April 27, 2017 8:19 AM

The Beauty of the Andes

Written by Jake Kincaid

MEDLIFE has two separate destinations, Cusco and Riobamba, where we work in primarily in rural indigenous communities in the Andes mountains. These communities are in very scenic locations in the mountains. This post showcases that the incredible beauty of the Andean communities that we work in. 

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April 4, 2017 8:50 AM

Water Tanks in Laderas Completed

Written by Jake Kincaid

      In March of 2017 MEDLIFE completed our largest water project yet in the community of Laderas de Nueva Esperanza, in Lima Peru. The three water tanks will serve about 500 residents from Laderas de Nueva Esperaza. The community is located high on the hillside and is dependent on water trucks. They are located so high, that the water trucks rarely drive to their community. Before the tanks, residents quickly ran out of water before the trucks returned. Now, with the tanks, residents will have enough water to last between visits, and be able to purchase the water at the much cheaper bulk rate to fill the water tanks. On Saturday April 1st, MEDLIFE staff, volunteers, and Laderas residents gathered to celebrate the completed project. Thank you to community leaders Victoria Ramos, Feliciano Curiñaupa, Gavilan Quispe, Nora Lopez, and Santiago Quispe. Also, to Paola Zapata, Cesar Reyes, and Dr. Carlos for your work and for speaking at the inaugeration.

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IMG 7742MEDLIFE staff, interns, and volunteers together at the inaugeration.

  

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The community surprised us an amazing performance of traditional Peruvian dance!

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Historic flooding and mudslides have hit Peru bringing the worst destruction from floods in two decades. An estimated 70,000 people have been displaced from their homes along with an estimated 72 dead due to the natural disaster.

Referred to locally by the Quechua name of huaicos, these natural disasters are a results of heavy rain brought on by the El Niño season in the Pacific ocean. The rains cause the rivers to overflow bringing floods to the normally dry desert coast of Peru.

IMG 0952Armando Calderon points to where his house was before the huaicos.

The flooding has overwhelmed local water treatment plants and Lima, Peru’s capital city, has been without water for almost a week. The Peruvian government has issued a state of emergency around most of the country as floods and debris flow into the streets.

The rains are predicted to continue into April, bringing more flooding to the already affected areas. Areas with vulnerable access to water have been completely cut off from their normal supply. The aguatero trucks that normally suppply many of our communities with water have stopped visiting, and many supermarkets have completely run out of water. Tap water was not working in large parts of the city for up to a week, and receiving intermitent water in other parts. 

IMG 0971A railroad is decimated by flash floods from huaicos in Chaclacayo.

Critical infrastructure has been damaged, the bridge that connects El Augostino y San Juan de Lurigancho collapsed due to the overflow of the huaicoloro river, makes access to the district very difficult. Many other roads and railroad tracks have been completely washed away.

This week, MEDLIFE went to survey the communities we work with around Lima that have experienced flooding, to make a plan for immediate relief aid and possibly plan a development project for the future. We visited Chaclacayo, a district hit badly by the force of the huaicos 

Screen Shot 2017 03 21 at 5.35.12 PMThe Chaclacayo District is one of many regions in Peru affected by the huaicos.

IMG 1010The village of Brisas de California, in the hills of Chaclacayo, experienced flooding and mudslides taking out bridges throughout the village. 

In Chaclacayo, people are lacking basic necessities like food, shelter, medicine and water. People in the valley experienced flash floods after surges of water hit the Rîmac River. The floods swept away homes, railroads and roads in it’s path.

 

IMG 0920Victims of the huaicos have been using tents as temporary shelter.

 

Those displaced by the huaicos have been seeking shelter in encampments of tents provided by the municipality of Lima. Guadelope, a resident of Chaclacayo, has been sleeping in a tent with her daughter since their home was flooded. When asked what she needed most, she responded with food.

With forecasts of more rain, the situation is expected to worsen bring more huaicos to the already vulnerable communities.

We have started a fundraising campaign to go directly to communities affected by the flooding. You can donate HERE. During times of natural disaster, direct donations can have the most impact because the money is going directly towards supplies for victims to start rebuilding their lives like food, water and medicine.

