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Brazil Travel Assessment Web Version

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Brazil Travel Assessment Web Version

  1. 1. Armada Global, Inc. 305 34th Street Pittsburgh, PA 15201 T: 412-253-2013 E: admin@armadaglobalinc.com W: www.armadaglobalinc.com Brazil Security Overview and Travel Assessment June 2015
  2. 2. A r m a d a G l o b a l , I n c . 1 The use of Armada Global's intelligence assessments constitutes the waiver from all liability for or by reason of any damage, loss or injury to person and property, even injury resulting in death, which has been or may be sustained in consequence of the recommendations made by Armada Global in its reports. Armada Global provides validated security recommendations but cannot guarantee the health, safety, or security of any individual. Use of Armada's assessments in planning or any other manner constitutes the waiver of all liability of Armada Global, Inc. Executive Summary Brazil, the largest country in South America, is a relatively safe destination for tourists; however, despite increased security measures in response to hosting the 2014 FIFA World Cup and 2016 Olympics, Brazil continues to suffer from high crime rates. Although most violent crime is targeted against locals, tourists can still fall victim to acts of violence. Tourists are also particularly vulnerable to “crimes of opportunity,” such as pickpocketing and purse snatching, and scams, such as being given counterfeit currency by vendors. Consequently, tourists should maintain a heightened situational awareness while in country. Nationwide anti-government demonstrations have continued since March 2015, and many have been infiltrated by violent anarchist groups. Tourists should avoid areas where demonstrations are taking place and plan alternative travel routes when affected. Organized crime, trafficking of illegal drugs and timber, and land disputes have led to violent clashes between criminals and police and locals. While these groups do not necessarily single out tourists, foreigners can still be harmed in these violent encounters. Illegal logging and land disputes are of particular concern and have sparked demonstrations and violent retaliation against activists. When travelling in Brazil, tourists should also pay attention to roadway conditions. Most of Brazil’s highways outside of cities are unpaved and are particularly dangerous during the rainy season, which differs throughout the country. Also, all tourists should practice standard health precautions, particularly to avoid mosquito bites. The Center for Disease Control has issued Level 1 health notices for Brazil for Malaria, Chikunyunga, and Dengue Fever; however, it must be noted that Dengue Fever in Brazil is spreading with more than 750,000 cases as of May 2015, including 229 deaths. Additionally, visitors to Brazil should be cautious of venomous snakes and spiders. While these species are often secluded to dark, shrubby areas, rainstorms and construction can bring them onto city streets and sidewalks. Hospital access is generally acceptable across Brazil. Due to the country’s large size, the impact of these issues varies from region to region.
  3. 3. A r m a d a G l o b a l , I n c . 2 Arrival Connecting Flights and Layovers Travelling from the United States to Amizade’s service sites in Brazil may require flight connections, usually with substantial layover durations. Travelers are advised to remain within the airport terminal during these layovers. An assessment of possible connecting locations follows: A) Manaus, Amazonas Eduardo Gomes International Airport was completely renovated in December 2013 in preparation for the 2014 FIFA World Cup. As such, it is complete with all of the amenities expected of a modern air passenger facility, including shopping, food courts, WiFi accessibility, and even a pharmacy and medical center. The airport complex is patrolled by private guards and police and should be considered safe. The airport is located about nine miles from the city center of Manaus, which can be reached via public transportation, taxi, or private shuttle in about 45 minutes. If travelers leave the airport, they are advised to use a pre-arranged private shuttle or one of the legitimate taxi services located in the airport. While independent taxis were banned from the airport in 2013, some may continue to attempt to pick up passengers; travelers should never accept a ride from a driver unaffiliated with one of the airport taxi services. Manaus is frequently ranked one of the most dangerous cities in Brazil. According to the United Nations Office of Drugs and Crime (UNODC), in 2013, Manaus’ homicide rate was 37.07 per 100,000 people. Comparatively, Pittsburgh’s homicide rate in 2013 was 14.6 per 100,000 people. The city suffers from high levels of gang activity and illegal drug trafficking, particularly around the city’s densely populated shantytowns, or favelas, where different houses are often painted varying colors corresponding to which type of drug that home sells. Travelers in Manaus should avoid these areas. Travelers should try to stay in the Ponta Negra beach neighborhood in the West part of the city where police presence and security is more robust. However, due to the area’s attraction of tourists, pickpockets and other criminals may target travelers with bags, jewelry, or those using ATMs. Throughout the city, travelers should also be aware of snakes, especially during the city’s rainy season (December through May). B) Belém, Pará Val de Cans International Airport is one of Brazil’s most modern airports and is equipped with amenities such as restaurants, shopping, showers and WiFi. Airport security includes private guards and police who patrol both the terminal and parking areas. The airport is about seven miles from downtown Belém, which can be reached via public transportation or cooperative taxi services in about 30 minutes. If travelers leave the airport, they are advised to use a cooperative taxi service located within the terminal. These are much safer than independent taxis and have consistent fares.
