not providing any information about it,” said Maria José de Brito, a nurse technician and a member of the quilombola community.
Evangelical churches are dominant in the region, and many quilombolas used to doubt that Covid-19 could be so contagious and serious. “Many people would go out without wearing a face mask. If I said something about it, they would tell me that ‘one must have faith in God’ and that ‘God protects the believers’,” she said.
But then several members of the community caught the disease and a pastor’s wife died. “After that, they understood the seriousness of it. So people who would normally repudiate the vaccine are now anxious to take it,” Ms. de Brito said.
Access to remote communities is another challenge. Vaccination teams sometimes have to travel several hours by boats or plane to reach them.
Two hospital boats, the Pope Francis and the Pope John Paul II, sponsored and operated by the Association and Fraternity of Saint Francis of Assisi in God's Providence, have been visiting Amazon riverside communities in order to care for Covid-19 patients.
“In February, we took a vaccination team to a remote quilombola community, where we also provided assistance to the sick,” said the Rev. Joel Souza, the boats’ coordinator. But the hospital ships themselves became object lessons in how the virus can move around the region to reach vulnerable communities. Their operations had to be suspended in mid-February after all the members of both crews tested positive for Covid-19, despite receiving vaccinations at the end of January. Seven crew members became seriously ill, including Father Souza, who has since recovered. (Crew members believe they may have already been infected when their vaccinations were administered.)
Francisco Hugo de Souza, a resident of the Jauari community of the Erepecuru quilombola territory, which was visited by the boat, said that only their elders had the opportunity then to be vaccinated. “The rest of the community is anxious to be vaccinated too,” he said.
According to Father Cob, like the Jauari, other indigenous groups of the Amazon have been “forgotten” by the current leaders of the Pan-Amazon region. R.E.P.A.M, he said, is committed to the struggle for a successful mass vaccination campaign. “But,” Father Cob said, “we know that indigenous and other traditional groups are at the end of the list of political concerns.”
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