Margarita Ahuanari, left, and Karina Ahuanari look at posters of their mother. The images were placed where they think she was buried at the mass grave that was later renamed the COVID-19 Cemetery in Iquitos.

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Margarita Ahuanari, left, and Karina Ahuanari look at posters of their mother. The images were placed where they think she was buried at the mass grave that was later renamed the COVID-19 Cemetery in Iquitos. / Angela Ponce for NPR

When Karina Ahuanari's mother Teresa died of COVID on April 24, 2020, at a hospital in Peru's port city of Iquitos, their family had no idea what happened to her body.

At the time, the country was in lockdown and people couldn't leave their homes. Despite the COVID restrictions, Ahuanari's brother and sister-in-law went to the hospital to try to find the matriarch of their family.

The scene at Loreto Regional Hospital was chaotic. Other relatives were seeking information about their loved ones — and harried workers attempted to attend to both the dying and the dead. At first, Teresa was listed as having been cremated, says Ahuanari. Then officials announced that, no, cremations had been suspended. Teresa's name showed up a few days later on a list of the buried, but no one could tell Ahuanari where the body actually was.

"We had nowhere to turn to get the answer to the question 'Where is my mom?' " she says. "That was the whole month of May. In June, we found out from the press and social media that the bodies had been dumped" in a mass grave on the outskirts of Iquitos.

Teresa is believed to be one of more than 400 COVID victims buried there. For more than a year, the Ahuanaris and other families have been trying to get their loved ones' bodies exhumed, identified and reburied in what they view as a proper resting spot. But for many reasons, that's complicated.

A burial site in a clearing in the jungle

The mass grave is in a clearing in the jungle just off a muddy dirt track. The path looks like a timber road. It's deeply rutted and impossible to drive over in a car or even a pickup truck.

When Ahuanari and her siblings go out to visit it, they walk the last quarter mile as if they're wandering into the forest. Then they turn right into the clearing.

Graves at a new expanded section of a cemetery in Iquitos.  So many people have died of COVID that cemeteries are overflowing.

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Graves at a new expanded section of a cemetery in Iquitos. So many people have died of COVID that cemeteries are overflowing. / Angela Ponce for NPR

"This whole area was wide open," Ahuanari says about the first time she came to the mass grave site last year. "There wasn't a single cross. Only some small little blue flags" which mark the locations of the bodies.

Now there are dozens of crosses and small shrines, some with photos of the deceased spread across the red soil.

The existence of the mass grave only came to light after local journalists found it in June 2020. Hundreds of people flocked to the spot seeking relatives who'd gone missing during the pandemic. But all they found at that point was what the local paper described as a "slab of earth sealed by a steamroller."

Months after the grave was uncovered, the local government put up a gate outside the muddy field and officially declared the site the "COVID-19 Cemetery." The health department released a diagram of the site identifying where each body was supposedly buried — in graves with bodies stacked three to a hole. It also showed which level the body was located: on top, in the middle or on the bottom.

But Ahuanari says, given the initial secrecy around the burial plot, she and her siblings don't have faith that officials really know where the bodies are — or if their mother is actually in the second level of the grave where they say she is.

Community members added crosses and other markers to the locations where they were told people were buried in the mass grave in Iquitos. The mass grave was later renamed the COVID-19 Cemetery but many family members still want to exhume the bodies and move them to individual graves in the San Juan Bautiste Cemetery nearby.

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Community members added crosses and other markers to the locations where they were told people were buried in the mass grave in Iquitos. The mass grave was later renamed the COVID-19 Cemetery but many family members still want to exhume the bodies and move them to individual graves in the San Juan Bautiste Cemetery nearby. / Angela Ponce for NPR

An overwhelming number of bodies

In Peru, deaths from COVID came so quickly that the health care system couldn't keep up.

When the country went into strict lockdown on March 15, 2020, Iquitos was in a particularly difficult position. The city is only accessible by air or by barge on the Amazon. Once the COVID measures went into place, flights that would normally carry medical supplies to Iquitos were cancelled, and river cargo was banned. The local hospital, which only had seven ICU beds, was rapidly overwhelmed. Patients that doctors say could have been easily saved instead died due to a lack of oxygen. Things were so bad across Peru in the early waves of the pandemic that the country now has the highest COVID death rate per capita in the world.

Elvis Sandoval (61) director of Environmental Health in Iquitos, Peru.

