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Mobility and Health in the Amazon.... An update...
2007-04-30
IFRTD member, Diogenes Ampan and his team members are collaboratively working on a Mobility and Health research study on the role of river transport in accessing conventional and traditional health services in the rural rainforest of Peru. A large part of their methodology consists of organising participatory workshops with indigenous communities to sensitise them on the relationship between rural access and overall health care and assess how they can overcome some of these challenges. The following is a report from IFRTD's Executive Secretary who was able to attend the second workshop in March 2007.
It took the team three days of travelling to the area, one of which was spent on a motor boat, also called a chalupa. Most Awajun communities in the Cenepa area, bordering Ecuador, are dependent on water transport using dug out canoes or peke peke's (longtail boats). The two-day workshop was attended by representatives of youth groups, local authorities, health posts, traditional leaders, the elderly, traditional healers, women's associations, reflecting a wide cross-section of the Cenepa community. Some of the representatives had to travel far, even up to a whole day in order to reach the community centre in Mamayaque in time. As part of the workshop participants worked in small groups and then presented their findings to the other members of the group. It was interesting to note that many women actively participated, in fact almost 50% of the participants were female and young women in particular made their voices heard. In addition to the workshop the team made visits to the various health posts in the areas and talked to the extension workers who were also willing to share their experiences.Although the team are only half way through their research and the final results will not be be published until early 2008, some of the preliminary findings are already worth sharing. In the Cenepa area the main problem realting to transport and health is a lack of access to fuel for emergency transport to health clinics. Many people do have access to boats but fuel for the motors is scarce and expensive. This applies to the extension workers of the various health posts as well as the remote communities. This means that quite a few people are dependent on dugout canoes for their journey to the posts, significantly delaying their journey as well as increasing the risk of drowning on the treacherous river rapids.
Also in this area the three delay model as explained in the literature review on Mobility and Health can be applied. The first delay is the cultural and socio-economic conditions, the second is the accessiblity to the facility and the third delay relates to the quality of care available. Fortunately in the Cenepa area these delays have not resulted in huge maternal mortality figures. This is thanks to a strong system of traditional health care in which mothers assist their daughters during pregnancy and delivery, and the passing on of this knowledge from generation to generation. Traditional health systems and healers are consulted by the majority of the population no matter what their socio-economic background is, before seeking advice from a western-educated health physician.
Other health problems were infections, arthritis, bronchitis and snake bites. For these health issues it was discussed whether an emergency fuel fund would be an appropriate local solution, although a final decision has not yet been agreed. This solution will surely come up during the next and final workshop as well as during household surveys yet to be carried out by the research team. The final case study will be published on the Mobility and Health web site and will also be presented during the international symposium on Mobility and Health which will take place at the end of October 2007.
For more information about this research and the other case studies that comprise IFRTD's Mobility and Health Networked Research Programme please visit the programme website: www.mobilityandhealth.org
