Approaching COVID-19 in the Upper Amazon

Adding Indigenous Experience and Caution

By Ted Macdonald

As Covid-19 works its deadly way into South America, many Amazonian indigenous leaders, anthropologists and concerned others are worried. They are protesting and prohibiting the possible arrival of Evangelical New Tribes Missionaries in Brazil and hoping to halt miners invading Yanomami lands. They are demanding appropriate and protective health care.  As much of the world hunkers down at home to isolate themselves, Amazonian groups certainly deserve the same protection, they say.  What is particularly impressive and widespread is the indigenous desire and willingness to do so….on their own. For most, normal life and labor is not sedentary, independent or indoors.  But their current response is not a major change. Past epidemic experiences and reactions were and remain wise strong influences. 

Many indigenous groups are closing off their communities and tell each other to stay indoors, according to information exchange with individuals in the Ecuadorian Amazon. They are fully aware of the high national incidence (over 23,000) and increasing mortality in the large port city of Guayaquil. But, as reviewed here, their own earlier epidemic and pandemic history provided many memories and stronger influence.  


On-line discussions with Kichwa indigenous from Arajuno, a growing Upper Amazon community of about 8,000 located between Napo and Pastaza Provinces, reported that in the nearby city of Puyo, there are relatively few cases of Covid-19, as well as  four others in one family in nearby Santa Clara. But, as of late April, there were only two cases in Arajuno. Such conditions are quite likely to worsen.  But what is impressive is the response. Community leaders have recommended “staying at home”  and have closed off traffic in and out of town…without any local opposition or protest. At the same time, members of the regional indigenous confederation, CONFENIAE, are distributing foods to those in short supply or stuck at home. 

While the illness is certainly new, responses have been learned over time.  Earlier accounts, when Arajuno was a far smaller and relatively isolated Upper Napo Amazonian community, illustrate that current responses were certainly not imposed on them from outside. Nor are they unique—on the contrary. Their actions have long been common and wise regional choices, despite bad health conditions and limited medical care. 


Fear of Illness

In 1974, while outlining the family genealogy of an elderly Zaparoan woman, Pasiona Shihuango from nearby Chapana, I listened to a sad history. At the time she was living alone with a distant nephew. Pasiona once had ten siblings, but she became the only living member. All of them, as well her parents, had died when a measles epidemic suddenly hit an earlier Upper Curaray settlement in the 1930s. The cause, as she saw it, was clustering after a Dominican Priest had congregated many dispersed Zaparoan and Kichwa families into his new Curaray mission station.  When measles suddenly arrived, the priest strongly encouraged them to remain settled near the church. They did. But since none had experienced measles earlier, there were no immunities. Also, with so many suddenly falling ill, they could not care for each other.  And nobody left the town. So, the sudden appearance devasted the entire community as well as most of her family. In some ways, this account has parallels with the arrival of Amazonian illnesses in the 16th century; in other ways it did not resemble later and frequent regional indigenous responses.   

As a Peace Corps Volunteer during the 1960s and also as graduate research student again in Ecuador in the 1970s, I and my colleagues were required to protect ourselves against the risky and serious liver infection associated with Hepatitis B, linked not to airborne virus but blood contacts. Before the vaccine was discovered, we had to receive large and somewhat painful injections of gamma globulin twice a year.  Otherwise, if we contacted the virus, we would quickly turn yellow with jaundice, then remain ill. In other words, infectious hepatitis was understood as a very serious illness. 

However, in Arajuno, when I became worried on seeing a jaundiced infant, the Kichwa indigenous mother explained that she had just weaned her child of breast feeding. She added that getting a little sick and yellow at that point was very common, but lasted only for a few days, then usually got better. It certainly looked that way. I later spoke to a doctor at Shell-Mera’s hospital. He explained that, many adults in the area had hepatitis. Children often picked it up early through breast milk. But at that age, he said, they quickly developed immunities. And if they became mildly ill when weaned, parents could easily take good care of them.        

