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Archive for the ‘health’ Category

The Sacred Valley is full of paradoxes. Stunning vertical landscapes. Tourism and a hippy mecca. Andean Waldorf schools. And grinding poverty…

I first meet up with Sandra and Sandy: two good natured, down-to-earth Canadians who are volunteering in Peru. Sandra with Kuasay Wasi Clinic (http://kausaywasi.org/) and Sandy with DESEA, Desarrollo en Accion (www.deseaperu.org), Green Empowerment’s new partner in implementing a project to improve health through household water filters. With the exciting news from the Metabolic Studios of Annenberg Foundation, the project finally has the resources to really get off the ground. I am in the Sacred Valley to see the team of DESEA, meet the communities and work out the logistics of the new grant.

Ricardinia, the newly-hired field manager, took us out to the communities: Totora, Accha Pampa and Chaipa. While at about 4000 meters (13,000 feet) themselves, they were nestled in valleys with the surrounding peaks towering at the aching heights of 5000 meters (16,400ft). Ricardinia grew up a day’s walk from the closest road, in some hidden village in these sacred hills. She left for high school and trained to be a teacher. She heard the radio ad for the DESEA field manager and was hired on. She is a huge asset as she is the main cultural and linguistic bridge to the poor communities.
ricardinia
In Totora we met Gregorio, the filter workshop manager, who was the young mayor of this adobe village. He was dressed in western clothes and spoke in fluent Spanish with a Quechua accent that made round words sound like triangles. He had attended the CAWST (www.cawst.org) training as is a devotee of the biosand filters that he builds everyday. We caught him with a bundle of wire mess as he was heading to Pampallacta to repair the school’s filter.

When they saw Sandra arrive in Totora, a group of women gathered for a “clinic” (not a building, but an event). They squatted on the ground and unwrapped their bundles of brightly woven cloth to reveal children that needed a nurse’s eye.
clinic
We met a woman and her baby that had lost a dangerous amount of weight from diarrhea. She had taken her to the Kuasay Wasi clinic where she was given a dehydration solution. By the time I met the baby, she had gained back some weight and looked like she would survive, but it drove home the point that simple hygiene and clean water are the most important things we can do to save children’s lives.
baby

These communities speak almost no Spanish. They maintain the poetic Quechua language and traditions alive. Everyday clothes look like a celebration, with dozens of buttons on the wrists arranged like pearls on an evening gown, and big flat round hats covered with ornate red cloth that dangled over the edge.

And yet, illiteracy, isolation, discrimination and malnutrition have taken their toll. Sandra describes meeting a woman who could not remember how many of her children had died; was it 5 or 6? I hear stories of a toddler eating paint, excessive alcohol and spouse abuse. I don’t see this kind of malnutrition where I live in Cajamarca, where rural people have few resources, but plenty of food, although both areas show signs of protein deficiency, with a diet based on rice and potatoes.

In Totora and Accha Pampa, we walk into the tiny dark kitchens, covered in soot, to see the filters. Ricardinia translates from Quechua. The people we met said they used the filters daily and even said that they had noticed an improvement in health of the children. They understand that the filters clean. The filters are made in one of the project communities out of local materials. The concrete structure is filled with sand and gravel which effectively remove pathogens.
biosand filter

Ricardina, Gregorio and the team say that everyone wants a filter. But once they have it, there are some (perhaps 15%) who don’t use it. Do they want it just because it’s a new thing to have in their home? It’s modern and different? Daily habits run deep too, thousands of years deep. And introducing some new-fangled things into those daily patterns is a hard thing to do. Even when you know it’s good for you. I know I should floss every day, but I don’t. It seems that here, the filter use and health education is not a secondary complement of filter installation, but needs to be at the core of the program.

school water

This pipe, from a dirty open sink hole, delivers water to schoolchildren


We surveyed the existing water sources. In Totora, there is “agua entubada” (piped, but not potable, water) that just comes from an open river, above which the animals graze… Kids drink from water that comes from an open sink hole near the school. Other communities have gravity-fed water systems that deliver spring water to some of the houses, but not to others.

