The invisible people of the Amazon

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The invisible people of the Amazon

Throughout our work in the communities in the Amazon River region, we noticed a common social issue that affects the various groups. Thousands of Peruvians in rural communities do not have a National Identification Document (DNI).  A DNI card is required to engage in a multitude of societal aspects such as the ability to vote, own land, marry, open a bank account, receive national healthcare, access social security benefits, and engage in formal work. Without this card many citizens remain invisible to the government and to society. However, many boundaries exist for the families that we work with to register for a DNI. These boundaries include proof of Peruvian citizenship, literacy, and money.

First, in order to register one must possess a birth or baptismal certificate proving Peruvian citizenship. However, many of the families live in indigenous or remote settings where such documents are not issued. CGCH identified this as a human rights issue that affects the families.

For the families that do possess birth certificates, literacy barriers exist. The families were unable to attend school due to their undocumented status, which means they do not know how to read or write. Without literacy, the families are unable to complete the paperwork necessary for registering for a DNI. In addition, many of the families are not educated about the importance of the DNI and the benefits they can receive as citizens.

The last barrier that exists is money. Each of the communities that CGCH works in experiences extreme poverty and is unable to afford the 24 soles (about US $8.50) required for registration.

To combat this human rights issue we partnered with RENIEC (Registro Nacional de Identificacion y Estado Civil) to set up information and registration sessions in each of the four communities where CGCH maintains a presence.

In 2011, RENIEC began offering free DNI registration to Peruvians living in poverty. Unfortunately, many of the individuals that are in the most need for the national support offered by the card are also unable to afford the time and price of travel to one of the RENIEC offices to file for a card. For this reason, we worked with RENIEC to outpost a staff member to visit each of the CGCH communities in person.

Prior to the sessions, volunteers went door-to-door informing the community about the upcoming DNI campaign and educating families. Many volunteers reported that the community members were excited about the campaign and reiterated their need for access to society.

CGCH continues to work with RENIEC and rural communities to combat this human rights issue that prevents many of the families from engaging in civil society and accessing benefits. In addition, we continue to challenge RENIEC to establish strategies to reach citizens living in poverty, so that we are only a stepping stone to establishing a long-term solution for Peruvians.

Written by Hannah Nusz

People standing in line for a DNI registration session in Bélen.

People standing in line for a DNI registration session in Bélen.

RENIEC employee registering people for their DNI's in Bélen.

RENIEC employee registering people for their DNI's in Bélen.

A toddler being registered for her DNI in Llanchama.

A toddler being registered for her DNI in Llanchama.

RENIEC registering people in Llanchama.

RENIEC registering people in Llanchama.


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San Martin

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San Martin

The CGCHealth mission to provide clean water access in the Amazonian region recently led us to the San Martin community along the Nanay River. The Nanay River begins in the Loreto District, and unlike the other Amazon tributaries that are born from the Andes mountain range this river is sourced from the rainforest. The small community of 11 indigenous families now residing in San Martin were displaced from their original homes further in the rainforest by commercial logging, and relocated to their new homes in the protected Allpahuayo Mishana National Reserve more than 20 years ago.

We first heard about the San Martin community from a fellow nonprofit in Iquitos, Sociedad Peruana de Derecho Ambiental (SPDA) that works to establish protected lands. Currently, SPDA partners with the San Martin families and the National Reserve to collaboratively form a lawsuit against the Peruvian government due to the pollution of the water source in San Martin. The lawsuit focus is on a dumpsite that the government established near San Martin without receiving necessary approval from the National Reserve. Chemicals from the dumpsite leaked into the water supply and caused an increase in diseases and skin rashes among the community. 

In response to learning about San Martin, we received permission from the National Reserve to enter the protected land, and met with the community to determine whether the community thought that CGCHealth’s health courses and water filters would benefit the members. All 11 families attended our meeting and at first were understandably apprehensive about another nonprofit entering their small community. However, after establishing a relationship and answering questions, the community expressed that they would like for CGCHealth to return and that was a need for water filters. In our conversation the communities shared stories of their difficulties accessing clean water. 

A week later we returned to the site joined by two medical students from the Universidad Nacional de la Amazonia Peruana (UNAP). The families gathered again in a classroom and learned about the symptoms, prevention, and treatment of common health issues in the region from the medical students and assembled the filters. Each of the families expressed their enthusiasm for a partnership with CGCHealth, and invited us to return. We will continue to visit this community monthly to maintain a relationship, address any necessary filter repair and maintenance, and to provide access to other human rights resources.

We feel privileged to gain the trust of such a strong and enduring community in this region, and committed to responding to the requests of communities like San Martin for access to clean water. In addition, we are grateful to be connected to a larger storyline that combats and addresses human rights issues in this region.

