Sierra Matis, Carleton University (NC intern)
With the expiration of the Millenium Development Goals (MDG’s) in 2015, the United Nations (UN) has introduced the Sustainable Development Goals (SDG’s), which seek to enable people around the world to improve their lives and living conditions. It is through these goals that the United Nations Working Assembly see’s eradicating poverty in the next generation as being feasible. In the context of Peru, the report on progress for the MDG’s put Peru on track for achieving their goals, as the country has been able to cut the number of people living in extreme poverty by half as a result of economic growth. However, despite such progress spurred by economic growth, major social and geographic inequalities have persisted, as rural areas continue to be neglected. I have witnessed this reality first hand through my internship with Nexos Comunitarios, an organization that promotes Responsible Human Development and is currently focusing on eradicating malnutrition in Cuncani, as children are not receiving the nutrients required for healthy growth. Thus, while recent gains are undoubted, it is evident that income growth and economic development in Peru alone is not enough to address the issue of poverty. Thus, efforts should be directed towards progress in the other dimensions of poverty eradication, such as culture and nutrition. This is because many complex factors such as cultural attitudes towards food and nutrition, maternal education, community isolation, and effectiveness of social programs all play a central role in understanding the causes and effects of poverty.
In light of persistent inequities between rural and urban areas, the Peruvian government has attempted to shift its focus from economic adjustment strategies to promoting the fundamental rights of women and vulnerable groups through Peru’s Ministry of Development and Social Inclusion (MIDIS). MIDIS is ultimately responsible for managing social programs through the adoption of the “Include to Grow” in 2013.
However, the effects of such reforms have been minimal as shown through the 2013 Demographics and Family Health survey. This survey shows that infant mortality has increased from a national average of 16 deaths per 1000 live births in 2011 to 19 deaths per 1000 live births in 2013. Neonatal mortality has also increased, rising from 9 deaths per 1000 live births in 2012 to 12 deaths per 1000 live births in 2013.
Thus, the question becomes; how come infant mortality, neo mortality rates and hunger in rural areas have increased, despite strategies designed to address social, educational and nutritional gaps and other dimensions of poverty?
Part of the answer to this question can be seen through the effect cultural gaps have upon people’s access to quality health care services. For instance, a country report on Peru by the World Health Organization (WHO) stated that vertical birthing is preferred among women in the Andes. In order to address this cultural barrier, certain health facilities in Peru have adopted a technical standard for vertical birthing in 2005, thus allowing for the number of people with access to quality health services to increase. However, the adoption of culturally appropriate health and delivery practices for users continues to be limited. The report also notes that many health care professionals do not speak indigenous languages, thus deterring indigenous women from seeking an institutional delivery.
In my visit to Cuncani, it was evident that community members have cultural practices similar to those identified in the WHO report. For instance, I learned from our local leader, Saturnina, that women in the community prefer to give birth vertically. Furthermore, Saturnina is one of the few Spanish speaking women, as the majority of community members speak the indigenous Quechua language. In observing these traits, it begs the question of whether language and birthing methods also deter women in Cuncani from using the Lares health care facility, the closest health center to Cuncani (located 1.5-2 hours away from the community).
In understanding the effect cultural gaps have upon access to quality health services, it caused me to question; do these barriers also have an impact upon malnutrition (NC’s current area of focus)? Institutional deliveries ensure that women receive antenatal health monitoring sessions as well as instruction on adequate feeding practices. Such instruction communicates the necessity of initiating breast feeding within the first hour of life as well as the importance of introducing semi solid foods at the age of six months. Thus, it can be argued that health inequities caused by cultural gaps also contributes to the issue of malnutrition.
Ultimately, the identified effects of cultural gaps helps explain why economic development and income growth alone have failed to eliminate noticeable inequalities between rural and urban areas in Peru. With the creation of MIDIS, Peruvian government has improved its social policies, however among other ministries has not delivered policies and programs flexible enough to accommodate the beliefs of its users, health inequities have been created, which has then had an effect upon malnutrition. Finally, such consequences brings to light how no one indicator can capture the many dimensions of poverty. Thus, the Peruvian government needs to ensure progress on the other dimensions of poverty eradication, as MIDIS needs to design programs programmes according to the cultural situation to combat persistent social and geographic inequities.
 “Achieving Zero Hunger the Critical Role of Investments in Social Protection.” Food and Agriculture Organization of the United Nations, 2015, iv
 “Success Factors for Women’s and Children’s Health.” The World Health Organization, 2015, 6
 “Success Factors for Women’s and Children’s Health,” 23
 Ibid, 28
 Ibid, 28
 “Success Factors for Women’s and Children’s Health,” 20
 Ibid, 30
 Ibid, 20