Rural Andean Research Articles

Being Paramuno: Peasant World-Making Practices in the Paramos [High Moorlands] of the Colombian Andes

In this paper we explore what campesino [peasant] livelihoods in the rural Andean mountains of Colombia offer to understandings of more-than-human co-existence and care. For, while new conservation paradigms promise to transform economic and social horizons, being “paramuno” [resident of the “paramo,” or high moorlands] in the small community of Monquentiva is already characterized by becoming-with-other-beings-and-practices; a disposition toward incorporation of elements that are at-hand, and an ethics of care toward other beings in the landscape. We draw on ethnographic data to present this case study, emphasizing the forms of social organization and persistence that have enabled the emergence of economically and ecologically sustainable livelihoods. We explore these processes in terms of what we call world-making practices, showing how relationships with Indigeneity and collectivity are being renegotiated, and arguing for modes of conservation that engage with existing forms of peasant innovation.

Short Commercialization Circuits and Productive Development of Agroecological Farmers in the Rural Andean Area of Ecuador

Fair commercialization networks represent a direct economic and social participation mechanism for small producers in rural areas. Women’s participation is a pillar in short commercialization, which incorporates family income and economic independence, as well as food diversification in the territory. This research aims to analyze short commercialization circuits (SCCs) for agroecological foods as a contribution to productive development in the rural Andean area of Pillaro canton. This research, developed between April 2019 and May 2020, involved a quantitative approach and cross-sectional data collection. The Farm Sustainability Indicators (IDEA) method was used for the analysis, which establishes three scales: agroecological, socio-territorial and economic sustainability. The results show that SSCs contribute to food security through low-cost food, diversification, and nutritional products. In addition, SCCs allow a closeness between producers and consumers that provides greater confidence in the products offered. The ratings of 35.0 for the sustainability scale, 30.52 for the socio-territorial scale, and 17.5 for the economic scale indicate that the short commercialization circuits observed in the area consist of a sustainable system that allows for the social and economic improvement of producers in the rural Andean area of Pillaro canton, as well as the improvement of the natural environment.

Can first phalanx multivariate morphometrics help document past taxonomic diversity in South American camelids?

South American Camelids (SAC) were of great economic and cultural importance for pre-Hispanic societies in the Andes and still are important for rural Andean communities. However, understanding their specific role and function over time is hampered by the lack of reliable taxonomic identification of their archaeological remains. Although this problem has been acknowledged since the 1970s, the identification of SAC from archaeological contexts still mostly relies on the first phalanx multivariate morphometrics developed by Kent in 1982. The goal of this study is to further explore the taxonomic potential of this method using a machine learning approach including new measurements of phalanges from modern Peruvian, Bolivian and Argentine SAC with additional measurements taken from the literature. Results have shown that fore phalanges reliably distinguish the wild guanaco and vicuña, but the distinction between the domestic forms and their wild relatives still remains tentative despite the new statistics. This is largely due to limited domestic SAC comparative material, especially for the alpaca, but also underlines the presence of an intermediate size morphogroup among the domestic SAC. Morphometric variations recorded for the pre-Hispanic SAC are greater than those of current SAC, preventing reliable identification of the archaeological specimens. These results emphasize the need to improve the current SAC measurments data base and develop new multiproxy approaches in the study of pre-Hispanic camelid diversity directly from the archaeological material.

Cardiovascular risk among 6-8-year-old children living in urban and rural communities in Ecuador: A cross-sectional analysis.

