January 31, 2018

The Awakening of the Waters: Clean water, health and village sanitation in the Peruvian Amazon

So it was, long ago, people had no clean water to drink. Instead, they drank from muddy swamps and stagnant puddles of algae and slime. One day, Shigentiri, the Dragonfly, watched a man hauling gourds of filthy water.  

"Wouldn't you prefer to have clean water to drink?" asked Dragonfly.

"Yes!" answered the man. "All we have to drink is this muck."  

"So be it," said Dragonfly, "I will awaken the waters. Follow me."

The man followed Dragonfly through the forest and soon they came upon a new spring, gurgling and splashing on the rocks. 

"Don't fill your gourds yet," said Dragonfly. "Wait 'til tomorrow, and never again will you have to drink swamp water."

The man obeyed Dragonfly's words, and when he awoke he saw that the spring had filled the stream basin. People have had fresh, clear water to drink ever since. And so it was. 

This myth was told to me by a Matsigenka elder named Tito in the mixed Matsigenka/Huachipaeri community of Santa Rosa de Huacaria on the fringes of Manu Biosphere Reserve in the Peruvian Amazon. In the first place, the story makes a specific association between dragonflies and clean water sources. As is the case for other Matsigenka tales, such mythical references often emerge from accurate ecological observations. Dragonflies, aquatic species that spend much of their life cycle underwater, are indeed considered by scientists to be important indicator species of environmental health, especially water quality

The story also highlights a number of important traditional concepts about water use and purity. Water that is stagnant or muddy is unpleasant and unhealthy to drink, while spring water that is clear, running and free of sediment (sanaari in Matsigenka) is considered pure, safe and drinkable. The story also makes clear the importance of restraint and respect in peoples’ relationship with natural resources: by obeying Dragonfly’s warning and resisting greedy thirst through the night, the man allows clean water to flow eternally. Indigenous mythology is replete with such lessons in restraint and balance in the use of natural resources. 

I gathered this story during anthropological fieldwork in Huacaria as a consultant for the non-profit organization Rainforest Flow, in preparation for a water and sanitation project that was implemented initially in Huacaria, and expanded more recently to remote native communities in the heart of Manu Biosphere Reserve.

Despite appearances, even limpid tributary streams in the Amazon can have significant levels of bacterial contamination
You might ask, "But what do anthropologists know about sanitation engineering?" And to be honest, I'd have to answer, "Not much." But anthropologists can apply their cultural insights, observational habits and research skills in order to help community development projects understand the local social context, translate complex concepts between languages and cultures, and avoid (or at least minimize) gaffes, misunderstandings and general gringo cluelessness.

You might also ask, "But I thought the Amazon was the largest body of fresh water in the world. Why do indigenous people living in a huge, pristine rainforest park at the headwaters of the Amazon need tap water?"

That, in fact, was the first question I posed to Rainforest Flow director Nancy Santullo when she approached me about being part of the project: "Isn't their stream water good enough? Prove to me they actually need a new water system!"

Conducting fieldwork in Huacaria

So on my first trip to Huacaria with Rainforest Flow, among my top priorities was carrying out laboratory testing of the drinking water sources available to the village. The results were shocking even to me.

All drinking water sources in the community had moderate to extreme levels of contamination with fecal bacteria. Some households in the community already had a government-installed tap water system, which fed raw stream water to cement tap stands near the houses. However analysis revealed that the tap water in Huacaria was actually more contaminated, on average, than water from fresh streams that some households used(!). Furthermore, the existing tap stands had no drainage system, depositing waste water directly onto the ground around houses, generating even more contamination. House-to-house health interviews revealed that 83% of children under five in Huacaria had experienced at least one episode of diarrhea during the prior month. Frequent diarrhea episodes in the early years of life can have a lasting impact on a child's health, and hence it was no wonder that 39% percent of children in Huacaria showed some degree of malnutrition according to World Health Organization standards.

The previous tap water system in Huacaria brought contaminated water to households and had no drainage system
In addition to measuring water quality and observing water use patterns, I also analyzed health data being gathered by the project team and conducted interviews with community members about their views on water, health and sanitation.

