The coronavirus is spreading rapidly throughout Brazil, overwhelming a health care system that is ill prepared to handle a pandemic of this magnitude and proving especially deadly for the medical workers on the front lines.

At least 116 nurses have died in this country of 210 million from Covid-19, according to Brazil’s Federal Nursing Council—the highest toll anywhere. That is more than the 107 nurses who have died in the U.S., where the total death count of people succumbing to the pandemic is about six times more than in Brazil. In Italy, which has about twice as many total deaths as Brazil, 39 nurses have died, according to Italy’s National Federation of Nurses, or Fnopi.