  4. 4. A r m a d a G l o b a l , I n c . 3 Belém has become an important node in drug trafficking routes from Bolivia, Colombia, and Peru into Brazil. Consequently, the city has experienced consistent increases in violent crime related to the illicit trade. According to the UNODC, in 2013, Belém’s homicide rate was 53.06 per 100,000 people, compared to Pittsburgh’s 14.6 per 100,000 people. While most of these crimes occur in the favelas of the city, the violence can also be found in the city’s tourist centers. According to local media sources, in 2009, several groups of youths from the favelas attacked tourists’ vehicles and began an altercation. Travelers should stay close to hotels and tourist centers where there is greater security, such as Estacao das Docas and the Umarizal area. Travelers should remain aware of their surroundings and avoid extravagant attire or carrying valuables. C) Belo Horizonte, Minas Gerais The Tancredo Neves-Confins International Airport in Belo Horizonte, Minas Gerais was renovated in March 2014 and, as such, has modern amenities such as WiFi accessibility, shopping, restaurants and banks. Private guards and police patrol the airport terminal and the parking structures. Incidents of luggage theft have been reported; therefore, travelers should make their way to the baggage claim area as quickly as possible and watch carefully for their luggage. As the sixth largest city in Brazil, Belo Horizonte has a high crime rate; in 2013, its homicide rate was 33.39 per 100,000 people compared to Pittsburgh’s 14.6 per 100,000 people. However, most of this crime is concentrated in the city’s favelas, where gangs and drug trafficking have led to increasing violence, and does not target foreign visitors. Travel Travelling throughout Brazil carries a variety of risks depending on the mode of transportation and the distance travelled. This assessment focuses on both travel within service sites and excursions away from the service site. Inter-Site Travel When travelling within Amizade’s service sites, volunteers will take transportation pre-arranged by Amizade on-site staff. When travelling by vehicle, it is important to check roadway conditions as many local roads are unpaved and suffer from potholes and sinkholes, especially following rainstorms. Both service sites are prone to heavy flooding and landslides that often block transit routes. Additionally, carjacking at stoplights is common in Brazil’s cities, both large and small. It is recommended that travelers lock their doors and roll up windows to at least two inches from the top to prevent someone from possibly reaching inside. If someone is approaching your vehicle, check to see if traffic is clear and continue through the traffic light, treating it as a stop sign. When travelling by boat, Amizade will primarily use vetted charter boat services. In the event that volunteers are forced to travel by larger public line boats, volunteers should stay as a group and hold onto their belongings carefully. As the line boats hold many more people, pickpockets may single out foreign visitors with bags, jewelry or cameras. Boat
  5. 5. A r m a d a G l o b a l , I n c . 4 accidents are not uncommon and volunteers should familiarize themselves with safety procedures onboard the vessel. When travelling on foot, volunteers should stay as a group and maintain heightened alertness. They should also look out for snakes and spiders, as both of Amizade’s service sites are prone to large venomous populations of these creatures. If volunteers decide to leave their housing during leisure time, they should notify Amizade staff of their destination and whom they will be with. If travelling by foot, volunteers should stick to main roads and avoid alleys and side streets, as these are often hotspots for criminal activity. Volunteers should also remain vigilant when crossing streets as many drivers ignore “stop” and “yield” signs. Volunteers can also reduce their risk of becoming a victim by alternating routes to and from their housing. Public transportation and taxis are available; however, volunteers should avoid crowded buses and independent taxi drivers. It is highly recommended that volunteers do not use either motorcycle taxis or minibuses. Motorcycle taxi drivers often ignore traffic laws and drive aggressively; many accidents have led to the deaths of both drivers and passengers. Minibuses are often overcrowded and foreigners are targets of robbery, assault and even rape. In 2013, two U.S. students visiting Rio de Janeiro were held captive on a minibus, robbed, and men onboard raped the female victim. While these incidents occur primarily in larger cities, they pose a risk to anyone using minibuses in Brazil. Volunteers should also remain alert when accessing ATMs as they may be targeted. This includes having their debit/credit cards cloned by a skimming device attached to the ATM or being victims of “express kidnappings” in which criminals force victims to withdraw as much money as possible before