The Matsigenka concept of well-being is summarized in the verb shinetagantsi, which means to be happy, productive, and well-fed as well as free of illness.  Concepts antithetical to well-being include illness (mantsigarentsi), suffering (tsipereagantsi), "skinniness" or weight loss (matsatagantsi), sorrow or worry (kenkisureagantsi), anger (kisatsi), and soul loss (gasuretagantsi). Health and well-being and, conversely, illness and malaise, embrace physical, emotional, and spiritual states as well as harmony (or lack thereof) in productive, social, and environmental interactions. Their classification of illness categories and their theories about illness etiology and treatment reflect these complex notions. In the Matsigenka cosmos-as-ecosystem, illness, misfortune, and death are often interpreted through the ecological metaphor of predation: just as humans hunt for sustenance, so do demons, illnesses, dangerous animal spirits—and more recently, human sorcerers—look on human beings as game animals to be killed and eaten.

Juan Coshante once gave me a very effective treatment for an excruciating caterpillar sting: The pain stopped instantly

The Matsigenka are respected by neighboring indigenous groups for their detailed knowledge of medicinal plants addressing a wide range of ailments. In the past, and in some communities through the present, shamans have practiced a special variety of spiritual and cosmological healing that depends on esoteric connections with forest spirits and the celestial realm. Through today in many communities, traditional medicine is still practiced in various forms and by various specialists and non-specialists. Matsigenka theories of illness are highly cosmopolitan and dynamic, often combining empirical, social and spiritual understandings of illness, and treatments likewise can combine herbal, shamanistic, Andean and biomedical treatment methods.

Amazon rainforest peoples such as the Matsigenka and Huachipaeri lived traditionally in widely dispersed, semi-nomadic settlements composed of a few related families. However throughout the 20th century, attracted by missionary outposts and government schools and health clinics, many indigenous families now live in permanent, centralized communities. Increasing population density and more sedentary lifestyles have generated a number of problems including decreasing stocks of fish and game near communities, social conflicts between families, fecal contamination of the water supply and high incidence of intestinal parasites and other gastrointestinal disorders. Although the Matsigenka maintain their rich knowledge of medicinal plants for treating a wide range of traditionally recognized conditions, their pharmacopeia is insufficient for addressing the full range of health conditions they face today, especially gastrointestinal and respiratory illnesses.

As I observed throughout the course of my field study, families in Huacaria who had tap stands used water much more frequently, whether for washing themselves, their clothes and utensils, or for cooking and drinking. Families without taps had to carry water from nearby streams, and thus used it much more sparingly. In order save water, these families would re-use waste water for hand-washing and cleaning utensils, increasing the chances of contamination. Despite the contaminated tap water, sanitary conditions were better in houses with taps than those without them because of the ease of access. Based on these observations, an overhaul and expansion of the existing tap water system seemed warranted.

Slow sand filters use locally available rock and sand loaded into portable geomembrane tanks to purify water in remote communities

Rainforest Flow carried out a complete renovation of Huacaria’s tap water system, using a technology known as "slow sand filtration" to purify the water. This simple but effective technology, used worldwide in remote communities and disaster relief situations, harnesses natural processes, both mechanical and biological, to remove 99.99% of disease-causing microorganisms. Locally-occurring rock and sand are loaded into portable geomembrane filtration tanks that purify water and make it safe for consumption. Water is distributed to households from a flexible geomembrane storage tank (it looks like a huge waterbed) through hygienic plastic tubing to durable, practical tap stands that incorporate local materials and design concepts. By taking advantage of the hilly terrain in the Andean foothills, the water system in Huacaria is entirely gravity-fed, requiring no external power sources (pumps, engines, solar panels) to distribute or treat the water. Portable geomembrane filtration and storage tanks greatly reduce the need for cement, rebar and other construction materials that are difficult to transport to remote communities. 

Community members participate in all stages of construction and maintenance of the water system to guarantee sustainability. A special stand-alone tap design using local river stones was developed after studying community needs and use patterns.