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Elvis Sandoval (61) director of Environmental Health in Iquitos, Peru. / Angela Ponce for NPR

In April 2020, Elvis Ricardo Sandoval Zamora, the director of environmental health for the provincial health department, was in charge of a team created specifically to collect corpses during the first wave of the pandemic.

"We'd go out on calls to pick up the dead in public, in the streets, from people's homes," he says. "And these cadavers were taken to the morgue at the regional hospital."

That morgue was designed to hold five bodies. Yet Sandoval says at the time in Iquitos, 20, 30, sometimes 40 people were dying from COVID each day. Funeral homes were overwhelmed. The sole crematorium in town had broken down. It was nearly impossible, Sandoval says, to buy coffins. Bodies were piling up at the hospital morgue.

"We had to rent a shipping container that could hold more or less 50 cadavers," he says.

But that also quickly filled to capacity.

The pandemic made it difficult for families to claim the bodies of loved ones. Under the nationwide lockdown people were only supposed to leave their homes to collect food. Wakes and funerals had been banned.

The issue of what to do with the accumulating bodies at the morgue, Sandoval says, was a huge problem that desperately needed to get solved.

Health care workers take deceased COVID-19 victims to the morgue at Felipe Arriola Iglesias Hospital in Iquitos on May 4, 2020.

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Health care workers take deceased COVID-19 victims to the morgue at Felipe Arriola Iglesias Hospital in Iquitos on May 4, 2020. / Getty Images

In April, the regional governor ordered the local health department to start burying bodies in an unmarked clearing south of the city. The intent, Sandoval says, wasn't to do it secretly as some people have claimed. His team was working 24/7 dealing with the health crisis. Everyone was overwhelmed. And health officials were simply trying to deal with the huge backlog of cadavers, he says.

Sandoval's office is now in charge of the COVID-19 Cemetery, which continues to be used as a site for unclaimed COVID victims today. He's sympathetic to the families that want to move their loved ones to formal cemeteries. But he says exhuming the bodies and re-identifying them would be expensive. And on top of that, it's unclear now how to legally authorize such exhumations.

"The law says that after a year and one day, you can't exhume the bodies," he says. The majority of the more than 400 people buried at the COVID cemetery were placed there more than a year ago.

The Ahuanaris and many others say they've been trying for months to arrange for an exhumation, but have run into bureaucratic roadblocks every step of the way. There are rumors that some people have gotten so fed up they've simply dug up their loved ones themselves. Ahuanari says the risk of random people digging up body bags in the middle of the night and trampling over her mom is one more reason she wants the remains moved to a proper cemetery.

Several families have filed a suit to try to get a waiver to the law banning the exhuming of bodies after a year. Ahuanari and her siblings are part of that effort — and for now, they are waiting in limbo.

People visit the San Juan Bautista cemetery in Iquitos, Peru.

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People visit the San Juan Bautista cemetery in Iquitos, Peru. / Angela Ponce for NPR

A proper burial

Sunday mornings in Peru, families often go to cemeteries to visit the graves of the recently deceased. The atmosphere is often festive. Vendors sell bouquets of flowers, soft drinks, empanadas and other snacks at the cemetery gates. Kids race around on the walkways between the rows of crosses. Adults gather around the headstones of loved ones, sharing drinks, tending to the flowers, chatting.

On a recent Sunday, I met Ahuanari and several of her relatives at the Cementerio San Juan de Bautista. If they are able to get Teresa exhumed, this is the type of place they'd like her to be reburied.

It's a simple cemetery run by the city. On this morning, it bustles with visitors. People have placed colorful umbrellas over many of the tombstones to shade them from the tropical sun. Ahuanari's brother Alex Pizango says this is what they want not just for Teresa but for their entire family.

"Since her death, we haven't seen my mom. We didn't get a chance to bury her," he says.

"That is why we are asking for the exhumation of the corpse, so we know exactly where she's buried. So we know where we can go to visit her on a Sunday as a family united forever," he adds. "And also to be sure that that's really my mother's corpse in that grave."

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Ahuanari family visits the San Juan Bautista cemetery, a place where they would like to bury their mother after exhuming her from the common grave for the deceased by coronavirus in Iquitos, Peru.

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Ahuanari family visits the San Juan Bautista cemetery, a place where they would like to bury their mother after exhuming her from the common grave for the deceased by coronavirus in Iquitos, Peru. / Angela Ponce for NPR