No one should die of malaria today

by Global Diversity Foundation
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No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
No one should die of malaria today
Please support health and cultural wellbeing!
Please support health and cultural wellbeing!

With this report, we announce a new phase of work of the project. Your contribution, today, will help us to once again deliver lifesaving results.

In preparation for a return to Venezuela this winter, Egleé has been back in touch this week with members of the amazing network that enabled delivery of those 3,000 insecticidal mosquito nets, almost 2 ½ years ago: the bush pilot, the health worker, the local doctor, tthe malarial specialist, he NGO leader, the shipping contractor, among others. Their consensus? After a year without visits by medical personnel to any of the three communities since early November 2020, there is critical work to be done, and it is newly possible to do it. “Our project strategy looks promising, with different dynamics,” reports Egleé.

We were delighted to learn that, thanks to an initiative of the United Nations Development Program (UNDP/PNUD), the government has offered to take up the work of providing nets and key antimalarial medications and diagnostic supplies to Atures, Manapiare and Cedeño, the counties that include Jotï, Eñepa and Piaroa sovereign territory. The UNDP partnered with Venezuelan health authorities to acquire all the necessary anti-malarial paraphernalia (preventive medications, treatments, diagnostic kits ) including all the estimated nets to fulfill the Venezuelan population exposed to malaria —including ones designed for hammocks. They expect to receive all these materials between January and February 2022. How wonderful, says Egleé, “to think that the mosquito nets can start to be part of the government health policy!”

The news arrives just in time, as the current nets approach the end point of their useful 2-3 year insecticidal life, and antimalarial medications have run out. After an astounding 2 ½  years of without a fatality from malaria in any of the three communities, news of the first lethal cases just reached us, via radio: two Eñepa who fell ill while they were outside the community, and also some members of the nearby Pemon community have ded of this terrible disease recently.

While the government/UNDP initiative is tremendous news, Egleé also learned, “there will not be resources for the little plane flights for distribution of the nets and medical supplies”. The new initiative doesn’t include last (several hundred-) mile delivery to small, isolated communities. 

That’s where your support comes in: no need for the project to navigate trans-Pacific shipping this time—but a critical need to cover other costs:

- the direct distribution to communities of the new nets, specialized medications, diagnostic materials, and training on use of both by trusted personnel. They’ll travel via small plane or by truck, accompanied by members of our project. This is the most important—and most costly—component of this new stage of the project.

- generic medicines and supplies associated with diagnosing and treating malarial infection that we’ll procure for the ambulatorios, the community clinics, to complement the specialized medications provided by the government. These items range from a new microscope, slides and vials for the dedicated microscopist in Betania de Topocho (first requested before the pandemic), to Tylenol (paracetamol), alcohol, swabs, and sterile gauze. As in the past, Egleé will send careful translations of the dosing and usage instructions for each medication. Each clinic has a trained field nurse on hand to received and manage them. We’re working to update the detailed lists clinic personnel provided in 2018. There’s a particular critical addition they are calling urgently for in their community radio updates:

- snakebite antivenoms and treatments, antiofidicos. These are out of stock because they are no longer being produced at the Universidad Central de Venezuela in Caracas. With your support, the project will work to obtain a supply of most critical antivenoms, ideally in neighboring Colombia, which hosts a strongly overlapping set of venomous snake species.

In addition, we hope to piggyback on these delivery efforts to begin to adapt and distribute small, portable malaria testing and treatment kits, called malakits, in partnership with our network and the three communities (https://www.malakit-project.org/; see images, below). First designed for and with small-scale miners in Suriname, the initiative would like to expand to Venezuela, building an initial strategy in highly mobile Indigenous communities like Betania, Caño Iguana, and Kayama: communities that are well-organized, and have trusted liaisons. The hope? For community members to be able to diagnose and treat malarial infections in real time while they are on the move, in the rainforest

away from any health center to confirm diagnosis and deliver treatment—further complementing the nets, and avoiding unnecessary malarial deaths and transmission. The central idea is to increase the capacity to learn where and when malaria in transmitted (local contexts) to improve the strategies to eradicate the infection, morbidity and mortality.