reaching the withdrawal limit. Volunteers should only use ATMs attached to banks and avoid private ATMs. In the event that an attacker approaches a volunteer on the street, it is highly recommended that volunteers do not resist. The U.S. government warns travelers that muggers are likely armed with either a pistol or a knife and if a victim resists, it may lead to injury or death. Volunteers should be particularly alert to ATM robberies during local holidays and festivals. Additionally, due to an increase in robberies at ATMs, some machines have been fitted with an anti-theft device that applies pink colored ink to the notes of an ATM that has been tampered with. Any pink colored note automatically loses its value and will not be accepted as legal tender. If a volunteer receives cash from an ATM with any pink markings, speak to the bank immediately to receive new notes. If you are unable to access a bank branch, get a receipt from the ATM showing the withdrawal and take it to the police station to file a report. Excursions Amizade volunteers may sometimes travel beyond the immediate vicinity of their service sites as part of an organized excursion. It is recommended that transportation be organized with a private shuttle or charter boat service. Brazil has one of the highest road accident rates in the world. When travelling via highway, travelers should check local sources for flooding, roadway washouts, accidents, or organized demonstrations that may block traffic. Many of the highways
  6. 6. A r m a d a G l o b a l , I n c . 5 surrounding Amizade’s service sites are unpaved, making them prone to sinkholes. Additionally, heavy rainfall turns many roads into mud, making them impassable. According to local media reports, there have been several instances of large buses getting stuck on muddy highways throughout the country. Rural highways also suffer from many accidents caused by high-speed and wreckless driving. Tourists should familiarize themselves with local traffic signage as many road signs are in Portuguese; for example, stop signs will say “Pare.” In the event of a traffic accident, travelers should call “190,” which will direct them to an emergency line maintained by the military police; dialing “192” will direct callers to ambulance services. Following the 2014 FIFA World Cup, Brazil also included “911” to its emergency phone line directory. Below is an assessment of possible excursions offered to Amizade volunteers: Volunteers will have the opportunity to travel to the Floresta Nacional do Tapajós (FLONA) and Alter do Chão. Once at the reserve, volunteers will be able to explore via hiking trails. While no incidents involving foreign visitors have occurred in the site, local police units do patrol the reserve for illegal logging and drug trafficking. Volunteers should stay alert and follow instructions given by police. Alter do Chão is often called “the Caribbean of the Amazon,” known for its clear waters and white sand beaches. It sits alongside the right bank of the Rio Tapajós. While this highways around Alter do Chão are paved, several stretches have no shoulder, vehicles travel at high speeds, and many drivers leaving Alter do Chão are drunk, which has led to several accidents involving pedestrians walking along the side of the highway. On May 7, 2015, a bus ran over a woman and her three children, resulting in the death of the woman and one of the children. The accident generated revolt and the community set fire to the bus and blocked the highway with tree branches in protest of the road conditions and unsafe driving behaviors of bus companies. Local traffic police and military police responded to the accident and calmed the crowds; no bus passengers were harmed. The Regional Director of the State Department of Transportation (SETRANS) has scheduled emergency road repairs in response. Not only do traffic accidents pose a threat to volunteers travelling on this highway, but also ongoing local protests against bus traffic on the highway may block traffic. While it is highly unlikely that demonstrators will harm passengers, these events are ongoing and may escalate in severity. Travelers should drive carefully and pay close attention to changing road conditions and speed limits. As a frequented site for tourists, Alter do Chão is relatively safe. The primary concern for criminal activity is petty theft and pickpocketing. Volunteers should safeguard their bags and valuables while at the beach or at shops. This is a particular issue on weekends when most tourists visit the beaches. Stingrays are often a problem for swimmers while visiting the community, especially in the afternoon and evening. Fortunately, they are very skittish, so it is safe to swim where other large groups are also in the water. When entering and exiting the water, swimmers should shuffle their feet to kick up clouds of sand, which will scare away lingering stingrays. If stung, go to one of the beachfront hotels for first aid and then seek medical attention.