Cardiovascular diseases have their origins in childhood. At least 20% of children and adolescents in Latin America are overweight or obese. However, little is known regarding the cardiovascular risk of young children living in the region. This paper aims to identify associations between socio-demographics, adiposity, and dietary intake with cardiometabolic risk among children between 6- and 8-years old living in urban and rural Andean regions of Ecuador. A cross-sectional study was conducted among 267 children attending elementary schools between February and August 2018. Sociodemographic data were collected using a structured interview. Bodyweight, height, and waist circumference were measured in duplicate; blood samples were taken after overnight fasting to determine blood lipids, hepatic enzymes, and adipokines; food intake data was assessed by two 24-h recalls administered to the guardians. Associations between cardiometabolic risk (i.e., blood lipids, hepatic enzymes, and adipokines) with sociodemographic characteristics, dietary intake, and waist circumference were tested using multiple hierarchical regression models. Twenty-nine percent of the children were overweight or obese, 12% had low HDL levels, and over 18% had high levels of LDL and triglycerides. Children living in the urban region had lower levels of HDL (β−4.07 mg/dL; 95% CI: −7.00; −1.15; P = 0.007) but higher levels of LDL cholesterol (β 8.52 mg/dL; 95% CI: 1.38; 15.66; P = 0.019). Hepatic enzymes were also higher among urban children (SGOT: β% 22.13; 95% CI: 17.33; 26.93; P < 0.001; SGPT: β 0.84 U/L; 95% CI: 0.09; 1.59; P = 0.028). Leptin blood levels were higher (β% 29.27; 95% CI: 3.57; 54.97; P = 0.026), meanwhile adiponectin plasma concentrations were lower among urban children (β%−103.24; 95% CI: −58.9; −147.58; P = < 0.001). Fiber intake was inversely associated with total cholesterol (β−9.27 mg/dL; 95% CI –18.09; −0.45; P = 0.040) and LDL cholesterol blood levels (β−9.99 mg/dL; 95% CI: −18.22; −1.75; P = 0.018). Our findings demonstrate that young children are at high cardiovascular risk; if no actions are taken, the burden of non-communicable diseases will be substantial. The differences in risk between rural and urban areas are evident; urbanization might predispose children to a different reality and, in most cases, result in poor habits.

Whole-Genome Characterisation of ESBL-Producing E. coli Isolated from Drinking Water and Dog Faeces from Rural Andean Households in Peru.

E. coli that produce extended-spectrum β-lactamases (ESBLs) are major multidrug-resistant bacteria. In Peru, only a few reports have characterised the whole genome of ESBL enterobacteria. We aimed to confirm the identity and antimicrobial resistance (AMR) profile of two ESBL isolates from dog faeces and drinking water of rural Andean households and determine serotype, phylogroup, sequence type (ST)/clonal complex (CC), pathogenicity, virulence genes, ESBL genes, and their plasmids. To confirm the identity and AMR profiles, we used the VITEK®2 system. Whole-genome sequencing (WGS) and bioinformatics analysis were performed subsequently. Both isolates were identified as E. coli, with serotypes -:H46 and O9:H10, phylogroups E and A, and ST/CC 5259/- and 227/10, respectively. The isolates were ESBL-producing, carbapenem-resistant, and not harbouring carbapenemase-encoding genes. Isolate 1143 ST5259 harboured the astA gene, encoding the EAST1 heat-stable toxin. Both genomes carried ESBL genes (blaEC-15, blaCTX-M-8, and blaCTX-M-55). Nine plasmids were detected, namely IncR, IncFIC(FII), IncI, IncFIB(AP001918), Col(pHAD28), IncFII, IncFII(pHN7A8), IncI1, and IncFIB(AP001918). Finding these potentially pathogenic bacteria is worrisome given their sources and highlights the importance of One-Health research efforts in remote Andean communities.

Attachment theory’s core hypotheses in rural Andean Peru

ABSTRACT This is the first study aiming to test two universality claims of attachment theory within a rural Andean sample from Cusco, Peru. A total of 69 mothers and their children (6 to 36 months) participated. Child attachment security was assessed with the Attachment Q-set (AQS), maternal sensitivity was measured during three naturalistic episodes (free interaction, bathing, and feeding) with the Ainsworth sensitivity scale and the Maternal Behavior Q-sort (MBQS), and a cumulative maternal risk variable was calculated. Results revealed that most children displayed less characteristic secure base behaviors in the interactions with their mothers, compared to other reference samples. Furthermore, an association between maternal sensitivity and child attachment security was found, and a negative relation between maternal sensitivity and the cumulative risk variable. These results support some of the attachment theory’s universality claims, and suggest new avenues for research on assessment issues in rural samples in the Global South.