 A 1996 World Health Organization (WHO) publication on hepatitis (HBV) in Third World countries supports the understanding of the Arajuno mother.   

WHO and UNICEF recommend that all infants be exclusively breastfed for at least 4 and if possible 6 months, and that they continue to breastfeed up to two years of age or beyond with the addition of adequate complementary foods from about 6 months of age. There is a considerable risk of morbidity and mortality among infants who are not breastfed. There is no evidence that breastfeeding from an HBV infected mother poses an additional risk of HBV infection to her infant, even without immunization. Thus, even where HBV infection is highly endemic and immunization against HBV is not available, breastfeeding remains the recommended method of infant feeding.

However, this positive case does not illustrate the residents’ far greater, broader and legitimate concerns regarding more dangerous illnesses viral illnesses. 

Arajuno Kichwa shop 2019, now making face masks

A bit later, in 1975, a South Asian (Indian) doctor and his family were touring Ecuador and wanted to see life in an interior rain forest village.  Talking with English-speaking missionaries near Puyo, they learned of several interior sites with airstrips. We later communicated by radio. The indigenous community appealed to him and his family. He offered to provide free medical care in exchange for the visit to Arajuno, where there was no resident doctor or frequent medical visitors. No other health care existed, except for a few basic medicines, including antibiotics, that were sold at the village’s single small store.  So, the doctor was certainly invited and welcomed. The family stayed with me for about seven days and, much to his surprise, the doctor attended patients much of each day.  

Two things illustrated long local concerns with illness. As the doctor viewed the numerous patients, he saw few serious illnesses—mainly colds, sore muscles, headaches, and old-age weaknesses. So, he frequently and warmly recommended nothing more than an increased diet of healthy fruits and vegetables. This led to a bit of local criticism. The residents wanted injections and pills. The doctor frequently hesitated. He then spoke informally to me asking why, as he put it, such strong men and women were so frightened by non-deadly illnesses.  Rather than attempt to explain, I suggested that we ask a few of the visiting patients. 


Indigenous Responses

One of the elder “strong” men, Santiago (Virdi) Calapucha, talked of the recent past and explained that sudden communal illnesses—particularly whooping cough and measles—were frequent, frightening and serious here. So Pasiona’s story was not rare.  However, Virdi explained that he and other villagers often survived such contagions. At the first sign of a “scary illness” like whooping cough, they simply picked up some gear and food, left Arajuno, and traveled quickly to their interior purina huasi to escape such contagious illness for at least several days. In brief, they have a history of social distancing and self-quarantining, as is now recommended globally with COVID-19.  

 Earlier, Virdi explained,  they shifted residence frequently because such illnesses were more regularly experienced. The doctor then saw that, in this Amazonian community and unlike his home in India, it was not young children alone who got infected by measles. He explained that, in such age groups, immunities developed quite quickly. By contrast, if susceptible adults became ill, they had a higher risk of serious illness. And if the illness was widespread, as in  Pasiona’s case, stricken adults would be unable to provide basic child care or food, drink and warm blankets to help their children recover. Equally wise and appropriate, even as late as the 1970s, at the first sign of a “scary illness” like whooping cough, the Kichwa would quickly abandon their main settlements (quiquin llacta)  for the interior residences (purina llacta).

These cases are not unique or odd examples. They were regionally common. Although the source and nature of the diseases were not scientifically understood (it was often linked to attacks by spirits, or supai as detailed in another ReVista ), the idea that everyone should self-isolate not only paralleled current global recommendations, but carried over from distant past when even more deadly pandemics arrived.    