  7. 7. A r m a d a G l o b a l , I n c . 6 Security Assessment: Brazil Crime Rate Brazil is often labeled as one of the most dangerous countries in the world because of its high crime rates compared to other countries. The U.S. Department of State rates the crime threat for Brazil as critical. In 2013, Brazil’s national homicide count was 53,646 at a rate of 26.5 per 100,000 people according to the UNODC. In that same year, the United States’ homicide count was 12,253 at a rate of 3.8 per 100,000 people. Brazil also suffers from comparatively higher rates of robbery and sexual assault. According to the U.S. State Department, these incidents increase during December and January due to a variety of factors including: prison furloughs that allow for leave during holidays, a higher percentage of police officers on annual leave during the holidays, and citizens receive a “thirteenth month” bonus that leaves them with more disposable income. Foreigners are not entirely immune from these crimes; many criminals may target foreign visitors because they are less likely to file a police report and are less likely to return to the country to testify in criminal proceedings. In January 2015, four criminals attacked a Lebanese diplomat while he was in his vehicle en route to a local shopping mall. He was hit on the head and suffered a broken nose and bruises. While most of these violent crimes occur in major urban centers and are more likely to be aimed against locals, a spatial analysis of homicides across Brazil shows intense clusters of violence around the country’s smaller cities and in rural areas. National and State police forces are attempting to reduce these crime rates by increasing the number of police and through programs targeting centers of violence, such as the “favela pacification program.” However, it should be noted that smaller cities and rural areas are only recently seeing increased police presence. Therefore, travelers to Brazil should remain alert even when outside of major cities. Homicide Rates in 2011 for Brazil's Municipalities Source: Brookings Institution, Latin America Initiative; October 2014
  8. 8. A r m a d a G l o b a l , I n c . 7 Organized Crime and Illicit Trade Gangs exist in Brazil’s large cities but also operate throughout the country and region. In major cities, such as Rio de Janeiro and Sao Paulo, these gangs exist almost exclusively in the favelas where police are not as present. These urban shantytowns offer a place of refuge to criminals and a way of selling illegally trafficked drugs. To rid the favelas of gangs, federal and state police forces have begun moving into the slums to arrest gang leaders and crack down on drug sales; these efforts often lead to gun battles between authorities and criminals. This has only been partially successful with many favelas still under the control of gangs. In the past, targets of gang violence outside of the favelas included police stations, buses, official buildings, businesses, and some tourist hubs. It is uncommon for gangs to get involved in petty crimes of theft or robbery because it yields much less money than narcotic and weapons sales. However, while most gang violence targets police or locals, foreigners have been victims in the past. Tourists should be aware of suspicious groups of individuals that appear to be watching tourist or other affluent areas. Visitors should also avoid going to restaurants or nightclubs that do not have security personnel after nightfall. Additionally, tourists should avoid any travel into favelas where gangs maintain considerable control. Foreigners should not attempt to purchase any form of illicit drugs or narcotics (including cannabis) as it will attract the attention of gang-related dealers and because all drugs and narcotics are illegal in Brazil. Outside of major cities, organized crime has expanded its presence through a growing drug trade. According to a Brazilian police intelligence report, the prison gang known as First Capital Command (PCC) now has a presence in 21 of Brazil’s 27 states. A burgeoning market for cocaine due to a growing middle class provides gangs with a huge source of revenue. Additionally, Brazil’s porous borders, especially with Bolivia, Colombia and Peru, allow for Growing PCC Influence in Brazil Source: National Public Security Secretariat (SENASP); 2012
  9. 9. A r m a d a G l o b a l , I n c . 8 easy transport of drugs between Brazil and the rest of South America. These trafficking routes transport drugs and weapons throughout Brazil. Government response to this issue has included deploying military and police forces to border regions. This has led to an increase in violent altercations between gang traffickers and police in much of southern Brazil. Travelers should avoid isolated areas, particularly along rivers or forests, as these are common places for drug traffickers to operate. Illegal Logging Eco-trafficking in Brazil’s Amazon Rainforest is also a growing cause of violence in the country. According to the Brazilian government, illegal logging accounts for 80 percent of all logging activity in the country. The profits on illegally sold timber has created a powerful criminal class operating in isolated corners of the Amazon but whose ties to organized crime groups throughout the country have been increasing. These groups are known to use violence to silence informants and activists. Between 2002 and 2013, at least 448 environmentalists and land rights activists were murdered in Brazil, including foreigners. These homicides are often marked by the extremely violent deaths of victims due to hired killers being required to bring proof of the kill to their clients. In 2011, a couple was murdered for campaigning against illegal logging and shutting down logging roads. Two assassins shot the couple in the head and removed an ear from each of the