A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes

Although female infants may have an early life biological advantage over males, gendered treatment can alter health outcomes. Ecuador has an unusually high ratio of male to female infant mortality, but gender norms have been reported to favor boys. This analysis of baseline data from the Lulun Project, a randomized controlled trial conducted in rural Andean communities of Ecuador, investigates the roles of sex and gender in undernutrition among infants 6 to 9 months of age. Twenty-four-hour recall frequencies were used to assess dietary intake. Food outcome models were analyzed as prevalence ratios calculated using a binomial distribution with a log link or robust Poisson regression. Linear regression was used to analyze the continuous growth outcome length-for-age z score. Socioeconomic and health history variables were comparable between male and female infants. Boys were more often fed liquids other than breastmilk within their first 3 days of life (17.1% vs. 5.2%, P = 0.026). Compared with girls, boys were less likely to be fed eggs by 33% (95% CI 0.46, 0.96), cheese, yogurt, or other milk products by 40% (95% CI 0.39, 0.92), yellow fruit by 44% (95% CI 0.33, 0.97), water by 37% (95% CI 0.45, 0.88), thin porridge by 29% (95% CI 0.56, 0.92), and tea without milk by 67% (95% CI 0.11, 0.99). Prevalence of boys with an adequate dietary diversity score (≥ 4) was reduced by 27% relative to girls (95% CI 0.54, 0.99). Males fared worse in length-for-age z scores (− 2.16 vs. − 1.56, P = 0.000), weight-for-age z scores (− 0.86 vs. − 0.33, P = 0.002), prevalence of stunting (50.6% vs. 23.4%, P = 0.000), and plasma concentrations of dimethylglycine (1.25 vs. 1.65 µg/mL, P = 0.021). After adjusting for demographic, caregiver perceptions of appetite, and biological factors, length-for-age z score for a male child was 0.62 units lower than for a female (95% CI − 0.98, − 0.26). Male infants were shown to receive lower quality complementary foods and have worse anthropometric measures than female infants.Trial registration clinicaltrials.gov, NCT02446873. Registered February 28, 2015, https://clinicaltrials.gov/ct2/show/NCT02446873.

The Entangled Past and Future of Midwifery and Cuys in Ecuadorian Andes

ABSTRACT The paper describes a healing practice with the cuy (guinea pig), and how it has maintained, continued and re-invented vital connections of people with their territories amidst oppressive structures, such as colonialism, capitalism and patriarchy. Moreover, I discuss how, through the ancestral relation to the cuy, people in rural Andean communities connect both to their past and future in meaningful ways. The paper highlights the role of rural women in maintaining and expanding the richness and diversity of the entanglements of humans and nonhumans shaping their territories. Furthermore, it argues that, by engaging with these stories, care can be mobilised to sustain practices that cultivate futures that are able to nurture a much-needed resiliency of peoples in the world amidst global crises, such as pandemics and climate change.

House personhood in rural Andean Bolivia

In the rural Bolivian Andes, personhood is defined by intersubjective reciprocal relationships between human and nonhuman beings. This paper examines the role of the house as a living being in itself and a conduit between its inhabitants and local place deities. In the rural Andes, houses (traditionally made from adobe but increasingly from brick) materially connect their inhabitants with a sacred landscape, and rituals performed at their construction create the house as a living being in its own right. This article, based on fieldwork with the Kallawayas, an indigenous nation in Northwest Bolivia, examines the Kallawaya relationship to the house in the context of Andean ethnography on housebuilding, observing the role of the house in communal ritual life. The house, for the Kallawayas, is argued to be an assemblage of energy with its inhabitants and the landscape, a fractal representative of the homologous structure of the rural Andean community, the ayllu.

EMS at 3600 Meters: Exploring Barriers to Emergency Care and Transport in Rural Andean Perú.

Given the demonstrated success of programs that bolster informal Emergency Medical Service (EMS) systems in other low- and middle-income counties (LMICs), this study aimed to explore formal and informal systems, practices, customs, and structures for emergency response and medical transport in Colca Valley, Perú while identifying possible opportunities for future intervention. Twenty-two interviews with first responders and community members were conducted in three mountain villages throughout rural Andean Colca Valley of Perú. Subjects were recruited based on profession and experience with medical emergencies in the area. Transcripts were entered into Dedoose, coded, and analyzed to identify themes. Providers and community members shared similar perceptions on the most common barriers to emergency care and transport. Challenges experienced equally by both groups were identified as "structural problems," such as lack of infrastructure, lack of structured care delivery, and unclear protocols.Incongruities of responses between groups emerged with regard to certain barriers to care. Providers perceived baseline health education and use of home remedies as significant barriers to seeking care, which was not proportionally corroborated by community members. In contrast, 86% of community members cited lack of trust in health providers as a major barrier.Community members often noted witnessing a high frequency of emergency events, their personal experiences of helping, and the formal utilization of lay providers. When specifically questioned on their willingness to engage in first aid training, all participants were in agreement. While structural changes such as increased infrastructure would likely be the most durable improvement, future interventions focused on both empowering community members and improving the relationship between the health center and the community would be beneficial in this community. Additionally, these interview data suggest that a layperson first aid training program would be feasible and well-received.

