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In late September, a team of Health In Harmony and Instituto Socioambiental (ISA) staff, and four medical professionals from the Federal University of Pará made a health expedition to communities in the Xingu River Basin. They visited two resexes (communities): Riozinho do Anfrísio and Rio Iriri – home to very remote Indigenous and Traditional People in the Brazilian Amazon.
The following report is based on the writings and reflections of Dr. Érika Pellegrino and Marcelo Salazar, Medical Coordinator and Executive Coordinator of the Health In Harmony Brazil team, respectively.
It was an incredible and intense trip that fulfilled multiple objectives:
- Providing healthcare – medical, dental and vaccination consultations to allow families to stay in their home communities
- Continuing active listening to further understand community needs Reaffirming our commitment to our partnership
- Deepening our understanding of what primary health concerns there are in each community
- Reconnecting with communities – especially important due to the amount of social isolation required this year due to COVID-19
Tricky Expedition Logistics
This expedition required a lot of complicated logistics! During this time of year, the river is very dry, which meant the team needed to plan their route carefully and precisely to allow the boats to travel through safely. The team had to travel as lightly as possible – a challenge due to all of the personal protective equipment (PPE) required for each team member because of the pandemic – not to mention all of the medications, equipment, and luggage they needed to bring along for the three-week journey.
In total, nine people were on the health expedition team traveling to Resex Rio Iriri and eleven people for the Resex Riozinho do Anfrísio portion of the journey.
There were three different legs to this expedition:
- Two trucks from Altamira to the Maribel community in Iriri (about 186 miles in total, with 124 miles of dirt-only roads)
- One 40-foot motorboat from the Maribel community to the Manelito community
- Several small boats from the Manelito community to the Paulo Afonso community (in Riozinho do Anfrísio)
At times, the team split up to reach more distant communities within the time set for the expedition. During the main seventeen days of the health expedition, the team slept in sixteen different places, which meant assembling and disassembling camp and WiFi networks (for communications) daily.
In twenty-one days total, the team traveled about 373 miles on land and 373 miles on the river – almost 750 miles in total!
Health Expedition Results
The trip had significant health outcomes:
- 423 medical visits
- 828 vaccinations
- 226 dental visits
- 450 dental procedures
With a relatively small population spread out over a large area, this means that the medical team was able to see nearly every community member on this trip!
Healthcare providers usually don’t make it to the most remote communities we visited on this trip. Many people had not seen a doctor or a dentist in over a year. Vaccines were in especially high demand, as children often don’t receive them (due to the lack of access to healthcare providers), and the team quickly went through our supply. They made note of how many more vaccines they will need to bring next time.
Identification of Key Health Issues
There were several main health issues and needs identified throughout the health expedition.
- Flu and residual respiratory symptoms related to COVID-19
- Worms
- Abdominal and back pain
- Headache
- Need for contraceptives
The Brazil medical team is working to develop training materials for health professionals placed in the communities based on the above list. They will also help us plan future expeditions.
Impact of COVID-19 on Communities in the Xingu
It was impressive to see the resilience of this population while facing COVID-19 so far. Unfortunately, theer were high levels of infection in many of the communities, with two reported deaths.
Several Traditional remedies are being used by the communities to both prevent and treat COVID-19, which, paired with their high recovery rates, reinforces the importance of Traditional medicinal knowledge and using medicines made from the rainforest.
Not only are Traditional medical treatments most likely aiding community members recoveries, but their healthy diets and active lifestyles play a major part as well. The communities expressed a feeling of COVID-19 “[arriving] weak at the edge.”
Marcelo remarked that people were more happy and tranquil than he had seen on previous expeditions as they seemed proud of themselves for their majority of strong recoveries from COVID-19.
Critical Invasions Driving the Climate Crisis
In addition to identifying major health issues, communities alerted us to the fact that invasions are occurring in both the Resex Riozinho do Anfrísio and the Iriri region. These invaders are stealing wood and squatting, in the respective regions.
Communities are also worried about water quality, which is worsening in Riozinho do Anfrísio, causing stingrays to die, and leaving the water unsafe to drink. Water quality is also worsening in several feeder systems to the main rivers in the area, including the Igarapé do Limão and the Rio Curuá. This increase in water degradation stems directly from illegal mining activities in the region.
The Planetary Health Connection
Through Radical Listening, the connection between this ongoing work to improve human health and fight against illegal activities contributing to deforestation is very clear. Several community members stressed that Riverine people get involved in these illegal activities with the intent to search for health resources in emergency situations.
Our Partnerships in the Amazon
This trip would not have been possible without the many organizations we are partnered with in Brazil.
We are grateful for the Community Association of Iriri River, the Community Association of Riozinho do Anfrísio, Instituto Socioambiental, the Federal University of Pará, the Mayor of Altamira’s Health Secretary, and the Pará State Health Secretary. Each one of these partners contributed medicine, food, equipment, logistics, and so on to make this trip possible.
This first three-week health expedition was a great success. Our team was able to provide critical health care, safely in the midst of a pandemic, and build deeper connections with the communities in order to work together to improve health and wellbeing and protect the Amazon rainforest from destruction. Our next health expedition will be in November, and we look forward to making even more progress.
Photos by Marcelo Salazar.
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