corpses; a witness in the case was later found dead. Many activists blame impunity and corruption for the violence, arguing authorities fail to thoroughly investigate these killings. In March 2015, the Brazilian government launched a new Environmental Operations Unit, made up of primarily military police, posted as strategic points along smuggling trails in the Amazon Rainforest to fight illegal logging. Volunteers should be attentive to their surroundings and avoid areas where police may be carrying out anti-logging operations. If volunteers are witness to crimes such as these, it is imperative that they cooperate with police but that they also contact the U.S. Embassy for legal advice. While it is unlikely that volunteers will be targeted, volunteers should remain conscious that advocating for environmental issues might draw the attention of these criminal groups. Nationwide Demonstrations and Civil Unrest Since early 2015, demonstrations have been taking place throughout Brazil to protest against corruption and increases in costs to basic services. Protests were triggered by revelations that members of Brazilian President Dilma Rousseff’s Workers’ Party had accepted bribes from the state-owned energy company Petrobras during a period when President Rousseff was on the company’s board of directors. Initial protests occurred on March 15 with protestors’ numbers being estimated between 1,000,000 and 2,000,000 nationwide. On April 12, the U.S. Embassy in Brasilia issued a consular security message to U.S. citizens in Brazil to warn them to stay away from demonstrations and large gatherings. While most of these demonstrations remained peaceful, violence did occur in a few instances. It should be noted that some demonstrations in the past have been infiltrated by anarchist groups, such as the Black Bloc. This group often
  10. 10. A r m a d a G l o b a l , I n c . 9 organizes its operations on social media sites and wears black clothing and black bananas/masks to demonstrations. These agitators sparked violent clashes between demonstrators and authorities. Volunteers should avoid demonstrations and making comments that may incite hostility towards them. Land Reform and Indigenous Populations Unequal distribution of land serves as a major flashpoint in relations between several groups in Brazil. Multinational corporations have been given priority access to arable land by government legislation, which has sparked resistance movements from workers groups and indigenous populations. The Landless Rural Workers’ Movement (MST) aims to reclaim large swaths of agriculturally rich land from large corporate holdings and reallocate it to groups of small farmers. MST lawyers fight in courts to gain a legal claim to properties that meet government requirements for redistribution, but squatter communities are also often established on these lands, a process referred to as “land invasions.” These communities have experienced violent clashes with large landowners and police trying to evict them from the lands. There have been several instances of landless farmers being murdered by groups connected to land-owning entities. MST has also staged demonstrations at public and corporate institutions, which often lead to violent skirmishes between protestors and police. Volunteers should stay away from squatter communities and MST demonstrations as they may be targeted by anti-land reform groups. Land reform issues have also been entangled in the protection of the ancestral lands of Brazil’s indigenous populations, primarily in the north and center-west areas of the country. Since the passing of the 1988 constitution, Brazil has demarcated 557 indigenous territories, and another 100 are still being reviewed. Many of the recognized territories have been affected by deforestation and mass development, particularly the construction of hydroelectric dams in the Amazon. Indigenous communities have lobbied the government and have held protests against these projects. Further, they have also seized hostages and burned several buses. However, this violence has been targeted against local employees of development corporations. Groups fighting to have their land claims recognized by the government have also participated in “land invasions.” This has led to the murder of several indigenous community members by local farmers and clashes with police trying to remove squatters from disputed lands. These groups have also organized demonstrations in major cities throughout Brazil. While advocating for indigenous populations is not generally unpopular or dangerous, publicly supporting land reform may draw attention to volunteers. Terrorism in the Tri-Border Area (TBA) Media reports have claimed the existence of extremist groups, such as al-Qai’da, HAMAS, and Hezbollah, in the Tri-Border Area (TBA) of Brazil, Argentina and Paraguay. These groups have reportedly used the area as a base for raising revenues through illicit trafficking. A history of
  11. 11. A r m a d a G l o b a l , I n c . 