Secsencalla, a small town of around 300 inhabitants, sits one hour outside the main city of Cusco. Like many communities outside the tourist capital, Secsencalla relies on corn as the main source of income. As community members wait for the February harvest, they’ll also work side jobs in construction, cleaning, or drive mototaxis – small two-seater vehicles pulled along by a motorcycle.
As we walk the unpaved streets of Secsencalla, I can’t help but notice how nice all the homes look; natural finishings, quaint balconies, tidy gardens. However, I also notice that Secsencalla has no plazas or public spaces, only one small building that doubles as both a small school and a community center – where MEDLIFE recently held a meeting to discuss the Healthy Homes project, an initiative which will work with 10 homes in the community that have children under the age of five and are at risk of malnutrition.
A main street in Secsencalla. In the background you can see the green schoolhouse
Mercedes Olave, the head of MED Programs in Cusco, understands the importance of working within the framework and goals of the local governments and communities which MEDLIFE partners with. Prior to the start of mobile clinic season, she has already held several meetings with municipal workers in the district of Andahuaylillas, where Secsencalla is located, in order to learn what they consider their needs and desires to be. “The most serious problems facing communities is what happens after NGOs leave without even telling us their plans. They have their own objectives, sometimes very different from our own, and with the best of intentions end up making our job more difficult. They can waste months preparing a project and once it has been built, it’s not even where the community really needs it†explains a municipal worker of Andahuaylillas as we meet to propose our plan. MEDLIFE avoids this through interactive meetings with communities to identify their greatest needs together – and for this clinic season both they and MEDLIFE agree that we should focus on children with malnutrition.
Many of the houses look nice from the outside, but on the inside lack many basic necessities.
The first house is made of cement and and looks nice from the outside but as we walk inside, I realize they don’t have a kitchen. “Come here and look†Mercedes says to me while we walk to the house´s backyard. “This is the stove†– located out in the open exposed to the elements, but for a small covering overtop.
During February and March, families have money from the corn harvest and often will use it for home improvements. Things such as repainting homes or redoing finishings are cheap. What’s more expensive is improving the inside or saving up for larger projects, which can be very difficult to save for when the profits from corn farming usually do not exceed 3000 Peruvian soles (around 700 dollars) a year.
The “stove†is just an open flame without ventilation, and has turned the kitchen wall behind it completely black. There’s food stored all around it, disorganized and exposed – obviously not a safe way to prepare food. “It doesn’t sting anymore†the homeowner tells with a smile. “You get used to the smoke.†It’s incredible how much damage smoke can do – the hacking cough of the homeowner is a reminder that even if members of the communtiy become accustomed to the discomfort, the health effects over time are profound.
In this kitchen not only can you see the blackened wall behind the stove but also the cuy’s (guinea pig’s) cage and food right next to it.
The other homes in Secsencalla are very similar. Some are bigger than others, or have an additional room or two, but all lack a proper stove. While some have a small gas stove, families typically run out of money to buy gas for the entire year and eventually go back to the open flame even though they’re aware of the health risks associated with it.
Cooking over an open flame is the main method employed by people in rural parts of Peru largely because firewood is cheap and easily accessible. However, cooking over an open flame is very dangerous and can cause serious health problems, most commonly respiratory diseases. This is why MEDLIFE builds improved stoves in Cusco, or stoves that do not rely on open flame and have proper ventilation. Smoke often contains carbon monoxide, nitrogen oxide formaldehyde and polyaromatic hydrocarbons such as benzo (a) pyrine. Families often suffer serious consequences due to exposure such as cataracts, blindness, increased risk of infections, chronic pulmonary obstruction, anemia and lung cancer. Smoke can also have serious effects on pregnant women.
Another stove we saw. The smoke coming out of it was so suffocating that we could only stay in the kitchen a minute.
This winter clinic season as part of the Healthy Home project, we will build fuel-efficient stoves for 10 families in Secsencalla that include ventilation through the ceiling of the home in order to eliminate prolonged smoke inhalation.
But apart from the great benefits that improved kitchens will have on the families of Secsencalla, the Healthy Homes program also has a bedroom improvement aspect.
In another of the houses we visited we found many clothes accumulated on the floor and on the bed, and in others, on the contrary, there was not a single piece of furniture. “It’s that the girls like to sleep with us,” one of the parents tells us when we ask them where their daughters are sleeping.
“The problem is that often they view it as innocent or a non-issue. But no boy or girl over 6 years old should sleep with their parents. First of all because it interrupts the marital life of the parents. There are things that children should not see, not because it is not natural, but because it is not the right age for them to see or hear those things, “Mercedes explains to the man. “And on the other hand, a young girl must have her own room or environment, separate from the men of the house whether they are the father or the brothers, because otherwise she is exposed to danger” Mercedes explains.
The Healthy Homes stove initiative provides the perfect opportunity to reform other aspects of the families home lives as well: MEDLIFE provides paints and shelves to organize their clothes, advice on personal and family hygiene, and ultimately we hold conversations to advise separating the environments and thus ensure that each son or daughter has their own space, a need that has a much deeper background.
This is the children’s bedroom (2 girls and 1 baby boy) in one of the houses we visited and will work in this Winter. The gentleman tells us that he has not yet implemented it because his children prefer to sleep with them in the parent’s bedroom. Mercedes explains the importance of separating living arrangements so that everyone has their own space as much as possible.
According to the WHO, in 2013 Peru ranked third in prevalancy of rape and sexual violence worldwide after Bangladesh and Ethiopia. In 2016, according to the Ministry of Women and Vulnerable Populations in Peru (MIMP), girls and adolescent women represented 65% of cases of family violence and 70% of victims of sexual violence.
“It’s unacceptable that many of our follow-up patients have suffered from gender-related violence… And much of the time it’s because they have to sleep in the same bedroom as their father or brothers,†Mercedes tells me. “Once, many years ago in another job, I asked a man why he had raped his daughter. He just told me that he could, if she changed her clothes in front of him because they slept in the same room.â€
Both girls live in one of the homes where we will be leading our Healthy Homes program this Winter.
Cases like that were the ones that inspired Mercedes to include the improvement of bedrooms within the Healthy Homes program that MEDLIFE is implementing in Cusco. “This program is an opportunity not only to improve the infrastructure and hygiene of each home, but to ensure the physical and mental well-being of children who may be at risk. It is a program that allows us to really know each family and make a real change. House by house “says Heidy Aspilcueta, Director of MEDLIFE Cusco.
“I just moved here to Secsencalla about two years ago with my wife and daughter, and I attended Mrs. Mercedes’ talk in the community. She spoke to us about the importance of separating the bedrooms and improving the kitchen. I am already building, little by little, and I hope that after the corn harvesting season I can get the kitchen ready to build my stove. Little by little it’s improving” says one of the parents who will have her kitchen put together by the third group of volunteers arriving in the beginning of March (Sign up here).
Here at MEDLIFE Cusco, we are very excited to start this program in the community of Secsencalla, where we have been amazed by the organization and the desire of this community to work with MEDLIFE. If you are a volunteer or a member of a chapter, please consider a Service Learning Trip to Cusco to help us implement our Healthy Homes program in some of the 100 homes that make up Secsencalla, so that come February it won’t only be the abundance of corn bringing good fortune to the village, but also our volunteers helping to create sustainable change and brighter futures for the families.