“In that sense,” says Egleé, “we believe that we can target our project with these ideas in main for this new stage. We will keep you posted!”

Please contribute today to support this community-driven, lifesaving, evolving work!

The clinic in Cano Iguana
The clinic in Cano Iguana
The Betania de Topocho clinic
The Betania de Topocho clinic
The clinic at Kayama
The clinic at Kayama
Malakit mobile malarial prevention & treatment kit
Malakit mobile malarial prevention & treatment kit
Malakit diagnostic components
Malakit diagnostic components
Malakit treatment elements
Malakit treatment elements
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Evaluating a severely malnourished child
Evaluating a severely malnourished child

Two years ago, an entire network of sensitive, committed people working in solidarity got together and articulated ourselves to really try to help alleviate the problem of malaria in key Venezuelan Amazonian Indigenous communities. Together with these committed individuals, and the concerted efforts of communities themselves, that initiative has been incredibly successful: even now, there has not been a single reported death from malaria in any of the three communities where the project distributed and trained residents on the use of nets.

“They love them, they absolutely love them,” says Egleé of the nets—and they continue to use them. The only suggestion for improvement? A community review, conducted recently through the radio, indicates community members like the nets and have put the nets to very good use. The nets have had a very positive effect in reducing morbidity (illness), as well as mortality. The only suggested design improvement? As the chemical repellents have begun to wear off the nets over time, tiny midges and no see ’ums are becoming bolder, and making their way through the mesh of the netting. Eglée and Stanford are contemplating a slight redesign for the replacement nets, which they hope to reorder and deliver this fall and winter.

Right now, though, Venezuela remains at a standstill: there is no fuel available to transport supplies by plane or truck to communities--or to transport patients facing serious illness or injury to medical treatment. And while an active Indigenous-led policy of isolation has largely protected remote communities from COVID-19, it cannot protect from all forms of illness and injury. It is also very difficult to obtain many needed supplies and medications locally, and those impacts are greatest on already marginal communities.

Indigenous patients facing extreme medical issues often arrive walking—or carrying infants and children—to the main hospital in the capital city of Puerto Ayacucho Amazonas State. Children are arriving very sick at hospital. Sometimes people arrive so ill that the hospitals are unwilling to accept them—and the hospital, too, has limited supplies.

Given that it has not possibility to directly deliver medication and supplies to address malaria to communities in the past 4 months or more, we have pivoted to redirect a limited quantity of project resources to support some of those determined patients seeking care. The project has helped Piaroa and Jotï patients, as well as Yanomami, Yek’wana, and members of other Amazonian ethnic groups. We are working through the same network of dedicated project partners who enabled us to deliver the mosquito nets, and extending our connections to partners to whom they introduced us, like Astríd, a woman who has an unflagging commitment to the health of Indigenous people, and supports patients with difficult cases.

Most of the cases we have partnered to support are those of Indigenous women and children: the most vulnerable. We have sent small tranches of money designated for specific cases: $40, $60. These funds supported have supported three women with breast and cervical cancers, and a woman with problems in the digestive tract. The funds have covered fees for x-rays, blood tests, 4 diagnostic breast x-rays, simple but specialized surgical apparatus to support care, and nutritious food to aid in recovery

With care so difficult to access, sometimes by the time patients arrive the care offered can only be palliative: despite support for medication and food, a Yek’wana mother who arrived at the hospital with a dramatic case of cerebral tuberculosis passed away. She was 33 years old. Project funds, though, have also successfully supported Indigenous children: kids with poor nutrition and malaria, surgical evaluation for children with hernias, with a broken femur, and two with injuries from snakebite. The difficult cases continue: just 3 hours before we sat down to write the report, a little girl arrived with 16% of her body affected by 3rd degree burns. 

Those seeking medical care are resourceful. “When you send resources,” says Egleé, “Indigenous patients who are mobile go where the resources are.” Thank you for sharing your resources: you have helped us to extend a small, protective net of care, patient by patient. Thank you for your solidarity with Indigenous Venezuelan Amazonian communities striving to care for one another, to find resilience, health and wellbeing in these challenging times.