10 lawlessness has made the TBA an ideal location for extremist groups to increase their presence in the Western Hemisphere. Additionally, a sizeable Arab population in the region, mostly Lebanese immigrants, has provided these groups local support and has made it harder for authorities to separate extremists from locals. While no credible evidence can be found that these groups operate beyond financial interests in the region, they may target large festivals or sporting tournaments, such as the 2016 Olympics. However, according to the U.S. Department of State, no significant threat from terrorism inside Brazil currently exists, and increased counter- terrorism efforts by Brazilian authorities has reportedly reduced the presence of extremist groups. These groups’ operations are unlikely to extend beyond the TBA region and further into Brazil due a greater presence of law enforcement and reduced local support. However, due to the high level of crime and drug trafficking activities, foreigners are advised against travelling to the TBA. Topography Many Brazilian cities are built into the side of steep valleys and have several precipitous slopes. Their winding and uneven streets are often constructed with large flat stones. Travelers should walk carefully as it is easy to suffer an injury from falling over these uneven surfaces. The streets are particularly dangerous during and following rainstorms when the wet stones are very slippery. Landslides and flooding are a concern during the rainy season. Roads can often become impassable for extended periods of time and may prevent volunteers from travelling. Health Concerns Dengue Fever Dengue Fever is a viral illness spread through mosquito bites. Dengue has rapidly spread throughout Brazil following a recent drought that caused many to fill buckets of water, which attracted infected mosquitos. The Center for Disease Control (CDC) currently has a Level 1 Watch issued for Brazil for Dengue. Though most infected people do not get sick or have only mild symptoms, Dengue can be a severe and sometimes fatal illness. Symptoms can take up to two weeks to develop. Mild Dengue symptoms include fever, headache, eye pain, muscle and joint pain, nausea, vomiting, or rash. Even if mild symptoms cease, this may be the beginning of severe Dengue. Symptoms of severe Dengue that volunteers should look for are intense stomach Tri-Border Area Source: Library of Congress; 2010
  12. 12. A r m a d a G l o b a l , I n c . 11 pain, repeated vomiting, abnormal bleeding from the nose or gums, vomiting blood or blood in the stool, drowsiness or irritability, clammy skin, or difficulty breathing. If volunteers develop any of these symptoms, they should be taken to an emergency room immediately. Follow the CDC’s Dengue Fever website for updates and warnings: CDC Travel Notices There is no medicine or vaccine to prevent Dengue; the only measure of protection is preventing mosquito bites. Mosquito bites can be prevented by the following methods:  Use an insect repellent with an approved active ingredient (DEET, Picaridin, OLE or PMD, IR3535).  Treat clothing and gear with Permethrin.  Cover exposed skin with long sleeves and pants.  Stay in a screened or air-conditioned room. In rooms exposed to the outdoors, use a mosquito net.  Empty containers of standing water and keep trash containers closed. Chikungunya The CDC maintains a Level 1 Watch for Chikungunya for all of Brazil. Symptoms usually begin 3-7 days after being infected and include headache, muscle pain, joint swelling, or rash. Chikungunya does not often result in death, but the symptoms can be severe and debilitating, especially for those with diabetes or high blood pressure. While most people begin to feel better in about a week, it is recommended those experiencing symptoms seek medical attention, as many of the symptoms may also be signs of Dengue Fever. Taking steps to avoid mosquito bites, as outlined above, can help prevent Chikungunya. Malaria Malaria is a serious and sometimes fatal illness carried by mosquitos that is prevalent in tropical and sub-tropical climates. The CDC has issued a Level 1 Watch for Malaria in Brazil. Symptoms of Malaria can take several weeks or months to begin and include fever, chills, headache, sweats, fatigue, nausea, and vomiting. Travelers to Malaria zones should see a doctor if they experience these symptoms up to a year after returning to the United States. Travelers can protect themselves from being infected by taking antimalarial drugs, obtained from a doctor in the U.S. prior to travelling, and preventing mosquito bites. Travelers can learn more about Malaria prevention at the CDC’s Malaria website: CDC Malaria Vaccinations The CDC recommends the following vaccinations for those travelling to Brazil:  Update routine vaccinations such as MMR, Chickenpox, Polio, Flu, and Tetanus  Hepatitis A  Typhoid
  13. 13. A r m a d a G l o b a l , I n c . 12  Hepatitis B  Malaria  Rabies  Yellow Fever Venomous Animals Brazil is home to several of the world’s most venomous species. Travelers to Brazil should be aware of these animals and what to do if they encounter one. Armada recommends that travelers in Brazil do not attempt to handle any animal that is unfamiliar. For those doing extensive travelling in the Amazon region, refer to this link for a list of dangerous animals to be aware of: The Amazon's Dangerous Animals. Below are some of the species visitors should be most concerned with. The Brazilian Wandering Spider, also known as the “Armed Spider” or “Banana Spider,” is listed as the world’s most poisonous spider. This spider can grow legs up to six inches long and is usually hairy, brown, and has a dark spot on its body. They are called “wandering” spiders because they do not weave webs but wander on forest floors at night, seeking prey. During the day, they hide in dark crevices or under logs and are often found inside of houses and cars. Volunteers should check bedding, bags, shoes, and vehicles for spiders that may be hiding. While these spiders normally only attack out of defense, they can become aggressive during the summer months when they are mating. Although their venom is extremely toxic, death from a bite is quite rare. This is because little venom is usually released during a bite and because an antivenin is available at hospitals. Initial symptoms from a bite include severe burning at the site of the bite, extreme sweating, and goose bumps. Within 30 minutes, symptoms can include erratic heartbeat, fluctuating blood pressure, abdominal cramping, blurred vision, and nausea. In males, a bite can induce a painful erection that lasts several hours. If bitten, volunteers should seek medical attention immediately.
