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Cholera Joins Long List of Peruvian Epidemics

March 15, 1991

LIMA, Peru (AP) _ The cholera epidemic rampant in Peru has claimed nearly 400 lives, but Peruvians see it as just one more on a long list of diseases flourishing in this Andean nation.

″In few countries do the conditions created by poverty, underdevelopment, economic crisis and the lack of sanitary services favor the permanence of cholera as among us here,″ wrote the influential daily La Republica.

Faltering health services, plus determents to treatment such as a guerrilla war, drug trafficking and a distrust of modern medicine, have allowed diseases once believed under to control to flourish.

Yellow fever, polio, Chagas’ disease, dengue, tuberculosis, and a type of leprosy have all become endemic throughout Peru.

Thousands of typhoid and hepatitis cases are registered each year. Malaria, which affected 30,000 people last year, is moving into Lima’s suburbs. Some 200 cases of rabies have been registered this year.

Since January, 70,000 cases of cholera have been reported - the Western hemisphere’s first epidemic of the disease since early this century.

At least 10 cases of bubonic plague have been reported over the past three years, making Peru one of the few nations where the disease still exists.

″Everyone thought these diseases had been wiped out years ago,″ said Dr. Wellington Chumbe, head of the Health Ministry’s department of tropical diseases. ″The most we can do now is to spray areas with DDT to kill off insects like the Aedes Aegypti mosquito, which spreads dengue and yellow fever.″

The highly toxic insecticide is banned by the World Health Organization, but the group has permitted Peru to use DDT as an emergency measure.

A lack of funds for health services hinders the fight against disease.

″The economic crisis has led to less health spending at the same time diseases are making a comeback,″ said Dr. Umberto Guerra of the Cayetano Heredia Medical School’s Tropical Medicine Institute.

Cuanto, an economic publication, calculated that annual health spending in Peru had fallen by the end of the 1980s to $28 million - a third in real terms of what it was at the beginning of the decade.

The World health Organization says over 40 percent of Peru’s population of 22 million has no access to health services. More than half Peru’s homes lack electricity, running water or sewage services.

Peru’s life expectancy of 61.4 years is third-lowest in Latin America after Haiti and Bolivia.

But not only the economic crisis has helped disease to flourish.

Health workers often can’t reach remote regions because of impassable roads. Peru’s bankrupt government has put almost no money into road repair since 1985.

And a mistrust of modern medicine among Peru’s rural population means many die for lack of treatment.

″They’re used to being treated by their own folk healers,″ said Dr. Abelardo Tejada, director of San Marcos University’s Tropical Medicine Institute.

The Upper Huallaga valley, a coca-growing jungle region in northeastern Peru, is rife with both uta, a form of leprosy, and dengue. But few health workers venture there because of violence by Maoist Shining Path guerrillas and cocaine traffickers.

″We have to ask the Shining Path for permission to vaccinate people in the Huallaga valley,″ Chumbe said. ″And we must turn a blind eye to coca paste laboratories and the presence of armed guerrillas.″

Violence and poverty have forced tens of thousands of rural workers to migrate to Lima in recent years and they have brought disease with them.

Most of the diseases Peruvians face can be treated if caught in time. Some, however, have no known cure. They include Carrion’s disease, which is spread by the bite of an insect. Like AIDS, it weakens the victim’s immunity to other diseases. Carrion’s disease infected 3,000 people last year.

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