Fiocruz accompanies German minister of Health on visit to project in Manaus

On Tuesday (10/29), the Leônidas e Maria Deane Institute (ILMD/Fiocruz Amazônia) and the Fiocruz Global Health Center (Cris/Fiocruz) accompanied the special agenda of the German minister of Health, physician and epidemiologist Karl Lauterbach, in Manaus, the day before his participation in the G20 Ministers of Health’s Meeting in Rio de Janeiro. The mission was coordinated by the director of Fiocruz Amazônia, Stefanie Lopes, together with the analyst from the Cris' Coordination for Cooperation with Europe, Ana Helena Freire, the Cris' international advisor for Cooperation with Europe, Ilka Vilardo, and researchers Fernando Herkrath and Pritesh Lalwani, from the Health Situation and Care Management for Indigenous Populations and Other Vulnerable Groups (Sagespi) and the Diagnosis and Control of Infectious Diseases in the Amazon laboratories at Fiocruz Amazônia.

The German Minister of Health, Karl Lauterbach (center), with representatives from Fiocruz and members of the German delegation (Photo: Júlio Pedrosa)

Accompanied by a delegation of representatives from the German government, the minister visited the riverside community of Jatuarana, located on the banks of the Amazon River in rural Manaus, to learn about the care provided by the Dr. Antônio Levino Fluvial Basic Health Unit (Fluvial UBS, in the Portuguese acronym), part of the Manaus Health Department, and thus assess the impact of the extreme drought currently experienced in Amazonas on healthcare services for this population. The minister listened to reports from the river dwellers and healthcare professionals working at the UBS, and talked to researchers from Fiocruz Amazônia about studies conducted in the region on pathologies and health problems resulting from deforestation and loss of biodiversity, control and prevention of arboviruses, surveillance of pathogens, food safety, as well as improving the quality of the healthcare service together with the communities.

The impact of climate change on people's health is currently one of the main concerns of the world's health authorities and subject of discussion at the G20. For the director of Fiocruz Amazônia, Stefanie Lopes, the importance of the minister's presence lies in the fact that he can live a little in the reality experienced by the local riverside populations. “We are here visiting the Jatuarana community with the German minister, who made a point of coming to Amazonas because it is a point of interest for him, a physician and epidemiologist, the issue of climate change, and we were able to show the Fluvial Basic Health Unit, which is a model of successful care provided to riverside populations, while presenting the work carried out by Fiocruz Amazônia with these communities, as well as projects related to climate change, infectious diseases, chronic diseases and vulnerable populations in the Amazon,” she explained.

Stefanie Lopes stresses that another point highlighted with the minister was the impact of deforestation and extreme weather phenomena, such as the dry season, on access to healthcare. "It was an opportunity for the minister and the delegation of the German government to see how Brazil innovates in these tools for access to healthcare for vulnerable populations and how we can improve this assistance through possible partnerships with that country," said the director of Fiocruz Amazônia. According to her, the Amazon is still an over-preserved forest, although the scenario is changing. "This year we have had the biggest deforestation on record in our forest and with that, the potential for new pathogens to emerge from this imbalance is great. We have many communities and populations that live and survive off the forest, and all this imbalance changes their way of life and raises the likelihood of a potential disaster, even more so when the population is extremely vulnerable and has little access to healthcare. As a result, diseases can break out and spread," he explained.

The Jatuarana community has around 120 families and 350 residents. The minister listened to reports from the riverside communities and healthcare professionals working at the Fluvial UBS and visited an Elementary School in the community, where 67 students who live in and around the locality study. "The drought makes it difficult to access healthcare services and leads to the worsening of illnesses," said retiree Nerimar Cunha do Norte, 70, a resident of the community and user of the services offered by the Antonio Levino Fluvial UBS. According to her, the lack of assistance for certain types of tests forces residents to travel to Manaus. "There are very ill people who need to go to the city and wait months for a certain type of test. Sometimes the wait takes years and, in this drought, the distance and the cost of the boat's gasoline increase. Many of them cannot afford to travel to the city or cover the cost of transportation to the healthcare unit," she lamented.

The international advisor for Cooperation with Europe at Cris/Fiocruz, Ilka Vilardo, highlighted the importance of the German minister coming to get to know the Amazon region and the research being conducted by Fiocruz Amazônia. We had the opportunity to take the minister and the German delegation to Jatuarana, where we saw how much the population benefits from the Fluvial UBS. “The minister interviewed physicians and healthcare professionals, and during the trip there and back, it was very important for him and other members of the delegation from the German Ministry of Health to talk to the director of Fiocruz Amazônia and other researchers who had the opportunity to tell us about the various health research projects that are being developed,” he said.

Ilka points out that Germany is a very important partner for Brazil and Latin America. "It was very important for the Fiocruz Global Health Center to be here, not only to testify, but also to contribute to the best possible relations and to the two-way cooperation between the two countries," she said.

Connections

Fernando Herkrath, who is the coordinator of the Sagespi laboratory, says that the model of organizing the Fluvial UBS in Primary Care is currently being applied successfully in the Amazon and Pantanal regions. “This is a super-important model for ensuring access to healthcare services and improving the health conditions of these populations, an itinerant model for care with professionals who stay in the territory and can work with promotion, prevention and assistance at the Primary Care level, a place of extreme importance for the work of Fiocruz Amazônia, in the sense of contributing to a better organization of the service, in partnership with various bodies and with the communities”, he stressed.

Researcher Pritesh Lalwani recalled that the visit of the German minister of Health shows his concern about the connections between the problems generated by the climate crisis. "The problems aren't just in the Amazon, they are worldwide. The partnership is important so that we can work together to bring permanent solutions in terms of resilience and leave a legacy for generations to come," he said. Back in the urban area of Manaus, the minister and his entourage were received by Governor Wilson Lima at the Government Palace. At the event, State government projects supported by the German government and new possibilities for partnerships and investments were presented.