  14. 14. A r m a d a G l o b a l , I n c . 13 The Bothrops Alternatus species of pit viper, also locally known as “Urutu” or “Jararaca,” is an extremely venomous snake that is found frequently in southeastern Brazil. It is usually a light or dark brown color with staggered dark spots on its body. While it primarily stays in jungle areas, it often enters homes searching for prey in both agricultural and urban areas. It is known for its aggressive nature and is quick to strike those who approach it. Volunteers should check under furniture and in vehicles for these snakes and, if found, should call local authorities to have the animal safely removed. Bites from this snake have led to several deaths; however, an antivenin exists but must be applied quickly to lessen long- term complications. Symptoms from a bite can include swelling and burning around the site of the bite and can also lead to paralysis. Additionally, travelers should be aware that Coral snakes, mostly found in the Amazon area, are extremely venomous and should not be handled. These snakes, however, are not common in well-trafficked areas. If bitten, volunteers should seek medical attention immediately. Victims should wash the wound area with soap and water and keep the affected area raised. If possible, take a photo of the snake to help medical staff identify the species. A complete list of venomous snakes in Brazil can be found here: WHO Venomous Snake List The Lonomia Obliqua caterpillar is very poisonous and found throughout southern Brazil. Its protective coloring allows this animal to blend in to the bark on trees. Even if travelers try to avoid these caterpillars, they often get exposed to its venom when leaning against a tree and unknowingly brush up against a caterpillar. Travelers should be extremely cautious when travelling through wooded areas and be particularly careful of leaning against trees and structures. Exposure to this animal’s venom can bring severe internal bleeding, renal failure, and hemolysis. If skin comes into contact with multiple caterpillars, enough venom is released that death can occur. Volunteers going on hikes are advised to bring antiseptic and duct tape in case of exposure. Clean the wound with antiseptic and apply tape to the wound, remove the tape to pull out any remaining hairs from the caterpillar. Immediately seek medical attention if exposed. An antivenin does exist but depending on the time between exposure and treatment, blood transfusions may be required.
  15. 15. A r m a d a G l o b a l , I n c . 14 Medical Facilities Hospitals and emergency medical services are available in Amizade’s service locations. In remote locations, municipal hospitals generally have better emergency treatment than private hospitals. Since public hospitals are free and usually better equipped to handle emergencies, these municipal hospitals can often be overcrowded. It is advised to go the municipal hospitals for emergencies and private hospitals for ambulatory (“walk-in”) injuries. While private hospitals have fees, the wait to be treated will likely be shorter. In smaller cities, medical facilities are poorer. While their physicians are usually well-trained, due to funding constraints, they are not always able to provide the treatment they are trained to give. It is also recommended to acquire evacuation insurance. In remote regions, medical evacuation systems are unrefined and often very expensive. Travelers should ensure they have medical insurance that is accepted in Brazil, as private medical facilities can be quite expensive without insurance. Alternative Medical Facilities In the event of injuries that require extensive medical attention beyond that of local capacities, travelers should be aware of the nearest medical facilities. Included in this assessment are hospitals in several major Brazilian cities. Manaus, Amazonas Manaus is home to several hospitals that meet Western standards of healthcare. One facility that Armada recommends for those travelling in the area is Hospital Santa Júlia. It is located at Avenida Ayrão 507 and its phone number is +55 (92) 3233-9693. This hospital offers a 24-hour emergency room with ambulance service and several non-emergency services, including oral and plastic surgery. It is home to well-trained physicians, many coming from the United States and Western Europe. This hospital also has cooperative agreements with several Western health insurance companies. Belém, Pará Belém has several teaching and research hospitals and is often recognized for its top medical facilities. Many of these facilities meet or exceed Western standards of healthcare. Armada recommends those travelling to Belém for medical attention go to Hospital Porto Dias. It is located on Avenida Almirante Barroso and its phone number is +55 (91) 3184-9999. This facility has a 24-hour emergency room with ambulance service and offers many preventative and non- emergency health services, such as ophthalmology and oncology. Its staff includes physicians well trained in a variety of specialties, giving patients access to a full spectrum of medical attention.
