The International Forum for Rural Transport and Development (IFRTD) is a global network of organizations that works with poor rural communities in developing countries to improve mobility options and access to services.
Researchers for IFRTD are working with indigenous communities along the Cenepa River in Peru. Located 65 km from the border with Ecuador in the far northern province of Amazonas, the Cenepa district is home to indigenous Awajun and Wampi communities whose main mode of transport is the river. Although Peru has experienced a prolonged period of economic growth, indigenous Amazonian populations like the Awajun and the Wampi have been left behind. According to Peruvian government statistics, these communities live in extreme poverty.
Complex concerns, innovative solutions
The villages of the Awajun and Wampi are scattered along the Cenepa River and are almost totally isolated. To access health services, the villagers must travel to health centers in larger towns downriver. But river transport – by canoe, peque peque, skiff, motor boat, or cargo boat – is unreliable and often slow. It can take hours or days to reach the nearest town. Even when transport is available, people rarely have money to pay for services or cover the high costs of fuel and they must go into debt or negotiate an exchange to obtain mobility. In the rainy season, river travel is unsafe for smaller vessels and flooding often destroys the makeshift ports and jetties.
The economic restrictions on mobility inhibit the capacity of patients to seek attention for an injury or illness, and by the same token, it restricts the ability of doctors, nurses, and other medically trained staff to get to isolated communities to provide even routine care. There are 12 health posts and 1 health center in the capital to serve the communities, but these are ill-equipped and patients that need greater intervention must travel 4 hours by river from the health center in Huampani to the hospital in Santa Maria de Nieva.
The Peruvian government provides small rations of gasoline to transport patients and to aid medical staff’s visits to local communities, but this is rarely enough to satisfy actual needs. This confluence of factors – poverty, high fuel costs, lack of transport services, lack of funding, and geographical distance – produces deadly consequences.
The leading causes of death among Awajun and Wampi are diseases that can be easily treated in most other parts of Peru: acute diarrhea, respiratory illness, typhoid, and intestinal parasites. Among women, childbirth is a leading cause of death (due to lack of midwives and/or inadequate medical equipment). The ingestion of detergents by young women with the intent of suicide is also a disturbing trend in Cenepa.
Messages from Amazonas, a social media project
In 2009, IFRTD armed villagers with mobile phones, camcorders, and wind-up chargers. According to Matt Barker, a volunteer with IFRTD, the idea is to use social media to “overcome the enormous distances between the community, the outside world, and the policymakers who can improve their quality of life.”Equipped with the proper tools, the villagers can explain in their own words the dire problems that they face. The stories are then broadcast to a global public on blogs, Facebook, and YouTube.
The videos are filmed against the backdrop of the rainforest, with green jungle growth all around and a cacophonous symphony of chirps, trills, and twitters that never stops. The self-selected interviewees share heart-wrenching accounts of how this health crisis affects them. In the video messages, the voices of the speakers are tentative, low with sadness, but sometimes strident with anger.
“We are timid,” says one Awajun man. The villagers recall the illness of a wife, the death of a son, or the suicide of a daughter. Their words convey a palpable feeling of frustration, of being thwarted and unable to take action to help a loved one. “I think we should be able to save children’s lives,” Rafael Ukuncham says in his testimonial. “We die quickly because we don’t know how to prevent or treat illness.”
ITRFD argues that, given the situation of extreme poverty in these communities, local and regional governments should recognize the lack of mobility and access to health care as basic problems that need real solutions. The videos provide a call to action to policy-makers in Peru to take responsibility for providing adequate access to medical services.
Delicia Santiak talks about her daughter. The young woman had an argument with her husband. Disconsolate and depressed, she ingested a toxic plant. The family was unable to find a motor boat or even a canoe to take her to a health center and the daughter died. Later, Delicia was told that the health center would not have been able to treat her daughter anyway because they are not supplied with the right medicines. At the end of her message, Delicia states, “I share my story with you in the hope that someone takes notice and can help us.”
Connect with the project
IFRTD is working with indigenous communities in the remote northern province of Amazonas along the Cenepa River in Peru.
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Anabel has been exploring the length and width of South America since 2010. Ditching preconceptions, settling into the local pace, and embracing the unexpected are the tenets of her philosophy of travel – and life.