Old World Arrivals 

What the first Spanish arrivals brought with them is widely known and heavily influential: violent armed conquest and devastating new diseases.  The early imagery was largely one of Conquistadores, mounted soldiers and men with guns storming into the Aztec and Inca empires. More recent history illustrates that they were usually accompanied, sometimes preceded, by Old World diseases that quickly spread and dramatically reduced the indigenous population. Illness was and remains a major concern. In the 16th century, populations declined significantly across the Americas due to airborne virus like smallpox, measles, typhus, plague and influenza.  The impact was greatest in the more densely populated areas like the Caribbean islands, Guatemalan highlands, the Valley of Mexico,  and the Andes. Though initially devastating, immunities developed, and populations later increased in many areas.   

Confeniae: supplies for the community.

The Amazon area was affected differently. Population decline among the relatively isolated upland forest tribes seems to have been far less that of the more vulnerable tribes of  the lower floodplains and savannas. The difference can be attributed to sporadic contact with virus carriers.

Two factors  regarding airborne virus are particularly significant when introduced into isolated communities. Not all groups in dispersed settlements were affected by the illnesses.   Unlike those Amazonian groups living in more densely settled, low riverbank settlements, or those congregated into mission settlements, many dispersed communities were bypassed, unexposed and escaped early contacts entirely. But, later they were at greater risk, with particularly important long-term results. Colonial historian Linda A. Newson writes that: 

Small communities may therefore remain disease-free for relatively long periods, but their lack of exposure to infection leads to a buildup of susceptibles, those who could fall when the illness reappears. …so that when disease is reintroduced from outside, it is associated with higher levels of mortality among adults as well as children.

That is, in relatively isolated communities introduced diseases can, of course, lead to population decline. But, in many cases, rather than lead to immunities for those who recover, the entire population remains susceptible once the illness reappears. Since it can affect adults as well as the children, those who would normally care for others during a new illness arrival could also be easily bedridden. This crisis can occur at any time, and it has. 

Early populations in the Upper Napo-Quijos region settlement was not concentrated demographically. Instead, they were inspired by greater natural resource access. Regarding initial Spanish arrivals, Newson adds that:

Even though a network of communication developed between the missions, for the most part, travel in the Oriente was slow and contacts limited, such that many diseases must have died out before they could reach new hosts. Acute infections thus failed to become endemic diseases of childhood, instead taking a limited but regular toll on the population. Rather, groups in the Oriente remained disease free for long periods until infections were reintroduced from outside, where all of those who had not been previously infected would be hit, resulting in higher levels of mortality and morbidity that affected adults as well as children. This pattern of infection contrasts with the Sierra whereby the early 17th century diseases were becoming endemic.

For example, during Gonzalo Pizarro’s first, quite long, entrada into the Upper Napo region in 1539, there is no evidence that his men carried Old World diseases with them, although a regional smallpox epidemic was reported for 1580s.  Diseases arrived later and a bit more slowly, producing a significant impact, particularly among denser lower riverine populations. But, the high Upper Napo seems to have been on the border of the areas most severely impacted.  

In the 17th century, measles epidemic reports indicate that 44, 000 died in the region, but the origin of that statistic is not clear. Population decline estimates were established by those entering the area. The most focused observations seem to have been those of the famous visita of Diego de Ortegón, but his visit of approximately forty days consisted largely of meeting with regional Spanish encomenderos and local indigenous leaders. Ortegón did not visit many settlements over the large area of widely dispersed residents. So it seems likely that the indigenous leaders who were asked to enumerate their populations simply did not reveal the numbers, particularly since the request related to demands for encomienda labor and tribute payments. 

Newson summarizes, 

…the only indirect evidence to support the early occurrence of epidemics in this region is the exceptionally high level of [attributed or estimated] decline within the first twenty years of conquest. However, nearly  all commentators attributed the decline to excessive extractions of tribute and labor, which maintained high levels of mortality, encouraged, forced or voluntary migration, and promoted infanticide and reduced levels of fertility.

