2020年8月19日 星期三

How an Indigenous Community in Brazil Used Tech to Contain the Coronavirus

Yanamá Kuikuro, president of the Kuikuro Indigenous Association of Upper Xingu, points to a satellite image of the Kuikuro territory. Associação Indígena Kuikuro do Alto Xingu - AIKAX

Every year during the dry season, the Kuikuro and eight other Indigenous groups of Upper Xingu gather to honor the dead. This important celebration, known as the Kuarup, marks the closure of a long mourning period for the families, who offer fish and beiju, or tapioca, to hundreds of guests. They cry and pray around ornamented logs that are later thrown into a river or lagoon so as to free the souls of the deceased, and members of different villages engage in a physical fight called huka-huka. In June, for the first time in 50 years, the Kuarup had to be canceled.

Since the novel coronavirus outbreak, the traditional rituals and communal lifestyle of the Indigenous peoples in the Xingu Indigenous Territory in Brazil’s central-western state of Mato Grosso have turned dangerous. Daily tasks like securing food, shelter, and well-being pose their own set of risks: Community members often travel to the nearest municipalities of Gaúcha do Norte and Canarana, roughly 100 miles south of the territory, to buy fuel for their fishing boats and motorcycles and supplies to build their homes, as well as to receive medical treatment at an Indigenous health support house.

Contact-tracer Kumessi Waura shows the survey app used by the Kuikuro to monitor suspected cases of COVID-19. Associação Indígena Kuikuro do Alto Xingu - AIKAX

When news broke of a “foreign” virus in early March, Indigenous leaders in the 6.5 million–acre territory that is home to more than 7,000 people from 16 different groups promptly mobilized to try to keep the disease at bay. They adopted a voluntary quarantine and produced videos and other educational materials with prevention tips in Karib languages. Still, despite their best efforts, the coronavirus arrived in Xingu. Since the first death from COVID-19, a 45-day-old Kalapalo baby in early June, at least 10 other deaths and more than 210 confirmed cases have been registered.

“It’s really scary for us,” says Kumessi Waura, a member of the Kuikuro people. “We are specially terrified of losing the elderly because they are the only ones who can carry on telling our stories.”

But the Kuikuro, who make up about 10 percent of the overall population of the territory, have managed to mitigate the spread—in part, thanks to innovative use of technology. In collaboration with a transnational collective of researchers and social scientists, the Kuikuro Indigenous Association of Upper Xingu, or AIKAX, has developed a community-level contact-tracing system to monitor who is coming in and out of the Ipatse village, as well as potential coronavirus cases.

First, they carried out a census of the village, registering the number of houses and the men, women, and children living in them. Then, using a phone app, trained contact tracers regularly updated the system with information about travelers within each family and indicated whether anyone had presented symptoms in the 14 days prior. They also recorded dates of entry and departure to and from town and between villages. “We believe it makes it easier to control [the spread] if we know where the disease is coming from and who the person is so we can isolate them,” says Waura, who is one of three Indigenous geo-spatial technicians.

The Kuikuro are not new to the use of collaborative data collection technology. Before the COVID-19 pandemic, they were already employing these tools to map out archaeological, sacred places and ancestral settlements, as well as cultivated areas. In one year, they recorded as many as 500 locations. The community had also recently started to receive training to monitor areas at risk of deforestation and wildfires. When the time came, they swiftly adapted this technology to tackle a public health emergency.

“We knew it would be impossible to stop everyone from coming and going, particularly in a communal village where social contact is everything and the very idea of isolation is terrible,” says Carlos Fausto, an anthropology professor at the Federal University of Rio de Janeiro’s National Museum and member of the Amazon Hope collective working closely with the Kuikuro. “What we needed was to buy enough time to shift from the monitoring stage to response preparation.”

“If one person catches the virus, everyone gets infected at once.” — Kauti Kuikuro

As cases continued to spike in nearby villages in the Xingu territory and surrounding towns of Mato Grosso, the Ipatse village showed no sign of community spread. The first two confirmed cases were patients who contracted the virus at the health care unit in town and were discharged without getting tested. “Our three contact tracers identified them and updated the system and our medical team was able to monitor these patients,” the president of AIKAX, Yanamá Kuikuro, says. Upon arrival at the village, they were immediately put in isolation at a traditional home the community built to house the sick.