Cardiovascular Disease in the Peruvian Andes: Local Perceptions, Barriers, and Paths to Preventing Chronic Diseases in the Cajamarca Region.

Objectives: Public health interventions can be improved by understanding peoples’ explanatory models of disease. We explore awareness and perceptions of cardiovascular diseases (CVD) and options for preventative actions in young adults living in rural Andean communities. Methods: We used convenience sampling to select 46 men and women from communities in Cajamarca (Peru). Subjects participated in eight focus groups where they discussed their understanding and perceived causes of CVD as well as barriers and pathways to healthy lifestyles. Results: Fresh foods, physical activity, unpleasant emotions, and healthcare access were cited as important determinants of healthy lifestyles. Barriers to healthy diets included lacking nutritional knowledge, fluctuating food prices, and limited access to foodstuffs. Women felt particularly vulnerable to CVD and identified gendered barriers to manage stress and engage in sports. Low health literacy, poor doctor-patient relationships, and long distances prevented participants from fully accessing healthcare. Conclusion: CVD prevention interventions should consider local knowledge of these diseases and of healthy lifestyles, and harness ongoing programmes that have successfully promoted good nutrition in children and pregnant women. In concert with public-private parterships, governments should include disease prevention interventions for the entire family.

Unpicking the Inter-relationships Between Off-Farm Livelihood Diversification, Household Characteristics, and Farm Management in the Rural Andes

Rural households across the world are increasingly turning to off-farm sources of income to complement or replace farm income. A better understanding of these livelihood adaptations, their consequences, and the processes behind them will facilitate more effective rural development policies and projects. The objective of this research was to examine how off-farm income influences rural livelihoods, elucidate factors that determine different livelihood strategies, as well as understand how these livelihood strategies are associated with different approaches to farm management. Using data from 588 Rural Household Multi-Indicator Surveys (RHoMIS) in three rural Andean regions in Bolivia, Ecuador, and Peru, we identified a typology of farming household livelihood strategies, and assessed the differences among these household types with regard to household and farm level characteristics, and farm management. We found that among the household types that incorporated off-farm income into their livelihood strategies, there were significant differences in approaches to farm management. Specifically, we observed an increased use of industrialized farming techniques among one household type, a deintensification, or a stepping-out of farming activities in another household type, and a tendency toward livestock specialization in the other household type. Moreover, our findings revealed that household level characteristics (age and education level of head(s) of household, and household composition) played an important role in mediating which type of livelihood strategy the households employed. For example, “stepping-out” households generally had younger and more educated household heads. Location-specific factors such as access to markets, irrigation, and off-farm employment opportunities were also likely to be highly influential in terms of which pathways farming households adopted as their livelihood strategy. We conclude that rural development programmes and projects must be driven by the rural communities themselves taking into account this heterogeneity in household characteristics and livelihoods and engaging in the already advanced conversations around different approaches to farming and the conservation of common natural resources.

Socio-cultural factors for breastfeeding cessation and their relationship with child diarrhoea in the rural high-altitude Peruvian Andes \u2013 a qualitative study

