Although more than half of Peru’s indigenous communities lack health facilities and chronic malnutrition is on the rise among indigenous children, an executive decree eliminated the Ministry of Health’s Indigenous Peoples Directorate earlier this month. The Ombudsman’s Office has called for its reinstatement “to guarantee measures in favour” of this sector of the population.
In Peru there are 1,786 indigenous communities, 51 ethnic groups and 47 native languages: the now eliminated agency had been created in February last year as part of the Vice-Ministry of Public Health, and was considered an achievement after years of efforts by indigenous organizations and experts. “A quarter of the population is indigenous. The health services in the areas they live in need to be adequate: not only in their mother tongue, but in the way the service is provided,” Alicia Abanto, assistant to the Ombudsman for the Environment, Public Services and Indigenous Peoples, told EL PAÍS. “In the Amazon we need a package of mobile services, not just a health post,” she adds.
Sixty-two percent of indigenous women do not have timely access to services to monitor their babies’ growth and development, and 53 percent live more than two hours away from an emergency obstetric care facility, according to 2016 data from the Ministry of Development and Social Inclusion. Seventy-eight per cent of babies under 35 months of age with an Aymara mother tongue suffer from anaemia and 49 per cent of indigenous Amazon people of the same age have chronic malnutrition, according to the 2016 Demographic and Family Health Survey.
Deputy Ombudsman Abanto points out that indigenous peoples require adequate services due to certain specific conditions, such as hepatitis B in Loreto (northern jungle), HIV and tuberculosis. Communities in voluntary isolation are increasingly exposed to epidemics, either because of the proximity of illegal activities (such as logging and drug trafficking) or legal activities such as hydrocarbon extraction.
A pronouncement by the Office of the Ombudsman indicates that in 2008 and 2015 it recommended that the Ministry of Health incorporate a high-level body to coordinate and regulate priority attention to indigenous peoples and promote an intercultural approach in services.
In the previous government there was a spirit of reconciliation with the indigenous peoples, and that’s why the executive branch [at the end of his term] took decisions to improve its approach to this sector,” Abanto says. Anthropologist Gerardo Seminario, a member of Salud sin límites, an NGO specialized in working with indigenous peoples, notes the Directorate that was eliminated from the ministry was important because it had a budget and the capacity to issue regulations and enforce them in its internal structure, regional governments and health networks. “The decision reveals a lack of knowledge of technical aspects in intercultural health. For example, in the Nahua territorial reserve [in the southern jungle], 70% of the population is contaminated by mercury.
Anthropologist Carmen Yon adds to this panorama: “A study that we did in the Amazon in 2015 and a meeting with indigenous technical nurses in 2016, showed enormous individual efforts of health providers and officials in charge of the health strategy of indigenous peoples that permanently collide with the little importance that the health of indigenous peoples has in the budget and institutional framework of the Ministry of Health