Medical supplies & nutritious food help patients
Medical supplies & nutritious food help patients
A child receives medical attention at the hospital
A child receives medical attention at the hospital
X-ray after casting a child's fractured femur
X-ray after casting a child's fractured femur
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Jkali x 2! A young Jkali with Eglee's, also Jkali
Jkali x 2! A young Jkali with Eglee's, also Jkali

Jkali, pictured above as a boy, has been this project’s main point of contact with his Jotï community, Caño Iguana. He received messages via the community’s radio, and relayed them to the project via WhatsApp message, using a project cell phone. Since he was able to catch a flight into the community in February, carrying the medicines and supplies sent by the project, we have not had any direct communication Caño Iguana. But we continue to receive news! Another group has supported the purchase of a satellite phone in the community. Now community members are able to send text messages every few days, keeping allies abreast of health issues, emergencies and difficult situations. Our project, in turn, receives news via those text messages—including the news that Jkali and the medicines arrived in good order. He has remained there, protected with his community from COVID by isolation.

The project leaders’ relationship with this group supplying the sat phone dates back nearly 30 years. When Egleé and Stanford first visited the Jotï, in 1994, the group’s representatives were suspicious of the young anthropologists, perhaps because of a previous experience with fractious graduate students. But after 2 years, in which the pair kept a respectful, low profile, the group came to appreciate their shared commitment to work for the community’s wellbeing, and have kept up a friendship ever since.

Egleé says, “The Amazon is difficult, very complex. If you start out in conflict, you won’t survive. Instead, our relationship has been one of cooperation and respect.”

School director Gerardo and his family have remained in town, and he continues to relay messages received via radio from his Jotï and Eñepa home community of Kayama. Project leaders learned some sad news that way, recently. Alberto, “one of the wisest men in Kayama”, passed away; he and his wife drowned when their canoe overturned. He was still strong and in good health, in his mid-fifties. The Jotï , Egleé says, are people of the mountains and deep forest; most of them only began to use canoes about a decade ago. “We met Alberto on our first visit to the community, in 1996,” she said, “He was very dear to us.” The radio has its limits; Gerardo didn’t have many details.

In February, a trainee doctor in his last year of residency was able to reach Kayama. He entered at the insistence of Gerardo, who was concerned about possible cases of COVID in the community. Fortunately there were none, but there were a few cases of malaria, and respiratory and stomach infections. The doctor spent just 3 days, but brought with him medicine that the project sent from the U.S., and other medicines and supplies purchased locally with project funds.

The copies of the book which the community co-wrote with Stanford and Egleé were published in Venezuela, but most have remained locked up in a deposit. On that same flight that carried the young doctor and the medical supplies, though, 15 copies of the book entered the community of Kayama, and it has been very well received, with delighted reports coming in by radio. Egleé isn’t sure whether they, in turn, have shared copies with Caño Iguana yet; a 529-page book is a lot to carry on a 4-5 day walk, over 100 km away.

Most recently in Kayama, Gerardo reports that there are many children with respiratory infections right now, who are at risk of developing pneumonia. The project has sent--and will send more--funds for medicines, to be delivered at the next opportunity. In addition, we plan to send anonther round of medicines and supplies via a monthly service that delivers items to Venezuela via container ship. 

Thank you for your gifts, which make  this continuing relationship of cooperation and respect possible, even in the hardest times. To celebrate the longstanding character of the connection with these communities, I asked Egleé to share some photos from the archives. Below are her selections, from the early to mid 2000's, in and near Caño Iguana and Kayama. "What nostalgia!" she says. 

Eglee in Cano Iguana with her son in 2003
Eglee in Cano Iguana with her son in 2003
Stanford prepares for a communal ritual, in Kayama
Stanford prepares for a communal ritual, in Kayama
Eglee and family, Rio Moya, Enepa territory, 2003
Eglee and family, Rio Moya, Enepa territory, 2003
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Joti field nurse Jkali tests PPE before a delivery
Joti field nurse Jkali tests PPE before a delivery

Project leader Egleé called me in excitement earlier this week.The three communities have finally received the boxes of medicines and supplies that we sent! “It’s almost a miracle,” says Egleé. She sent the boxes from the U.S. months ago—you can find pictures in an earlier report—and they finally arrived, complete with Egleé’s meticulously detailed pages translating indications and dosing instructions. The boxes sent to the community Caño Iguana arrived on a recent Sunday; Jkali entered on a flight. He was the first person with medical training to visit his community in over a year. 

