Before the clinic ran out of oxygen, Maria Auxiliadora da Cruz had been showing encouraging signs of progress against Covid-19. On 14 January, her oxygen levels had been above the normal level of 95% but, within hours of being deprived of that vital resource, her stats plummeted to 35%.
At this point, patients would normally be given intubation and oxygen by machine. Instead, the 67-year-old retired nurse died. “It was horrible,” her grieving daughter-in-law Thalita Rocha told the BBC. “It was a catastrophe. Many elderly patients began to deteriorate and turn blue.”
In an emotional video that went viral on social media, she described what was happening at Policlínica Redenção in the northern Brazilian city of Manaus. “We’re in a desperate situation. An entire emergency unit has simply run out of oxygen… A lot of people are dying.”
Brazil has the world’s second-highest Covid death toll with more than 221,000 fatalities. In Manaus, the health system has collapsed twice during the pandemic and deaths doubled between December and January.
Now there are fears the lack of oxygen supplies seen there could unfold elsewhere in Brazil and even in other parts of Latin America, where a second wave of Covid-19, in many countries, is proving to be worse than the first one.
In Peru, some hospitals have been unable to meet the demand brought by a steep rise in cases in recent weeks. As a result, patients’ relatives have had to hunt for oxygen in the black market. In some cases, they come back with nothing.
A black market is also thriving in Mexico, where more than 155,000 have died in the pandemic. To make things worse, there have been reports of thieves taking oxygen cylinders from hospitals and clinics.
According to the World Health Organization (WHO) one in five Covid-19 patients will require oxygen. In severe cases, this rises to three in five. The organisation says some hospitals have seen demand for oxygen increase between five and seven times above normal levels because of the influx of patients with severe and critical disease.
The most dramatic situation in the world is in Brazil, where nearly 340,000 oxygen cylinders are needed every day, according to the Covid-19 Oxygen Needs tracker. The online tool helps estimate the scale of the challenge for policymakers and was developed by the Covid-19 Respiratory Care Response Coordination partnership which includes Path and Every Breath Counts.
Also according to the tracker, Mexico and Colombia each need more than 100,000 cylinders daily.
So how does a hospital run out of oxygen?
Oxygen has been considered an essential medicine by the WHO since 2017, but Lisa Smith, from Path’s market dynamics program, says ensuring adequate supply depends on many “components” falling into place.
This includes not only sources of production, but also training to enable medical staff to monitor and manage oxygen levels.
Medical oxygen is produced in large quantities at plants and delivered to hospitals in two ways: either in bulk in liquid tanks or as pressurised gas in cylinders containing smaller volumes.
Liquid oxygen is the cheapest and best technology available but it requires hospitals to have the right infrastructure to pipe oxygen to the patient’s bedside. This is common in developed countries such as the US and those in Europe.
Cylinders do not require pipes and can be delivered to clinics without a sophisticated infrastructure. However, their distribution on a smaller scale means they are less cost-effective, in addition to being cumbersome to transport and handle, which also carries an increased risk of cross-contamination.
Another source of production is on-site oxygen plants, which produce oxygen to be piped or compressed into cylinders. The WHO says it is currently trying to map how many such plants exist in the countries.
After Manaus reached crisis point, oxygen donations were sent from the federal government and other states – as the local providers said they were unable to increase production – and across the border from Venezuela. But even transporting them became a problem.
Jesem Orellana, an epidemiologist at the Oswaldo Cruz Foundation in the Brazilian city of Rio de Janeiro, said the risk of shortage continued and was exacerbated by global demand.
According to Path, medical oxygen accounts for just 5-10% of the world’s oxygen production. The rest is used in various industries, such as mining, chemical and pharmaceutical.
“We need to think about oxygen as much as we think about electricity, water or other essential utilities,” says Ms Smith. “This can’t be something that we’re only concerned about when it’s bad, because when it’s bad, people will die.”
In the meantime, there are concerns that the strain of Covid-19 on oxygen supplies could have a knock-on effect for the treatment of other diseases.
“Covid has shown us just how essential it is in countries where there is no vaccine against Covid, no medicines,” says Leith Greenslade, who leads the Every Breath Counts Coalition. “Often, it’s down to whether you get oxygen or not, whether you live or die.”
Read from source: https://www.bbc.com/news/world-latin-america-55829424
Brazil’s indigenous communities fear mining threat over war in Ukraine
Maurício Ye’kwana worries about the future. He comes from the community of Auaris, in northern Brazil, close to the border with Venezuela.
The area, part of the Yanomami Indigenous Territory, is rich in gold, diamonds and minerals – and illegal miners want a piece of it. In all, there are an estimated 20,000 illegal miners on the land.
“It’s got worse in the past few years,” Maurício says, explaining that during the pandemic, the number of planes, helicopters and boats linked to illegal mining increased.
He’s only 35, but it’s the younger generation that concerns him – boys increasingly being lured into illegal work.
“The young people are the best boat drivers,” he says. They can earn as much as 10,000 Brazilian reais ($2,140; £1,645) for a single trip.
Maurício has come to Brasilia to take part in the Free Land Camp, an annual event that brings together indigenous communities looking to defend their land rights.
On Brasilia’s main esplanade, a grand avenue that leads to Congress and the presidential palace, communities from across the country have erected hundreds of tents.
Milling around the camp are indigenous Brazilians, many of them wearing feathered headdresses, intricate beaded jewellery and painted with geometric tattoos identifying their tribe.
This year, the event has taken on an even bigger meaning.