 IMG 1037In Brisas de California, huaicos overwhelmed the waterway, eroding the banks and taking out bridges.

Sources: 

http://www.reuters.com/article/us-peru-floods-idUSKBN16O2V5

http://www.bbc.com/news/world-latin-america-39318034

http://abcnews.go.com/International/wireStory/death-toll-rises-72-peru-rains-flooding-mudslides-46225609

https://www.theatlantic.com/photo/2017/03/peru-suffers-worst-flooding-in-decades/520146/

http://gestion.pe/economia/huaico-huaycoloro-ocasiono-caida-puente-talavera-san-juan-lurigancho-2184846

 

February 22, 2017 10:50 AM

The challenge of getting to the hospital

Written by Sam Roberson

In the weeks following MEDLIFE’s mobile clinics, nurses are busy traveling door to door to patients homes to follow up with those who need further care after the clinics. This is the second step. After the medical clinic has come to the patients, the nurses will come to patient's home to talk more about treatments.

In the community of San Martin, Carmen, a MEDLIFE nurse, talks to an woman in her sixties through the door of her bodega. She had visited a mobile clinic in her neighborhood and this is her first meeting with a nurse to choose to become part of MEDLIFE’s patient follow-up program. Carmen explains her symptoms could be indicative of breast cancer and she should have a mammogram.

“What do I have to do?”, the woman responds.

It’s a valid question. MEDLIFE aims to break down the barriers to healthcare, the most obvious being the monetary, but long waits, transportation and  A trip to a clinic or hospital can mean a day away from the responsibilities at home or work, a steep cost to those living in poverty.

Carmen tells her a MEDLIFE nurse would accompany her to visits and assist with paperwork. She decides to join the follow up program to get a mammogram.

554 hospital visits Those living in the outskirts of Lima can have a long journey without paved roads into the city for an appointment.  

For Luis Oyolo, a trip to the hospital is a family affair. Luis must use a wheelchair due to a fracture in his vertebrae. He typically has at least two family members accompanying him to visits, for loading in and out of taxis and navigating the curbs and bumps of Lima.

Many taxis will choose to not transport Luis due to the burden of loading and unloading the wheelchair. MEDLIFE is able to cover most of the cost of the taxi, but the cost of time used by Luis and family members spending most of their day in a waiting room is still there.

Luis waits anxiously with his father and brother for a consultation in the National Institute of Rehabilitation in the south of Lima. This is the only hospital with a rehabilitation program close to where Luis and his family live. The waiting area is full of patients, young and old, waiting for an appointment as well, most accompanied by family. When Luis is called in, they spring at their chance to talk to a doctor.

“I was first hospitalized in a hospital very close to my home, but unfortunately not all hospitals are the same,” Luis said. “I was in a hospital for 20-30 days, where the doctors did not come, they did not see me, they did not take care of me.”

Finding a hospital with the right care and ease of access for a patient is crucial for a long term solution. Although it is Luis says this hospital is still close to his home, making a physical rehabilitation program one step easier. Throughout his rehabilitation, a MEDLIFE nurse will work with Luis, helping to sort out the various papers and forms.

MEDLIFE can cover almost the entire cost hospital visits and operations, although even with funding, the daunting task of navigating the Peruvian healthcare system can keep those who need care out of hospitals and clinics. One of the most valuable services MEDLIFE nurses give to patients acting as a guide to the healthcare system and accompanying them to check ups and procedures.


Money is not the only barrier to healthcare. To fully address the problem of healthcare access in a sustainable way, local and personal difficulties must also be taken into account.

         If one only visits Lima’s developed and wealthier districts like Miraflores, San Isidro, Surco, or San Borja, in can be hard to tell that Lima is a city located in the desert and one of the driest capital cities in the world. But if you the continue driving into what are known as “los conos” on the city’s periphery, to the north, east, and south, within a few blocks the view changes dramatically and the realities of the desert are revealed as dusty hills covered in shantytowns stretching as far as the eye can see. In many of the low-income communities that cover the hills known as "pueblos jovenes" or "asentamientos humanos," the resources, community organization and urban planning are not capable of turning the desert green. Far from it, many people don’t even have adequate access to drinkable water. Overcoming significant barriers to access water is one of the most pressing daily hardships faced by the residents of Lima’s perpetually dusty slums.

screen shot 2016 12 14 at 4 03San Isidro, Lima, Peru.

