As the coronavirus outbreak in Brazil rockets past 1 million cases, higher than anywhere outside the US, the front lines have shifted increasingly from modern hospitals in major cities to remote, poor corners of this enormous country.
The cities of Belem and Macapa at the mouth of the Amazon River emerged as major coronavirus hotspots in April and May. The virus has since spread deep into surrounding rural areas.
In isolated settlements built on stilts along the river, most households survive on fishing and harvesting local fruits, earning just a few dollars a day. Social distancing is nearly impossible in wooden shacks built close together. Many lack phones, and it can take a day or more to reach health clinics.
The coronavirus has taken root here, killing scores and infecting hundreds more, public health records show.
Public health professionals keep making house calls and ferrying patients on hours-long boat trips.
“It’s quite complicated because of the difficulty of access,” said Alex Glaison, a medic, after treating a patient in their riverside home. “What keeps us going is getting results.”
For many residents, the pandemic marks their first contact with the public healthcare system. It is a relief for some, but can bring gnawing anxiety as treatment means sending relatives far downriver.
Andreza Lima de Cruz, 25, watched as doctors on a floating ambulance motored away with her father to the hospital in Portel after he tested positive for the coronavirus.
“We know that arriving there, there’s no certainty that he’ll come back,” Lima said. “I honestly want him to stay here. But we have to think of him as well.”