Far from hospitals and often lacking basic infrastructure, Brazil's indigenous people are dying at an alarming rate from COVID-19 with little help in sight.
The mortality rate is double that of the rest of Brazil's population, according to advocacy group Articulation of Indigenous Peoples of Brazil (APIB) which tracks the number of cases and deaths among the country's 900,000 indigenous people.
APIB has recorded more than 980 officially confirmed cases of coronavirus and at least 125 deaths, which suggests a mortality rate of 12.6 percent -- compared to the national rate of 6.4 per cent.
While the Health Ministry's Special Secretariat of Indigenous Health has reported only 695 cases of coronavirus in indigenous communities and 34 deaths, they monitor a smaller group of people -- only those living in traditional villages and registered at local health clinics, and not indigenous people who have moved to towns and cities.
Indigenous people who have moved to larger towns or urban areas in order to study or in search of work can end up in precarious living conditions with few public services, increasing their vulnerability to health issues. Meanwhile, those living in remote areas may not have basic sanitation and health facilities -- a 15-year-old Yanomami boy from a remote village in the Amazon was one of the first indigenous Brazilians to die of COVID-19 back in April.
"The coronavirus has taken advantage of years of public neglect," said Dinaman Tuxa, APIB's executive coordinator and a member of the Tuxa people in northeastern Brazil. "Our communities are often in remote, inhospitable regions without access or infrastructure."
He said that in the Tuxa community of 1,400 people there aren't any hospitals and the nearest ICU is a four and half hour drive away. Their main form of prevention has been complete isolation.
"In the face of the pandemic we haven't had many choices," he said. "We have completely isolated ourselves. We set up barriers. No one is allowed in and we try to keep anyone from going out."
So far, there haven't been any confirmed cases in Tuxa, but he doesn't know how long they will be able to stave off the virus. More than 60 indigenous communities have confirmed COVID-19 cases, many of them in the Amazon region, where people can only get to hospitals by boat or airplane.
According to a study by the non-profit InfoAmazonia, the average distance between indigenous villages and the nearest intensive care unit (ICU) in Brazil is 315 kilometers. And for 10 percent of villages that distance is between 700-1,079 kilometres.
"Indigenous communities -- even the ones with basic health clinics -- just aren't prepared for coronavirus, which means those infected have to be removed and often travel long distances," Joenia Wapichana, the first indigenous congresswoman in Brazil, said in an interview. "And when they get there, they have to compete for hospitals, for ICU beds, for ventilators, because there just isn't enough."
The northern and northeastern states have been among the hardest hit by the coronavirus in Brazil. Most of the COVID-19 deaths in indigenous people have occurred in Amazonas, one of the states with the highest infection rates where local officials have warned that the health system was collapsing back in March.
Indigenous rights activists warn that illegal mining and logging on indigenous lands, which have increased since Brazil's pro-development President Jair Bolsonaro was sworn in last year, now pose an even greater threat to remote communities.
Deforestation in the Brazilian rainforest increased by nearly 64% in April this year, compared to the same month last year, according to data from Brazil's National Institute for Space Research (INPE). Last month alone, more than 156 square miles (405.6 square kilometers) of rainforest were destroyed -- a vast swath more than double the size of Washington, D.C.
The first trimester of 2020 had already seen a more than 50% increase in deforestation compared to last year, according to INPE data.
"The indigenous people in the Amazon don't have the antibodies for the diseases that come from outside of the rainforest," Brazilian activist and photographer Sebastião Salgado told CNN's Christiane Amanpour during a recent interview. "There is a huge danger that the coronavirus could come inside indigenous territory and become a real genocide."
Brazil's Congress passed an emergency plan for indigenous communities last week that would not only provide medical equipment and field hospitals but also potable water and food supplies that allow tribes to isolate themselves. But it still needs to be approved by the Senate and get a green light from Bolsonaro, who has downplayed the virus and has a historically antagonistic relationship with indigenous communities.
"Indigenous people can't always be the last ones to be treated, the last ones to receive equipment," said Wapichana, who is the plan's rapporteur. "There isn't a single field hospital just for indigenous people. They are building them in the wrong places."