.screen shot 2016 12 14 at 3 59Pamplona Alta in Cono Sur, about 11 kilometers across the city from San Isidro.

      The city has about 91% water coverage and 90% sewage according to the World Bank. However, the reality is that half of the population receives unsafe water and the poorest communities in “los conos,” at least half a million people are dependent on private water vendors that sell the water at up to 12 times the price of a public utility (2).

       To make matters worse, the poorest residents live in communities at the top of the hills that often have no road access or even a staircase to make the climb easier. The water trucks only drive to where there is road access and make infrequent trips to many communities, so residents are forced to walk long distances to get to the water trucks, and then carry the water up to their homes. In Lima, the poor pay the most for water economically and with their time and labor.

        Most of the communities that are not connected to Lima’s public water utility, SEDAPAL, because they do not have the land title to the land they settled on and are thus not legally recognized by the government. This is compounded by a total lack of roads, or by roads that are mere loose dirt paths and not driveable by construction limiting access into the communities.  

        The government has put in place several programs to attempt to improve water access, the most prominent of which was called “Agua Para Todos,” launched in 2007.  Despite a huge investment of public funds, the results have failed to reach vast stretches of the conos. Edomia Poma Pallcarcajo, a community organizer in Los Jardines has worked for years to try and get the government to connect her community to the public water utility with little success.

img 1134Director of MEDPrograms Peru Carlos Benavides and Edomia Poma Pallcarcajo planning a future staircase project in Jardines.

        “We tried to wait for the government to bring us “agua para todos,” but the years passed, and now we are old. Jardines has been here for 24 years. I got here when I was 19, now I am 42.”

In 2015, Jardines asked SEDAPAL how they could access the benefits of the program.  They told the community that in five or ten years, they could get connected.

“Then, I will be in my fifties,” Edomia said. “ I don’t want to still be without water.”

        In 2011 Agua Para Todos was investigated by the Peruvian National Congress and found that the program, along with the public utility SEDAPAL had been badly mismanaged with a cost of around $1.5 billion USD was accused of fraud. Antonio Iorvis, who has written extensively on the commodification of water and in particular Lima’s water system, concluded that Agua Para Todos clearly shows that a large investment of public funds does not guarantee improve water services or water scarcity. (1)

In light the dismal state of the public water service, Edomia and the community of Jardines decided to take matters into their own hands and contracted a private company to build the infrastructure for them.  One year later, Jardines is ready to connect to SEDAPAL. They will have water pumped directly into their homes for half the monthly cost of buying water from water trucks. The downside is that this project cost each household 1500 soles (about $500), a very high price to pay for low-income residents in Lima.

Privatized Water

Internationally, water privatization has been advanced as a solution to government failures to provide water, as seen in Lima. Joanna Robinson sums up the logic in her book about water privatization:

   “Some argue that water privatization was promoted as a lucrative investment for the private sector and a way for governments to allocate resources more efficiently, more recently private sector water delivery has been endorsed and encouraged by the World Bank and other global financial institutions, as a way of correcting the failures of public water management, including increasing environmental conservation, reducing social and economic inequities—particularly in developing countries—and providing clean water to the billions of people who currently lack access worldwide. Since the 1980s, public water systems have been under attack by proponents of market-based models of governance, who argue that “governments are less productive, efficient, and effective than markets.”With the massive governance failure on the part of the public sector, including poor planning, crumbling infrastructure, and pollution and degradation of water systems, private sector involvement in water systems has been hailed as a means of correcting those failures and increasing equity in terms of access to and affordability of water services by poor and marginalized populations.” (2)

In 2000, more than 460 million people had their water supplied by transnational water firms and that number has only continued to grow (2). The results of this effort have been mixed internationally and sparked heated debate, with many critics arguing that privatization is another form of neo-colonialism, and proponents on the other side of the debate arguing that it serves to spread access and increase efficiency.

In Lima, news that the government was considering privatizing SEDAPAL caused large protests that blocked traffic on major roads.  Protesters cited fear of increased tariffs, high buy in costs like those in Jardines and the extremely poor and expensive service for those currently being serviced by private water truck companies as reasons why privatization should be opposed.

