Peru has an indigenous population of four million people, the most vulnerable of which are the indigenous communities of the Peruvian Amazon, with poverty rates exceeding 80%. The district of Rio Tambo (department of Junín, 300 km east of Lima) is primarily populated by the native Ashaninka. 46% of children under five suffer chronic malnutrition, and only half of the population has a health insurance.

One of the priorities of the Peruvian government is to provide free healthcare to the vulnerable native communities. That poses a big challenge, as access to the remote villages is quite difficult.

Within the framework of the Belgian program supporting the universal health insurance policy in Peru (SISTEC), a fact-finding and information mission to Rio Tambo district was organized in May 2015. The mission consisted of representatives of the national health insurance (SIS), the national civil register (RENIEC), regional and provincial health services and municipal officers. One of the purposes of this first joint mission was to bring together different public organizations in the health sector and to foster closer cooperation between them.

The 11-day mission visited fourteen indigenous communities and nine local health centers, in order to inform the Ashaninka about their right to free health care under Peruvian law. As a result, more than 1100 people requested to be affiliated to the national health insurance. The team also discovered that the district has critical needs for basic health care, both in terms of human resources, infrastructure and drugs. The Tambo river basin has a population of 25,000 people, and there is just one nurse to attend them (no medical doctor). There are no ambulances nor medical boats for emergency interventions.Facts

• In Peru, regional governments are responsible for the health districts and health centers.
• The national health insurance (Seguro Integral de Salud) has 500 employees and over 15 million affiliates. Peru has a total population of 31 million.
• The native communities in Peru have been classified as 'vulnerable' and therefore have the right to universal healthcare.
• The area of Rio Tambo is known for coca cultivation and drug-related activities.
• BTC's SISTEC program unfolds its activities in five regions: Cajamarca, Huancavelica, Junín, Piura and San Martín. The objective of the program is to provide quality healthcare to every person living in poverty.