Every day, all over the world, USAID brings peace to those who endure violence, health to those who struggle with sickness, and prosperity to those who live in poverty. It is these individuals — these uncounted thousands of lives — that are the true measure of USAID’s successes and the true face of USAID's programs.
In the mountain valleys on the Bolivian Andes’ eastern slope, most of Bolivia’s horticultural crops are grown though agricultural conditions which are largely unfavorable. In the Chuquisaca state high valleys, farmers make up the poorest people of Bolivia, with an average annual income of only $350. Families struggle to live on remote, arid land where roads are few and in poor condition, soil is poor, and the temperature fluctuations are extreme. People live in adobe houses and mostly cultivate low value potatoes and forage corn.
The Yungas - a mountainous, tropical region northwest of the capital La Paz - is where for centuries indigenous peoples have grown coca leaf for chewing and for religious purposes. In recognition of this tradition, Bolivian law permits up to 12,000 hectares of coca only in this region. In recent times, however, additional coca has been planted that often ends up in the cocaine production circuit. Given the political and cultural sensitivities surrounding coca cultivation in the Yungas, the Bolivian Government does not rely on forced eradication to reduce the excess coca. Instead, Yungas farmers are offered community improvements, development projects and technical assistance in cultivating other crops in exchange for uprooting excess coca or for not planting it in the first place.
The City of El Alto in Bolivia has become a focal point for social and political unrest. Much of the discontent arises from poor living conditions, low incomes, and inadequate social services. For example, recent surveys indicated that only 68% of children under one year of age in El Alto had received the third required dose of a vaccine to protect them against pertussis, tetanus, polio, hepatitis B, and Hemophilus influenza B meningitis.
Malaria affects over 3.5 million people in Bolivia each year. The Amazon basin regions of Beni and Pando have the country’s highest infection rates. In these regions, migratory worker populations, such as castañeros, or Brazil nut harvesters, run a high risk of malaria infection. Malaria is a great burden on the workers, their families, and even the country’s economy. When castañeros are sick with malaria, family income drops since workers do not earn their wages and family members stay home to care for them. In addition, the country’s Brazil nut market suffers. Bolivia supplies about 80 percent of the world’s Brazil nuts, with an annual market value of $48 million. At least 15,000 families from rural areas depend on this market for survival.
High quality, real-time data are helping Bolivian health officials carry out more effective HIV/AIDS prevention education, including counseling and testing services. While HIV/AIDS prevalence rates in Bolivia in the general population have remained under 0.1 percent — a remarkable success compared to Bolivia’s neighbors — the rates are much higher in specific risk groups. One study in Santa Cruz detected a prevalence of 22 percent among high risk groups. Tracking these groups remains a high priority for the government, but effective public health programming depends on access to reliable information. Until recently, data were not automated and were sometimes incomplete. This inadequacy limited the ability to make informed and timely decisions.
COMBASE (the Bolivian Evangelical Commission) is a faith-based organization that provides health services to the low income population in the city of Cochabamba, 250 miles east of the capital, La Paz. USAID has supported the organization’s reproductive health program since 1991. COMBASE’s small hospital and five clinics offer maternal and child health services to approximately 65,000 people every year. For many, this institution is one of the few affordable medical facilities within their neighborhoods. An internal evaluation showed that the organization was in a difficult financial situation and lacked the systems needed to effectively evaluate its services, costs and sustainability prospects.
Bolivia has a high maternal mortality rate and an elevated incidence of sexually transmitted diseases. Only a decade ago, topics such as family planning, reproductive health and HIV were taboo there. The citizens’ knowledge and understanding of disease transmission, consequences and cure were deficient, and in many cases inaccurate. Yet, no services were available to provide information.
Last updated: January 12, 2015