When Marie Hoskie first heard about the new coronavirus on a local radio station in the Navajo Nation, the largest indigenous reserve in the United States, she was paralyzed.
Not because of the virus itself, but because of one of the most effective recommendations for avoiding it.
"They said we should wash our hands for 20 seconds. And I wonder how I would do that if I don't even have water to drink, cook or clean," he told BBC News Mundo, the BBC's Spanish service.
Hoskie lives in Monument Valley, one of the diverse communities of the Navajo Nation that were severely affected by the covid-19 pandemic.
She, like many there, needs to travel almost 30 km several times a week in order to find a source of drinking water.
"Now we are told that we should stay home. But I have to leave, even if I don't want to."
She does not face these difficulties alone. Almost 40% of the Navajos living in the reserve do not have access to drinking water.
Electricity, internet and paved streets are almost luxury there.
And as if that were not enough, the Navajo Nation is the region with the most cases of coronavirus per capita in the United States.
As of May 18, more than 4,000 indigenous people had contracted the virus, and about 170 had died as a result of the covid-19.
"There are many here who have lost their father, mother and brothers in a few weeks. The blow has been strong, very strong," laments Hoskie.
If it were a state, it would be the poorest
If the Navajo Nation were a country, it would be almost the size of Portugal. It is the largest indigenous reserve in occupied area in the USA, over three states (Arizona, Utah and New Mexico), but it is only a fraction of the area it occupied until the US government took it.
Today, about 170 thousand people live there, descendants of one of the peoples of the American West.
Even though they currently live in mining, hotels and casinos, like many other indigenous reserves, Navajos also suffer from a high rate of poverty, drug abuse, sexual violence, low levels of education, unemployment, empty health services and poor housing.
If the Navajo Nation were an American state, according to several studies, it would be the poorest in the country.
Data from the Department of Housing and Urban Development points out that more than a third of the homes there are overcrowded and lacking water, electricity, heating, refrigerators and other basic needs.
The Navajo Nation is also the most toxic: it houses 521 abandoned uranium mines, four deactivated nuclear processors and more than 1,100 places contaminated by radioactive waste, according to the US Environmental Protection Agency.
Apparently, it all started with a religious celebration.
The Navajos, who maintain their ancestral rites, were also influenced by evangelical congregations that promise them a better life after the countless sufferings throughout history.
Several people from different places gathered in mid-March for a service in the Chilchinbeto, Arizona community.
Someone who had contracted the new coronavirus went to the meeting and since then the disease has spread throughout the reserve.
"I believe that the way the coronavirus has spread so fast has to do with the very conditions in which the communities live," said Brazilian doctor Carolina Batista, who is part of a team from the organization Médecins Sans Frontières who went to the region to BBC News Mundo. provide help.
According to her, there are residences where four generations of the same family live together, and if a person becomes ill, it ends up contaminating several family members.
"Hospitals are scarce and lacking resources and professionals", he says. According to her, many do not imagine that "these conditions, which are common in poor nations in Africa, Asia and Latin America, could also be found in one of the most developed countries in the world".
'I've known most patients since childhood'
"My name is Michelle Tom. I was a professional basketball player and now I am one of the few Navajo doctors who work in the community.
I work at a hospital in Winslow, Arizona, a small town on the southern border of the Navajo Nation.
I never had any doubt that I would return to my community after studying medicine.
I could have ended up in a hospital in a big city, I certainly wouldn't lack resources or better conditions, but that was not an option for me.
I believe it has to do with the way we create Navajo. You, as an individual, never come first: your family and your community come first.
I never imagined that a year after returning I would see myself in something like this.
It is a very emotional moment in my life, perhaps the most intense that I will have in my entire career.
Most of the patients who come with coronavirus patients to the hospital where I work are people I have known since I was a child. They are not strangers.
This is my place, these people are my family. The members of our clan are all family, because we feel that we are connected with each other.
And it only adds to my distress.
I arrive every day to work and we don't have enough tests, I can only test those who are very sick. We have no cardiologists or other specialists needed to address these cases.
For the entire Navajo Nation, there are only 25 intensive care beds, so many patients need to be transported by air to other hospitals hundreds of miles away, and in this disease that time can mean life or death.
Nor do we have the necessary protective equipment for me and my teammates. I started talking to an NGO to try to get them.
Since mid-March, I have had to move house so as not to put my family at risk. I grew up in a home with nine people, and we are very close.
It is also a very impotent situation, because many times, no matter how much we want to help others, it is not in our hands.
80% of the food sold on the reserve is 'junk food'
When Amber Kanazbah Crotty needed to shop, she traveled almost 65 km to the market nearest her home.
The delegate of the Council of the Navajo Nation, a kind of Congress of the internal government of the reserve, told BBC News Mundo that this is a reality for thousands of people there.
According to Kanazbah Crotty, finding fresh food in the Navajo Nation is almost a utopia, and there are high rates of disease in the community associated with poor diet.
A survey by the Navajo group of experts, the Diné Community Advocacy Alliance, identified only ten markets, and 80% of the food sold in them can be considered "junk food".
"The most accessible food is the worst quality, and this influences our high rates of diabetes, obesity and cardiovascular diseases, conditions that we know to have an impact on the lethality of the coronavirus", says Kanazbah Crotty.
"We also have respiratory problems and cancer because we have coal and uranium mines, things that have affected our bodies for years and weaken our response to the virus."
According to official data, almost a quarter of the inhabitants of the Navajo Nation have diabetes, about 10% suffer from some cardiovascular disease and half of the population is obese.
Even though there are young people among those affected, one of the greatest fears in the community involves the health of the elderly, considered sacred and wise figures within the tradition and without the necessary cultural resources to understand what is happening.
"We have an adult population that speaks only one language, and translating the Navajo language takes time and experience."
The Navajo, who have a very descriptive language, call the new disease "Dikos Ntsaaígíí-Náhást'éíts'áadah", which literally means "the great disease of cough 19".
"We explain that it affects the lungs, that they will have difficulty breathing, that it causes a lot of cough and fever. We have to explain a lot didactically because, otherwise, they don't understand what we are talking about."
For Allison Barlow, director of the Johns Hopkins Center for the Health of Native Americans, the situation in the Navajo Nation for decades has hit a "perfect storm", and the coronavirus crisis has become a massacre there.
"What we see today is the result of a failed and dysfunctional system that has endured for generations," he told BBC News Mundo.
According to the expert, the situation in this and most indigenous tribes in the United States is caused by the "lack of action by the federal government, which does not respect the terms of the agreements with these nations".
After taking over the territory of most indigenous tribes during the country's territorial expansion (and years of conflict), the United States pledged to offer special treatment to members of the original peoples.
As with other communities, the central government signed an agreement more than a century ago with the Navajo Nation in which it was responsible for providing health, education and social welfare services, among others.
"But in practice the federal government fails to adequately finance these programs. It does not matter who is in charge of the White House, Republicans or Democrats. Mistreatment of indigenous peoples is a constant," said Barlow.
"Covid-19 just shed light on this failed system in which the American government forces them to …