Although some communities like Jardines have been able to construct their own water infrastructure, many cannot afford this, and high cost and constant struggle to procure basic necessities like water is a constant burden that holds communities back from moving forward. MEDLIFE recognizes that one of the best ways to empower communities is to alleviate this burden, and so help communities improve water access in whatever way we can.

How MEDLIFE Works to Improve Water Access

If a community can get the government to pay to build them the infrastructure, this is the best solution, but fulfilling the requirements is costly and there is no funding from the government for these sorts of projects. Along with being useful to communities in their own right, many MEDLIFE development projects serve to complete the requirements for both water connection and land titles.

Communities need road access and a safe entrance and exit from communities. This can be very difficult, as these communities were built without any urban planning oversight, and thus are often built on land that would never be chosen by a developer. Retention walls must often first be constructed to stabilize the land for construction and to prevent rockslides. MEDLIFE staircases fulfill the requirement of a safe entrance and exit.  

MEDLIFE is in the process of building a road in one of the communities we have worked in the most, Union De Santa Fe. This road, combined with the many staircases and the retention wall MEDLIFE has built should qualify Union Santa Fe for connection to SEDAPAL.  However Union Santa Fe Community Organizer Casani, who is working with SEDAPAL to organize the connection says that even after a six year development process process of building the staircases and the roads with MEDLIFE to improve infrastructure and help Union Santa Fe meet SEDAPAL requirements, the process will take around three years.

        We know that the families of Union De Santa Fe and countless other communities could not wait that long when they are thirsty today. We built a water pylon like the one in Jardines that connects to the SEDAPAL system down the hill and brings water directly into residents homes in Union de Santa Fe and now they have affordable water in their homes.

 screen shot 2016 12 14 at 3 56A photo of Urucancha taken from above by a drone.

However, sometimes, it is not possible to construct a Pylon to connect to the public utility, as many communities are located far away from connection points to the SEDAPAL system on very poor sites for construction. Meeting requirements would be extremely expensive and time consuming in these places, and then it could take years for the government to get around to doing the project.

In Urucancha, for example, a community in the Southern Cone that is located on the top of the hill that separates La Molina, one of the wealthiest areas, from Pamplona Alta, one of the poorest, a pylon project was not feasible. Yet Urucancha was badly in need of better water access, the water trucks only drove that high on the hill about every two weeks and residents had no way to store enough water to last that long. Recently, the water trucks have decided that the amount of water Urucacha was purchasing wasn’t worth the long trip up the hill, so they didn’t come for 6 weeks, leaving the residents with no option but to make the 40 minute steep hike from the next nearest water stop carrying their water.

Lack of water is Urucancha’s main problem, but storing water in sanitary conditions for long periods was also an issue. The big open barrels of water that can be cheaply purchased by residents to store water often become unsanitary and contaminated with “green fungus,” as reported to us by many residents.

img 1225Urucancha Residents next to the new water tank.

In this case, MEDLIFE constructed a huge tank that could be filled by the water trucks and leave the community with enough water to last between visits.  The tanks are sealed, and thus will keep the water clean from contamination. The trucks will make the trip often enough to keep the tanks filled, because they are now selling in bulk, which also reduces cost. This project brings water to 150 families.

We knew we could reach more people, so we are currently constructing a larger and more ambitious water tank project that will be able to service several communities at once higher on hillsides in Laderas. We are building three water tanks that will be filled by water trucks and then funnel water directly to the homes of 220 families and around 1000 residents. This will be our largest water project yet, and we won’t stop here.

 IMG 1145Water tanks under construction in Laderas

Sources:

1:Barajas, Ismael Aguilar, Jürgen Mahlknecht, Jonathan Kaledin, Marianne Kjellén, and Abel Mejía. "5."Water and Cities in Latin America: Challenges for Sustainable Development. Abingdon, Oxon: Routledge, 2015. N. pag. Print. 

2: Robinson, Joanna L. "1." Contested Water: The Struggle against Water Privatization in the United States and Canada. Cambridge, MA: MIT, 2013. N. pag. Print.

 

 

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