No one should die of malaria today

In our last report, we shared the importance of good communication needed to get direct news on health conditions from the three remote Amazonian communities. This matters especially because it is effectively impossible to reach the communities: planes are grounded, and it is a 10-12 day trek from the Eñepá and Jotï community of Kayama to the nearest city, Bolivar, in Bolivar State. 

To get news out from the communities requires radios and phones. Residents of Kayama now have the use of a radio that the project paid to get fixed: it was fixed, made the trek back to Kayama, and is now in working condition. The phone the project gave to Kayama teacher Gerardo lets him share results, questions, needs and concerns to us and other project partners when he comes to the city. He continues relaying information he hears by community radio while he's in town.

Both Kayama and the Jotï community of Iguana in Amazonas State have committed to sharing their health news, in the form of photos of their health data forms. In Amazonas, where the community radio is working, the project just gave a phone to a young teacher, Jkali, to relay health data from there. Jkali has acted as a promotor de salud (health promoter), collecting health data for the community. He works closely with Oscar, the amazing doctor supporting our malaria project. When Jkali got his phone, the first thing he did was to send Eglée a photo of himself... with Oscar!

The news remains good: somehow, amidst all that is going on, there is not much malaria in any of the three communities this year. "It's absolutely wonderful," says Egleé. She shared a photo of the form they filled and relayed on one of the new project phones. Egleé notes that it is very difficult to communicate with the Piaroa community, even though they are only a 2.5 hour drive from Puerto Ayacucho, Amazonas. Egleé's main contact in that community had a motorcycle, but it was stolen. They relayed similar good news about reduction in rates of malaria, but have not been in good communication.

The radios and phones are proving broadly useful: the teacher in Iguana told Jkali through the radio, who then communicated with Egleé by phone the need for school supplies for Iguana. Egleé sent money to Jkali for the supplies, which he then purchased. Gerardo used project funds to secure important medical supplies for Kayama.

Just as Jkali, Gerardo and his family were preparing to return home, coronavirus arrived in Venezuela. Its extent is unknown. Gerardo, Jkali, and the very few other Jotïs visiting cities and towns made the difficult and important decision not to return to their home communities, lest they bring the virus with them. They are staying in the city, and in communication via radio with their communities. Egleé is fearful for these Indigenous communities: "for them", she says "illnesses go straight to the lungs". She has seen how small colds can become pneumonia, so she celebrates these community leaders' choices. The project has been supporting Gerardo and Jkali's courageous decision to stay away from home with a small stipend to purchase food. Jkali is supplementing his stipend by hunting on the outskirts of town, and on 19 March posted a picture of himself wearing a facemask, and encouraging friends to do the same.

(Photos by Jkali and Gerardo)

I called Dr. Egleé last night to learn the latest from the Venezuelan Amazon. She had just heard from Gabriel, a young Jotï man, It was the first news from a remote community that, without bush plane flights, has been incommunicado for six months.

"Three days ago," she told me, "Gabriel and another young man came walking into Ciudad Bolivar. They came through Eñepa territory. It’s a good time to travel, the rivers are low. They must have walked to Caicara, on the edge of the Orinoco River, and taken a bus from there. It must have taken them a week, walking, even at their rapid pace."

"They contacted us—it’s always one of the first things they do when they come into town, which is lovely—to say there are very few cases of malaria, and no deaths. They’re mostly just dealing with cases of colds and coughs, but no one is seriously ill."

It gives me great joy to learn about the ongoing effects of the nets and malarial treatment medications whose delivery this project has made possible to date. Together with the communities' other strategies, they've made a tremendous difference even in a historically wet year. You, our donors, helped us respond to the communities' request, and deliver nets and more than 300 sets of malarial treatments to Gabriel's home community. Those treatments are worth their weight in gold, almost literally: in Venezuela, sometimes they can only be bought for gold grains.

Egleé’s favorite pilot, Enrique, believes he might be able to fly into communities again at the end of January. Meanwhile, Egleé and Stanford remain in close contact with a network of medical providers and agencies serving Amazonian Indigenous peoples so they can rapidly secure more key medicines if transport to the communities becomes available. As part of that work, Egleé reports:

"We attended and offered an oral presentation at the American Society of Tropical Medicine and Hygiene 68th Annual Meeting and presented at the symposium on Malaria Resurgence in Venezuela and Its Regional Implications. Our talk was called Indigenous populations and malaria: an ethnobiologist view.

"The whole health situation of my country is painfully sad: there are nine pandemic diseases affecting and killing many people. Among the most vulnerable are Indigenous people: 12% of all the (reported) cases of malaria in Venezuela affect Indigenous people although they represent less than 3% of the population. A main conclusion of our session and another on Venezuelan health is that we do not have enough...statistics to understand tendencies and to build efficient strategies to deliver health help. Ideally the communities themselves should have their own records to have a good sense of the incidence of the diseases. 

"Given the complex logistical situation in Venezuela nowadays, we are trying to look for alternative ways to follow with the second stage of our health and bio-cultural conservation project. [We face] (1) the problems to enter the communities and (2) that the main issue of the second stage was to have a detailed record of the malaria cases we have to count on the local people to gather the date. 

"Last week I proposed to [Kayama community leader] Gerardo if they [the Kayama] would be willing to provide monthly data on the cases of malaria in Kayama, ideally on all the diseases in the area of influence of the rural health clinics, the ambulatorios. Gerardo is the only Jotï right now in the city (Cuidad Bolívar). Previously, early in the week, he had specifically asked me if I could help them with their communication system: their only contact from the Amazon to the outside world. He said that their radio in Kayama has been functioning badly and has been broken; recently they have been using the Eñepa’s. Also, the phone they have is not working properly. Electronic devices tend to function poorly or require more intensive maintenance in wet tropical areas, and now it is more difficult in Venezuela to have spare parts or overall maintenance. [So,] I requested that he ask the community to have a meeting or consultation about sending the health data in a systematic way.   

"The two pieces of equipment required and that have proved to be good in the area, since they have been used by the Jotï ,are the following:

- radio transceiver ICOM IC-735. Gerardo sent me the pictures attached. 

- smart phones (Samsung A20, or the like).

"The community members at Kayama talked about our suggestion and contacted Gerardo today. They had had the consultation, and told him that they agree. The central ideas will be:

(1) to provide the media to have fluid communication with people to and from the community, and someone in the city who in turn will communicate with us about the morbidity and mortality data. 

(2) these phones and radios would record potential unwelcome people [on Kayama territory], as has already happened (miners, guerrilleros, invaders, etc.)."

So, we sent $160 of project funds, and Gerardo purchased two phones for Kayama. "They have the [shared] radio that still works," Egleé reports. "We’ll send additional project funds to replace or try to repair the other one. The phones can help to take pictures and keep records of both health and territorial safety dynamics.”

Egleé concludes, “Ideally, we could also carry out the same data-gathering strategy in the Iguana region through the radio, so, I requested that Gerardo contact community leaders Jkali, Lucia, Baluwe or the people in charge of health in that community.

She signs off, "All the best, abrazos de paz, salud y bien."