Journal, March 25

Usually in my bi-weekly reflections, I focus on a specific experience – an event that I attended, or a project that I worked on. But for my last bi-weekly report, I would instead like to focus on an important undercurrent of all of my experiences here in Peru: privilege. Privilege can be defined as an unearned advantage that one has as a result of being identified with a certain group. From the opportunity to come to Peru and work at CEDEMUNEP in the first place, to the opportunity to leave and take up a new cause at the end of my internship in April, I have experienced a cornucopia of privileges this year as a result of being a white, heterosexual, able-bodied, dual Canadian and U.S. citizen who grew up in a functional, educated, middle class family in the Global North. Back at the University of Waterloo, where many of these categories were considered to be the norm, I did not so often think of myself in these terms. But in the context of my work at CEDEMUNEP, my privilege has been harder to ignore. The very goal of my work here—development—is deeply entwined with the social, economic, and cultural ideals of privileged groups. And I have confronted daily the realities of black women living in poverty in a developing country—a quadruple disadvantage.

I do not exaggerate the plight of Afro-Peruvian women in order to victimize them; nor do I want to romanticize their lives and paint them as being happy despite their poverty.  They have great ambitions for their lives, families, and communities, and they are moving and shaking society with their powerfully strategic campaigns. Being honest about the enormity of their challenges makes their success all the more impressive.  It has been an honor and a privilege to work alongside them this year and support their vision for their people.

My social advantage has both helped and hindered this process.  It has definitely hindered personal interaction. I can recall countless awkward instances with my co-workers: pulling up to my gated community in a taxi, explaining that a hired cook made my food, hesitating to share my travel stories when I realized that they might never have the opportunity to visit these places in her own country. But more than creating a sense of awkwardness, my identification with different social groups and my resulting privilege have made it impossible for me to ever fully identify with their struggle. The failure or success of their movement has few direct implications for my life. However, I don’t think that this has to prevent us from working together. Who would say that the work of anti-discrimination is just for minorities?  Each and every one of us can work for change in our own spheres of influence, and I can certainly use my privilege to my advantage in this respect. However, I think my greater role is to help the women of CEDEMUNEP to expand their influence—not to “give voice to the voiceless,” but rather to help them find their voices (plural, because they are diverse), and amplify them! Perhaps Ivan Illich was right when he said that “the only thing you can legitimately volunteer for in Latin America might be voluntary powerlessness.” Humility might not win you any awards at an International Development conference, but it is what is desperately needed.

One of my principal questions going into this field placement was: “What does the concept of development mean to people in the Global South?” This is still a question, and it will continue to be until I have met each person in the “Global South.” But I’ve come to realize that, more important than holding all of the answers, is holding the question and remembering to let others lead their own development project, even when society would put me out front.

Journal, March 11

“Statistics is both a science and an art,” explained Dr. Woudsma in second-year Advanced Environmental Research Methods. While we learned in depth about the scientific side of statistics from his lectures in ENVS 278, my field placement has “coloured” in my understanding of the more artistic side of real, on-the-ground social research.  On February 28^th and 29^th, I had the opportunity to join 25 Afro-Peruvian leaders in two days of workshops on the inclusion of the Afro-Descendent variable in the upcoming 2017 National Census. This important event was co-organized by my host organization, CEDEMUNEP, and the Washington D.C.-based capacity building NGO, Global Rights, which has been accompanying us for several years.  Besides being a wonderful opportunity to network and engage in the exciting work of political strategizing, the event opened my eyes to the complexities of statistics.

The Peruvian census has not included any questions about race or ethnicity since 1940. This has resulted in a troubling lack of information on Afro-Peruvians, contributing to their invisibility, and providing an excuse for successive governments that do not have the political will, never mind the data, to create public policies that address their severe poverty and marginalization. For these reasons, the inclusion of the ethnic variable in the upcoming census is an incredible opportunity for Afro-Peruvians to finally gain access to the data they need to pressure the government into action. Two key factors will determine the success of this project: first, is the phrasing of the question and the racial/ethnic categories listed on the census, and second, is the effectiveness of the public awareness campaign that will take place over the next four years. If either of these tasks is not well executed, and only a small percentage of the Afro-Peruvian population chooses to self-identify on the census, Afro-Peruvians could be worse off than before, with hard statistics on the books that do not reflect their true numbers.

