Benicio Segundo is the village elder in Palmarito, a Bolivian community of the Guarani ethnic group. Here a simple farming lifestyle has not changed much in hundreds of years. Water is still collected and carried by hand, there is no electricity, and the homes are simple mud hut structures. People depend on chickens and pigs for food, and they keep them close.
Just like the insect, the illness, which is called Chagas disease, is hard to detect. And that is the problem. People can be infected for years without knowing it – there may be no symptoms as the parasite reproduces inside the person, slowly damaging the heart, brain and intestines. Many people lose the ability to breathe easily and to walk, eventually dying of heart disease. In these communities, 30-40 percent of children under 15 years old are infected, and the levels are even higher In adults. There is treatment, but these communities often do not have the diagnostic tools or medications available. However, they do have a powerful weapon, and that is prevention, which is providing hope to this community.
A unique research programme is being carried out in Palmarito and three other villages in Bolivia. The goal is to develop environmental and educational tools to help the community reduce the numbers of the insect and control the infection.
Each village selects volunteers to work with the medical doctor to visit homes and teach people how to protect themselves. They are shown how to put articles away neatly and to check their mattresses regularly for nests, to keep their dirt floors inside and out clean of leaves and debris, and to move their farm animals and pens further away from the house, since the bugs nest in the animals’ fur. The bugs will even live in the cracks of the mud huts, so these are promptly covered with new layers of the mud and straw mixture
Dr Daniel Arroyo, the Palmarito doctor, says, “With this project, we are teaching the community how the insect behaves, where it hides inside their houses and what it does to their health. As a first step, they are learning what to do with their domestic animals, that their livestock must live outside of the house. They are also learning that they should keep their houses clean and even how to fix their houses.”
He says, “First you have to know the community. Later you start with the training, talking to the group of mothers and speaking in community gatherings as well. My interest is to serve my people and that is the reason that I keep working here for so many years.”
The local government provides regular insecticide screening of walls both inside and out, but the most important factor in all this is the education and empowerment of the community to keep their homes free of bugs.
Dr Fréderic Lardeux, the research principal investigator, says, “At present, the strategy is based on the spraying of insecticides and although there are some positive results, they are clearly insufficient. There are resistance problems, as even when the houses are sprayed, the insects re-colonize very rapidly. So the public health authorities will be observing the results that we hope to achieve with our study, and they are now thinking of introducing an eco-bio-social element in their strategies.”
The future is looking much brighter for this community. The research is finished, and the people living here are continuing this approach, having seen the positive impact it has made in their lives.