Agua y Vida: Water as a Limitation and Key to Improving Maternal/Community Health

I ask those of you reading this to take a moment and reflect upon your daily relationship with water. Where did your last cup come from? Do you remember the last time you went to a restaurant and they provided you with a nice glass of ice water, free of charge, or even drank from a public water fountain? Or how about the time you came home after a long run and you just grab a cup and fill it with tap water?  If you did this in Quito, Ecuador, you would run the risk of infecting yourself with all types of water-born diseases and parasites. If you live in various parts of the Amazon Rainforest, such as the communities of Pumpuentsa and Kurintsa, and drink the water, you ARE ingesting harmful water organisms.  But isn't the Amazon one of the last places in the world where the air is still fresh, the soil is pure, and the water exists in a pure abundance, you might ask?


Unfortunately, as discussed in the previous post, river water in most parts of the jungle is dangerous.  When it doesn't rain, women often go to the river early in the day to collect water to be used for drinking, cooking, and washing.  Both Kurintsa and Pumpuentsa have a water pump system built by the municipal government years ago. They are systems that require diesel oil to power a motor that pumps water from an underground source and delivers it via pipes to only half of the families in each community. Due to a lack of capacity building and education about the systems, people do not know how to repair the system should it get damaged.   Last April, a branch fell and damaged a pipe connecting the system. It has not been fixed since then, meaning that 271 people have been without pumped water and thus forced to go to the river to collect it from the stream. At 4 pm, families usually make the journey to bathe and wash clothes in the river. Much of this washing is done with soap full of chemicals, making the water foggy and full of suds. Not to mention the contact made with various human and animal wastes.

A comparison of various water collected from the river. The bottle on the far right is purified water brought from outside, or what most people drink in towns and cities. The water in the pots is collected from the river at one of the cleanest times of day.

This water was collected from the river at 1:30, before people bathe, wash clothes, etc. in the afternoon.

Bottled and potable water from "outside" the jungle in comparison to its river counterpart.

In the rainy season, this spring provides people with water in Kurintsa. It is unclear as to how clean it is, as the soil could possibly be contaminated with human waste. In the drier seasons, this spring dries up.

 An abandoned and broken water pump, installed by who knows what development organization in the 90s. It hasn't worked for years, largely due to the fact that no one taught people in the community how to fix the system.

 Local [temporary] solutions for local problems. When we were in Pumpuentsa in early June, we discovered that the community water pumping system had been broken since around the last time we were in the community (April...we didn't break it, btw). The municipal govt has not taught people how to fix the system, so many families have had to collect from the river, OR if they're "lucky" and have tin roofs, they have fashioned systems similar to the one I replicated for us in the community.

It is nearly impossible to improve maternal and child health (let alone health in general) when contaminated water causes so many basic health problems that are easily preventable and treatable. Water is a right. But it appears that some people have more access to these rights than others. Whether they live in the cities and can buy bottled water, have the water truck make weekly deliveries, own filters, or tin roofs, clean water is a scarce resource.  Which in the case of the Amazon Rainforest, seems quite ironic, as water itself exists in abundance. As a part of the Jungle Mamas/Ikiama Nukuri women's health program I'm working on at Fundacion Pachamama, our fabulous team is currently working with the communities of Kurintsa and Pumpuentsa to empower them to come up with long-term solutions to these issues. We have been working with people in the trained birth attendant workshops in teaching them about prevention, treating diarrhea (e.g. oral rehydration prep.), prevention, while simultaneously recognizing the interconnectedness with water.  In July, we have a community grant proposal writing workshop planned, to arm community members (both men and women) with the capacities necessary to create project plan(s) and seek funds to actively search for their own solutions.  Stay tuned for updates!