The question of racial categories and labels elicited enough discussion to fill an entire afternoon. Negro, Moreno, Zambo, Afroperuano, Afrodescendiente, Mulato, Mestizo—it was clear in our small group that these words carried different meanings and sentiments in different countries, regions, neighbourhoods, and even among individuals.  While some people readily identify as being negro (black), in areas where there is a lot of discrimination, more people identify as being Moreno (brown). The term Afroperuano highlights a person’s belonging in Peru and their descendence from slaves, while Afrodescendiente could apply to any member of the African diaspora. Mulato is commonly used in countries such as Brazil and Costa Rica, but is considered derogatory in Peru, where people resent its derivation from the word “mule.” Mestizo (mixed) is a preferred term for many in Peru, but it erases identity and is seen by Afro-Peruvians as unhelpful for data collection. These labels are extremely subjective and personal, and it is no small task to determine the categories that will define a whole people. Even if we come up with the best possible question and answers for the census, the public awareness campaign will still be extremely important in ensuring the widespread self-identification of Afro-Peruvians.  As one speaker noted, when Afro-Peruvians are dancing, playing music, or partying with family, they self-identify as being Afro. But afterwards, they do not. Furthermore, in other areas, they identify as being black, but they do not identify with the culture. This identity mix-up associated with discrimination and cultural loss could cause Afro-Peruvians to not self-identify, even if the question is phrased perfectly.  The public awareness campaign will help to paint Afro identity in a more positive light and promote self-identification.

Throughout the INDEV program, we have heard over and over again the histories of colonization from across the world. In Peru, as in many other countries, the colonizers succeeded in dominating the people by dividing them across racial and ethnic lines.  This legacy lives on today in Afro-Peruvians’ exclusion from society, as well as the categories that fracture their movement and keep them from uniting as one racial/ethnic group.  If Afro-Peruvians want to escape these historical chains that keep them imprisoned in poverty, they will need to agree on how to identify, and more importantly, realize why it is important that they identity: for the development of their own community.  If the public awareness campaign is able to communicate this important goal, the 2017 Census could become the rallying point for Afro-Peruvian unity and a bridge to a better future.  


 If you're interested, check out these cool youtube videos:

This one features my awesome supervisor, Cecilia Ramirez, talking about the behind-the-scenes work that CEDEMUNEP and Global Rights have done to get to this point and achieve inclusion in the census. It's a good reminder that real, positive change takes time!

And this video comes from the parallel public awareness campaign that Afro-descendents are running in Colombia, leading up to their 2015 census. It's cool to see minority groups working together across borders to achieve equal rights around the world. Afro-Peruvians and Afro-Colombians have a lot to learn from each other's experiences, and this video is a good example of the type of work we hope to be doing in Peru over the next 4 years to promote Afro identity!

Journal, February 25

With Valentine’s Day on February 14^th, and the upcoming celebrations of International Women’s Day on March 8^th, countless events and workshops are being organized around women’s issues this month in Lima.   As Peru has one of the highest rates of sexual violence in Latin America, many of these events are seeking to address violence against women and families.  In 2011, the National Institute of Statistics and Information found that 4 in 10 women had been assaulted by their partners, with the majority being mothers between the ages of 26 and 35 with 1 to 3 children.  These alarming statistics speak to the culture of machismo and religious conservatism that permeates Peruvian and Latin American culture and perpetuates traditional gender roles and violence in society.  While the government is largely propped up by these values and has yet to seriously challenge them, it is beginning to work alongside civil society organizations to reduce violence, and has even been 

recognized internationally for its recent efforts.

As a volunteer at an Afro-Peruvian women’s organization, I have had the opportunity to attend several women’s events over the last few weeks, including two workshops on domestic violence organized by the Municipality of Brena, a workshop on identity and self-esteem organized by a women’s group in the poor urban district of Rimac, the launch party for a new book on Afro-Peruvian women’s slavery and resistance, and V-Day’s One Billion Rising. In addition, CEDEMUNEP is preparing to host our own workshop on identity and self-esteem later this week.  These events have provided me with a window into the contemporary and historical experiences of women in Peru, and some critical observations on approaches to women’s empowerment in the country.

While I commend the government for any efforts to reduce violence against women, I have to note the lack of men involved in these initiatives.  The workshops that I have seen have been directed at, and attended exclusively by women and children.  Participants usually receive a folder filled with brochures on violence and various community services, and they listen to short messages from representatives of various government and civil society organizations.  These messages generally focus on defining violence and helping women to recognize if they are in violent relationships, as well as informing them of the supports that are available to them in their area, such as help lines and free counseling services.  While this approach might help to empower women as individuals, I think that it is important that not all the responsibility for ending violence be placed on the shoulders of women.  As discussed in the literature on empowerment, successful empowerment initiatives must work to transform relationships and societal structures, as well as individuals.  If men, as the recognized perpetrators in most cases of sexual violence, are not educated and given the necessary tools to change their relationships with women, the situation will not improve.  One Billion Rising did a much better job of involving men, as the event was held on Valentine’s Day, and was attended by many couples. It also featured both male and female celebrities dancing side-by-side and spreading the message of non-violence.  However, I was concerned when the organizers celebrated the “safe space” that had been created at the event, thanks to all the (mostly male) police officers who were protecting us while we danced.  To me, male protection of women is just the flipside of male violence against women, because it perpetuates machista ideas of male dominance.  Therefore, their message seemed to empower men in the wrong way, and disempower women, which was unfortunately not at all what the organizers had intended.

