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Inequities in care, misinformation fuel COVID deaths among poor, indigenous Brazilians

All across Brazil, slums — known as Favelas — have long been places of crime and poverty, marked by overcrowding and unsanitary conditions. They are among the hardest hit by the pandemic, in a country where the death toll just passed 450,000. In the second of two reports, NewsHour special correspondent Simon Ostrovsky and producer Charles Lyons report on Brazil's COVID crisis.

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  • Judy Woodruff:

    All across Brazil, slums, known as favelas, have long been places of crime and poverty marked by overcrowding and unsanitary conditions. They are among the hardest hit by the pandemic in a country where the death toll just passed 450,000.

    In the second of two reports, "NewsHour" special correspondent Simon Ostrovsky and producer Charles Lyons report on Brazil's COVID crisis.

  • Camila De Oliveria Souza (through translator):

    I couldn't speak. I couldn't breathe, the whole time thinking I was going to die suffocated.

  • Simon Ostrovsky:

    Camila de Oliveira Souza is a hairdresser who lives in Vila Kennedy, a favela about an hour's drive from the famous beaches of Rio de Janeiro.

    Late last year, she woke up one morning without any sense of taste. Things got worse quickly. She was taken to a local hospital, where there were no beds and she was forced to sleep in an armchair. Several days later, a doctor told her, if she stayed any longer, she'd likely die. She returned home, where she isolated in her cramped apartment.

  • Camila De Oliveria Souza (through translator):

    Many people turned their back on us, but many people also reached out.

  • Marcia Castro:

    As with any epidemic or pandemic, what we see are all inequalities are illuminated. So, when you look at the number of deaths in Brazil, or the U.S., for that matter, what we see is the most vulnerable, the people that were most isolated, the ethnic minorities, they are the ones that are really suffering the most.

  • Simon Ostrovsky:

    Marcia Castro is chair of the Department of Global Health and Population at Harvard's Chan School of Public Health.

    She said an equitable response by the Brazilian health service would have led to fewer deaths. That didn't happen.

    With its thousands of crowded slums and hundreds of far-flung indigenous communities that are underserved, Brazil's minorities are dying at a much higher rate than the average across the country.

    Camila might just be a statistic, if it weren't for nonprofits that picked up the slack from a government that ignored people like her.

    How come the favelas have done so much worse than the average across Brazil?

  • Mario Love (through translator):

    The pandemic did not cause, but actually exposed the already existing problems in these communities.

  • Simon Ostrovsky:

    Mario Love works with an organization called CUFA, a favela union that fights to improve the lives of people in favelas like Vila Kennedy.

  • Mario Love (through translator):

    One of the times that I was delivering some hygiene products, the basic materials that help prevent contamination, I went to a house that had 14 grandchildren inside of it.

    And that's not even taking into account the rest of the family. This is the reality that shows how the virus can be spread, not only inside a house, but in the streets as well.

  • Simon Ostrovsky:

    But overcrowding is not the only issue Brazil's slums, favelas, face.

  • Priscila Franca:

    The population living in the slum, it does not have access to sanitation. When the pandemic crisis that we are facing started, we had and still have a great difficulty having access to water.

  • Simon Ostrovsky:

    Priscila Franca is a co-founder of the Sao Paulo-based National Anti-Racist Front, an NGO that fights racism against the mostly Black populations in favelas there.

  • Priscila Franca(through translator):

    Most people living in favelas are Black people, they're poor people, and most of them are women. They're heads of families.

    Speaking of inequalities, we live in a country where 97 percent of people living in the favela do not have access to any kind of medical insurance.

  • Simon Ostrovsky:

    Poor sanitary conditions and overcrowding increases the likelihood of infection, and yet lack of medical insurance decreases the chance of favela residents getting proper care.

    Across the country, in the Amazonian state of Para, Ribeirinhos, or river people, suffer opposite problems. Their isolation is their Achilles' heel, making it challenging for them to get the medical help they need during a global health crisis like this one.

  • Caetano Scannavino:

    Brazilian society is finding out, with the pandemic, that, if we are in a difficult situation, we could be much worse without the community associations, the indigenous movement, the favelas movement, a big, big movement of solidarity, doing what the government should do, but didn't.

  • Simon Ostrovsky:

    Caetano Scannavino co-founded the NGO Saude & Alegria, Health and Happiness, back in 1987, its mission, to insure food security and a wide range of support for communities along the Amazon and Tapajos rivers outside the city of Santarem.

    During the pandemic, the organization went into overdrive, giving food and PPE to over 50,000 people since the crisis began.

  • Caetano Scannavino:

    We work with traditional population communities, like indigenous people, people that are here before the Portuguese arrive.

    And they are in remote areas. There is no mobile, no cell phone, and no energy.

  • Simon Ostrovsky:

    Caetano told me government health agents don't fully understand the complexities of helping the tiny river communities his NGO serves.

    This is why Brazil needs far more vaccines urgently. Small medical teams like this one have to travel for hours to villages like this one, where, sometimes, they're only vaccinating a dozen people. Sometimes, they're only vaccinating one person.

    With more vaccines, communities like this could be fully vaccinated, and they wouldn't have to come back. But one marginalized group that is finally getting the vaccine is Brazil's indigenous people, despite widespread misinformation campaigns earlier in the pandemic.

  • Sonia Guajajara (through translator):

    There were many lies spread and a lot of fake news. This ended up creating fear and mistrust among many people. Coming from the indigenous, there was a high rate of rejection to being vaccinated.

  • Simon Ostrovsky:

    Sonia Guajajara is not only a leader in her territory in the Northeastern Brazilian state of Maranhao; she's also a nationally recognized figure who, in 2018, ran for vice president of Brazil on a far left ticket that challenged eventual winner Jair Bolsonaro.

    Now she serves as one of the executive coordinators of a national organization dedicated to indigenous rights and health. In mid-April, when Sonia invited us to visit, she and others in her tribe had already been vaccinated. And yet, months earlier, many indigenous friends and relatives had been infected and died.

    According to data collected by Guajajara's group, since the beginning of the pandemic more than 54,500 indigenous people have been infected and more than 1,080 indigenous have died, including dozens of elders. That's a massive toll for a countrywide population of roughly 800,000.

    It's a death rate six times higher than that of the rest of Brazil. While Guajajara said her people's communal way of living and immunological vulnerabilities contributed to the high rate of infection, she mostly attributes the large number of COVID deaths to President Bolsonaro's harsh views on indigenous, which he expressed even as a candidate.

  • Sonia Guajajara (through translator):

    In his first day of office, the first acts were to dismantle the indigenous people's rights and to try to end the indigenous policy of Brazil.

    It's impossible to have a health system that fits all indigenous people. We are 365 groups, over 6,000 villages all over Brazil in different regions. It should be a priority for a system to make itself suitable to the different realities.

  • Simon Ostrovsky:

    Guajajara says Brazil's national immunization plan doesn't include the large swathe of indigenous living in urban areas. She fears they won't get vaccinated quickly enough and will continue to die.

    She believes help should come from outside of Brazil.

  • Sonia Guajajara (through translator):

    It is important to have international solidarity at the moment to help put pressure on Bolsonaro's government to be more responsible with the population, adopt responsible and effective measures in his public policies, to avoid the increase of infection and deaths.

  • Simon Ostrovsky:

    For the "PBS NewsHour," I'm Simon Ostrovsky in Maranhao.

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