Sustainable Development Goal 6 (SDG-6) addresses poor water quality, inadequate sanitation, and improper hygiene, all of which negatively impact health and disproportionately impact Indigenous Peoples’ health. Understanding and responding to local contexts is critical to effectively improve water, sanitation, and hygiene (WASH); however, in-depth understanding of local knowledge, practices, and perceptions are often overlooked. As such, this study described the knowledge, practices, and perceptions of WASH held by residents of two Indigenous Shawi communities in the Peruvian Amazon. Quantitative data were collected via a cross-sectional survey and analyzed using descriptive statistics. Qualitative data were collected via interviews, PhotoVoice, focus group discussions, and participatory transect walks, and analyzed using a constant comparative approach to thematic analysis. Emergent themes included characterizing water sources, collection methods, and consumption patterns; knowledge, perceptions, and practices related to WASH; and knowledge and perceptions of health issues related to WASH. This study provides insight into the ongoing challenges related to WASH in Indigenous communities in the Peruvian Amazon and highlights the need to prioritize interventions that will advance WASH-related SDGs.

Climate change impacts on water systems have consequences for Indigenous communities. We documented climatic changes on water systems observed by Indigenous Shawi and resultant impacts on health and livelihoods, and explored adaptation options and challenges in partnership with two Indigenous Shawi communities in the Peruvian Amazon. Qualitative data were collected via PhotoVoice, interviews, focus group discussions, and transect walks, and analyzed using a constant comparative method and thematic analysis. Quantitative data were collected via a household survey and analyzed descriptively. Households observed seasonal weather changes over time (n = 50; 78%), which had already impacted their family and community (n = 43; 86%), such as more intense rainfall resulting in flooding (n = 29; 58%). Interviewees also described deforestation impacts on the nearby river, which were exacerbated by climate-related changes, including increased water temperatures (warmer weather, exacerbated by fewer trees for shading) and increased erosion and turbidity (increased rainfall, exacerbated by riverbank instability due to deforestation). No households reported community-level response plans for extreme weather events, and most did not expect government assistance when such events occurred. This study documents how Indigenous peoples are experiencing climatic impacts on water systems, and highlights how non-climatic drivers, such as deforestation, exacerbate climate change impacts on water systems and community livelihoods in the Peruvian Amazon.

RRH: Rural and Remote Health. Published article number: 7198 - Diarrheal disease and associations with water access and sanitation in Indigenous Shawi children along the Armanayacu River basin in Peru

Globalization has been the consequence of an important opening of the economies, achieved through the reduction in the obstacles to commerce, elimination of the capital controls and exchange restrictions. The impact of the Camisea Project in the Peruvian economy has aroused great interest and controversy with respect to the future social and economic national impact, and especially, in the Matsigenka population, located in the 88 and 56 lots, where gas extraction is being done. The area of Camisea gas exploitation offers the challenge of a complex sanitary problem, not only because of the impacts and risks produced by the hidrocarbon exploitation, but also due to a legacy of economical and sanitary precariousness that has accumulated from other times. At the same time, this area offers the opportunity to rethink the public health system according to the indigenous reality. It is necessary to take action in the social determinants of inequity and poverty in order to reach the positive effects the globalization can have in health, ensuring the interests of developing countries and vulnerable populations.

Indigenous populations in the Americas carry a disproportionate burden of disease. Common to populations affected by health inequities is the exposure to structural factors—social, political, environmental and economic—that shape the risks for disease. We conducted a photovoice study in three Shipibo-Konibo indigenous villages in the Peruvian Amazon. Twenty-four indigenous participants consented to take part. The study found that Shipibo-Konibo villagers are exposed to a series of structural factors such as malfunctioning latrines, lack of garbage disposal systems, lack of health services, migration, and mixing with outsiders which they see as important determinants of their health. While primary health care is urgently needed among indigenous communities in this region, any public health intervention must take into account the structural forces that affect indigenous people's health.

El cambio climático es atribuido directa o indirectamente a la actividad humana y se considera como la mayor amenaza a la salud pública del siglo XXI. Tiene impactos sobre el acceso al agua, la alimentación, en la agricultura y medios de vida, y en la salud de las personas. El objetivo de este texto es evaluar las percepciones del cambio climático en niños, niñas, adolescentes, autoridades y representantes de organizaciones juveniles, de mujeres y que trabajan con la niñez en las regiones de Cusco, Loreto y Piura, en Perú. Para ello se realizó un estudio cualitativo que utilizó la técnica de Fotovoz con doce adolescentes y entrevistas a profundidad con veintidós actores clave. Para el análisis se utilizaron las narrativas en las fotos y el análisis temático de las entrevistas. En las tres regiones se identificaron cambios extremos en el clima. En la región de Cusco reconocieron el cambio de temperatura con sequías y heladas, mientras que en Loreto y Piura manifestaron aumento en la intensidad de lluvias. En general, estos cambios afectaron la agricultura. El cuidado del agua como recurso, tanto en su acceso y calidad, fue una gran preocupación para todos los participantes. El estudio concluye que no se identifica el concepto de cambio climático como tal, sin embargo, describen cambios y variaciones en el clima que afectan sus actividades diarias, en particular la agricultura. Un tema transversal a todas las regiones fue el cuidado y uso del recurso del agua. Además, los jóvenes se mostraron particularmente entusiasmados en colaborar en iniciativas futuras contra el cambio climático.