Marcia Castro: Climate and health in the Amazon – 01/14/2024 – Marcia Castro

2023 was the hottest year on record. The Earth’s average temperature was 1.48°C above that observed in the pre-industrial period (1850-1900). In 2023, droughts were also observed in several regions of the planet. A United Nations report shows that 1.84 billion people (almost a quarter of the planet’s population) were in areas experiencing drought in 2022-23, 85% in low- or middle-income countries.

Drought, among other things, affects agricultural production and food security, results in involuntary migration, increases the chance of fires, has negative consequences for health and can harm the maritime transport of goods (as occurred in the Panama Canal).

In Brazil, the drought in the Amazon created dystopian environmental scenarios. The Rio Negro had the worst drought since measurements began to be taken in 1902. Communities that depend on river transport were isolated, affecting health, education, commerce, tourism, etc.

The impact of climate on the navigability of rivers is one of the challenges facing the SUS in the Amazon. In the state of Amazonas, for example, routine transport logistics is a challenge that worsens during periods of drought. Of the state’s 62 municipalities, 10 can be accessed by car, 16 can only be accessed by plane, 21 only by boat, 12 by boat and plane, and 3 by car and boat.

Illegal mining, deforestation, fires and violence add to these challenges. Therefore, the SUS in the Amazon needs to be innovative, creative, participatory and collaborative.

Partnerships and collaborations between different sectors of the government and between the government and the private sector are essential to unite efforts and resources to face problems that are, by nature, multisectoral. Joint actions between health, environment and public safety are necessary. The private sector could (and should) collaborate with inputs (vehicles, fuel, etc.).

The recent agreement with billionaire Elon Musk’s satellite internet company (Starlink) could be a unique contribution to health and education in the Amazon, if schools and basic health units (UBS) were prioritized. Starlink’s expansion, however, did not start with schools, nor with UBS. Antennas have already been seized by the Federal Police and Ibama as they were used by organized crime.

Searching for solutions demands the engagement of society and the humility to listen and learn from the different cultures and knowledge that make up the Amazon. Manaus will soon open a UBS in Parque das Tribos, the only indigenous neighborhood in Brazil. The UBS will have four primary care teams, care using traditional indigenous medicine, as well as a vegetable garden where herbs used in traditional medicine will be planted. An example of respect for local culture.

Basic care in the Amazon not only needs community health agents, but also indigenous health agents, who work proactively in the villages where they live. Without this element of local action, it is very difficult to avoid health crises.

One year after the humanitarian crisis observed among the Yanomami people, there is still hunger, malnutrition, malaria and the return of mining. A child does not become malnourished overnight. Yanomami children with severe malnutrition reveal flaws in the health care policy for indigenous peoples. They show the absence of professionals who detect problems and prevent a crisis from happening.

The permanent presence of the Armed Forces in the Yanomami area can help contain mining. But what about health? What about other indigenous lands?

Changing health care policy for indigenous peoples is more than a necessity, it is an obligation.

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