SÃO PAULO – After over three years of work to transform a traditional passenger’s ship of the Amazon into a hospital boat, Saint John 23 will finally be launched on Dec. 7 and begin to offer healthcare services to riverside communities of the Amazonas state, in Brazil.

It is the third vessel of a fleet of hospital ships built and operated by the Franciscan-inspired “Associação e Fraternidade São Francisco de Assis na Providência de Deus” – a congregation that runs dozens of hospitals and clinics all over Brazil.

Five years ago, the first one of them, named Pope Francis, was launched and began to operate in Pará state, also in the Amazon region. Later, the hospital boat Saint John Paul 2 joined it.

The idea is to provide medical attention to communities that live by the many Amazonian rivers and don’t have access to healthcare infrastructure.

“We want to serve those communities where they are located. Those are the people who preserve the Amazon and take care of our common home. They should be healthy without needing to leave their original regions,” Father Francisco Belotti, who founded the institute, told Crux.

Among the riverside communities that are the fleet’s target, many Indigenous groups have been visited by the two boats that are operating, as well as quilombola settlements, formed by the descendants of enslaved Africans who fled captivity when slavery was legal in Brazil (1500-1888).

The project was first conceived when Pope Francis visited Brazil in 2013 and asked Belotti if his association was operating in the Amazon, adding that it “should be there.”

The boats ended up playing a central role in combating the second wave of COVID-19, which hit hard in the Amazon region. At some point, all professionals and crew members were infected by the coronavirus at the same time and had to take a break from work. Several communities were helped by the ships.

Beyond the pandemic, the boats have taken care of people with numerous health problems, amounting to more than half a million medical appointments.

“People who had never done any kind of examination and test, people who had never been to a dentist had a first opportunity to do so,” Belotti said.

The focus of the fleet is on medium complexity medical attention. The boats have hospital equipment to do several kinds of tests and surgery rooms, where doctors usually operate on hernias, cataracts, hemorrhoids, and perform cesarean sections.

The ships have cabins for post-operative recovery and for hospitalization, besides offices for appointments.

When more complex cases appear, patients are taken care of and then referred to one of the Amazonian hospitals of the association, located in cities like Juruti and Óbidos in Pará, or Parintins in Amazonas.

Frequently, special missions can be planned, depending on the needs of a community. That was what recently happened in Óbidos, when the boats visited a specific location and focused on performing endoscopy and colonoscopy. More than 5,000 examinations were carried out.

“We have also organized missions focusing on psychiatric attention,” Belotti said.

Saint John 23 was funded by donations done by the Labor Prosecutors’ Office, which is commonly paid fines by companies that don’t comply with labor legislation in Brazil. It also received relevant donations from beef processing company Marfrig, as well as other private sponsors. The central Franciscan mission in Germany finances medicines and medical equipment.

“We’ll sign an agreement with the government of Amazonas and will receive operational funds from the federal healthcare system,” Belotti added.

All doctors and dentists temporarily working in the boats are volunteers. The priest said they have never lacked professionals to help them.

“If a doctor asks me today to embark, I’ll have to tell her or him that it will only be possible next year. There’s a queue of professionals waiting to collaborate,” he said.

Each one of the three hospital ships has two ambulance boats able to function as mobile UCIs. They’re fundamental to bring people from faraway settlements through small rivers and canals. Patients in critical conditions can be quickly stabilized in the ambulance boats and taken to the ships.

Amazonas Governor Wilson Lima, who visited Saint John 23 last week, told the press that the hospital boat will play a central role in the healthcare system of the state.

“It has an infrastructure that no other hospital out of the capital has. […] We’ll make great progress in the countryside,” Lima said.

The 177-feet-long ship has a system to treat all gray water and waste. A long ramp is able to connect the rivers’ margins to the boat’s entrance area, something that is needed due to the variable conditions of docking.

The idea of sending it to Amazonas came from the local authorities, who had been accompanying the work of the two other boats in Pará.

“Now, we’re analyzing the possibility of sending Saint John Paul 2 to Marajó Island, where it would be quite helpful,” Belotti said.