Jkali, shown above wearing PPE (“Amazonauta!”, a friend quipped), has completed a field nurse training program. He is currently working with a network of NGO medical personal delivering medicines and health information to tiny, remote satellite communities of Caño Iguana. “Everybody know him,” says Egleé. “All are Jotï, making him almost uniquely qualified to do this work.” Jkali is one of only 4-5 bilingual Jotï/Spanish speakers with this medical training. In addition, he contracted and recovered from COVID-19 early in the pandemic, while stuck in the city. The NGO’s doctors believe this makes him the best person to carry out these deliveries. 

As far as we know—from Jkali’s conversations, and reports relayed by radio, then cell phone, COVID has not reached these communities. But no medical doctor has visited in 14 months. No flights have been possible, and the communities have kept themselves in isolation throughout the pandemic.

Project partners helped the other two sets of boxes reach their destinations. “In Kayama there is a set of wonderful medical doctors who have, for at least 30 years, been traveling to at least 60 Indigenous communities,” says Egleé. Kayama is one of those communities. “Just for the month of December, it has become possible, informally, for NGO workers to travel once again to the communities. These doctors just delivered the medications we sent to Kayama.”

A Piaroa nurse delivered the supplies to her community of Betania de Topocho, overland. “They sent a really lovely message of gratitude,” Egleé reports. “They said were going to go walking to deliver medicines to the houses where they were needed.”

Egleé is hoping to travel herself early next year to deliver additional medical supplies and more mosquito nets, as soon as she can get vaccinated against COVID-19, so she will not risk being a carrier when she visits communities.

It took too long, she says, to honor communities’ requests. But once again, despite all odds and in this year unlike any other, much-needed medicines and supplies were delivered.We thank you for your part in that work! Please consider a year-end donation to support the project’s ongoing efforts.

Medicines and supplies reach Kayama
Medicines and supplies reach Kayama
COVID-19 health infographics shared, in Joti
COVID-19 health infographics shared, in Joti
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Medications and supplies for the recent shipment
Medications and supplies for the recent shipment

Community health authorities used the project-funded radio recently to convey a list of needed supplies to Jöti teacher Gerardo, who continues to self-isolate in the city with his young family. Gerardo reached via phone out to Egleé, who painstakingly assembled four enormous boxes of over-the-counter medications and supplies to be delivered to his home community. She just shipped them via courier from the U.S. to the nearest possible location to Gerardo's  hometown.

And for now, that's where they'll have to stay.

"The most important message," Egleé writes,"is that there is NO way to get to the communities, due to COVID-19.... We are sending meds, to have them stored in cities surrounding the communities, for when access is possible." She hopes to travel a little later this year, to help deliver those packages.

For now, as coronavirus sweeps the interior of South America, the strategies Venezuelan Indigenous communities have developed to protect themselves from contagious diseases seem to be serving them well. When families learn of the threat of a potentially serious communicable illness, they socially distance, leaving gathering places and moving deeper into the forest.

"Good news is no reports of cases [of COVID-19] among the Jöti, Eñepa or Piaroa. Not much incidence of malaria either," writes Egleé. "All seems frozen. Incertitude seems to be the constant, now more than ever, in the Amazonian region."

While we all wait, we thank you for your support of this project, which has enabled us to be in effective relationship to these three communities, and to respond to their carefully articulated needs. With your help, we were able to provide robust tools to address the malarial outbreak, deliver critical medications, and most recently, to make sure each community has the means to communicate their current situation via radio. With your continued support, we will be ready to respond, together with communities, to what comes next.

All packed up and ready to go: supplies head out
All packed up and ready to go: supplies head out
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Organization Information

Global Diversity Foundation

Location: Bristol, VT - USA
Website:
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Project Leader:
Susannah McCandless
GDF International Program Director
Bristol, VT United States
$8,294 raised of $12,000 goal
 
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