Colombia: Preventing the COVID-19 pandemic among indigenous communities in the Amazon

Following consultation with the authorities and leaders of the Uitoto, Bora, Okaina and Muinane indigenous peoples, the Pan American Health Organization is helping to increase health services in the Amazon, accompanied by an educational campaign to prevent COVID-19, with an emphasis on vaccination in the villages of La Chorrera, Puerto Arica and Tarapacá.

At the height of the summer solstice in 2021, La Chorrera, a non-municipalised area of the Colombian Amazon, is the seventh victim of the pandemic. It is the leader Jesús Teteye, who contracted the virus on a trip to Bogotá. On his return to the Amazon, convinced of his own wisdom, he decided to carry the disease alone. He did not want to purify himself in his own territory, did not accept the ancestral medicine and refused to receive care at the health center.

Refusal of treatment and prevention measures, including vaccination, is common among indigenous peoples throughout the Amazon, reaching also aboriginal communities in Peru and Ecuador.

"Preserving indigenous life motivated the Government of Colombia to donate resources to the Andean Community of Nations to promote immunisation against COVID-19 and save lives, through technical cooperation actions of the Pan American Health Organization," explains Dr. Gina Tambini, its representative in Colombia.

For this reason, the UN agency carried out a complex process of consultation with the authorities of the Uitoto, Bora, Okaina and Muinane indigenous peoples, which allowed the entry of the humanitarian missions of the Organisation and the implementation of a series of training in public health surveillance and workshops on first response measures, psychological first aid and risk communication.

The goal is for the population to acquire emergency care skills, mental health protection and COVID-19 prevention knowledge with a culturally appropriate approach.

Ultimately, the aim is to enable the 2,500 inhabitants in the territory to make well-informed, life-saving decisions.

One of those inhabitants is Damien Funoratofe Dokoe, who after suffering from COVID-19, and feeling the fragility of existence, understood that his great mission is to be a good father, which means taking care of the disease and protecting his loved ones. And one of those ways is to get immunised. That is why, as soon as the vaccine arrives, without hesitating twice, he assures that he will put his shoulder to the wheel to have an "air of life" and thus be able to grow old with his descendants.

At the onset of the pandemic, COVID-19 taught profound lessons. The disease knows no borders, no race, and the Amazonian jungles also witnessed the tragedy. Like many in Colombia, Rosa Inés Herrera and her husband caught COVID-19 at a party and spread the virus to five family members. Rosa's father was one of six older adults who lost the 'air of life' in 2020.

Overwhelmed by sadness, the authorities and wise men from 22 cabildos of the Uitoto, Bora, Okaina and Muinane indigenous peoples, who are part of the Asociación Zonal Indígena de Cabildos y Autoridades Tradicionales de la Chorrera (Azicatch), gathered in each of their villages in rituals of harmonisation to find remedies in traditional medicine to appease COVID-19.

At night, as children of tobacco, coca and sweet cassava, in the sacred space of the maloca, wise men, women and men and listeners invoked the spirits of wisdom and enlightenment, through prayers and dances to the sounds of beads and rattles, to find the causes of illness. And they had meetings marked by dialogue, in which they exchanged ancestral knowledge to find in plants, bark and lianas, drinks and vaporisers with which to try to control the illness, defined as reik+, "candela" in the Uitoto language.  

It was the same in other parts of the world. Scientists from around the world flocked to research centres, laboratories and universities to find scientific and medical recommendations to prevent the spread of the virus, as well as life-saving treatments and vaccines.

For several months in this part of the Amazon, there were no more COVID-19 duels, but that did not stop fear from spreading throughout the territory. From the beginning, they understood that the virus was going to stay forever; they had to learn to live with it and not let their guard down.

Some even decided to bear the rigours of the disease quietly, receiving care from family and friends, entrusting their lives to ancestral medicines and to the spiritual strength that for some of them being community leaders requires. Others felt the symptoms of COVID-19 without the certainty of knowing whether they had been infected.

In addition to the reluctance to take the diagnostic test for fear of acquiring the virus, it was not possible to do PCR screening because the health centre in La Chorrera does not have refrigerators and chemicals to process them and, as infections increased in the country, it became increasingly difficult to send them to the departmental capital. Some antigen tests were even damaged because they could not be kept at the right temperatures.

With winter came flooding and the proliferation of mosquitoes, bad smells and health problems due to acute diarrhoeal diseases, acute respiratory infections and skin diseases, which put further pressure on the territory's fragile health system. Indigenous people with COVID-19 chose not to go to the health centre and did not allow themselves to be referred to the hospital in Leticia, in the departmental capital, as there was a widespread belief that this meant going to die far from home.

Respectful of beliefs, but also convinced that vaccination and biosecurity measures can break the chains of transmission of the virus and save lives, the Pan American Health Organization has proposed to carry out educational activities with an ethnic approach so that, in combination with traditional medicine, the indigenous people accept these solutions offered by science and can save their lives.