In Peru, during the first 50 years twentieth century epidemics were mainly due to the lack of adequate health infrastructure and poverty. Usually began with an unexpected outbreak and after the initial confusion identified the causative agent.
There were three major epidemics during the first 50 years of this century in Peru:
· Bubonic plague that affected the main coastal cities from 1903 to 1930. Yellow
· Fever epidemic in the most important ports of the northern coast and in the production areas of sugar, from 1919 to 1922.
· epidemic typhus and smallpox in the Andes.
Summary Chapter I: Public Health and Community: "The smallpox epidemic typhus in the Andes" the book "The Return of Epidemics" Health and Society in Twentieth Century Peru Düring Mark Cueto, 2003.
epidemic typhus
This illustrates a successful attempt at self-help and collaboration of the natural leaders of the Andean communities, and emphasizes the ability of people to make creative and efficient responses face of adversity.
Travelling through the Andes (Martin Chambi)
To understand why the Epidemic Typhus was endemic in the Andes and less frequent on the coast we have to note some features of this disease. typhus is caused by
"Rickettsia prowazetti" , and is only transmitted to people through
"Pediculus humanus" (louse), this guy eats the blood of the sick and spread the germs to people not infected, this louse lives near the body heat in the hair and clothing.
Pediculus humanus corporis
This is a disease characterized by high fever, prostration, headache, body aches, and you must remember that the unsanitary conditions, overcrowding and low temperatures are the conditions for the development of Epidemic typhus.
French Army suffered by
Typhus epidemic typhus most notorious in the history of Western culture came in 1812, when more than 500 000 French soldiers died during the winter Russian.
Andean Peasant Poverty
In Puno (Los Andes in south-eastern Peru), the harsh climate, lack of fuel poverty, (as shown by the possession of a torn dress only) are factors that helped the spread of the disease.
Pediculus humanus capitis
crowded huts of the Andes are an ideal condition for the spread of typhus. These homes had only a small, narrow, dark room built of adobe bricks and straw, with a dirt floor, and without any ventilation or lighting.
Couple India (Brent Road)
The people slept on the floor or platform of mud, wrapped in dirty rags and sheep leather. According to witnesses in a house in the Andes Puno families lived in crowded, where children and family, sleeping, eating, cooking together, storing their household belongings in these places. These conditions were ideal for the lice.
dump Serrano (Camino Brent)
Control of Epidemic Typhus in the Andes during the 30's: The main protagonists of this story were: Some brigades and rural health Manuel Núñez Butrón doctor
(* 1) , who worked in the department of Puno
(Los Andes of Peru) in the year 1930. This particular combination is favored by the influence of cultural movement called "Indians"
(* 2) .
occurred this exceptional case of hygiene promotion and community participation in accordance with the existing cultural conceptions. This happened in Puno in the 30's, where were found new ways to understand and control the disease.
The department of Puno was the scene of this experiment that combines indigenous beliefs and methods Western doctors in public health. The main protagonist of this story was Butrón Núñez, a doctor who organized health brigades, and published a medical journal in the general public dissemination.
RITI Q'OYLLUR Party (Martin Chambi)
Epidemic typhus in the Andes: In the 1920 infectious disease had spread because of the mobility of peasants carrying to rural fairs and worked temporarily at harvest in different parts of the country. The decline of the wool trade during these years led to the decline of the economy natural and the replacement of annual fairs festivals frequently.
Andean Villagers Raising a Cross (Martin Chambi)
lice spread the disease through the crowd of people attending markets, and religious ceremonies were also spread because of some customs Andean and ensure their dead for several days, sleeping in the bed of the sick, and washing the clothes of the dead eight days after his death. In some parts of the highlands is believed that children should not be cutting hair from birth to their second birthday (when performing a special ceremony) because it was believed that doing so undermined the child's teeth.
