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HEALTH: Northwestern Argentina – a “Paradise” Only for the Tourists

Marcela Valente

ABRA PAMPA, Argentina, Jun 1 2006 (IPS) - The silence is overwhelming in the desolate Puna plateau region in northwestern Argentina. The cold is penetrating, although the locals say winter hasn’t even really arrived. When it does, in June, temperatures drop to 15 degrees below zero Celsius.

Abra Pampa, a town of 13,000 which is considered the capital of the Puna region, is located in the northern part of the province of Jujuy, 1,800 km northwest of Buenos Aires. The squat adobe houses are ochre-coloured like the streets, sidewalks and even the few trees. The wind colours the entire landscape with the oxide from the earth and surrounding hills.

This town, located 3,500 metres above sea level, is reached by a road that first runs through the Humahuaca valley, with its thorn and cactus scrub and rocky ravines. Visitors must take precautions to prevent “apunamiento”, the name given in this region to altitude sickness.

Shortly before reaching the town, a layer of fog makes it look like the destination is above the clouds. “For tourists, this is paradise,” says the owner of the hotel. “There is no theft and no drugs, and you can walk along the streets at any time of the day or night.”

People leave their bikes unlocked, and no one has to be wary of muggings. Nor are there swarms of homeless people asking for spare change, like in Buenos Aires or other large cities.

However, in this “paradise,” the needs are infinite – especially when it comes to health care – as Jujuy is one of the poorest provinces in this South American country of 37 million.

Although there is a subsistence economy based on small-scale farming and livestock raising, most people in the town depend on public sector employment or assistance from the state.

The head of the Abra Pampa Department of Social Action, Silvia Alanis, told IPS that more than 60 percent of the population is unemployed.

“That brings in its wake an endless list of problems. People have no dignified means of subsistence,” said Alanis, speaking from a full-time municipal day care centre. “For example, every day we receive complaints of children who have been abused by their mothers.”

“That is why we bring the kids here, feed them, help them wash up and keep them entertained, to somewhat ease the problem. But we know that what is really needed is an in-depth solution,” said Alanis.

Many women in Puna are the heads of their households, which tend to consist of a large number of children.

Meanwhile, many men can be seen wandering around the streets with red eyes and a glazed look. Alcoholism is a serious problem, which also affects women, teenagers and even children, said Alanis. “There are no drugs here, but there is a lot of alcohol, and too many women with serious mental problems,” she added.

The most serious cases of mental disorders are referred to San Salvador de Jujuy, the provincial capital, 220 km south of Abra Pampa. “There, they medicate these women and send them back without treatment, even though we have no psychologists here. All we have is a social worker at the hospital, who assists the families in the most critical conditions,” she said.

In terms of intellectual development, children in the region are an average of two years behind their counterparts in Argentina’s main cities, said Alanis. “We don’t know if it is the lack of stimulation, the mistreatment, or the pollution.”

From the dusty streets of the town can be seen a huge heap of mercury and lead-contaminated waste, left there by a smelting plant that is no longer operating.

Catholic priest Laureano Puca Suárez said that “grey threat” worries him so much that during Holy Week he set up one of the Stations of the Cross there.

According to the Argentine environmental group Fundación Vida Silvestre – a WWF affiliate – 59 percent of children in this town have excess levels of lead in their blood. Lead poisoning diminishes the intellectual capacity of children.

“When it’s rainy and windy, you can smell it,” said the priest.

Suárez also noted that the sewers in Abra Pampa directly dump the untreated sewage into a stream behind the Cerro de la Cruz, a hill that forms a backdrop to the town. “Shepherds bring down their llamas and sheep to drink there, and afterwards these animals are butchered, and their meat is sold,” he said, with alarm.

The United Nations Development Programme’s (UNDP) Human Development Report 2005 described nine northern provinces (including Jujuy) as Argentina’s “critical region”, where poverty affected 60 percent of the population in 2004 compared to 44 percent nationwide. In Abra Pampa, however, the poverty rate was above 70 percent.

Infant mortality, which stood at 16 per 1,000 live births in 2004, was 22 per 1,000 in the critical region – and over 28 per 1,000 in Abra Pampa.

The incidence of cervical cancer in the nine northern provinces, meanwhile, is three times the national average.

The Nuestra Señora del Rosario hospital in Abra Pampa and the hospital in La Quiaca, 200 km farther north, are the only ones in the entire Puna region.

Inside the rundown one-story building of Nuestra Señora, the plaster is peeling, and it is freezing cold. Near the back door is a room with a broken-down gurney and an ancient wheelchair that looks like it should be in a museum.

There are four occupied beds in the freezing women’s wing, which consists of a dozen old iron hospital beds with chipped paint and a woodstove that is not in use. “We don’t have firewood; we can’t afford it on our budget,” said the head nurse, José Patagua.

To try to keep the patients warm, the nurses use what they call “the poor man’s heater”: they place their beds or chairs near a window, in the weak sunlight.

Despite its proximity to Bolivia, which has the second-largest natural gas reserves in South America, there is no network of natural gas pipes for heating in the Puna region. Nor do people have blankets made of llama wool, despite the abundance of llamas.

“Those blankets are for the tourists. The ones we have are synthetic, and aren’t as warm,” said Patagua.

Some people in Abra Pampa say that if you have to go to the hospital, you should bring along a mattress, sheets and blankets.

“It’s not that we don’t have these things, but it’s true that everything is in pretty poor shape,” the head nurse admitted.

Although there are five ambulances, fuel isn’t always available. The three newest ones are used for short trips within the town limits, or to take patients in critical condition to the provincial capital. The other two, which were purchased in 1976, are used to bring patients back from rural communities in the rest of the Puna region.

But a closed pick-up truck with a vinyl leather mattress is the “ambulance” used for Kolla indigenous families living in remote rural areas.

“At least once a month a baby is born in that cold vehicle which has no medical equipment, and we help,” protested driver-cum-mechanic (and occasional birth attendant) Hilarión Valderrama,

The hospital director, Gladis Cruz, a dentist and other health workers periodically take the pick-up truck to make a tour of the 28 rural health posts in the Puna region, each one of which has a first aid room and a health promoter. The team comes equipped with medicines, food, contraceptives and equipment for carrying out a few medical tests.

“The women have 10 to 12 children on average, and when you ask them about the father, they say that only ‘the last little one’ has a father,” said Cruz. “Despite all of that, they are willing to accept whatever children God sends them.”

“They’re afraid of the IUD (intrauterine device). They think it will hurt when they sit down, and that it will change their personality,” she said.

Cruz said that many babies are born in the traditional “ranchos” or adobe and straw huts, a custom that the hospital is attempting to change, encouraging women in rural areas to come to Abra Pampa 15 days before their due date, in order to give birth attended by health professionals. But many fail to do so.

They prefer to stay in their visually stunning but poverty-stricken “paradise”, where they are surrounded by hills, llamas and sheep, and looked after by “Pachamama” (Mother Earth).

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