Vaccine Paths: Health professionals enter forests to immunize indigenous population
Bringing health care to the Amazonian villages is not an easy task for the health professionals of the Special Indigenous Health Districts (DSEI) that make up the Special Secretariat of Indigenous Health (SESAI) of the Ministry of Health. The indigenous communities are in the middle of forests, on the banks of rivers and streams and on top of mountains or in valleys whose access mobilizes great logistics of personnel and air, river and land transportation. The health professionals use several modes of transportation to reach the villages, including pickup trucks on muddy roads with rustic bridges, single engine airplanes and helicopters that depend on the weather in the region to fly, large boats for long distances, and small boats to enter in igarapés (streams). But at the end of the journey, you always have to walk through the forests carrying a box with COVID-19 vaccines and attendance forms.
The effort does not always yield large numbers. A xapona (maloca) Yanomami, for example, is composed of 20 to 30 people in a large collective house, most of whom are children, nursing mothers, postpartum women, and pregnant women who can only be vaccinated with a medical prescription, according to the technical guidelines of the National Immunization Program (PNI). The Multidisciplinary Indigenous Health Team (EMSI) can immunize against COVID-19 about 10 people between men and women over 18 years old in each xapona visited. The distance between one house and another is 20 minutes to 3 hours walking in the Waphuta Base Pole. It is persistence and responsibility that move the EMSI from village to village with a list of indigenous people over 18 years old who are able to be vaccinated against the new coronavirus. The DSEI Yanomami has already vaccinated 33% of the population and continues working to reach more indigenous people.
Indigenous people served by the Indigenous Health Care Subsystem (SASISUS) and specificities of the Argument of Noncompliance with a Fundamental Precept (ADPF) 709 are a priority in the National Plan for the Operationalization of Vaccination against COVID-19. Reaching an indigenous population in protected areas of the Union requires major logistics. The Districts with land access serve the villages faster, like the DSEI Alagoas e Sergipe and DSEI Pernambuco, which have already reached the 90% immunization goal stipulated by the Plan. However, the regions with difficult access face logistical, climatic and technological difficulties.
The EMSI stay up to 30 days in the field without access to internet and cell phones, depending only on the radio signal of the DSEI for communication. When they return, the data are entered into the Information System for Indigenous Health Care (SIASI) by the District, which is why the data from the Amazon region takes longer to be computed. Follow the "VACCINATION" data that are updated daily by SESAI.
The immunization is voluntary, the Districts have carried out awareness and sensitization campaigns with the support of local leaders and the presidents of the District Indigenous Health Councils (CONDISI), especially in the fight against Fake News. And the Ministry of Defense has been a great logistical partner in the immunization campaigns for indigenous health. Aircraft from the Armed Forces are used in transportation and distribution of the vaccines, from Operation Drop to the immunization against COVID-19. The vaccines reach the states and municipalities that pass the doses on to the Districts through the state and municipal health secretariats.
Even in the face of the difficulties faced by the EMSI, by leaps and bounds the DSEI have advanced in the vaccination against the new coronavirus. In less than two months from the beginning of the Vaccination Campaign against COVID-19, on January 18, more than 66% of the indigenous population of the priority group has already received the first dose of the vaccine and most of the DSEI have already started the second dose.