Hello again,

I thought I would send out one more update on my experiences in my final week in Peru, as I had a unique opportunity to see a side of the country that is very different from Lima that shed new light on the depth of the challenges faced in developing national-scale development policy.

The opportunity to leave the desk and hit the field in Madre de Dios during my last week was extremely important to snap into focus the magnitude of the challenges faced in Peru. Here are a couple of pictures of the capital:

The extreme climactic and cultural diversity of the country was well illustrated in this Amazonian town. Witnessing the precariousness of the situations of indigenous and migrant miner communities facing too much growth, too few resources and devastating poverty brought the most pressing problems to the center of professional conversations in a much sharper way then I ever witnessed in Lima, where people felt more freedom to play with multiple theoretical approaches to health policy.

For example, the implications of simply failing to count people properly can be disastrous. Residency is recorded based on a birth registry system, and government resources are distributed by population. However, in mining communities the vast majority are internal migrants, meaning that health, education and other resources are about one quarter of what they would be if residency statistics were up to date. For example, it is very rare for the child of a minor to have access to school. Medical personal burn out and leave very quickly as they only have the time and resources to care for only one quarter of their patients. In the face of this reality, extending health center activities toward control of the very recently arrived HIV cases becomes difficult to prioritize.

One more striking observation is the implications of economic instability to environmental and cultural sustainability. Driving through the countryside in this jungle region feels like driving through an oven, and not just because of the 40+ degree tropical heat. The whole country side seems to be on fire. What looks like mist over the river and fields is actually smoke from the slash and burn agriculture that represents the only means of survival for many families. The implications however include an accelerated destruction of the rainforest, and the devastation of the traditional lands of indigenous communities who rely on these vanishing ecosystems for not only their material survival, but for their entire sense of culture, religion and identity.

Madre de Dios has a very distinct landscape in terms of development challenges, but I can’t leave out their other important characteristics of distinction: their unique culture and incredible natural richness. It is the center of the greatest biodiversity in Peru, which is a title worth protecting!

Salud!

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