President Jair Bolsonaro has made it his mission to push economic development in the Amazon. In his latest attempt to make inroads into indigenous territories, he has cited the war in Ukraine. Brazil relies heavily on imported fertilisers for its agribusiness industry – more than 90% of its fertilisers come from abroad, and Russia is its most important partner.
“A good opportunity arose for us,” Mr Bolsonaro said of Russia’s invasion of Ukraine. He has argued that by mining in indigenous territories, Brazil can build more of its own potassium reserves.
It’s an argument questioned by some experts.
“Only 11% of the reserves are inside indigenous lands and other states like São Paulo and Minas have reserves,” says politician Joenia Wapichana, the first indigenous woman voted into Congress in 2018. “It’s a false narrative that tries to confuse the minds of the Brazilians, making them believe it’s important, that people won’t have food on their table.”
Also, it’s not a short-term fix.
“From a technological and environmental perspective, the licences needed and the infrastructure – it all takes time. Being able to offer these products to the Brazilian market would probably take seven to 10 years,” says Suzi Huff, Prof of Geology at the University of Brasilia. “We’re talking about an extremely sensitive area in which care needs to be taken. It’s false to say that it will solve Brazil’s problems.”
The bill has been in the works since 2020. But last month, the lower house voted to consider it under emergency provisions, removing the need for committee debates.
“It’s very clearly blackmail,” says Prof Huff. “Bolsonaro saw an opportunity to continue with this project of allowing mineral exploration including in indigenous lands and used the scarcity of fertilisers in Brazil to move forward with this project.”
It was expected to be voted on in the lower house this week, but that hasn’t happened – and few believe, in this election year, that it will. Not even the big players in the industry agree with it, with the Brazilian Institute of Mining last month saying it was a bill “not suitable for its intended purposes”, and calling for broader debate.
While a delay in voting is seen as a relief by indigenous leaders, it’s still a challenge on the ground.
“A fiery political discourse encourages invasions in indigenous lands,” says Joenia Wapichana. “The fact that Bolsonaro says he supports mining, that he will regulate mining in indigenous lands already exposes the indigenous people and makes them more vulnerable.”
The discourse is, of course, deeply political, especially with elections around the corner. On Tuesday, former president Lula da Silva – and the man leading in the polls to win October’s vote – made a visit to the camp.
“Today the headlines are about a government that doesn’t have scruples when it comes to offending and attacking the indigenous communities who are already on this land,” he said.
The response was huge cheers of “out with Bolsonaro” – but there are still six months until the elections. And this is Brazil – much can change in politics here, and the future of Brazil’s indigenous tribes is more uncertain than ever.
Homes engulfed as deadly landslide hits Colombia
A landslide triggered by heavy rains has killed at least 14 people in central Colombia, officials say.
Another 35 people were now in hospital after several homes were engulfed in the Dosquebradas municipality, Risaralda province, on Tuesday.
The officials issued a photo showing a gash in the lush foliage covering a mountain overlooking the area.
Other residents living close to a swollen river nearby have been moved to safety.
Rescue teams have been searching in the mud for more survivors, Colombia’s disaster management officials said.
“A very loud noise scared us. We went out and saw a piece of the mountain on top of the houses,” taxi driver Dubernei Hernandez told the AFP news agency.
“I went to that place and it was a disaster, with people trapped.”
Mr Hernandez said he helped dig up two bodies and a survivor. At least five homes were buried by the mud, he added.
There are fears that the death toll will rise further.
Landslides are common in Colombia and houses built on steep hillsides are at particular risk during the country’s rainy season.
In 2019, at least 28 people were killed after a landslide hit the south-western Cauca province.
Two years earlier, more than 250 people were killed when a landslide hit the town of Mocoa, in the southern Putumayo province.
Mexico violence: Third journalist killed this year
A Mexican journalist has been shot dead in the northern border city of Tijuana, officials say, the third journalist to be killed in the country this year.
Lourdes Maldonado López, who had decades of experience, was attacked in her car as she arrived home on Sunday.
She had previously said she feared for her life, and was enrolled in a scheme to protect journalists, activists said.
The country is one of the world’s most dangerous for journalists, and dozens have been killed in recent years.
Many of those targeted covered corruption or powerful drug cartels. Campaigners say the killings are rarely fully investigated, with impunity virtually the norm.
The motive for Maldonado’s killing was not clear and no-one has been arrested.
During a news conference in 2019, Maldonado asked President Andrés Manuel López Obrador for his “support, help and labour justice” because, she said, “I fear for my life”.
She was referring to a labour dispute with Jaime Bonilla, who was elected governor of Baja California state later that year as a candidate from the president’s Morena party. Mr Bonilla, who left office late last year, owns the PSN media outlet, which had employed Maldonado.
Maldonado had sued the company for unfair dismissal and, last week, said she had won the lawsuit after a nine-year legal battle. Mr Bonilla and PSN have not commented.
Rights group Article 19 said she had previously been attacked because of her work and was registered in the Mexican government’s programme to protect journalists.
The campaign group Committee to Protect Journalists (CPJ) said it was “shocked” by the murder.
The killing came six days after photojournalist Margarito Martínez was shot dead outside his home in Tijuana. He covered crime in the city, with his work appearing in national and foreign media.
A week earlier, José Luis Gamboa Arenas was found dead with stab wounds in the eastern city of Veracruz. An editor at the Inforegio and La Notícia news websites, he often wrote articles about organised crime and violence.
Exact numbers of victims are hard to come by as investigations often get nowhere, and different studies apply different criteria in counting the dead.
According to Article 19, 24 journalists were killed between December 2018, when President López Obrador took office, and the end of 2021.
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