However, while migrants into areas near Quito were easily noted, observations in the large Upper Amazonian forested area were limited to the settlement of Baeza, the closest to the sierra. It was suggested that some left there to join Andean communities while other “fled” into the interior. However, there is relatively little evidence of any regular Spanish presence of Spanish near lower- altitude indigenous communities, nor of much tribute payment or related labor. So there seem to have been little regular presence by outsiders to provide a clear sense of the size and nature of the local indigenous populations. Many did not flee; they simply stayed away, and were not counted because they were relatively unknown or not visible.

Confeniae: supplies for the community.

Likewise, during the much-documented Jesuit Mission of Mainas, the Upper Napo not only sat on the periphery, with Archidona serving as a jumping off station for downriver Jesuits, but the site was abandoned well before the Jesuits were first expelled from Spanish America in 1767. 

Consequently, although population decline was said to be highly significant, it is questionable where and to what extent it declined.  Disease alone was not seen as responsible for the early and large population decline noted by historians of the Quijos and Upper Napo, even though it certainly took place in or around the Spanish-established pueblos.  But how that affected the more desired forest residences of indigenous is not clear, or easily visible.

However, other factors such as immunities and fade-outs, when a virus simply disappears in a small settlements after an epidemic passes through, remain unclear. Unlike conditions that developed in the more densely populated areas, leading to reduced impact of such diseases when and if they returned, virus return in the Upper Amazon remained a major concern. In such areas the illness disappeared but high mortality could occur with any reintroduction.  

In brief, although low population densities and dispersed settlements led to comparatively low early disease mortality, settlements in the area later suffered sudden shocks, affecting some communities up through the 20th century.  Although much changed in the mid-20th century as medicines and mosquito eradication appeared, fears remained, as evidenced among Arajuno residents. But their cultural behavior was and remains appropriate. Perhaps this behavior deserves more attention. 


Leaping the Globe Tribally 

In a curious international comparison and indirect salute to Amazonian indigenous peoples—and perhaps a sharp critique of separating plagues from global economy—the Amazonian history and cultural appropriateness of concern and self-solation amidst the Covid-19 pandemic could be compared to another of the world’s greatest pandemics,the bubonic plague. It first devastated Europe in the 14th century and persisted in some areas until it leaped dangerously across the globe in the late 19th to early 20th century. 

CONFENIAE delivers food to elders.

Unlike the airborne coronavirus, bubonic plague is carried by rodents. But there was little understanding of such sources when the infamous Black Death swept across Europe. Locally, it was often assumed to be God’s punishment, received with penitent flagellation amidst groups’ Dance of Death.  The author of Plagues and Peoples, William H. McNeill, details the illness and, more important here, how it spread widely and quickly due to steamship passage in the early 20th century.  He then explains how, at that time, modern epidemiological research and international collaboration led to an appropriate closure of the plague’s movement.  Part of the research  focused on relatively wise tribal groups of the Asian steppe lands. Aware of the movement of plague-laden rodents who burrowed under their lands, the nomads never carried them from one settlement to another. Trapping such animals was taboo. So, they killed them and left them. The plague was thus somewhat controlled. But later, when Chinese immigrants rerouted through the steppe lands, they sought and sold the rodent furs. The bubonic plague was thus carried to ports and shipped around the world, in a similar fashion to the global flights that even more quickly spread the coronavirus. So, while Asian nomadic peoples did not end the bubonic plague, they showed appropriate cultural behavior and inspired science.  Amazonian indigenous peoples can do likewise as Covid-19 arrives,  showing appropriate understanding and responses. In brief, they deserve attention to their history and culture, as well as assistance in preserving their land and public health, currently at risk.  


Ted Macdonald is a Lecturer in Social Studies and a Faculty Affiliate of DRCLAS at Harvard. As an anthropologist interested in human rights, he has worked with Amazonian indigenous organizations and individuals since the 1980s, and has advised many similarly interested Harvard students. He is currently a member of the SALSA COVID-19 Task force