Transportation challenges

The driver of our 16-passenger van jumped out to slide large rocks under our back tires which were skidding in the mud, and I finally understood the severity of the road situation here in Peru. We were returning from a large promotora training and during the later hours it had started raining fiercely. The unpaved roads turned to mud slides. After the training wrapped up, we loaded our supplies and the promotoras into the van in the pouring rain. We went higher and higher up curving mountain roads, trying to take our passengers as far as possible before letting them out to begin their walk home. As we drove, I stared out the window and straight down over a high rocky cliff, squeezing my eyes shut as we occasionally drove over a rushing waterfall. As soon as things got dangerous, we had to turn around and let our promotoras walk the next few hours home in the deluge. It was difficult to watch them get out of the van, but as people of the Andes, they are used to vehicles only being able to take them so far.

A beautiful view from a treacherous road.
A beautiful view from a treacherous road.

Many rural communities in Peru lack consistent road access, and therefore it can be really hard to access health care quickly.  That is one of SVH’s main motivations for training promotoras who live in these isolated villages – they are available to provide onsite first aid and to determine when a patient needs to undertake the journey to a clinic. Especially in bad weather, it quickly becomes apparent how difficult it is for patients to get to a government health center (posta) when they are ill, in labor or have an emergency.

Promotoras learn CPR.
Promotora practices CPR on a dummy in order to be prepared for emergencies in her community.

Not only health care, but education too, suffers as a result of bad roads. Early one morning, I caught a ride up to the communities I serve (Patacancha and Rumira Sondormayo), with the van that brings the teachers to mountain schools. The road that leads to these communities is eroding and is so bad at several points that the entire bus must unload so that the driver can gingerly navigate over the rock-filled mud pits dotting the path. As we walked behind the bus, one of the teachers confessed to me that she was afraid the road would fall away completely and leave her no option but to walk the several hours up to her school. Teachers in Peru are woefully underpaid, and the prospect of waking up very early in order to begin an several-hour hike to work has been a strain for the educational staff in the region.

Passengers get out to walk as a van drives carefully over part of the eroding road.
Passengers get out to walk as a van drives carefully over part of the eroding road.

Just last week, I was unable to go up into a community due to a transportation strike, which we heard was happening in support of a salary increase for the teachers. All of this directly effects the school children, who suffer from an increasingly spotty education.

These difficulties highlight the need for SVH/ Ayni Wasi’s work both in direct health care and health education. Our promotoras take care of the ill in their communities, assist and accompany patients who must go to a posta, and provide much-needed health education in schools and for community groups such as weaving cooperatives and mothers’ clubs. As frontline health workers, our promotoras provide fellow community members with much-needed support.

Promotor Anastacio makes an oral rehydration solution in case of dehydration while community coordinator Lydia looks on.
Promotor Anastacio makes an oral rehydration solution in case of dehydration while community coordinator Lydia looks on.

– Written by Mary Underwood

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