Death in the Amazon: In the lungs of the world, people die from coronavirus for lack of oxygen

• Words By News Editor Emma Burrows, Video report by Juliet Bremner

In the city of Iquitos in northeastern Peru, the bodies of coronavirus victims are piling up on the floor of the mortuary.

In this video posted on Twitter, dozens of bodies are seen taped up in black plastic with what appear to be their names pinned to their chests.

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There is no room left in the mortuary refrigerator and so the dead are lying on gurneys, across the floor and on top of each other. It is unclear how long they have been here for.

In another video, people wearing protective clothing push a body wrapped in plastic off a trolley and on to the floor. There are already at least five bodies – encased in plastic shrouds – already lying on it.

In this part of the Amazon, a place dubbed ‘the lungs of the world’ by environmentalists, people are dying from lack of oxygen.

"When the pandemic started, the majority of patients started to have respiratory problems’ Dr Carlos Calampa, regional health director for the area of Loreto and the capital Iquitos, told ITV News.

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"About 80% of people had pneumonia caused by Covid. There were no cylinders to refill with oxygen and it was so frustrating. Many people died because we just did not have enough oxygen."

Officially 3,983 people have died from coronavirus in Peru, including 288 in the Amazonian region of Loreto, but Dr Calampa told ITV News the real figure is much higher.

According to him, 1,187 people have died with the virus in the region of Loreto - although, again, he believes this figure to be much higher that officially recorded.

"You have to take into account that a lot of people have died in their homes and have been buried in a very irregular way - suddenly, clandestinely. There are also lots of people who may be overweight, but who come in suddenly with a fever, a headache, feeling sick and with respiratory failure.

"There have been patients who were getting treatment for tuberculosis and who were improving well but they contracted coronavirus and they died.

"They [officials] say 'this patient had tuberculosis' and that is correct. But it wasn't the tuberculosis that killed them, it was Covid."

As the healthcare system in Iquitos has been overwhelmed with people dying from coronavirus, the city has seen angry protests over the rising number of deaths, especially among medical staff.

Doctors and nurses have protested outside the local hospital, reading out the names of colleagues who have died from the virus and have begged the Peruvian president, Martin Vizcarra, to help them.

The president responded by insisting his presidential plane is "100% at the disposal of Iquitos" to bring supplies – including doctors and medical professionals – to the city, the largest in the world which cannot be reached by road.

"Iquitos has struggled for many years with a whole system that has been unattended for decades,’ said Valerie Paz Soldán associate professor at Tulane School of Public Health and Tropical Medicine, based in Lima.

"The deficiencies in the system have been clear to all of us who have been working there,’ she said.

"We have a system which is fragmented and there is a lack of communication. This isolation and decades of lacking care and attention has created a problem that is now evident to the whole world."

The situation is even more challenging outside the regional capital, in villages and towns deep in the Amazon rainforest, where a journey to a hospital can take days by boat or road.

Speaking to ITV News from the city of Pucallpa in the Peruvian Amazon, a 20-hour drive from the Peruvian capital Lima, Miguel Hilario-Manenima explained that people in the city with suspected coronavirus are being turned away from hospitals.

Hilario-Manenima, a community leader from the eastern Amazon region, told ITV News that locals are forced to buy their own oxygen but, because of demand, the price of a cylinder of the gas has risen from US$200 dollars to US$1,000 dollars.

"My aunt is 70 years old. She has needed oxygen for the last six days or so", he said.

"We have been collecting money so we could get her oxygen but it finished at six o’ clock in the morning today. We have to find another thousand dollars to buy her oxygen again for just 12 hours. Families who are not able to collect money have relatives who are dying from lack of oxygen."

Hilario-Manenima is a member of the indigenous community, which has been especially hard hit by the coronavirus. Many of Peru’s indigenous population live in isolated areas, far from medical facilities and are particularly vulnerable to the virus.

"Once an infection arrives it often decimates the whole population," Valerie Paz Soldán from the Tulane School of Public Health and Tropical Medicine said.

"Because they often live in remote areas with limited access, if Covid arrives at one of these indigenous communities…we are talking about possibly two days of river travel to get to a hospital."

Officially in the region of Ucayali (in which Pucallpa is situated) 104 people have died from coronavirus, but Hilario-Manenima told ITV News that in the last few weeks, in Pucallpa alone, more than 500 people have been buried at the local cemetery with suspected coronavirus. Even more deaths, he said, may not have been registered at all.

"When my uncle died we had spent all our resources and we did not have the money to do the paperwork…to get his death certificate.

"My cousin decided to take him on a motorcycle to the port and then by boat to the village where they buried him," he said.

"He is one example of someone who died with symptoms of Covid 19, he had no test for it and he was buried in the village. He is not officially dead but he is dead. There are countless other people like that all over Peru."

It is a situation that has led those living in the Amazonian regions feeling helpless and abandoned, and the government struggling to respond to a crisis in a large country that stretches from the Pacific Ocean to the Andes Mountains and the Amazon rainforest.

"I don’t feel this is the government’s fault,’" Professor Paz Soldán said. "They are trying to manage the realities of all these communities with one plan which doesn’t fit all. That’s the problem."

In the meantime, the people of Peru are still dying. Just hours after recording his interview Hilario-Manenima contacted ITV News to say his aunt had died from suspected coronavirus and from complications due to lack of oxygen – the fifth relative he has lost since the pandemic began.

"This,’ he said, ‘is a complete nightmare."