In the remote Shipibo village of Caimito, 80 percent of the community has shown symptoms of coronavirus, according to local nurse Elias Magin. The closest hospital is eight hours away by boat.
When we arrived in late May, a line of people meandered around a simple building with a makeshift sign declaring the Health Post, or health clinic, for Caimito. It was only 10 o’clock in the morning and those who could walk patiently waited for medical attention.
“In the past three days, we have run out of the medicine the government gave us,” Magin told us. “The only medicine we have left is for other conditions. I don’t even have paracetamol.”
Due to Covid-19, the Shipibo have discouraged visitors. But after communicating with the leader of the Caimito community, Juan Carlos Mahua, he extended an invitation, since he wanted to highlight the devastating impact of the virus.
There’s only one way to get to Caimito, and it’s via an eight-hour boat ride along the Ucayali River from the regional capital of Pucallpa, which is another 18 hours’ drive from Lima. Due to the blockage of transportation by the national government, we had to obtain a special permit to undertake the trip down the river to the heart of the Amazon.
The further we go inland, the fewer people and more wildlife we saw. We saw a handful of boats and villages scattered along the river.
When we reached Caimito, Mahua and Magin were waiting on the riverbank, surrounded by other local officers and warriors with bows and arrows. Everyone coughed and looked sick.
Greeting the village leader, I asked Mahua how he was doing. “Not very well,” she replied between coughs. He gestured to those around him: “We are all positive for Covid-19.”
Of the 750 people in this community, about 80% are believed to be infected with Covid-19, based on their presenting symptoms, Magin said. At least four people have died.
When the virus first attacked, the government-appointed doctor left Caimito when his contract had 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 administered tests to about 20 people. They also left supplies that quickly ran out.
Because the clinic is so understaffed, Magin has continued to work despite her diagnosis.
Peru’s health ministry did not respond to a request for comment.
Boisterous clinic and home visits
During our visit, the clinic was full of people. One patient was being weighed. Another patient took a deep breath while a medical assistant listened to his chest with a stethoscope. More like a simple doctor’s office than a critical care unit, this outpost was never intended to handle a crisis like coronavirus. There are no respirators, no ICU beds, no advanced equipment or technology.
After seeing patients all morning in 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 put on protective gear before entering the thatched-roof cabin where Fernández lived with his wife and four children. The interior was spartan, sparsely furnished, and the floor made of uneven wooden planks. There was no running water.
Fernández was lying on the ground, hiding under a makeshift tent, his breathing was difficult, too weak to even stop. “My heart is pounding. It seems like it wants to stop,” Fernandez told Magin.
His wife Karina was nearby while the nurse attended to her husband. She bit her lip and paced.
Fernández had lost 17 pounds since he became ill. I still had a fever. But if things got worse, it would be almost impossible to find urgent medical attention: the closest hospital was in Pucallpa, a city overwhelmed by the virus.
Little help at the nearest hospital.
It is not just the deep Amazon that is in trouble: the entire Ucayali region has been hit hard by the coronavirus. At the main Pucallpa hospital, workers have had to clean the bodies of people who died outside the doors. Inside, there are not enough staff to care for the sick.
“It has been very difficult to see people die,” said Dr. Ricardo Muñante, head of the Covid neighborhood at the Pucallpa Hospital. “See people who ask for help and can’t do anything.”
Staff work 12-18 hour shifts, wearing full protective gear in temperatures that can reach 100 degrees Fahrenheit. There are no ICU beds here, and only 1 in 10 critically ill patients is expected to survive, Muñante said.
This is the story that unfolds in all the towns and cities of Peru, which has been affected by more than 257,000 cases of the virus and at least 8,000 deaths across the country.
Initially, the Peruvian government’s response to the outbreak was swift and sober. Shortly after the first cases were reported in the capital of Lima, President Martín Vizcarra announced a national closure on March 15.
But as the blockade dragged on, many of the more than 70% of people working in the informal economy in Peru suddenly found themselves out of work, money, and little or no food. And despite strict travel restrictions, hundreds of thousands of migrant workers had little choice but to travel from larger cities like Lima and Pucallpa on foot and by boat back to their home towns and cities.
Some brought Covid-19 home with them. Others brought him back as they had to travel to nearby cities to collect Covid’s support payments of $ 225 that the government made available to low-income households.
There is no bank in Caimito, or in other remote Amazon cities like this one. So the residents had to travel to Pucallpa to get their money.
Last week, Vizcarra acknowledged the government’s shortcomings in responding to the pandemic, saying that on June 15 there were “many administrative and bureaucratic failures.”
Social distancing is still a distant idea
In Caimito, it is up to residents to implement the measures themselves. I saw no signs that local authorities were applying restrictions on social distancing and shelter in place, and Magin said the locals were not yet taking the virus as seriously as they should be.
One morning during our visit, Magin brought a microphone and amplifier to the center of the village. Taking a deep breath, he conveyed his message:
“We have not defeated this virus,” he said. “And yet we are not socially estranged. We still go to church, play sports and volleyball,” his words reverberated through speakers connected to a publication high above his head.
“And if we don’t change our ways, then we will continue to die.”
A few weeks later, I got back in touch with Magin. He said that the situation has stabilized in Caimito, that the isolation has helped contain the virus, and that a community group had traveled to Pucallpa to collect medicines from the regional health ministry.
Although he is still weak, Reiner Fernández is better now, Magin said. And there have been no new deaths.