In the remote village of Shipibo in Caimito, 80% of the community has symptoms of coronary heart disease, according to local nurse Elijah Magin. The nearest hospital is eight hours by boat.
When we arrived in late May, a number of people were hiding around a simple building with a makeshift sign stating that Puesto de Salud, or a health clinic, for Caimito. It was only 10am and those who could walk waited patiently for medical help.
“In the last three days, we’ve run out of medicine,” Magin told us. “It simply came to our notice then. I don’t even have paracetamol. “
Visitors were discouraged
Due to the Covid-19, Shipibo has discouraged visitors. But after I reached out to Caimito community leader Juan Carlos Mahua, he extended an invitation as he wanted to point out the devastating effects of the virus.
There is only one way to get to Caimito, and it is an eight-hour boat ride along the Ucayali River from the regional capital Pucallpa, which is another 18 hours by car from Lima. Due to the blockade of transport by the national government, we had to obtain a special permit to transport the river to the heart of the Amazon.
The more we pushed the hinterland, the fewer people and the more wildlife we saw. We located a few boats and scattered villages along the river.
When we arrived in Caimito, Mahua and Magin were waiting on the river bank, surrounded by other local officials and warriors with bows and arrows. Everyone was coughing and looked sick.
Saying goodbye to the village leader, I asked Mahua how he did. “Not very well,” he replied in a cough. He showed those around him, “We are all positive about Covid-19.”
Of the 750 people in this community, about 80% are believed to be infected with Covid-19, based on their symptoms, Magin said. At least four people have died.
When the virus struck for the first time, the government-appointed doctor left Kaimito as his contract expired, leaving Magin in charge along with another nurse and an assistant.
Magin himself was diagnosed with Covid-19 three days before our arrival when a government team visited Caimito and tested about 20 people. They also left supplies that ran out quickly.
Because the clinic is so staffed, Magin continued to work despite his diagnosis.
The Peruvian Ministry of Health did not respond to a request for comment.
Overnight clinic and home calls
During our visit, the clinic was noisy. One patient weighed. Another patient was breathing deeply while a doctor was helping his chest with a stethoscope. More like a simple doctor’s office than a critical care unit, this outpost was never meant to deal with a crisis like the corona. There are no respirators, no ICU beds, no advanced equipment or technology.
After seeing patients all morning at the clinic, Magin went to the community to see people who were too sick to leave their homes.
One of his patients was Reiner Fernandez, 32, who had been ill with Covid-19 symptoms for the past two weeks and was too weak to walk to the clinic.
Magin wore protective equipment before entering the straw roof hut where Fernandez lived with his wife and four children. The interior was simple, with little furniture and the floor of irregular wooden planks. There was no running water.
Fernandez lying on the floor, hiding under an improvised tent, his breath was tired, too weak to stand. “My heart is troubled. He feels like he wants to stop, “Fernandez told Magin.
Karina’s wife stood nearby as the nurse tended to her husband. She pursed her lips and paced.
Fernandez had lost 17 kilos since he fell ill. He still had a fever. But if things got worse, it would be almost impossible to find emergency medical help – the nearest hospital was in Pucallpa, a city flooded with the virus.
A little help at the nearest hospital
It’s not just the deep Amazon that is in trouble – the entire Ucayali area has been hit hard by the corona. At Pucallpa Central Hospital, workers had to clean the bodies of people who died outside the doors. Inside, there is not enough staff to care for patients.
“It was very difficult to see people dying,” said Dr. Ricardo Muñante, head of Covid Ward at Pucallpa Hospital. “Seeing people ask for help and can’t do anything.”
Staff work shifts of 12-18 hours, wearing full protective equipment at temperatures that can hit 100 degrees Fahrenheit. There are no ICU beds left and only 1 in 10 patients in critical condition is expected to survive, Muñante said.
This is the story that takes place in all the towns of Peru, which has been hit by more than 257,000 cases of virus and at least 8,000 deaths nationwide.
At first, the Peruvian government’s reaction to the outbreak was quick and sober. Shortly after the first cases were reported in the Lima capital, President Martin Vizcarra announced the national closure on March 15.
But as the blockade continued, many of the more than 70% of people working in the informal economy in Peru suddenly found themselves without jobs, without money and little or no food. And while there were strict travel restrictions, hundreds of thousands of migrant workers had no choice but to travel from major cities such as Lima and Pukalpa on foot and by boat back to their villages and towns.
Some brought the Covid-19 home with them. Others brought it back as they had to travel to nearby cities to get the $ 225 Covid support payments that the government provided to low-income households.
There is no bank in Caimito or any other remote town in the Amazon. So the inhabitants had to travel to Pucallpa to get their money.
Last week, Vizcarra acknowledged the government’s weaknesses in tackling the pandemic, saying there were “many administrative and bureaucratic failures” on June 15.
Social distance is still a distant idea
In Caimito, it is up to the residents to implement the measures themselves. I saw no signs that local authorities were imposing restrictions on social distance and housing, and Magin said locals were still not getting the virus as seriously as they should.
One morning during our visit, Magin carried a microphone and an amplifier to the center of the village. Taking a deep breath, he gave his message:
“We have not defeated this virus,” he said. “And yet we are not socially distant. We still go to church, we play sports and volleyball “, say his words through the speakers that were placed in a position high above his head.
“And if we don’t change our ways – then we will continue to die.”
A few weeks later, I came in contact with Magin again. He said the situation in Caimito had stabilized, that isolation had helped reduce the virus and that a community group had traveled to Pucallpa to get medicine from the regional health ministry.
Although he is still weak, Reiner Fernandez is doing better now, Magin said. And there were no new deaths.