Written by Hannah Nusz


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Sigue la huelga

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Sigue la huelga

“Doctors seem like a profession that shouldn’t go on strike,” once said a wise person. To many, this statement may seem almost comical—it’s absurd, doctors on strike?—Never. To others it comes with a sense of unrest and disappointment. Currently, doctors in all of Peru have been on an indefinite strike since the 13th of May, fighting for better working conditions, more funding, and equal rights. There are times that I have difficulty understanding how doctors, a profession meant to serve the ill, could go on an indefinite strike and hope their movement will bring better access to medical care. At times I feel it is hypocritical. This is me with my western lens, coming from a place where doctors swear by oath to treat the ill, where the government treats their doctors well, and access to healthcare is not threatening the lives of a majority of the population. This is the doctor’s proposal:

“Faced with the government's proposal that pushes for health to be a business and that does not help those excluded from health services, FOROSALUD and FENUTSSA note the following:

1. We reject the intention to confront the health workers by the healthcare users and patients. We are committed to social articulation and joint defense of the right to health. 

2. THE RIGHT TO HEALTH SHOULD BE UNIVERSAL, namely only the people with their identification cards have access to health services. 

3. THE RIGHT TO HEALTH MUST BE COMPREHENSIVE, which means that the system must meet all the health needs of all 30 million Peruvians. 

4. THE RIGHT TO HEALTH SHOULD BE JOINTLY FUNDED through a public fund integrated with a public budget increase to 8% of the GDP. 

5. Modification of practices in health emphasizing PREVENTIVE AND PROMOTIONAL ACTIVITIES. 

6. STANDARDIZATION OF RATES FOR SERVICES CONTRACTED BY THE STATE, regulation to the profits of health care institutions in the private sector. 

7. DECENT PAY AND WORKING CONDITIONS for professionals, technicians, assistants, healthcare administrators, and all appointed and hired Peruvian health system workers.”

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Loreto is the largest department of Peru and is home to the entirety of the Peruvian Amazon. Its massive landscape is sparsely populated with zero road access to connect the communities. This geographic isolation accentuates the inequality for the access of healthcare to the rural and impoverished people of the Peruvian Amazon.

A travel of at least 50 miles by river, a several days journey, may be necessary for a patient to see a general physician in the Amazon. The only specialty doctors in the department work in the hospitals in Iquitos. Thus, if a patient needs more than general attention, a surgery or specialty service, a travel of 2-3 weeks may be necessary to seek care, depending on their geographical isolation from Iquitos. Those 2-3 weeks are spent away from working the chakra or farm, typically one’s lively hood and only source of income and nutrition. For nearly all of the ribereñas—those who live on the rivers—this is not an option and the sick must simply live with their illness. Those who choose to take the journey are often left penniless and stranded upon arriving to the medical centers—this is a cause worth fighting for. 

While emergency services are still available, it has been reported by the Peruvian Medical Federation (FMP) and the Ministry of Health (MoH) that since the beginning of the strike, over half a million health queries have not been addressed, more than 50,000 surgeries have not been performed, and nearly 30,000 patients in outpatient clinics have stopped being attended to. Now, allow for a brief moment to contemplate those numbers.

Here in Iquitos, CGCHealth works with the Ministry of Health in the Centro de Salud 6 de Octubre in a district called Belén. We operate within the health clinic by working alongside doctors and speaking with patients diagnosed with intestinal illnesses due to drinking contaminated water. These patients are given the opportunity to attend a 4-day health education course and receive a water filter upon completion of the course. There are not any doctors to work with, currently. While this leaves us without the ability to get clean water directly to the people who need it most imminently, people within the community of Belén have been seeking out CGCHealth to receive what is rightfully theirs; clean water.

Even while doctors are attending patients there are many residents of Belén and other more distant communities that are never able to receive medical attention due to their lack of identification cards. This strike has given CGCHealth team members time to work with RENIEC, the national registry for identification cards, to begin registering those who are unregistered.  

While it is difficult to stand by the side of the doctors and watch unattended patients suffer, it is equally as difficult to not support their fight. 

Written by Chase Hamilton


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Clean Water Campaign 2014

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Clean Water Campaign 2014

CGCHealth Clean Water Campaign round 2 is now in full effect. We have arrived with 8 students from the University of Kansas and Colgate University, all with unique goals to help communities help themselves. 

Wilger, the heart of our presence in the Amazon, has been buzzing up and down the river since January meeting with community leaders, doctors, and government officials. He discovered many communities where our presence is needed. We now find half of our team in the jungle teaching educational courses and directing a medical clinic in San Jose de Lupuna. The other half is working in the Centro de Salud 6 de Octubre in Belén.

We are working with the communities to fight infectious diseases spread by consuming contaminated water. We provide immediate relief of symptoms in the medical clinics by prescribing medications but we have learned from communities over the years that it is wiser to take preventative measures so that the diseases may never afflict the populations. And to that we say, “AGUA LIMPIA!” 

Each week of this month we will work with at least 55 families in San Jose de Lupuna, Belén, Llanchama, and San Martin to provide medical care, health education, and clean water. Our educational efforts are bolstered by a strong presence from medical students from Universidad Nacional de la Amazonía Peruana (UNAP). 

We are able to treat the person and not just the symptoms by providing educational courses to better educate populations about their illnesses and ensure that their preventative health measures are met by providing clean water solutions. 

Along the way we have been establishing lasting relationships with the communities we work with so that we can facilitate the changes they wish to see in their communities. 

We are excited to see the direction the communities take us! We will be sure to keep you updated along the way.

 

Written by Chase Hamilton


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