Amnesty International says rural and Indian pregnant women in Peru get unequal health care

Amnesty: Peru’s pregnant Indian get unequal care

LIMA, Peru — Peru’s government doesn’t provide adequate care for pregnant women in the impoverished highlands and jungle, a failure reflected in one of the highest maternal mortality rates in the hemisphere, a human rights group said Thursday.

“Health services for pregnant women in Peru are like a lottery. If you are poor and indigenous, the chances are you will always lose. The fact that so many women are dying from preventable causes is a human rights violation,” Nuria Garcia, Amnesty International’s researcher in Peru, said in a statement.

Peru’s government says 185 women die for every 100,000 live births, but the United Nations estimates the number is really closer to 240 when unregistered cases are included. The average for Latin America and the Caribbean is 130 per 100,000 births. In wealthy industrialized nations, only 9 women die for every 100,000 births.

Amnesty says the high death rate in Peru can be attributed to lack of access to care for poor mothers, especially in the rural highland and jungle regions where nearly half the people are malnourished and 59 percent of indigenous communities do not have a health facility, according to government surveys. Roads and phone systems also are lacking.

The government does not track maternity deaths by region, but Amnesty said a survey by Peru in 2007 found only 36 percent of women in the poorest sectors of society gave birth in a health institution.

Lucy Del Carpio, Health Ministry policy coordinator for reproductive health, agreed there are inequalities in access to care, but she said improvements are being made.

“Investment and works have been carried out. The country is working hard to diminish maternal mortality. You can’t speak of negligence,” del Carpio told the Associated Press.

Changes in recent years include the building of waiting houses to lodge pregnant women who live far from clinics, official acceptance of Indians’ traditional birthing method of standing up and training of health professionals in the Quechua language of the highlands.

Among encouraging signs, according to official statistics, is an increase in the percentage of babies being delivered in health facilities, up from 55 percent in 1996 to nearly 73 percent in 2007. Registered childbirth deaths also have fallen, from 755 in 2000 to 509 in 2008, the government says.

Amnesty’s report welcomed the initiatives, but it said health professionals and women consulted by the organization reported the efforts “are not being effectively implemented.”

Public health activist Susana Chavez, director of the Lima-based Center for the Defense of Sexual and Reproductive Rights, agreed with that assessment. She also said the maternity death situation is aggravated by the government’s failure to provide adequate sexual education and maternal care for teens.

“The highest maternal mortality rate is among teens, especially in poor, rural areas. Yet the only measure taken by the government has been to criminalize sexual relations between minors,” Chavez said.

Del Carpio said Peru’s ethnic diversity and geography work against delivering adequate care.

Resentment in these poor communities to centuries of neglect by Peruvian governments in Lima exploded into protests this year. At least 33 people died in June during a government crackdown at a highway blockade manned by Amazon Indians opposed to government-promoted oil and mining on their ancestral lands.