Overdue Updates

I can't even begin to recant all that has gone on here in just over a month. I apologize for not being as diligent as I had promised with these updates, but things have been both insanely busy and emotionally intense. Now for the mundane details of my life here:

I am sharing a beautiful house in a barrio in Quito called Bellavista. It is located on the eastern part of the city valley, and it overlooks Mt. Pichincha and the whole of downtown Quito. It's very safe, and most people would say it's a barrio where you can find many pelucones (Ecuadorian slang for uppercrusties). I'm sharing a house officially with 4 other people (all from the US), though the house is beginning to feel a little bit like a hostel (we will see how long this lasts). My room is very tiny, fitting a double bed, a dresser, and one nightstand, yet despite the size, I am paying a ridiculously low rent. It's a 15 minute walk and busride downhill to work (about 25 minutes coming from work because it is steep and uphill). The house is also an office for a green business that works with Kichwa communities to produce Guayusa tea (pronounced way-you-suh), which is an herb that boosts energy.

Work at Pachamama is excellent; there is never a dull moment or activity. I will dedicate an entire blog entry to the work I'm doing and going to be starting this year, because it is really interesting and covers all sorts of interesting issues. To be brief, I will be working primarily on two projects: Jungle Mamas, which will blossom into a health program for indigenous Achuar women in a community called Pumpuentsa in the Amazonian province of Pastaza. This program was started by a midwife from Berkeley, California, who upon having many discussions about childbearing with the women in the community, found that there was a huge interest in learning about midwifery and non-local birthing techniques. The traditional way women have been giving birth in this community has been by themselves; when it is time to give birth, the pregnant woman walks into the jungle by herself and comes back a day or two later with her child, oftentimes still connected to the umbilical cord. Last year, the project consisted of training women in these communities in Home-Based life-saving skills techniques that also incorporated local knowledge. The problem with this form of treatment was that the last resort in the treatment process always required visiting a healthcare professional or a clinic. The only way to access or leave Pumpuentsa is via airplane, which makes it difficult to leave the community if you don't have the resources to do so. So the training was taken off as a priority (however there are people in the community who have been trained and do actually serve as health providers).

My role in this project will be developing over the next month or so, but for the time being, I will be conducting a lit review of health-related projects conducted among the Achuar people and in the Amazon region in general. I have already made contacts with anthropologists who have conducted medical anthropology-related fieldwork in the area, and have even met some who have collaborated on public health programs among the Achuar. From this lit review and list of contacts, we will be able to not only have a better idea of how projects like these have been received and carried out among the Achuar, but it will also serve as a useful way of informing people in our network of partnerships. Unfortunately, it is not often that the Achuar get to use the information collected about them in studies for themselves, which is one of the reasons why the NAE (Nacionalidad Achuar de Ecuador, Achuar Nationality of Ecuador) have been increasingly opposed to social science investigation in their territories.

After the lit review and meeting with the project coordinators from the community in the jungle (and the community itself), we will be doing some fieldwork and interviewing families about their general perceptions of illness and health, numbers of deaths, births, etc. in the community, among other interesting information that will be useful in the design and implementation of an intercultural health program. I am especially excited about this aspect of the work, because it is very rare that people talk with individuals and families about identifying local needs and healing techniques when creating sound healthcare programs. There is going to be a lot to learn, and I still have much reading and relationship-building to do before everything magically turns into a health program, but I am working with such a wonderful team of people that the collaboration will be fruitful.

The other project I am helping out with is called the RED transfronteriza de territorios indigenas (the transborder network for indigenous territories). Pachamama is currently working with transborder indigenous nationalities from Colombia, Peru, Ecuador, Bolivia, and Brasil to work for the right to libre de transito, or the right of free border crossing to indigenous peoples whose territories are separated by national borders. It is a long and complicated process to get governments to recognize the territorial rights of these people to cross borders (especially when you have border "safety" issues, like the border between Colombia and Ecuador). Feel free to check out the website and radioprograms here and here.

I've been sitting on a really powerful and intense experience about women's health I had to advocate for on New Year's. I hope to have it ready in a few days. Please stay tuned, because it is one of the experiences I have had here so far over the last four years that I think has impacted me the most on a personal and professional basis.