Indian Huts (Julia Codesido)
The areas most affected by typhoid fever in Peru were the central and southern mountains. Low temperatures and low humidity in areas over 2000 meters above sea level favored the spread of Rickettsia
prowazetti .
Coast and the Amazon jungle were free of epidemic typhus. In the early twentieth century, doctors believed that typhus Peruvian was a disease of the plateau due to a combination of factors: climate (low temperatures and low humidity), biological factors (immunity produced by the disease) and social factors (crowded housing of Andean peasants). A study in 1920 indicated that typhus was not contagious when the temperature was higher than 20 degrees Celsius (and more), on the coast was never reported epidemic typhus.
Around 1930, the only way to control the disease was through the removal of lice and maintaining good personal hygiene such as shaving, hair cut and wear clean clothing. However, even these measures were implemented. When Nunez Butrón was alive, the control of typhus involved a disciplined organization and promotion of personal hygiene.
Rural Education (Camino Brent)
The Health Brigade: In 1933, Manuel Núñez Butrón created the first medical brigade in the Island community, near Juliaca - Puno.
leaders were the brothers first brigade Cutipa Coaquira Adventists who had completed primary school. They were also members of the brigade some Indians who had served in the Army for two years. Finally, the brigade included healers and herbalists who have accepted some of the methods Butrón Núñez, without leaving fully their beliefs.
participation Adventists, former soldiers and healers demonstrates the wide acceptance of the political discourse of Butrón Núñez, who encouraged the indigenous communities to protect their health.
Instead of relying heavily on the presumed dominance of Western medicine, traditional activities are legitimated through their relationship with the natural leaders of the communities. This attitude was very different from other people who were in charge of public health.
A decisive step in the development of the brigades was the publication in April 1935 issue of the journal "Runa Soncco" in Quechua, this meant "Native Heart." In its first issue, the magazine was defined as a publication by the Indians and for Indians. Some witnesses claimed that the magazine was read aloud to the members of different health brigades.
Playing Quena Andean Campesino (Martin Chambi)
An article in Rune Soncco approved and compared the benefits of some of the methods used by the Indians to control head lice, such as land use nitrous ( Kallpa), the left out of the hut wet clothes as the cold may kill the lice (kasacheska), put the clothes in the container with boiling water (putesta) or eating hot peppers, parsley or cumin. The magazine even found an explanation for the use of urine when she washed her hair, the amount of ammonia from the urine.
However, the integration of Western and Andean culture was never complete. The essential conflict between magical and scientific explanation of the disease persisted. Western medicine, including that practiced by Núñez Butrón, was based on the belief that diseases were caused by a biological disorder or malfunction of an organ. For Traditional Medicine Andean root of disease lies in an imbalance between the body and the natural order, social and religious occur the intervention of deities and demons at random. Núñez Butrón wisely avoided the conflict in an attempt to merge the Western therapies and indigenous cultural patterns.
This experience remains unique in the history of Peruvian Medicine. 
(* 1) Manuel Núñez Butrón: (1899 - 1952) Butrón
Manuel Núñez was born in 1899 in the town of Saman, a small town in the province of Azangaro Puno. He faced obstacles, pressures and expectations of social mobility. He
was considered "white" in his hometown and his parents spoke English. But he was considered an "Indian" while attending primary school in Juliaca, because it came from within the province. The same experience happened again, at the School of San Carlos de Puno his classmates called him "Indian", as happened at the University of San Agustin (Arequipa) University of San Marcos (Lima), and when he went to study Medicine in Barcelona, \u200b\u200bSpain, in all these universities fellow students was called "Indian."
When he returned to Puno in 1930 was appointed physician to the state in the provinces of Azangaro Huancané, Lampa and San Román. In those years, their activities were affected by the ideas of "indigenous." He died in 1952.
Indian (José Sabogal)
(* 2) Indigenismo A cultural movement that encouraged a positive reevaluation of the beliefs of the Andes in Peru affected the arts ( especially painting and literature) during the first 50 years of the twentieth century.
