Vicente Piratapuia, 69, of the Piratapuia tribe had a high fever and could hardly breathe, but he refused to leave his home on the outskirts of the Amazon rainforest's biggest city. It took a stern word from a trained nurse in his community to convince him he would die if he refused a ride with her to the emergency room. Vanderlecia Ortega dos Santos, or Vanda to her neighbors, has volunteered to provide the only frontline care protecting her indigenous community of 700 families from the COVID-19 outbreak ravaging the Brazilian city of Manaus. It is an uphill battle. The ramshackle settlement of descendants from 35 different tribes, called Parque das Tribos, lacks plumbing and electricity in most homes. Ambulances regularly refuse to pick up the seriously ill because there is no public health clinic nearby. As the coronavirus pandemic has begun spreading across Brazil, indigenous people who live in and around cities have been caught in a dangerous limbo. The country's indigenous health service, Sesai, focuses its resources on those living on tribal reservations. Sesai has reported 10 indigenous deaths from the pandemic on native lands, but indigenous umbrella organization APIB estimated this week it has taken the life of at least 18 indigenous Brazilians if fatalities in urban areas are counted. The real number of cases in often remote villages across Brazil's vast hinterland is difficult to ascertain. REUTERS/Bruno Kelly SEARCH "CORONAVIRUS INDIGENOUS NURSE" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY. Matching text: HEALTH-CORONAVIRUS/BRAZIL-INDIGENOUSNURSE