Wabash Blogs Peru, Parasites & Global Health

« Investigating work in the Puno region of the Andes | Main | Worms in the Rainforest -- A Trip to Tarapoto »

Andean Adventure Part II -- Ayaviri

This past week was spent in the Puno region of southern Peru. Puno is the city adjacent to Lake Titicaca. I was fortunate to visit the Lake late in the trip and, as you might expect, it was beautiful. The visit there almost didn't happen -- a Peruvian colleague and I had heard that there was a strike along the road between the city of Juliaca (where we were staying in a hotel) and Puno, a distance of about 45 km. After getting varying reports, we were assured the road was open. Arriving in Puno was interesting, however, as we navigated around the clear evidence that there were some folks in Puno who clearly were not happy about something. Large and small rocks had been thrown across the road in several places, along with trash and broken glass. Much of it had been cleared earlier that day, apparently, but it was a good reminder of how quickly travel conditions can change.

Much of my time was spent in Ayaviri, a much smaller city / town about 100 km from Juliaca. Ayaviri is a bit over 13,000 feet and is about 275 km from the better-known city of Cuzco. Interestingly it's still possible to take a train from this area to Cuzco, despite the problems Cuzco and the region had with flooding about 1.5 months ago.

I was in Ayaviri to meet with Caritas-Ayaviri, an organization that does a great deal of community development work in about 3 districts in the Puno region -- districts that have some of the worst disease, malnutrition and anemia problems in the Andean zone. Among other things, Caritas works in large and small communities, focusing on education, various health issues (anemia, malnutrition, parasitic disease) in women and children, as well as trying to bolster the health care systems in the region. For example, because many of the people live in isolated regions, distances are sometimes a mystery. Thus, when folks make it to a local clinic (if one exists), it's often unclear to which hospital they should be sent. Most ambulances are covered pick-up trucks with a mattress in the back (but no medical equipment), and the level of technical training in highly variable.

There are several important parasitic diseases which impact the people in this vast region, but little baseline information exists on these infections. Moreover, a growing amount of evidence suggests that large-scale patterns of infection are changing quickly. One area of interest has to do with climate change. One of the trematode infections that is a major human health problem in the area (Fasciola hepatica) is truly an emerging infectious disease for the highlands of Peru, because the distribution of its snail intermediate host is shifting -- reports from the area point to the fact that host snails are showing up at altitudes where they've never been reported in the past. In any case, there are several opportunities for Wabash to participate in projects with Caritas in this area including education, basic diagnostic work, research, water projects.

I had the privilege of visiting one of the projects having to do with providing potable water for people in an isolated community. We traveled several hours in the mountains to reach the community, finally switching to a 4x4 truck to reach our final destination. What I saw was truly impressive and reinforced the impact that can be reaped from seemingly small changes.

In the mountains many of the people get and use water from the rivers. Even in isolated areas this water is not clean, in part because of the intersection of humans with animals, both wild and domestic (many of the people graze animals -- sheep, llama). As a result various parasitic and diarrheal diseases impact a large percentage of the population. In the project I visited, Caritas works to educate the community and then works to help them address the problems. Local committees are formed with Health Agents (and other officers) elected to run the program. Work projects build water collection stations and reservoirs that then serve the homes in the area. Members of the community oversee the chlorination and distribution of water as well as the construction of latrines, sinks, and showers outside the homes in the communities.



It's important to understand that these are areas in which homes lack electricity, running water or sanitation systems. Life is hard. Clean water means good health for people in these areas. To hear women in the community speak about how a sink with a faucet, along with an outhouse, means that their kids are not sick from infections and how that has changed their lives is a powerful experience.

My hope is that Wabash students will be able to learn about, and participate in, these kinds of systems in the larger context of global health. For me, this is one of the best ways that I could challenge students to act responsibly and live humanely.