Hans Bossan is 40 hours into his 72-hour work week, but despite his marathon nursing shifts and the pandemic claiming an alarming number of his colleagues' lives in Brazil, he barely looks tired.
Bossan works three jobs to provide for his wife and two-year-old daughter -- at two different hospitals and a mobile emergency unit.
Double and triple shifts like his are not unusual in Brazil, where the average salary for nurses, nursing assistants and health care technicians is just 3,000 reals ($600) a month for a 30- to 44-hour work week.
The coronavirus pandemic, which has thrust health care workers into the spotlight around the world, has in Brazil also highlighted the plight of nurses, who often face bad working conditions and are now getting sick and dying from COVID-19 at a startling rate.
"Nursing was always an overworked profession, and this pandemic has just made things worse," said Bossan, 41.
"We're highly undervalued. Nurses deal directly with patients, with the virus, we're on the front lines of the war. But not everyone realizes that," he told AFP at his home in a poor neighborhood on the eastern outskirts of Rio de Janeiro.
Nurses have been hit particularly hard as Brazil has become the latest epicenter in the pandemic, with 39,680 deaths, behind only the United States and Britain.
Around 18,000 nurses in Brazil have been infected with COVID-19, and at least 181 have died -- among the highest numbers in the world, according to the International Council of Nurses.
Last month, nurses protested in the capital, Brasilia, against the poor working conditions they blame for contributing to their colleagues' deaths.
Brazil accounts for nearly one-third of the 600 deaths among nurses and other health professionals registered worldwide by the International Council of Nurses, though the organization says many countries are not doing enough to track the real number.
- 'Anxiety and depression' -
More than 80 percent of Brazil's 2.3 million nurses are women.
Often they work double and triple shifts caring for patients and then go home to care for their own families -- now with the added worry of infecting them.
"It's a time of great anxiety and depression" for the profession, said Nadia Mattos, vice president of Brazil's Federal Nursing Council (Cofen).
When the initial flood of cases hit Brazil's hospitals, health care workers faced shortages of protective equipment and inadequate training on dealing with the new virus, she said.
Although the situation has improved with time, "we're still getting lots of complaints about lack of protective gear or low-quality equipment," she said.
The council has set up virtual psychological counseling for nurses, available 24 hours a day.
The group has also pushed for years for nurses' minimum salary to be increased to $1,200 a month, double the current average.
- Heroes without capes -
One of Bossan's jobs is in the intensive care unit at Che Guevara Hospital in Marica, about 60 kilometers (35 miles) outside Rio.
Working behind a face shield with a mask underneath, he monitored the constantly beeping machines helping to keep his patients alive.
One of them, 56-year-old Eliane Lima, thanked her health care team from behind her oxygen mask.
"The doctors and nurses are excellent here. They take care of us with a lot of love. It's badly needed in a place like this," she said.
Outside, in the semi-intensive care ward, nurse technician Flavia Menezes summed up her profession thus: "It's the art of caring for people."
"Not all heroes wear capes," she added.
Nurse Hans Bossan puts on his PPE to go inside the Intensive Care Unit (ICU) of the Doctor Ernesto Che Guevara Public Hospital, where patients infected with COVID-19 are being treated, in Marica, Rio de Janeiro state, Brazil, on June 6, 2020
Health professionals check a patient infected with COVID-19 at the Intensive Care Unit (ICU) of the Doctor Ernesto Che Guevara Public Hospital in Marica, Rio de Janeiro state, Brazil, on June 6, 2020
Nurse Hans Bossan plays with his daughter after his shift at one of his three jobs assisting patients infected with the novel coronavirus (COVID-19), at their house in Sao Goncalo, Rio de Janeiro state, Brazil, on June 3, 2020
(L-R) Amanda, Claudia, Hans Bossan, Tatiana and Erika, of the nurse team of the Intensive Care Unit (ICU) of the Doctor Ernesto Che Guevara Public Hospital, where patients infected with COVID-19 are being treated, pose for a portrait, in Brazil