After this baseline research, I carried out a five-year follow-up study of the project impacts in Huacaria (2002-2007). More recently, I have evaluated the initial phase of the project's expansion (2007-2014) to the communities of Tayakome and Yomibato in Manu National Park.

Ongoing biomedical monitoring in collaboration with the Peruvian health ministry suggests a significant impact of the water purification system on child and overall community health. The prevalence of diarrhea among children saw a 45% reduction over a three year period after the water system was renovated (see report for complete health data). Prior to the water system renovation, over half (54%) of Huacaria’s children and youths suffered from multiple parasite infections (two or more parasite species simultaneously). After three years of access to purified water, only 20% had multiple infestations, while 23% of children were parasite-free, up from only 9% parasite-free prior to the water system renovation, a nearly threefold improvement. 

Height and weight measurements suggest a trend in improving nutritional status for Huacaria's children during just the three initial years of the project. The percentage of children considered of "normal" weight (according to WHO standards) increased from 83% to 90%, while the percentage of children considered to have normal stature doubled from 35% to 70%. A concomitant trend is noted in decreasing numbers of children considered malnourished because of being underweight (from 17% to 10%) and undersized (from 39% to 30%) for their age. Though it is difficult to assign causality for such a small population, the drastic reduction in episodes of infant and child diarrhea, and the notable reduction in intestinal parasites certainly appear to be relevant in reducing malnutrition rates.

Microbiological analysis shows the progressive reduction of fecal bacterial colonies (red-brown dots) in samples taken at different stages of purification, from stream source water (left), to the output of the gravel pre-filter (top), to the safe drinking water emerging from the slow sand filter and taps (right). No chlorine or other treatments were added.

After witnessing the health improvements in Huacaria, observing the community empowerment generated by Rainforest Flow's programs and attesting to the organization's socially and environmentally sustainable practices, I suggested to Nancy Santullo that she expand the project to include the much more remote communities of Tayakome and Yomibato within the core zone of Manu National Park, where I have worked for almost thirty yearsShe accepted the challenge and now, after arduous years of even more difficult work, both communities have sturdy tap stands delivering clean, safe water to every household where it is technically possible. The schools in Tayakome and Yomibato also have utility sinks and hygienic, well-ventilated bathrooms with a sealed, composting septic system. 

Getting to Yomibato is an extreme sport: the narrow stream is an obstacle course of fallen trees, submerged trunks, shallow rapids and sandbars.

Spacious, well-ventilated, eco-friendly bathrooms at the community schools in Tayakome and Yomibato

The water systems and sanitary installations brought by Rainforest Flow have delivered far superior results to those found in communities of the adjacent Camisea region, outside Manu Biosphere Reserve, where a gas pipeline has caused serious social and environmental impacts, while generating over one billion dollars in royalties that have been invested in mostly failed community development projects, with particularly dismal results in the areas of health and community sanitation, at least so far. Rainforest Flow's project design and results have been shared with indigenous associations and government representatives in the Camisea region in the hope that better use will be made with gas royalties and other community investments in the future.

To learn more about Rainforest Flow's projects, programs, and mission, visit rainforestflow.org

Proceeds from the sale of selected artworks at Linda Matney Gallery in Williamsburg, Virginia, support Rainforest Flow and other community projects in the Amazon


The following reports and publications on water projects, health status and ethnomedical practices in native communities of Manu Biosphere Reserve and the Camisea region are available for download:

Matsigenka: Encyclopedia of Medical Anthropology (2003)

Huacaria Hygienic Center: Summary of goals and results of field research carried out in June, 2003 (2003).

Rainforest Flow/House of the Children’s “Project Huacaria”: Five-Year Evaluation (2002-2007) of Social and Health Impacts of an Integrated Water Purification/Health Education Project (2008)

Revenge, Envy and Sorcery in an Amazonian Society: Revenge in the Cultures of South America (2008). 

Rainforest Flow’s “Manu Expansion Project”: Preliminary Evaluation of Social and Health Impacts of an Integrated Water Purification/Health Education Project in the Native Communities of Tayakome and Yomibato in Manu National Park, Peru (2014).

The Vampire Pipeline: Unhealth and undevelopment in the lower Urubamba (2014).