Black Plague May Wipe Out Brazilian Tribes

     Black Plague May Wipe Out Brazilian 
Tribes

    Brazil’s National Health
    Foundation is being accused of neglect
    for letting scores of Amazon Indians die from an acute syndrome
    caused by hepatitis. According to backwoodsman Sidney Possuelo,
    from the National Indian Foundation, if the same situation
    occurred any place else, authorities would order a quarantine.
    by: Beth
    Begonha

    An acute syndrome, probably caused by the mixture of hepatitis B and D (delta)
    viruses, can, over the course of 20 years, wipe out the communities that occupy
    the second largest Indian reserve in Brazil, the Javari Valley.

    The alert is being sounded
    by Jecinaldo Satere-Mawé, president of the Coordination of Brazilian
    Amazon Indigenous Organizations (Coiab). There are no official statistics,
    nor even estimates, but, according to the Javari Valley Indigenous Council
    (Civaja), each week Indians are removed from the reserve to receive health
    care.

    In 2003, 15 Indians from
    different communities died from the syndrome. According to the Civaja, the
    diagnosis is always the same: Acute Hemorrhagic Fever and Jaundice Syndrome.
    The organization reveals that blood tests to identify the presence of hepatitis
    virus were performed on only two of the victims. The results were positive.

    The Javari Valley reserve,
    the second largest in Brazil, is about the same size as Portugal. 3,500 Indians
    from the Kanamari, Kulina, Matis, Mayuruna, and Maruba ethic groups live there.
    There is only one health post in the entire territory, in the city of Atalaia
    do Norte. Access to the region is difficult, and transportation possibilities
    are limited, especially at certain times of the year.

    Hemorrhagic Hepatitis

    Dr. Thor Dantos, a specialist
    in infectious and tropical diseases and director of the Rio Branco General
    Clinical Hospital, in the state of Acre, confirms that the Javari region is
    highly contaminated by various types of hepatitis virus.

    Among them, the virus
    responsible for hepatitis delta, a form of the disease that is very aggressive
    and hard to cure and which, in its acute form, is known to history as the
    "black plague of Labria."

    The hepatitis delta virus
    can only manifest itself when it coexists in the organism with the hepatitis
    B virus. It is the union of these two infectious agents that causes the acute
    syndrome. The medications designed to combat the delta virus have proved ineffectual,
    achieving success in fewer than 10 percent of the cases and producing serious
    side effects.

    Nevertheless, the vaccine
    against hepatitis B is highly effective. This, in Dantos’s opinion, can prevent
    the onset of "superinfection," the result of the combination of
    the two viruses in the human organism.

    The manifestation of hepatitis
    delta leads to fever, general hemorrhaging, and numerous other symptoms. Various
    examinations are necessary to confirm the diagnosis.

    "Once the syndrome
    has appeared, the chances of saving the person’s life are always close to
    zero. Only prevention, through vaccination and the use of condoms during sexual
    intercourse, can save these people, by avoiding simultaneous infection by
    types B and delta," the specialist warns.

    Funasa’s Responsibility

    The National Health Foundation
    (Funasa), the federal organ responsible for Indian health, is accused by the
    organizations in the Javari Valley of neglect in caring for victims of the
    syndrome. A charge with which backwoodsman Sidney Possuelo, general coordinator
    of Isolated Indians in the National Indian Foundation (Funai), concurs. In
    his view, if the same situation were confirmed in "any of the country’s
    tiny towns," the health authorities would order a quarantine.

    Iraneide Barros, general
    coordinator of Indian health care in the Funasa, refutes the criticisms. He
    claims that the organ has a policy for the region but encounters difficulties
    in putting it in practice.

    "We are working with
    only one boat," he declares, admitting that the institution is aware
    of the high degree of hepatitis contamination in the region.

    "However, not all
    of them showed symptoms of superinfection, a mixture of B and D-type viruses.
    They didn’t die of hemorrhagic fever. We need to test for other diseases,
    such as hantavirus and even malaria," he argues.

    Jungle Health Care

    During a period of one
    week, last April, a group of Brazilian Air Force healthcare officials visited
    over a thousand people in some of Brazil’s most remote areas. The inhabitants
    got medical care and medicine.

    This was the inauguration
    of a new CAN (Correio Aéreo Nacional) airline route that runs through
    five isolated municipalities in the Amazon region in the state of Acre. The
    idea of the new CAN is to bring health and social services to distant parts
    of Brazil.

    The C-98 Caravan aircraft
    left on April 5. But for the medical team to actually arrive in the locations
    they were to assist, they had to use boats, walk long distances through the
    jungle and frequently cross bridges that were far from safe.

    One of the locations they
    finally reached was Marechal Thaumaturgo, just 13 kilometers from the border
    with Peru and 850 kilometers from the state capital, Rio Branco. All the obstacles
    the group met were overcome with the help of local people, like when the plane
    got stuck in mud on the local dirt runway that is usually used by drug lords.

    The local population is
    3,000—many of them Ashinika Indians. The medical group stayed in Marechal
    Thaumaturgo for only four hours—enough time to assist 140 people. Pediatrician-29,
    dentist-27, gynecologist-45, general clinic- 31 and urology-8.

    First Gynecologist

    Another location was Tarauacá,
    located 300 kilometers from Rio Branco. It is so isolated that most of the
    30,000 inhabitants will raise their heads to look at an approaching airplane.
    It is a place where an Indian, Maspã, 34, got her first ever visit
    to a gynecologist although she has been pregnant six times.

    Two of her babies died
    because of miscarriages, and she is pregnant again. She saw lieutenant Ana
    Paula who gave her some medicine. "I will do everything she told me to
    do. She is a good person," said Maspã, very pleased with the doctor.

    As for doctor Ana Paula,
    she said that what most surprised her was the number of women who had never
    seen a doctor before. "They sure pay attention to what we say. That is
    good for us and good for them. Another thing is that here couples normally
    have six or seven children. So we have pregnant women who are in their late
    thirties, and pregnant teenagers, as well," she said. The total number
    of people assisted in Tarauacá was 217.

    The last stop on the CAN
    flight was a land reform settlement almost 100 kilometers from Rio Branco.
    In this case, the medical team, led by major Marcus Vinicius Bergo Coelho,
    arrived by bus.

    A very long line formed.
    "So many kids," said pediatrician Renata Mariscal (an Air Force
    lieutenant). "We just have to see them all."

    The dentist, Dina Berman
    (also a lieutenant) had to show the kids how to brush their teeth. All of
    them.

    Major Bergo Coelho says
    the trip was rewarding because over a thousand people got medical attention.
    "It was extraordinary. We sure got a warm welcome," he said.


    Beth Begonha works for Agência Brasil (AB), the official press agency
    of the Brazilian government. Comments are welcome at lia@radiobras.gov.br.

    Translated
    from the Portuguese by David Silberstein.

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