Monday, May 9, 2011

Peruvian Potatoes

Open air market in Pisac
Large variety of potatoes can be seen on display on left above fruits

Potatoes are a classic Peruvian dish.  The Inca cultivated an extensive array of potatoes and used raised bed terraces on the sides of their fortresses to maximize crop yield. The Spanish conquistadors brought potatoes back to Europe with them when they returned from the Conquest.  In the open air Peruvian markets there are literally hundreds of types of potatoes in all shapes and colors  -- far more of an array than is ever seen in the United States, even at Farmer's Markets.






A favorite Peruvian potato recipe is Papa a la Huancaina, which is basically potatoes in a spicy cheese sauce.  This dish is served cold, and is typically used as an appetizer or a luncheon dish.  The recipe can be found at the following link:


http://www.food.com/recipe/papas-a-la-huanca-na-143492













Clandestine Abortion in Peru

Currently, abortion is illegal in Peru unless the mother's life is at risk should she continue the pregnancy.  Despite the illegality of the procedure, there were approximately 352,000 abortions performed in Peru in 2004, the last year for which numbers were estimated.  That year there were 1,000,000 total pregnancies in Peru.  Thus, the estimated number of abortions represents 35% of the total pregnancies.

The government views abortion as a moral and religious issue, even though clearly it is a public health issues.  Governmental response has been to punish those having or performing abortions, rather than addressing the root causes of the need for abortion services.

Peru is a predominantly Catholic country, and as such, the Church is highly influential in setting and maintaining moral standards.  Despite the fact that the Church forbids the use of birth control other than the rhythm method, 68.9 percent of women who are married or in a committed relationship use some form of birth control.  Of these, only 14.4% use the rhythm method.  The rest use the pill, IUD, barrier methods, injections, rings, or have been voluntarily sterilized.

The statistics are more sobering when we look at the use of birth control among all women of reproductive age.  Only 44% of these women use protection.  It is clear that a large number of single women are sexually active, yet not practicing safe sex.

Counterintuitively, the "typical" Peruvian woman who has an abortion is married or in a committed relationship, and has children already.  The unwanted pregnancy comes at a time when they feel their family is complete, or at a time of economic hardship, wherein they cannot afford the child.

A clandestine abortion in Peru is usually sought, sourced, and paid for by the father of the child.  Despite  the illegality of the procedure, there are many people who will perform them, including physicians, nurses, midwives, pharmacists, shamans, and the patients themselves.  Peruvian law has relaxed the penalties for individuals who present at hospitals with post-abortion injuries or infections, as well as for those connected with performing the procedures.

The most popular method of inducing abortion is to take prostaglandin drugs orally and have them applied to the vagina.  These, in conjunction with oxytocin, begin strong contractions which cause the fetus to be expelled.  Other methods include taking large doses of aspirin and acetominephen (20-50 pills at a time); drinking herbal extracts and special teas; introduction of foreign objects such as knitting needles, catheters, and wire in to the vagina; being beaten or pushed down the stairs by a family member or friend; and the introduction of liquids into the vagina, such as bleach or Coca Cola.

Access to family planning information and services is very hard to come by in Peru.  There is no sex education in the schools, and as with many places in the world, families are reluctant to talk about sex, or feel that their religious practice forbids the use of family planning.  The large number of abortions in the country is reflective of a desperate lack of information and access to assist women in controlling their reproduction.  This is especially true in the poorer jungle and Andean Highland regions, where the only source of health care is often the local shaman.

Source:  F. Delicia.  Clandestine Abortion in Peru - Facts and Figures 2002. Flora Trista Center for Peruvian Women. Pathfinder Institute, April 2002.

Tuesday, May 3, 2011

Childhood Malnutrition in Peru

Peru has one of the highest rates of income inequality in Latin America, with a huge disparity between rich and poor. Approximately 45% of Peruvian citizens are characterized by WHO as poor, and 20% are extremely poor. Poverty impacts children especially hard in Peru. Three out of 5 children live in poverty. Non-Spanish speaking children suffer dramatically. indigenous populations that live in Amazonia and in the Andean Highlands have the highest rate of poverty in the country.

Indigenous children exhibit symptoms of stunted growth as early as 3 months of age. Breastfeeding is not universally accepted and babies are fed soup and broth from ages 6-24 months. This is an inefficient and nutritionally deficient means of feading children.

In addition to poor food, indigenous children work at a very early age. They begin as early as age 5 and 6 to perform regular work -- most of which is not paid and labor intensive in support of family activities. In Quechua and Aymara communities, work is highly valued and takes precedence over schooling. As a result, children learn the basics of the first several grades (simple reading, writing and some math) but do not value progressing further. As children grow, their families expect more labor from them. With limited food availablity, low level malnutrition is a constant among indigenous children.

In addition to malnutrition, rates of chronic anemia are also high among indigenous children. This can be attributed to diets that are largely centered on corn and corn derived products.