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Vaccinators in Peru's Amazon face many challenges including religion and rivers


In Peru, roughly 55% of the population is fully vaccinated against COVID 19, but there are still millions yet to be immunized. So the most difficult to reach are in the rainforest of northeastern Peru, right where it pushes up against Brazil. Many remote villages, days away from any health clinic by boat, are spread along the Amazon and its numerous tributaries. NPR's Jason Beaubien reports health officials face many challenges as they try to run vaccination campaigns in this isolated area.

UNIDENTIFIED PERSON: (Speaking Spanish).

JASON BEAUBIEN, BYLINE: In the port town of Indiana on the Amazon River, dozens of people are waiting outside the municipal gymnasium to get vaccinated against COVID. Those waiting for the Pfizer shot are lined up on the right side of the building. Those waiting for Sinopharm are on the left. Fifty-six-year-old Juan Lomas Tejada is in the Pfizer line.

JUAN LOMAS TEJADA: (Through interpreter) I'm taking the opportunity on this Saturday to come from my village to get vaccinated. This way, we'll be safer during this pandemic that's coming through the area.

BEAUBIEN: Tejada says it took him just over an hour in a peque-peque, a long, narrow wooden boat with a small engine on the back, to get to Indiana. Another man in line says it took him four hours by boat. Some people travel for days, health officials say, to get to this commercial hub. There are very few roads in this part of Peru. The Amazon and its many tributaries are what link remote villages to each other, to the regional capital of Iquitos and to larger settlements downstream in Brazil. Dr. Maura Elizabeth Pachas Pinedo, who's running the vaccine clinic, says her teams have been traveling to some remote Indigenous communities to do vaccinations. But she says their ability to do that is limited.

MAURA ELIZABETH PACHAS PINEDO: (Through interpreter) As the health department here, we only have one boat that we use to get out into the communities. And we also use that boat for emergency evacuations to the hospital in Iquitos. So with just this one boat, we can't be out of Indiana for very many days.

BEAUBIEN: Another issue, the doctor says, is that the Pfizer vaccine is difficult to use in remote parts of the rainforest. They have special coolers to carry it in. But in order not to waste any doses, they won't open a vial unless they have six people ready to be vaccinated.

PACHAS: (Through interpreter) Sometimes, in a village, you don't get six people who want to be vaccinated. You get four or five. So rather than running the risk of wasting those doses, we've asked that the people come here.

BEAUBIEN: Another major challenge - crazy rumors. A common one is that the injection actually plants a microchip in your arm. And one of the biggest impediments, she says - religious groups that are opposed to vaccines.


BEAUBIEN: One of the villages where most of the residents have refused the vaccine is Suni Cano. It's an hour by peque-peque down the wide, mocha-brown Amazon from Indiana. The village of several dozen families isn't visible from the river. We have to hike through swampy rice fields and cross a lagoon in a canoe to reach it. Demister Riz Zambrano is the leader of Suni Cano. He's 25 years old. He greets us with charm and swagger. And he's unapologetically opposed to vaccines.

DEMISTER RIZ ZAMBRANO: (Through interpreter) Here in this beautiful community of Suni Cano, most of the people are not vaccinated,

BEAUBIEN: And Zambrano is proud of this fact.

ZAMBRANO: (Through interpreter) Do you know why? Because we are religious people. We believe in God, and we put our trust in God.

BEAUBIEN: Suni Cano is so far out of the way that it doesn't show up on most maps. The only electricity is from solar panels. Zambrano says their remoteness means they're less at risk from COVID. Nobody here has gotten infected that they know about. But residents from time to time do visit the bustling port of Indiana, and they do travel on the crowded boats that ply the Amazon. An outbreak, even in what seems like a small, remote village here, still could pose a threat to them and the rest of the region. But Zambrano's bigger point is that he and many other people in Suni Cano could care less about vaccines developed in some far-off land.

ZAMBRANO: (Through interpreter) God is the one who takes care of us. God is the one who protects us. He gives us life, air, health and everything for everything. And so if I got the vaccine, I wouldn't be believing in God.

BEAUBIEN: Suni Cano and places like it was a problem for public health officials. Dr. Pachas back in Indiana says the largest pockets of vaccine resistance in this region are among religious communities. For her, what is most important is to repeatedly make vaccines available, even if communities at first reject them. But when it takes a team all day in boats and by foot to reach a community where no one wants the jabs, it's unclear how many times they can keep doing that.

Jason Beaubien, NPR News, Indiana, Peru. Transcript provided by NPR, Copyright NPR.

Jason Beaubien is NPR's Global Health and Development Correspondent on the Science Desk.