In July, the Kuikuro’s preparedness was put to the test when many of the residents of Ipatse fell ill after attending a funeral at a nearby village for a COVID-19-related death. With help from the monitoring system, the technicians quickly identified and isolated the sick. The tests initially came back negative for COVID-19, but a second round detected 55 confirmed cases, only two of which remain active and are currently under control.

“One house sometimes has 20, 30 people living together so if one person catches the virus, everyone gets infected at once,” says Kauti Kuikuro, a nursing technician and health monitor who goes door-to-door checking in on the older residents and patients with diabetes or high blood pressure. “Doing it every day, sometimes you get tired but I keep doing it because it’s getting to us.”

Not all communities have been so successful. More than 26,000 cases and 689 deaths from COVID-19 among 154 different Indigenous groups have been recorded across the country, according to Brazil’s Indigenous People Articulation. (These figures are higher than the official statistics from the Ministry of Health’s Special Secretariat for Indigenous Health as they also include Indigenous people living in cities.)

The mortality rate among Indigenous people is almost double that of the overall population, underscoring a historic susceptibility to highly transmissible and respiratory illnesses largely due to a lack of access to health care services and basic sanitation. “The challenge for our generation is to prevent COVID-19 from becoming the measles from 1954,” Fausto wrote in an op-ed referring to an epidemic that took the lives of 1 in 5 Indigenous people in Upper Xingu.

The combination of President Jair Bolsonaro’s refusal to confront the virus with his previous policies opening up Indigenous lands to mining and logging has led advocates to allege that a “genocide” against the country’s 800,000 Indigenous people is underway. On the International Day of the World’s Indigenous Peoples, commemorated on Aug. 9, protesters in London covered Trafalgar Square in fake blood to raise awareness to the plight of Indigenous groups in Brazil. The U.N. High Commissioner for Human Rights Michelle Bachelet also remembered the “tragic death” from COVID-19 of Chief Aritana Yawalapiti, one of the main leaders of Xingu, and highlighted the “importance of ensuring that indigenous peoples can exercise their rights to self-government and self-determination.”

The Brazilian government says it has invested more than $12 million in actions to protect the Indigenous peoples that include the distribution of masks, gloves, and COVID-19 rapid testing kits among the 34 Special Indigenous Sanitary Districts. But Indigenous groups and rights activists say the official response has been slow and insufficient to protect these populations, pointing out that the national contingency plan is “vague“ and lacks critical input from the communities themselves. Some groups worry that health agents, the military, and missionaries might be contributing to the spread of the virus.

“The government is not helping us here.” — Yanamá Kuikuro

In July, Bolsonaro signed into law an emergency plan to protect at-risk groups but vetoed provisions obligating the government to provide access to drinking water, hygiene products, and internet, and to ensure that villages have more hospital beds and intensive care units, citing financial burden as a reason. The Supreme Court has since ordered the installation of sanitary barriers restricting movement into the Indigenous territories and called on the government to address the ongoing issue of land invaders.

“The government is not helping us here,” Yanamá Kuikuro says. “We’re struggling; the supplies we buy aren’t enough, and we just don’t have the resources to reach the other villages.”

That leaves groups like the Kuikuro to do most of the heavy lifting themselves. They are relying on the data they collect on the ground to inform strategies including launching public awareness campaigns, raising funds to hire additional health professionals, arranging the regular delivery of fuel and food to families, and setting up a new oxygen therapy center.

“Many of them don’t want to leave the village because they often feel they are treated in a hostile way at the hospitals,” says Bruno Moraes, a researcher with the Emílio Goeldi Museum and the collective’s operations director. He says it can take as many as 12 hours by land transportation to reach the closest hospital equipped to treat COVID-19 patients. “If we can offer basic assistance and prevent the disease from progressing without having to remove them, then they can continue their traditional treatments.”

“The more lives we can save, the better,” he adds.

Future Tense is a partnership of Slate, New America, and Arizona State University that examines emerging technologies, public policy, and society.



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