BackgroundIn some areas of the world, breast milk is seen as a potential source of child diarrhoea. While this belief has been explored in African and Southeast Asian countries, it remains vastly understudied in Latin American contexts. We investigate socio-cultural factors contributing to breastfeeding cessation in rural high-altitude populations of the Peruvian Andes. The role of socio- cultural factors in the local explanatory model of child diarrhoea, and whether these perceptions were integrated in the local healthcare system were assessed.MethodsWithin the framework of a randomised controlled trial, we conducted semi-structured interviews with 40 mothers and 15 health personnel from local healthcare centres involved in the trial.ResultsCultural beliefs on breastfeeding cessation included the perception that breast milk turned into “blood” after six months and that breastfeeding caused child diarrhoea. We identified eight local types of child diarrhoea, and women linked six of them with breastfeeding practices. “Infection” was the only diarrhoea mothers linked to hygiene and the germ disease concept and perceived as treatable through drug therapy. Women believed that other types of diarrhoea could not be treated within the formal healthcare sector. Interviews with health personnel revealed no protocol for, or consensus about, the integration of the local explanatory model of child diarrhoea in local healthcare and service provision.ConclusionsThe local explanatory model in rural Andean Peru connected breastfeeding with child diarrhoeas. Cultural beliefs regarding diarrhoea management may increase home treatments, even in cases of severe diarrhoeal episodes. Future national breastfeeding support programmes should promote peer-counselling approaches to reduce negative attitudes towards breastfeeding and health practitioners. Local explanatory models should be incorporated into provincial and regional strategies for child diarrhoea management to promote equity in health and improve provider-patient relationships.

Antimicrobial Resistance in Humans, Animals, Water and Household Environs in Rural Andean Peru: Exploring Dissemination Pathways through the One Health Lens.

Antimicrobial resistance (AMR) is a global public health threat, especially for low and middle-income countries (LMIC) where the threat has not been fully identified. Our study aims to describe E. coli AMR in rural communities to expand our knowledge on AMR bacterial contamination. Specifically, we aim to identify and describe potential dissemination routes of AMR-carrying bacteria in humans (children’s stools), community water sources (reservoirs and household sources), household environments (yard soil) and domestic animals of subsistence farmers in rural Andean areas. Our cross-sectional study was conducted in rural households in the region of Cajamarca, Peru. A total of 266 samples were collected. Thirty-four point six percent of reservoir water and 45% of household water source samples were positive for thermotolerant coliforms. Of the reservoir water samples, 92.8% were positive for E. coli, and 30.8% displayed resistance to at least one antibiotic, with the highest resistance to tetracycline. E. coli was found in 57.1% of the household water sources, 18.6% of these isolates were multidrug-resistant, and displayed the highest resistance to tetracycline (31.3%). Among samples from the children’s drinking water source, 32.5% were positive for thermotolerant coliforms, and 57.1% of them were E. coli. One third of E. coli isolates were multidrug-resistant and displayed the highest AMR to tetracycline (41.6%) and ampicillin (25%). Thermotolerant coliforms were found in all the soil samples, 43.3% of the isolates were positive for E. coli, 34.3% of the E. coli isolates displayed AMR to at least one antibiotic, and displayed the highest AMR to tetracycline (25.7%). We determined thermotolerant coliforms in 97.5% of the child feces samples; 45.3% of them were E. coli, 15.9% displayed multidrug resistance, and displayed the highest resistance to ampicillin (34.1%). We identified thermotolerant coliforms in 67.5% of the animal feces samples. Of those, 38.7% were E. coli, and 37.7% were resistant to at least one antibiotic. For all the samples, the prevalence of resistance to at least one antibiotic in the E. coli and Klebsiella spp. isolates was almost 43% and the prevalence of MDR in the same isolates was nearly 9%, yet the latter nearly doubled (15.9%) in children’s stools. Our results provide preliminary evidence for critical pathways and the interconnectedness of animal, human and environmental transmission but molecular analysis is needed to track dissemination routes properly.

From the coast to the highlands: tourism as a field for neo-extractivism in the rural Andes

From the coast to the highlands: tourism as a field for neo-extractivism in the rural Andes

From the coast to the highlands: tourism as a field for &lt;i&gt;neo-extractivism&lt;/i&gt; in the rural Andes

From the coast to the highlands: tourism as a field for &lt;i&gt;neo-extractivism&lt;/i&gt; in the rural Andes

Tourism, education and women’s empowerment. The case of the women weavers of Chinchero (Cusco, Peru)

This article studies the relationship between tourism, education, and women’s empowerment through ethnographic research in the rural town of Chinchero (Cusco, Peru). The participant observation and interviews with Quechua-speaking women weavers working in textile centers show the importance of tourism as an economic resource and educational resource for them and their children. Beyond the investment in education through tourism income, it is argued that interaction with tourists offers weavers a platform to acquire, practice, and improve their language (English and Spanish) and public speaking skills. This second little-studied aspect allows us to understand how economic and educational elements favor female empowerment in the rural Andes, taking into account its possibilities and limitations.

