The second session of this AEA webinar series (April 29) exposed the unpreparedness of healthcare systems in the Amazon region to provide an effective and intercultural assistance to Indigenous peoples (IPs) in response to COVID-19,  how the disease specifically impacts their wellbeing, and alternative measures and strategies to overcome this situation.

On the occasion, Tuntiak Katán, Leader of the Shuar Indigenous Nationality of Ecuador and Vice Coordinator of the Coordination of the Indigenous Organizations of the Amazon Basin (COICA)Frederica Barclay, Peruvian anthropologist specialized in intercultural health and President of Perú Equidad, and Alfredo Amores, Healthcare Director of the Cuyabeno – Putumayo District in Ecuador,  exposed their views from their non-governmental and governmental perspectives with an intercultural and rights approach, and shared ideas to address the double vulnerability that COVID-19 represents to IPs.

During the conversations, facilitated by Daniel De La Torre, Lead of COVID-19 Action Plan for All Eyes on the Amazon at Hivos, the following main actions, challenges, recommendations and resources were shared in a dynamic conversation among the panelists and the audience, aimed at contributing with ideas to strengthen the intercultural approach of healthcare systems in the Amazon region.


  • Community isolation and protection measures: Indigenous communities, sometimes with the support from local government authorities, are promoting self-isolation and “health protection cords”, blocking access roads and rivers to avoid the entrance of outsiders into their lands, given the risk of COVID-19 infection.
  • Digital activism: To overcome the lack of commitment from national governments, Indigenous organizations are promoting several initiatives to raise funds to support IPs in their response to COVID-19, through healthcare assistance, equipment and data, as well as through awareness raising about their specific vulnerabilities under the pandemic scenario [see more on ‘Resources’ below].
  • Intercultural Communications: Indigenous organizations have taken the lead to produce precautionary materials in native languages with graphic and video features, to make them accessible to more people. Some examples are the materials produced by ORPIO (regional IPs organization of Northern Peru), OPIAC (National IPs organization from Colombia) and COIAB (National IPs organization from Brasil).
  • Advocacy for indigenous participation in policy making: The indigenous movement is promoting a strong advocacy work for the inclusion of their representatives in the policy making and implementation of governmental strategies to address COVID-19 among Indigenous peoples. Their participation is key as they are the ones that really know the reality in their communities and what are the demands that need to be addressed.
  • Collaboration to strengthen Amazon Health Systems: Some indigenous and non-indigenous civil society organizations are working with allies as well as with governmental entities to strengthen the healthcare response in indigenous populations for COVID-19, with a focus on the reality and perspectives of local and indigenous communities. For instance, Hivos is developing, in coordination with local organizations, an “Amazon Indigenous Health Route” in Ecuador, that identifies the step-by-step to be followed and the measures that communities must take for prevention, diagnosis, sampling and treatment; in a georeferenced way, the Route indicates the healthcare establishments that attend COVID-19 cases, how to get to those establishments and and how to adapt the prevention and biosafety protocols to the proper context of the peoples and nationalities.


  • Weak infrastructure and services in the Amazon, especially in rural areas: Besides complicated access to healthcare facilities and equipment, lack of healthcare professionals and diagnosis tests, the Amazon region also faces other obstacles such as low internet connectivity and limited accessibility between urban and rural areas. These conditions represent complexities to provide a timely response for COVID-19, especially for indigenous and rural communities. 
  • Lack of intercultural healthcare policies: The Indigenous movement denounces that, up to date, no government from the Amazonian region has promoted or published healthcare prevention protocols or information related to COVID-19 in native languages, nor have they taken into account ancestral medicine and practices as precautionary guidelines against the disease. On the other hand, there is a concern about the demand for intercultural policies being reduced to the availability of precaution information in indigenous languages, rather than amplifying its focus to providing healthcare protocols as a whole, through other important axes such as indigenous healthcare professionals.
  • Shortage of diagnostic testing: The lack of diagnostic testing for COVID-19 also compromises the general recommendation from indigenous movements and leaders in the Amazon region for urban Indigenous people to return to their communities. Without diagnostic tests, people in that situation and IPs that need to move from their communities to urban centers for supplies or any other reason, risk to expose themselves as well as their community members to the disease when they return.
  • Illegal and extractive activities in indigenous lands: Besides the well-known threats that illegal and extractive activities represent to indigenous lands, the fact that they not only continue but have also increased in some regions represents one of the main COVID-19 infection risks for IPs, especially for isolated Indigenous peoples. The uninterrupted presence of workers from extractive and infrastructure industries working close to indigenous lands is a high infection risk that’s not being considered by healthcare authorities, nor controlled by law enforcement agencies.


  • Active participation of indigenous movements in policy making and implementation: Government authorities should not only communicate their actions of response to COVID-19 health emergency to the indigenous movement, but also ensure the participation of those organizations in the design and implementation of healthcare policies and programs.
  • COVID-19 as an opportunity to strengthen the promotion of healthcare policies for indigenous peoples: Healthcare authorities must provide intercultural protocols, translated into native languages, to deal with the specific complexity of COVID-19 among IPs. Furthermore, actions need to consider indigenous healthcare professionals – that speak Indigenous languages – to assist people infected with COVID-19 and also to build on ancestral knowledge regarding respiratory diseases when possible. 
  • Preparing for a future Covid-19 immunization: The Amazon region has a weak immunization chain, with people in the region presenting lower immunization coverage compared to the general population in their countries. Hence, governments must adopt measures to reinforce the vaccination chain in the region, including equipment and connectivity, so Indigenous peoples can have access to the coronavirus vaccine when available.


Below, a list of some fundraising campaigns promoted by indigenous organizations aimed at supporting rapid response grants for prevention and care against COVID-19; food and medical supplies; emergency communications and evacuation; protection for Forest Guardians; and food sovereignty and community resilience. 

  • Amazon Emergency Fund: a regional initiative coordinated by COICA and the Rainforest Foundation US, in coordination with several civil society organizations, including Hivos and the All Eyes on the Amazon program.
  • APIB Fundraising campaign: a Brazilian initiative led by the Articulation of Indigenous People of Brazil (APIB).
  • I Support Amarakaeri (Yo me sumo a Amarakaeri): a Peruvian initiative led by the ECA Amarakaeri Communal Reserve for the assistance of the communities of Harakbut, Yine and Matsiguenka Indigenous peoples located in the Southern Peruvian Amazon against COVID-19.
  • Ecuador’s Amazon Emergency Action Fund: an Ecuadorian initiative led by Alianza Ceibo, the Confederation of Indigenous Nationalities of the Ecuadorian Amazon (CONFENIAE), the Ecuadorian Alliance for Human Rights, the regional Kichwa peoples’ indigenous federation FCUNAE and Amazon Frontlines.

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