Sandy has a kit to test for total coliforms and fecal coliforms, which are indicators of unsafe drinking water. The streams have lots of fecal coliforms, the sealed water spring water distribution systems are clean and the filtered water is clean. However, this has shown several of the systems are not working properly and need to be fixed (the sand was not fine enough and the water passes too quickly). This monitoring tool helps them adjust the filter fabrication.
lab test
The complex social and cultural environment will pose plenty of challenges, but also makes the need for the health and water program all the more evident. With the support of Metabolic Studios of Annenberg Foundation, 150 filters will be built and installed. Most importantly, workshops on health and hygiene will be integrated into the program and health promoters trained from the communities. Something so simple can save a life. After spending time with the DESEA team and going to the communities, I am optimistic that this partnership has what it takes.
landscape

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Water the Price of Gold

An elderly woman, wrapped in a hand-knit shawl tells me “Agua es vida,” water is life. Here in the highland communities of the Tumbaden district of San Pablo province in northern Peru, water is not taken for granted. It seeps from shallow holes in the meadows of high grasses, running in narrow streams through fields of scattered cattle. People dip their buckets into the green pools to sustain life over 10,000ft above sea level.

drinking water?

drinking water?

I spent the day in Incatambo (also spelled Ingatambo or Inkatambo, meaning Incan Trail) to better understand the water issues facing this quiet community of 70 dispersed families. The mayor had invited us to attend a gathering to discuss the threats to the lagoons at the top of the watershed which filter into the ground and emerge as springs throughout the province. The big Denver-based mining company, Newmont Corp., which owns the enormous Yanacocha gold mine in the area also owns the land that contains the lagoons. The provincial government created an ordinance to protect the water sources, and now the company is suing. The case is pending in a high court in Lima, but people are not sitting idly by waiting for the legal proceedings. They are organizing to make their voices heard. The provincial, district and village mayors, a leader of the irrigation association, a priest and other leaders spoke passionately about saving the lagoons as they are the headwaters that feed the watershed. They called to unite the communities of the watershed in the name of life and health: “Aqui queremos la vida, queremos la salud, no queremos al oro a al plata!” The conflict redefines what real value is, after all, you cannot eat or drink gold. In eloquent orations leaders called for the defence against the translational company and the protection of the natural resources that give life to the people. The arguments on the dangers of resource extraction are often heard in the critique of ‘globalization’, but the words have a whole new power when spoken by campesinos with dignity and urgency since their very livelihood depends on the outcome.

Forming the Frente de Defensa de las Lagonas

Radifying the Frente de Defensa de las Lagona

When the crowd disbursed in the early afternoon, Florintin, Incatambo´s mayor and primary school teacher, and Ronald, the village’s registrar, and I walked the quite hills to see where people were currently getting their water. 20 of the 70 households are connected to a decent water system fed by a closed spring box. Three other households capture a few springs and channel them into a pond. Water is then delivered in pipes from the pond to the households. Everyone else drinks directly from ‘puqjios’ (shallow surface water holes) or ‘quebradas’ (streams or gullies). Some people boil the water because a health promoter told them that the surface water is dirty, but others drink it ‘crudo’ (raw).

Florintin and Roland showing drinking holes

Florintin and Roland showing drinking holes

Incatambo is not alone in its water problems. There is a grouping of 5 highland communities in the district of Tumbaden that do not have potable water systems. There are another 4 communities where less than 40% of the families have access to safe drinking water. We would like to launch a larger water program in the area to address the needs of all of these communities.

The easiest place to start is in the neighbouring community of Suro Antiguo. The 70 families in the community of Suro Antiguo have no drinking water system, and rely on shallow surface water holes and streams for drinking, washing and cooking. In an area with livestock and no latrines, these water sources are simply not fit for human consumption. Two years ago, 30 households did have access to a system that captured spring water and delivered it via gravity to household taps. However, that system fell apart and, despite pleas to the local government, has not been repaired. ITDG and Green Empowerment propose to rebuild the water system and assist the community in organizing to keep the system up and running in the long-run. Experience from other communities shows that a micro-enterprise from the village that collects a small tariff, and thus creates a fund for long-term maintenance, is effective at sustaining water projects.

In Suro Antiguo and Incatambo as in much of the developing world, easily-preventable illnesses pose a serious health threat, especially to children. It is frustrating to see that something so basic, cheap, and relatively simple as a clean water has yet to reach these communities so close to one of the largest gold mines in the world.

If anyone reading this would like to help us work with the community to build lasting water systems, please email me at anna@greenempowerment.org or Donate Online.

little cow, big mine

little cow, big mine

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At 5 am I waited until other passengers came to fill up the taxi. Eventually there were 4 of us in the back seat, 3 up front, and 2 in the hatch-back trunk. The car was so full that I didn’t feel that bad about my sleepy head bobbing on the shoulder of the woman next to me. A few hours later we made it to Chilete, and from there, another overstuffed taxi up the green hills of the Andean valley, past an abandoned mine and finally to San Pablo. The town of 2000 homes and the seat of the province was draped in thick fog.