Pterygium in Rural Andean Ecuador: Epidemiology, risk factors, and barriers to care

Background: Pterygium is an ocular surface lesion that causes chronic eye irritation and eventually, vision impairment. Pathologically, prolonged ultraviolet (UV)-induced radiation damage leads to conjunctival and limbal stem cell damage. As such, rural, high-altitude equatorial communities are at particular risk due to proximity to the sun, outdoor work, and a lack of access to eye care. Methods: We conducted a cross-sectional study to determine the epidemiology of pterygium in the Chimborazo region of Ecuador. Adults presenting to Clinical FIBUSPAM's medical clinics for both ocular and nonocular reasons were examined by optometrists/ophthalmologists to identify pterygium. Affected patients completed a questionnaire about self-reported known risk factors, treatment, and barriers to care, and received UV-blocking sunglasses. Results: Of 296 patients, 165 (55%) had pterygium. The mean age was 60.2 years (range 19–88), 69% were female; 63% had unilateral pterygia, and 37% had bilateral pterygia. Symptoms occurring daily included severe photophobia (36%), foreign body sensation (28%), eye pain (24%), burning (31%), and itching (28%). In addition, 40% reported concern about eye appearance. Risk factors included spending >5 h outdoors each day working (93%), smoking (8%), and alcohol (14%). For prophylaxis, while 91% routinely wore hats outdoors, only 16% used sunglasses. For treatment, 30% used eye drops, of which two-thirds were natural remedies. About 93% wanted treatment (medications or surgical removal), 78% were concerned about access to treatment, and 43% reported cost as the major concern. Conclusions: Pterygium is highly prevalent (55%) among adults presenting for care in community health clinics in the Chimborazo Province of Ecuador. This treatable and potentially preventable cause of ocular irritation and vision loss greatly impacts the quality of life in this region. This and similar communities would benefit from improved education and outreach through care delivery models that bring affordable prevention and eye care services closer to home.

An innovative subterranean spring capture method for improved water quality

Abstract Many rural communities in Andean countries of South America rely on springs as their primary drinking water source. A variety of spring capture methods are employed resulting in varying water quality. Water from these spring-fed sources, delivered to the community via a distribution network, is often not chlorinated, increasing the risk of water-borne pathogens. A simple, improved technique has been developed in Ecuador's Chimborazo Province by a local Christian organization, Corporación de Desarrollo Integral Socio Económico (CODEINSE), to protect spring water sources for community water supply. This new technique, ‘the CODEINSE method’, builds on the strengths of traditional subterranean spring captures while employing several design improvements, like a concrete cap and sufficient gravel pack, to prevent surface water contamination. According to water quality data collected in Ecuador, the CODEINSE method consistently provides high-quality water with substantially reduced levels of water-borne pathogens compared to traditional spring capture methods. On average, the CODEINSE method yields water with less than 1.0 CFU/100 mL, water that is deemed no risk by the World Health Organization. The CODEINSE method has the potential to improve water quality not only in the rural Andean communities in Ecuador but also in developing countries across the world.

Maternal sensitivity in rural Andean and Amazonian Peru

ABSTRACT In the current study, we observed 12 mothers with a 4–21-month-old infant for around 3 hours during their daily activities such as feeding, bathing, and soothing in the multiple-caregiver cultural contexts of rural Peru. Overall, sensitivity levels were high, with an average of 7.33 (out of 9), and seven of the twelve mothers scoring in the high range (scores 7–9), and the remaining five in the good-enough range (scores 5–6). A qualitative description of sensitive responsiveness is presented through representative examples. Notable patterns were flexibility in caregiving routines that allow for very child-centered maternal behavior; mothers’ ability to multitask, combining household and agricultural work with high sensitive responsiveness to their infants’ signals; the presence of multiple caregivers that ensured that the infants were well attended when mothers were temporarily unavailable; and what seems to be a culturally normative tendency to be sensitively responsive to very young children.