  16. 16. A r m a d a G l o b a l , I n c . 15 Belo Horizonte, Minas Gerais Belo Horizonte is home to a 21st century healthcare system that attracts many well-trained physicians from around Brazil, the United States and Western Europe. For foreigners seeking medical care in Belo Horizonte, Armada recommends Hospital Felício Rocho. Its emergency room is located at Rua Timbiras 3585 and its phone number is +55 (31) 3514-7000. The facility is home to several specialty clinics, including one for infectious diseases. The hospital has received several international awards and accreditations for its services. Brasilia, Federal District As the capital of Brazil, Brasilia is home to some of the country’s best healthcare. For those travelling to the city for medical attention, Armada recommends Hospital Daher. It is one of the most well respected hospitals in Brazil because of its quality of care and medical technology. It is located at SHIS QI 07 Conj. F in the Lago Sul neighborhood and its phone number is +55 (61) 3248-4848. Most known for its plastic surgery services, the facility also provides patients access to a full spectrum of medical services. The hospital also has several cooperative agreements with several Western health insurance companies. Rio de Janeiro, Rio de Janeiro Rio de Janeiro is the second largest city in Brazil and attracts millions of tourists each year. Consequently, its healthcare system is one of the best in the world. For those travelling to Rio de Janeiro for medical attention, Armada recommends Casa de Saúde São José. It is located at Macedo Sobrinho 21 in the Humaitá neighborhood and its phone number is +55 (21) 2538-7626. This facility is popular with Western expatriates living in the area because of its international patient section with English-speaking staff. While it has a long history in specializing in cardiac care, the hospital has physicians who specialize in a wide variety of medical fields. Security Recommendations Deteriorating road conditions and reduced police presence make remote regions particularly dangerous for travelers. Additionally, the threat from eco-related criminal activity operating throughout Brazil is a legitimate concern. To mitigate these concerns, Armada recommends that Amizade consider hiring a local vetted security transportation service, for both overland and river travel, who can direct travelers away from areas of concern. In the event of a deteriorating security situation, Armada recommends traveling to a nearby safe site to seek support. Depending on the nature of the incident, the closest police station may be the preferred location; however, during demonstrations, police stations may be targets. In the event of a large-scale security concern, Amizade volunteers and personnel should travel to the
  17. 17. A r m a d a G l o b a l , I n c . 16 nearest metropolitan area and seek shelter in a Western hotel. Once relocated, remain in shelter and avoid unnecessary travel outside of the hotel until the situation is resolved. Armada advises all travelers to practice the following security awareness techniques:  Be cognizant of your surroundings  Avoid predictable patterns  Do not dress extravagantly or wear expensive jewelry  Travel in groups  Use only trusted transportation nodes (arranged by western hotel, for example)  Do not hail street cabs  Prior to your trip, register with the U.S. Department of State’s Smart Traveler Enrollment Program (https://step.state.gov/step/) and if travelling with a smartphone, download the Smart Traveler app (available on iOS and Android).  Ensure you have proper vaccinations and have registered for travel insurance and medical evacuation coverage Emergency Contact Information Local Emergency Phone Numbers  Police- Dial “190”  Ambulance- Dial “192”  Fire- Dial “193” U.S. Diplomatic Missions  U.S. Embassy Brasilia SES 801- Avenida das Nacoes, Lote 03 70403-900 - Brasilia, DF Brazil Telephone: +(55)(61) 3312-7000 Emergency After-Hours Telephone: +(55)(61) 3312-7400 Fax: (61) 3312-7651 BrasiliaACS@state.gov  U.S. Consulate General Rio de Janeiro Avenida Presidente Wilson, 147, Castelo 20030-020, Rio de Janeiro, RJ Brazil Telephone: +(55)(21) 3823-2000 Emergency After-Hours Telephone: +(55)(21) 3823-2029 Fax: +(55)(21) 3823-2093 acsrio@state.gov
  18. 18. A r m a d a G l o b a l , I n c . 17  U.S. Consulate General Sao Paulo Rua Henri Dunant, 500, Chacara Santo Antonio, 04709-110 - Sao Paulo, SP Brazil Telephone: +(55)(11) 3250-5000 Emergency After-Hours Telephone: +(55)(11) 3250-5373 Fax: +(55)(11) 3250-5159 SaopauloACS@state.gov  U.S. Consulate General Recife Rua Goncalves Maia, 163, Boa Vista 50070-060 - Recife, PE Brazil Telephone: +(55)(81) 3416-3050 or +(55)(81) 3416-3080 Emergency After-Hours Telephone: +(55)(81) 3416-3060 or +(55)(81) 9916-9470 Fax: +(55)(81) 3231-1906 RecifeACS@state.gov

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