I found the clinic, with colorful murals of cartoon like drawings of such ills as malaria and the bubonic plague, and touting the virtues of hand washing. There, I met up with Juan, from La Mancha, Spain who was leading a workshop with the nurses from all of the rural districts to get a sense of the need, and willingness, of the medical network to adopt new technologies to improve communication. We had made little drawings of phones, radios, computers, solar systems, and electricity icons for them to paste on a big map showing each of the 10 health posts in the province. Juan facilitated a discussion of how these telecommunication technologies were being used, who used them, who maintained them, and what are the missing links. The information was also put up on a map, and at the end one of the nurses commented how the visual representation helped put the whole picture together. The workshop was one step in a participatory evaluation process to see how telecommunications could strengthen the network of rural health posts.

We spent the rest of the afternoon getting to know the local characters. We ate lunch (quartered guinea pig) at the 1 restaurant in town with Fidel, from the municipality. When I say I’m from the US, people either ask about the new free trade deal, George Bush or about school shootings…

Then we headed to the house of Wilson, who runs “Tropicana Stereo” radio station who is glad to make any announcements for any programs. We also met his mother who invited us to a gathering to sell “OmniLife” vitamins in a pyramid scheme. “Unfortunately,” we had to head over to the municipal building to greet the local officials. The building, as most in San Pablo, is an old thick-walled adobe building with a courtyard and rickety wooden balconies. Inside, a famous battle against the Chileans, is remembered in graphic paintings.

From there, we stopped by the electrician’s shop/house since we heard that he was selling solar equipment. I was especially interested in meeting him, since we are gearing up for a Provincial-wide renewable energy program, and I was excited to hear that there are already some local resources. The San Pablo electrification plan was also born out of numerous workshops, interviews and surveys. It envisions solar power, micro-hydro and wind turbines for all of the villages that are out of reach of the national grid. We’re working on finishing up the plan, and identifying funders, to begin implementation this year.

Next we walked to see the big construction work on the edge of town, the “Colosio Multiuso” (multi-use coliseum). The massive structure will seat 5000 people for bull fights, soccer matches and concerts. Apparently, a doctor from San Pablo went to the US, and made it rich. He said that he would sponsor a bull fight, complete with Torreros from Spain, if the municipality built a new, larger bull ring (since the existing bull ring in San Pablo is in bad shape). Thinking that that was a good deal, the municipality invested half a million dollars in the first stage of the multi-million dollar coliseum, which is supposed to eventually have a roof that mechanically opens. The foreman, and the (very drunk) workers were quite excited and proud of the work of progress, but I couldn’t help but recall the statistics at the health center that 36% of the province doesn’t have piped water, and 86% doesn’t have light.

To escape the rain, we headed back to the 1 restaurant, and hung out in the kitchen for a few hours, eating Chinese fried rice (interestingly a Peruvian national dish) and hot-out-of-the-oven cake and enjoying the conversation. It was Friday night so we hit the streets to see what ‘the scene’ was and who else we could meet. On the main strip, there were a few people hanging out in the street in front of the school-supplies store. In lieu of a bar, young people play loud pop music off the computer in the store (with no lights on), drink juice and gossip until late into the night. The young people seem to lament that there is nothing going on in San Pablo and yearn for the bigger cities and at the same time, the older generation worries that the young people don’t go out to the real countryside anymore.

The next morning, at the simple old Hospedaje, I decide not to take a shower, given the sign that says, “Dear Clients, Please do not take a shower for longer than 6 minutes, as you may experience an electric shock”.

Today we have another session back at the health center. Juan asks questions to rate the functioning of their current communications, management, and adaptation to change. The nurses, medical technicians, obstetricians, and administrators write their answers on cards and peg them on the big paper on the wall. A few hours later they draw some conclusions of what kind of changes they’d like to institute and hopefully all of this will be channeled into a proposal for the next stage of the project.

After lunch with an American peace corps volunteer living in San Pablo, a few of the nurses, Juan and I squish into another taxi heading back to Chilete. But there are more adventures in store. The wide muddy river had risen during the day of rain, and was impassible to cars. A few men, without pants, sloshed through the currents on foot, but most people waited on the banks for a bigger vehicle to come by. Luckily, a huge old bus barreled down the valley, and stopped to haul us across the whitewater rapids.

In just 2 days I felt like I had already gotten to know some of the local characters that give life to this sleepy town, and I’m already looking forward to going back.

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