Recognizing the Value of Indigenous Knowledge and Responses
Climate change is rapidly transforming the Amazon region, presenting significant health risks for the local populations. From intensified heat waves and floods to emerging infectious diseases, the region’s diverse communities are facing a growing array of climate-related health challenges. However, the experiences and traditional practices of Indigenous peoples in the Peruvian Amazon offer valuable insights and strategies for building climate-resilient health systems.
During the COVID-19 pandemic, Indigenous knowledge and community-led responses played a critical role in protecting public health. This has underscored the potential for Indigenous participation to enhance the resilience of health systems in the face of other emergent threats, such as climate change. By examining how Indigenous and non-Indigenous health systems in the Peruvian Amazon are adapting to climate change, this study aims to identify key pathways for strengthening the climate resilience of health systems in the region.
Adapting to Climate Change: Insights from the Peruvian Amazon
The Peruvian Amazon, which covers 60% of the country’s territory, is characterized by a tropical climate with high temperatures and frequent precipitation. In recent decades, this region has experienced significant changes in the duration and intensity of wet and dry seasons, which have been consistently attributed to climate change. Projections indicate a 10% decrease in precipitation and a 1.6°C rise in maximum temperatures by 2030, with further increases by 2050.
Our study, conducted in the Loreto and Junin regions of the Peruvian Amazon, found that both Indigenous and non-Indigenous health systems are actively adapting to these climatic shifts. Indigenous responses include the use of traditional ecological knowledge to predict weather patterns, the application of medicinal plants to manage climate-sensitive health risks, and the establishment of community-based food and resource sharing networks.
“At the beginning of August, the weather is changing, so we have to be prepared. I take a sachawiro, portoncillo, ginger, beehive, and sugar cane, and I crush it and cook it. It is prepared like syrup, so you take it in a teaspoon, like syrup, that helps to treat the cold.” – Indigenous health system, wise woman, Loreto region
The official health system, on the other hand, has implemented strategies such as disaster risk management platforms, training communities on preventive health practices, and monitoring air and water quality to address climate-related health risks. However, these responses have often been reactive, focusing on managing the impacts of climate hazards rather than proactively preventing them.
“Before the events, almost nothing is done… once the event happens, then everyone reacts, but the disaster is already done, the problem is nothing or little is done to prevent it.” – Official health system, health sector, Junin region
Strengthening the Articulation between Indigenous and Non-Indigenous Health Systems
A key finding from our study is that the articulation between Indigenous and non-Indigenous health systems remains limited, despite the valuable contributions that Indigenous knowledge and responses can make to enhancing climate resilience. We identified several pathways to strengthen this integration:
Governance and Leadership
Incorporate Indigenous representations in climate and health governance platforms, especially at the local and regional levels, to ensure that Indigenous perspectives and priorities are reflected in decision-making processes. This can involve establishing in-person dialogue spaces between Indigenous leaders and local authorities, as well as formalizing partnerships between Indigenous organizations and government agencies.
“Local Indigenous organizations could strengthen health and climate governance by providing insight into community health needs, vulnerabilities and capacity before and after climate events. Also, Indigenous knowledge regarding weather variability and climate hazards would help local governments take preventive measures.”
Health Workforce and Training
Improve the cultural competency of the health workforce by providing training on Indigenous health practices and the value of traditional ecological knowledge. This can help bridge the divide between Indigenous and non-Indigenous health systems and foster mutual understanding and collaboration.
“We struggle with that situation but it is in a minimal way. In general, the majority of people accept the official treatment given by the health establishments.” – Official health system, health sector, Loreto region
Service Delivery and Access
Formally incorporate Indigenous health workers, such as traditional healers and community health agents, into the official health system. This can enhance the acceptability and utilization of health services by Indigenous communities, as well as improve the organizational capacity of the health system to respond to climate-related health risks.
Evidence and Research
Strengthen the scientific evidence on the use of Indigenous medicine and Amazonian foods for managing climate-sensitive health risks. Incorporating this knowledge into the research agenda can provide valuable insights into local solutions and build a stronger foundation for integrating Indigenous and non-Indigenous approaches.
“It is with technology, and Ashaninka people do not know it, they’ve used a smartphone” – Indigenous health system, community leader, Junin region
Financing and Budgeting
Increase the budget for climate emergency responses and the support provided to community health agents, who play a crucial role in delivering health promotion and disaster response services to remote communities.
“The budget. Because without money you do nothing. Sending a health brigade to an Indigenous area is very difficult. It is expensive, It is also difficult to find health workforce who want to go and are committed. This has been a weakness for us.” – Official health system, health sector, Loreto region
Toward a Holistic and Participatory Model of Health System Resilience
The findings from this study call for a broader paradigm shift in health systems that recognizes Indigenous resilience as valuable for health adaptation, moves towards a more participatory model of healthcare delivery, and embraces a holistic vision of health as inherently tied to the environment.
“Key resilience pathways call for a broader paradigm shift in health systems that recognises Indigenous resilience as valuable for health adaptation, moves towards a more participatory health system and broadens the vision of health as a dimension inherently tied to the environment.”
By strengthening the articulation between Indigenous and non-Indigenous health systems, the Peruvian Amazon can leverage diverse knowledge, resources, and community-based strategies to build climate-resilient health systems that serve the unique needs of local populations. This approach not only enhances the capacity to anticipate, respond, and adapt to climate-related health risks but also contributes to the broader goals of universal health coverage, global health security, and sustainable development.
Conclusion
The climate resilience of health systems in the Peruvian Amazon depends on the recognition and integration of Indigenous knowledge and responses. By creating pathways for meaningful collaboration between Indigenous and non-Indigenous health systems, the region can harness a wealth of localized expertise and community-driven solutions to protect the health and well-being of its diverse populations in the face of a changing climate. This study offers a roadmap for other regions to follow, showcasing the transformative potential of embracing a more inclusive and holistic model of health system resilience.
