World Health Day: what happens when 'guardians of the forest' require medical care?

Daniele Macuxi has been protecting her land in the Amazon that has been around since the time of her ancestors. By preserving these ancient lands, she is protecting the habitats of both plants and animals. She and other indigenous people are ensuring the survival of the Amazon and keeping the harmonic relationship between themselves and the forest alive. They are what we call “the guardians of the forest”. Honouring this relationship – and doing all that we can to keep it intact – is critical to the future of humanity. That is because indigenous territories contain more than 80 per cent of the world’s biodiversity. The Amazon rainforest, in particular, is one of the most crucial areas of land on our entire planet. A recent report by the World Resources Institute found that parts of the Amazon managed by indigenous people removed more carbon dioxide from the atmosphere than they released, while areas not managed by indigenous people saw widespread deforestation, producing more carbon dioxide than they removed. The report underscores the important role indigenous people play in ensuring the Amazon’s future, and the future of our planet. But what happens when these guardians of the forest fall ill and require medical care? Their way of life precludes a complex healthcare infrastructure and travelling to a major city for treatment can be extremely cumbersome; a boat trip can take up to 20 days and the complete treatment of a simple surgery, such as cataract surgery, could require the patient to stay in the city for a year or more. Many indigenous people in the Amazon develop degenerative eye disorders, such as cataracts, due to frequent exposure to the equatorial sun. Cataracts are the leading cause of reversible blindness in the world and can be highly disabling. Indigenous people also suffer from abdominal hernias because of hard manual labour, besides other treatable diseases. When Daniele, a young mother of two small children, developed cataracts at a young age due to diabetes and eventually became blind, the Expedicionarios da Saude (EDS) team arrived in her village in the Indigenous Land Raposa Serra do Sol territory to treat her. The procedure was a success and Daniele was discharged the next day, with the ability to see again for the first time in years. There are hundreds of positive stories like Daniele’s thanks to the transformative work being carried out by EDS. I established EDS with Dr Martin Affonso Ferreira and other friends back in 2003. What began as a hiking trip to explore the Pico da Neblina Mountain, turned into a series of medical expeditions to support the indigenous communities of the Amazon. What we do is take the hospital into the forest. We provide specialised medical and surgical care for indigenous communities geographically isolated within the Amazon through our Mobile Hospital Complex, so they do not have to leave their communities to seek medical treatment in distant cities. Since 2003, we have carried out 50 expeditions, with a total of 9,837 surgeries, 70,809 consultations, and 126,000 exams and procedures. Most surgeries are related to specialties of ophthalmology and general surgery, in addition to paediatric, orthopaedic, and gynaecological surgeries of medium complexity. Today, with more than 300 active volunteers and 20 tonnes of equipment, EDS works all over the Brazilian Amazon forest. It is fitting that this year’s World Health Day, which is themed “Health for All”, focuses global attention on the importance of extending quality health care to all corners of the globe, especially those in remote and last-mile communities. Access to health care is a basic human right, and it is important that all individuals, regardless of where they live, have access to the healthcare services they need. Remote communities, such as the indigenous communities of the Amazon, are often at higher risk of certain diseases due to their geographical isolation and limited healthcare infrastructure. By providing them with high-quality healthcare access, they can receive timely diagnosis and treatment for illnesses, reducing mortality rates and enabling them to lead productive lives, and of course, carry out the critical work of protecting the Amazon rainforest. Earlier this year, EDS won the Zayed Sustainability Prize , further validating the work we are doing to extend health care to vulnerable and isolated communities. Now, thanks to winning the Prize, we can carry out even more missions, consultations and surgeries. We will invest in the development of our employees, create efficient processes, and enhance the level of professionalism in our work methods so that we can offer even more high-quality health services to the guardians of the forest.