It is exciting to see the growing women’s movement in Peru.  The countless groups that are emerging are making huge strides in raising awareness of violence against women and creating spaces for them to share their experiences and find support.  However, in the future I hope to see more widespread participation of women and men, and more careful attention to the underlying values that are perpetuated by the messaging of non-violence campaigns and programs.  Poco a poco.  Little by little.

Journal, February 11

            Over the last two weeks, CEDEMUNEP has been preparing to run health workshops in four Afro-Peruvian communities in Lima.  It has been interesting for me to work alongside my co-worker, Ada, who has volunteered as a community health promoter in Lima for over 10 years, and has a wealth of on-the-ground knowledge about public health in Lima.  On a quiet afternoon at work last week, I had the chance to interview her about her work, and it was an incredible opportunity for me to learn about the complexity of international development in the health sector.

In my 2^nd year urban planning course, People and Plans, we discussed the Social Determinants of Health (SDOH).  The World Health Organization (2013) defines the SDOH as “the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics.”  When it comes to diseases like Tuberculosis (TB), there is a strong direct correlation with unemployment, inadequate housing, malnutrition, social exclusion, and other dimensions of poverty.  In fact, when I asked Ada about the causes of TB, she never mentioned bacteria.  While she acknowledges that the most important part of her job is to take patients their medicines every evening, and supervise them to ensure that they never miss a dose, there is much more to her visits.  First, she observes her patients’ living conditions and communicates her observations to the health centre.  Second, she ensures that they have enough food, and provides them with baskets of rice, milk, and other staples if they are not receiving proper nutrition.  Third, she teaches them how to make simple handicrafts in order to take their minds off their disease, make them feel useful, and provide them with basic income-earning opportunities.  Fourth, she makes friendly conversation and provides emotional support and encouragement, as many patients are quite socially isolated and suffer from a lack of self-esteem.  Finally, she talks to patients’ families to dispel the myths and stigma around TB, and offer recommendations for how to prevent illness and support their family members through treatment.  All of these efforts contribute to a patient’s ability to complete their treatment regimen and recover. 

Socios de Salud in Lima, 2011

Ada's account of her daily work in community-based Directly-Observed Therapy, Short-Course (DOTS) illustrates the complexity of TB and its treatment.  For decades, the Peruvian government struggled to deal with the growing TB epidemic because of their simplistic, top-down approach. Not only did treatments fail in more than half of cases—many patients that failed to complete their treatment regimens developed cases of Multi-Drug Resistant TB (MDR-TB).  Fortunately, in 1994, the not-for-profit organization Socios en Salud (the Peruvian sister organization of Paul Farmer, Jim Yong Kim, and Ophelia Dahl’s Partners in Health) began to offer assistance to Peru’s Ministry of Health, based on their experience of successful community-based TB treatment in rural Haiti.  Socios first worked with poor residents of Lima’s shanty towns to conduct community surveys, which revealed many of the aforementioned social barriers to effective treatment.  The organization then began to train community health promoters in DOTS, and design individualized treatment plans for MDR-TB patients to help surmount these barriers.  These initiatives were highly successful, and went on to revolutionize TB treatment in Peru and around the world. 

The history of TB treatment in Peru, along with Ada’s account of her experience as a community health promoter, serve as important reminders that complicated solutions do not work for complex problems in international development.  When the Peruvian government and the WHO relied on best practices in TB treatment, they were unsuccessful in treating patients who faced more significant social challenges, and they were unable to respond to the unexpected emergence of MDR-TB.  It was Socios en Salud’s innovation that finally led to a solution for outlying cases.  Furthermore, Socios proved that treatment must be holistic, considering an array of medical and social factors that lead to sickness and impede treatment. They also demonstrated the importance of approaching complex problems from the bottom-up, treating cases on an individual basis so that people do not fall through the cracks of a large, impersonal health system.  And finally, they showed us that TB treatment requires constant attention and monitoring, because people’s lives and health are always in flux. Community health promoters must constantly collect information about their patients and their environments, in order to respond effectively to their situation and determine an appropriate course of treatment.  These lessons in solving complex problems are crucial for international development practitioners to understand, and they will stay with me as I continue to work in this field.

References

World Health Organization. (2013). Social determinants of health.  Retrieved 7 February 2013 from http://www.who.int/social_determinants/en/