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‘Telemedicine’: A toxic state’s response to a health crisis in Peru

By Salil Shetty, salilshetty

The small shack, standing a few meters away from the colorful houses of the Indigenous People community of Cuninico, in the Peruvian Amazon, looked unfinished.

Four clumsy thin walls, a tin roof and a door equipped with a ramp was the Peruvian government’s answer to the desperate calls for help coming from a community where most of its members have fallen ill in recent years. There is no doctor in sight, just this makeshift shack.

The Peruvian government calls it “telemedicine”, allegedly a state-of-the-art way of connecting isolated communities with doctors in the country’s capital through a computer.

The problem, however, is that the community in Cuninico does not have steady electricity let alone access to Internet that will allow for an uninterrupted medical appointment via teleconference.

What they do have is a catalogue of illnesses, including stomach cramps, burning when urinating, allergies, skin rashes and miscarriages. Next to them, a river known to be contaminated with toxic substances is their only source of fresh water.

Community of Cuninico Community of Cuninico
Community of Cuninico. Kat Goycochea/Amnesty International

Over the course of a year, Amnesty International’s teams visited Indigenous communities in Cuninico and Espinar, in the country’s Amazonian and Andean regions. We have just published the results of our investigation into the health crisis affecting this community.

In Cuninico, dozens of people told us that in 2014 the river water and the fish that the community depend on starting tasting strange. Since then women, children and men have reported new and more intense illnesses they had not previously experienced.

That same year, Peru’s regional health authority revealed that the levels of aluminum and total petroleum hydrocarbons in the water in Cuninico exceeded those allowed for human consumption.

Two years later, a study by Peru’s Ministry of Health showed that more than half of people in the community had abnormal levels of mercury in their blood. Alarming levels of cadmium and lead were also detected in people, including children. According to the World Health Organization, exposure to mercury and lead can cause extremely serious health problems and irreversible damage to foetal development.

The closest health center to Cuninico is an hour and a half away by speedboat and does not have the specialists required to meet the needs of a local population exposed to toxic metals.

What stands out is the absolute lack of willingness on the part of the Peruvian government to determine the cause of the communities’ ills or indeed take any steps to address it. Despite the fact that the government declared a public emergency in the area in 2017, no real steps have been taken to help the local population.

Instead, every day the local communities are forced to make an intolerable choice of using toxic water that may possibly be poisoning them and their children, or going without. This is not a choice at all. 

Carmen Catalina Chambi show some polluted water from her community Carmen Catalina Chambi show some polluted water from her community
Carmen Catalina with contaminated water from her community, Espinar. Diego Cárdenas/Amnesty International

People have resorted to collecting rainwater for their household consumption, but are forced to drink contaminated river water when rainwater is insufficient. Their calls to be able to protect their children and to have their basic human rights to health and clean water are falling on deaf ears.

It is a similar pattern around the world, where Indigenous communities are facing an uphill struggle to fight for their right to clean water and health. From Canada to Brazil and Nicaragua, we are seeing Indigenous Peoples push back against the many abuses they suffer in a cruel attempt to stop their activism.

But this is not without its own risk. The evidence shows that environmental defenders – the people who defend their community’s land, natural resources or wildlife – are being killed in record numbers, at the rate of four a week around the world. It is often indigenous activists who find themselves on the frontlines of this battle.  

However in a world that is rapidly running out of sources of clean water, these struggles should not be seen as an isolated issue effecting only Indigenous communities. By 2030, the global demand for water is expected to outstrip supply by as much as 40 percent. This means that there will be more competition for the water we do have, and an even greater need to ensure that what is available is fit for human consumption.

We may not realize it yet, but the well-being of every single person on this planet is invested in the Indigenous communities’ struggle for clean water. The Peruvian government owe it to Indigenous Peoples themselves and to the future of all their citizens to take the lives and health of these communities seriously. Makeshift hospitals with unplugged computers will no longer do.

This article was originally published in El Páís

Salil Shetty

A long-term activist on poverty and justice, Salil Shetty leads the movement's worldwide work to end human rights violations and has spearheaded a significant move of Amnesty International's work to the global south.

Community of Cuninico

Health effects of the population

26

months since the authorities found that the water in Cuninico is contaminated with heavy metals and other toxic substances, but the community still does not have access to safe and clean water

129

Number of people from the communities of Cuninico and San Pedro tested for lead, cadmium, arsenic and mercury in 2016 by the government. All those tested were confirmed to be exposed to at least one of these toxic substances

0

Number of operational health centres in Cuninico. The closest health centre is an hour and a half away by speedboat

Community of Espinar

Health effects of the population

41 out of 58

Water sources contaminated by heavy metals or other chemical substances beyond the limits for safe human consumption

7

Types of heavy metals or other chemicals toxic to human health identified in the communities’ water sources

Health Problems in the communities of Cuninico and Espinar

Health problems in adults

Migraines, muscle cramps, vomiting and diarrhea, skin lesions and rashes, hypertension, anaemia, infertility, miscarriages, premature birth, memory loss, insomnia, motor impairment, vision loss, diabetes, liver disease, kidney failure, cancer