Socios En Salud / Peru

THE SITUATION IN PERU

A South American country of nearly 30 million people dominated by the towering Andes Mountains, Peru has long had a heavy burden of tuberculosis. Despite earlier efforts, it’s only in the past 15 years that TB control efforts have become effective.

A patient and her children walking home in the slums lining the northern limits of Lima.

In the 1960s, Peru was estimated to have one of the highest case rates of TB in Latin America at 400 active cases for every 100,000 people. National legislation enacted to fight the epidemic made little progress. In 1980, only less than half of patients receiving treatment were cured.

PIH’s sister organzation Socios En Salud works in the Carabayllo, Comas, and Independencia districts located just outside the capital city of Lima. These districts consist, as does much of the area surrounding the capital, of urban shantytowns and settlements in the desert hills. The population of these districts is estimated at over 700,000 inhabitants, many of whom have emigrated from Peru’s countryside, fleeing from poverty and political violence.

They settle in the dry, dusty hills, building unheated shacks in a swelling community served by only two roads and almost completely lacking in basic public utilities such as water, electricity and sewage.

PIH’S WORK IN PERU

Since 1994, SES has been treating disease and training community members to provide prevention and care for their neighbors. As a valued partner to Peru's Ministry of Health, SES has also had an impact on national policies for prevention and treatment of drug-resistant tuberculosis and HIV and provides important training and support to help implement those policies nationwide.

Drawing on PIH’s experience with community-based tuberculosis treatment in rural Haiti, SES has achieved remarkable success in confronting an epidemic of MDR-TB in the slums of Lima. In the process, SES has treated more than 10,500 people, overturning assumptions that treatment of MDR-TB is too expensive and too complicated to succeed in poor communities, and has instigated major changes in national and global health policies.

SES’s MDR-TB cure rates are 75 percent – the highest in the world.

Today, SES is a global leader in clinical and operational research on MDR-TB. The multiyear EPI Project study is spread among 124 heath centers, and involves 4,000 patients, 20,000 contacts and hundreds of staff. In partnership with Brigham and Women's Hospital and Harvard Medical School, this project is among the world’s largest MDR-TB research initiatives.

With the end goal of eradicating TB and HIV across Peru, SES is now providing training and support to assist the Ministry of Health through community-based directly-observed-therapy trainings.

On the 2011 World TB Day, SES staff and supporters advocated for greater awareness around tuberculosis in Lima, Peru.

The team operates 16 botiquines (small health posts) in the shantytowns of Lima that serve patients who would otherwise have no access to primary care. The botiquines are overseen by local women trained as health promoters, who manage supplies and coordinate medical care.

SES also provides food baskets, transportation, lodging and social support for impoverished patients whose needs have been confirmed by an extensive interview and evaluation. The project also provides opportunities for income-generation projects, job-skills training, and small loans to start businesses.

Learn more about PIH's work in Peru.