Brazil: Indigenous communities threatened by COVID-19

People in the southwestern state of Mato Grasso do Sul have been hard hit by the pandemic

Home visit at Lagoinha indigenous village

Brazil 2020 © Diego Baravelli/MSF

Doctors Without Borders/Médecins Sans Frontières (MSF) teams are working to prevent, diagnose, and treat COVID-19 in Mato Grosso do Sul state, in southwestern Brazil, home to indigenous communities disproportionately affected by the pandemic.

With few doctors in Mato Grosso do Sul, there is often no one to identify when a person with worsening symptoms needs hospital care. When they finally arrive at the hospital, it may be too late to save them.

"Where COVID-19 has arrived, it has left a trail of destruction," said Oto Lara, a community leader from the village of Colonia Nova in the indigenous land of Taunay/Ypegue. “Our concern increased when we learned that the disease was already in the neighboring cities, because we knew that we had no medical facility here.”

Indigenous people in Brazil have been historically neglected and often left out of the public health care system. Access to care is difficult—not only due to long distances from urban areas, but also because of budget cuts and the lack of doctors in the country's more remote areas. There is also a high prevalence of chronic diseases among the indigenous communities of Mato Grosso do Sul. This puts them at greater risk of serious complications and death from COVID-19.

Chronic diseases, such as diabetes and hypertension, often go untreated due to the obstacles people face when seeking access to health care—from discrimination in health units to a lack of proper health information.

MSF’s request to work in this area was initially rejected by federal authorities. Since August 27, mobile teams have visited 11 villages in the region to provide medical consultations at local health posts and conduct home visits to monitor people who have tested positive for coronavirus. Teams are also working to detect new cases.

Edivaldo Felix is an indigenous community health officer who lives and works in Limao Verde village. As a health worker, he was on the front line when the new coronavirus arrived in his community. He was also one of the first people in his village to contract COVID-19, experiencing breathing difficulties and spending 31 days in the hospital in Aquidauana.

“It’s a horrible disease,” Felix said. “You try to breathe but always feel short of breath. Because of my job, I had some knowledge, and I think it helped me. I think I will be able to provide better assistance to my patients after going through this.” Now back at home, Felix is receiving regular visits from the MSF team to monitor his health.

MSF teams are also spreading health education messages to provide people with clear information about the disease and how to prevent it.

"Awareness and prevention are very important so that the population is more informed and calm and can follow our recommendations," said MSF doctor Pedro Ueda.

MSF teams have also been providing support to medical staff from the local health department and the Special Indigenous Sanitary District of Mato Grosso do Sul (DSEI MS), responsible for the health of indigenous people in the region.

Our teams' activities are not limited to the indigenous communities. MSF is also working in Aquidauana regional hospital to supervise and train local health staff. Team members accompany local health workers on home visits across the city of Aquidauana to monitor the condition of sick people and detect new cases among their families.

“In the urban mobile clinic, we monitor people who have had contact with patients or the ones who have tested positive, as well as patients who have returned home,” said José Lobo, MSF project coordinator in Mato Grosso do Sul. “Our aim is to check if people need to be referred to hospital or need specialist treatment."

MSF has been providing medical care for vulnerable people in Brazil since the start of the COVID-19 pandemic, beginning with the homeless population in São Paulo in early April and later providing care in Rio de Janeiro and Amazonas state (in Manaus, São Gabriel da Cachoeira, and Tefé). Currently, MSF teams are working in Mato Grosso do Sul, São Paulo, and Boa Vista, as well as conducting trainings in infection prevention and control in the state of Goias.