In the remote village of Shipibo, Caimito, 80 percent of the population have shown symptoms of coronavirus, according to local nurse Elias Magin. The nearest hospital is eight hours away by boat.
When we arrived at the end of May, a line of people meandered around a simple building with an emergency sign that said it was Puesto de Salud, or health clinic, for Caimito. It was only 10 am and those who could walk patiently waited for medical treatment.
“In the last three days, we have run out of drugs given by the government to us,” Magin told us. “The only medicine left for other conditions. I don’t even have paracetamol.”
Visitors are discouraged
Because Covid-19, Shipibo has discouraged visitors. But after I contacted the Caimito community leader, Juan Carlos Mahua, he delivered the invitation, because he wanted to highlight the adverse effects of the virus.
There is only one way to reach Caimito, and that is by taking an eight-hour boat ride along the Ucayali River from the regional capital Pucallpa, which is a further 18-hour car journey from Lima. Because of the locking up of the national government in transportation, we had to get special permission to take river trips to the heart of the Amazon.
The further we push inland, the fewer people and the more wildlife we see. We saw several boats and villages scattered along the river.
When we arrived at Caimito, Mahua and Magin were waiting by the river, surrounded by officials and other local fighters with bows and arrows. All coughed and looked sick.
Welcoming the village head, I asked Mahua how he was doing. “Not very good,” he answered between coughing spells. He gestured to the people around him, “We are all positive for Covid-19.”
Of the 750 people in this community, around 80% are believed to be infected with Covid-19, based on the symptoms they face, Magin said. At least four people died.
When the virus first struck, the government-appointed doctor left Caimito because his contract had ended, leaving Magin in charge together with one other nurse and an assistant.
Magin himself was diagnosed with Covid-19 three days before our arrival, when the government team visited Caimito and gave tests to about 20 people. They also left behind supplies that quickly ran out.
Because the clinic was very short, Magin continued to work despite being diagnosed.
Peru’s health ministry did not respond to requests for comment.
Crowded clinic and house calls
During our visit, the clinic was crowded. A patient is being weighed. Another patient took a deep breath while the medical assistant listened to his chest with a stethoscope. More like a simple doctor’s office than a critical care unit, this post was never intended to deal with crises like coronavirus. There is no respirator, no ICU bed, no equipment or advanced technology.
After seeing patients all morning in the clinic, Magin went to the community to check on people who were too ill to leave their homes.
One of his patients was Reiner Fernandez, 32, who had been ill with symptoms of Covid-19 for the previous two weeks and was too weak to walk to the clinic.
Magin wore protective gear before entering the thatched hut where Fernandez lived with his wife and four children. The interior is simple, with some furniture and a floor made of uneven wood boards. There is no running water.
Fernandez lay on the floor, tucked under a makeshift tent, breathing tight, too weak to stand. “My heart is restless. I want to stop,” Fernandez told Magin.
His wife, Karina, stood close when the nurse took care of her husband. He bit his lip and paced.
Fernandez has lost 17 pounds since he was ill. He still has a fever. But if things get worse, it’s almost impossible to get urgent medical treatment – the nearest hospital is in Pucallpa, a city that is overwhelmed by the virus.
A little help at the nearest hospital
It’s not only the deep Amazon that has problems – the whole Ucayali region has been hit by coronavirus. At Pucallpa’s main hospital, workers must clean the corpses of the deceased outside the door. Inside, there aren’t enough staff to care for the sick.
“It’s very difficult to see people dying,” Dr. Ricardo Muñante, head of the Covid Ward at Pucallpa Hospital. “Seeing people who ask for help and can’t do anything.”
Staff work 12-18 hour shifts, wearing full protective equipment in temperatures that can reach 100 degrees Fahrenheit. There are no ICU beds left here, and only 1 in 10 patients in critical conditions is expected to survive, Muñante said.
This is a story that has been screened in all cities and towns in Peru, which has been hit by more than 257,000 cases of the virus and at least 8,000 deaths nationwide.
Initially, the Peruvian government’s response to the outbreak was quick and simple. Shortly after the first case was reported in the capital Lima, President Martin Vizcarra announced national lockdown on 15 March.
But as lockdown continues, many of the more than 70% of people working in the informal economy in Peru suddenly find themselves without work, without money, and little or no food. And despite strict travel restrictions, hundreds of thousands of migrant workers have little choice but to travel from big cities like Lima and Pucallpa on foot and by boat back to their villages and hometowns.
Some brought Covid-19 with them. Others brought it back because they had to travel to nearby cities to take Covid-support payments of $ 225 provided by the government for low-income households.
There are no banks in Caimito, or in other remote Amazon cities like that. So, residents have to travel as far as Pucallpa to get their money.
Last week, Vizcarra acknowledged the government’s shortcomings in responding to the pandemic, saying on June 15 there were “many administrative and bureaucratic failures.”
Social distance is still a long idea
In Caimito, it is the responsibility of citizens to implement the action itself. I see no signs that social restrictions and shelter restrictions are imposed by local authorities, and Magin says local residents have not yet responded to the virus as seriously as they should.
One morning during our visit, Magin brought a microphone and amplifier to the village center. Taking a deep breath, he broadcast his message:
“We have not defeated this virus,” he said. “But we don’t distance ourselves from the social. We still go to church, play sports and volleyball,” his words echoed through the loudspeakers mounted on a pole high above his head.
“And if we don’t change our ways – then we will continue to die.”
A few weeks later, I returned to contact Magin. He said the situation had stabilized in Caimito, that isolation had helped control the virus and that community groups had traveled to Pucallpa to take drugs from the regional health ministry.
Even though he is still weak, Reiner Fernandez is doing better now, said Magin. And there is no new death.