Investigating work in the Puno region of the Andes
I'm writing this from Ayaviri, a town of about 25000 people in the Puno region of southern Peru. Puno (city) is next to Lake Titicaca, the highest freshwater lake in the work and a place I hope to visit tomorrow. Yesterday we flew to Cuzco then continued on to Juliaca. We then drove about 100 km to Ayaviri. The town is relatively quiet and surrounded by beautiful rolling mountains; elevation here is about 3900 m (approx. 12,800 ft.), so we weren't exactly sprinting around town.
Last night I met for about 4 hours with an organization called Caritas-Ayaviri. This group has several ongoing projects involved with rural community development, particularly within 3 provinces surrounding Ayaviri; in fact, Ayaviri is included in one of those. They work closely with the Ministry of Health in Peru and were recently invited to expand some of their regional programs to the national level. That sounds good, but there are always "interesting" tensions with how the government allocates funds for this kind of work, etc. Shouldn't be surprising, I suppose, but it's one of the ways that politics and economics have an impact on the health issues; of course, this is not unique to Peru, but there are important cultural aspects to this.
Some of the issues addressed by Caritas-Ayaviri include work with the high levels of malnutrition in these mountain communities, the impact of anemia and diarrheal diseases on the mortality rate (particularly for expectant mothers and their small children), and accessibility to health care. Many of the "ambulances" here (of which there are only a few for the area) are just a covered pick-up truck with a mattress thrown in the back -- no medical equipment whatsoever. Local clinics struggle with the task of knowing the closest hospital to which to refer people, distances are sometimes a mystery, and the level of medical / technical training which exists in different areas is highly variable, to say the least.
Parasitic / infectious disease is a big problem here and one that contributes directly to the problems they have with anemia. Rates of malnutrition and anemia in children in many of the communities far exceed the averages for Peru (and even for the Puno region at large).
In thinking about a "global health program" I am sensitive to the issue of sustainability and whether bringing a group of college students to an area -- particularly for a short period of time -- is really any kind of help. In many ways it's easy to see how students can benefit; we can visit, learn, observe and experience a different culture for a time. In other words, the benefit is largely one-sided. What we can bring to the table is not as easy of an issue.