David Sanchez doesn't know what type of cancer his late mother suffered from. "It was just general cancer, I guess. The doctors didn't specify anything," he says. "It first started around the stomach and then it spread to the rest of the body. She was gone within seven months."
The 34-year-old taxi driver of indigenous Ashaninka origin lives in Pucallpa, the bustling port city which is also the capital of the Ucayali region – the Peruvian Amazon basin. But he was born in the forest and lived there with his family until he was a teenager.
“When we lived in the forests, we didn’t have illnesses like this,” explains Sanchez. “Survival is tough there. But we lived naturally. We fished and ate plants. When we got ill, we had our shamans and traditional medicine.”
Sanchez recalls a happy and free childhood in the forest. But as he grew older, his family began to feel the burden of the armed conflict in Peru between the government and the Maoist guerrilla group Shining Path, which took the lives of more than 70,000 people in the 1970s and 1980s.
Secluded jungle villages such as those Sanchez came from weren’t isolated from the conflict; in fact, the jungle became a sanctuary for armed groups – who were also involved with illegal logging and drug trafficking.
“It wasn’t just the security issues in the jungle,” says Sanchez. “Our forests were being destroyed by loggers. Narco-traffickers were polluting our rivers and poisoning our fish. We lost the means to live like we knew.”
Fast forward to 2016: the armed conflict has died down, but life in the jungle is tougher than ever. The Amazonian tribes now also have to share their resources with oil companies, one of which recently caused a devastating spill into a river used by eight indigenous communities.
A better life
Like Sanchez and his family, millions of indigenous people originating from the Amazon have migrated to cities in pursuit of a better life. In the Amazon basin of Peru and Brazil, there are now more indigenous people living in the cities than in the jungle. But once Sanchez's family came to the city, what they faced wasn't exactly bliss or a happy ending away from deprivation.
When they can no longer fish or eat plants of the forest, indigenous people usually adapt to a diet of junk food and cheap carbohydrates in urban areas – a choice that’s also linked with poverty.
According to Paul Roberts, director of Alianza Arkana, an organisation working in support of the Shipibo community, such indigenous groups are particularly vulnerable to health issues including diabetes and cancer, due to sudden lifestyle changes.
“[Once indigenous communities move to the cities] they usually end up living in smaller houses, with more people and with less land, which leads to unhygienic conditions in settlements that lack adequate drainage, water and washing facilities. They are therefore highly vulnerable to contagious diseases such as flu which spread very quickly through the urban indigenous settlements,” Roberts says.
“They no longer have free access to traditional foods, such as fish and the crops like yuca, fruits and bananas that they grew in their chakras. They therefore have to buy food and often seek to buy the cheapest food possible, as they are poor. This generally means low-quality, western-processed food with a high sugar content and low nutritional value. Their diet changes substantially, which leads to problems in their health such as diabetes and cardiovascular disease – plus a general weakening of their immune system.”
For an indigenous person, accessing health services can be a challenge. According to the World Health Organisation, in recent decades, Peru has made important progress with healthcare. It has increased the number of medical staff, and the overall quality of healthcare services are better than ever in more affluent parts of the country such as the capital Lima and other major towns.
The neoliberal nature of healthcare reforms in Peru in the 1990s , however, has brought about increases in fees and privatisation of services. While the wealthier segments of society have benefited, the improvements haven’t been geographically and racially equitable. Pucallpa, situated in one of the most deprived regions, with a dominant indigenous population, is among the areas to have lost out.
Jeiser Suarez Maynas, an indigenous rights activist of Shipibo origin and president of the Indigenous Association for Integral Development, says indigenous populations are systematically discriminated against and racially bullied in hospitals.
“I have much fairer skin than my brother,” he said. “One day, he was waiting at the hospital for four hours. He was in pain and wasn’t getting treated. Then he called me and I went to the hospital. They helped him immediately when I asked.”
Language barrier
When the doctor saw Maynas with his brother, he couldn’t believe they were brothers and mocked them about the difference of their skin colours. “He looked at us and laughed. He called my brother ‘coffee’ and called me ‘coffee with milk’. It was infuriating. But it wasn’t a unique experience,” he says.
Another problem indigenous communities encounter in hospitals is the language barrier. But according to Maynas (32) that issue is sorting itself. “I am probably the last generation to speak the Shipibo language,” he says.
Amazonian indigenous languages are disappearing fast due to rapid urbanisation. According to a study by the ofUniversity of Cambridge, languages are dying out faster than the rate of biodiversity loss.
Sanchez’s experience mirrors that of Maynas. His children don’t speak his native indigenous tongue.
“Still, the worst isn’t this,” he says. “In the city, I cannot pass my values about forests and nature to my children. A few days ago, I saw one of my daughters throwing a plastic bottle into the [Ucayali] lake,” he says.
He was devastated, as he recalled his own childhood in the forest and how much his community respected the nature and strived to protect the environment.
“My grandparents would never allow this. Never, ever,” he adds, shaking his head.
Second article of two. This article was supported by a grant from the Simon Cumbers Media Fund