Making health a community-owned matter.

Our programs have dramatically increased health outcomes by leveraging an engaged, participatory model.


Addressing Urgent Health Risks

Indigenous people of the Andes (campesinos) are faced with extremely difficult health issues. Despite having made significant improvements in the under-five child mortality category in Peru, rural Andean areas still experience higher than average mortality rates. These communities experience poor standards of living, particularly at higher elevations where residents are exposed to harsh climates and face difficulties with agricultural production. The communities we serve are at elevations ranging from 3,700 to 4,300 meters (approximately 12,000 to 14,000 feet), with most homes near or above 4,000-metres (approximately 13,000 feet). At such high elevations, food production and consumption consist almost entirely of potatoes. Families in these areas live in small, crowded adobe buildings with rustic furnishings, poor smoke ventilation, no access to potable water, limited or no telephone or transportation services, and, in many cases, no functional latrines. Drinking water sources at streams, springs, or shallow wells are usually contaminated by bacteria, parasites, and other pathogens. These adverse living conditions, coupled with limited access to healthcare services (health posts can be up to five hours away by foot), produce high rates of illness and mortality, especially for young children, mothers, and the elderly.

Our Health Programs

DESEA nurses carry out comprehensive, community-based health programs rooted in health promotion and illness prevention. Together with our qhalis (community health workers), we’ve created an extensive home visiting program that ensures community members receive regular medical assessment and treatment. We also work with the Peruvian Ministry of Health by providing assistance with government health clinics and programs.

Our efforts have resulted in the near eradication of deaths from preventable illnesses for mothers and children under five. We’ve also contributed to a steep decrease in diarrheal disease and pneumonia, as well as to a significant improvement in nutrition for children and pregnant and lactating women.


Health Services

Total Home Visits


Program Purpose

To Address Urgent Health Risks

The Qhali Program

The term Qhali is derived from the Quechua expression “working for health” (qhali’kaypac llank’sun). Qhalis are women who are elected by their community to train and practice as community health workers. Because women are the principal caregivers in high Andean culture, they tend to be best positioned to provide this level of care.

DESEA maintains a unique training program that empowers qhalis to act as medical first responders, provide sustainable family treatment, and promote health education in their communities. To accommodate the low levels of literacy, we’ve developed an innovative training program which provides instruction primarily through art and hands-on learning. This participatory approach has proven highly effective at transmitting knowledge to illiterate trainees. During their first year in the program, qhalis receive more than 200 hours of healthcare training alone, with ongoing education and support taking place thereafter.

Thanks to our intensive training program, qhalis become proficient in handling a truly wide range of health matters, including advanced first aid, reproductive health, pre- and postnatal health, child healthcare, chronic health conditions, elderly care, traditional and occidental medicine, hygiene and sanitation, nutrition, mother and child stimulation, tuberculosis, alcoholism, domestic violence, leadership, and social change. Qhalis are also trained in the proper usage and maintenance of our biosand water filters, including installation and filter monitoring.

After one year of training, qhali’s will be able to:

  • Teach safe hygiene and sanitation practices to families, groups, and school classes.
  • Know when to seek outside medical assistance.
  • Monitor and maintain all household biosand filters, and instruct families in correct usage and routine maintenance practices.
  • Provide emergency first aid, such as managing fractures, burns and bleeding in their communities.
  • Measure and interpret vital signs and assess basic health conditions.
  • Supervise the use of basic medications.
  • Clean and dress wounds.
  • Support community members who require hospital services.
  • Advocate for improved community health services.
  • Support families in improving nutrition and monitoring children using iron supplements.
  • Routinely monitor pregnant and postpartum women and know when to act in an emergency.

Maternal and Child Health Program

DESEA offers a number of community health programs that are significantly improving health outcomes. These programs, managed by DESEA nurses in collaboration with community qhalis, focus on key areas such as maternal and child health, student health, and vitamin supplementation.


Prenatal Health

Qhalis visit all prenatal patients in the community on a monthly basis to provide reproductive and maternal health education, assistance with birth preparation, and distribution of maternal vitamins, as well as to facilitate communication between DESEA Peru and government nursing staff. Qhalis and nurses work in coordination with the Peruvian Ministry of Health to ensure patients are provided with the support they need to give birth in licensed birthing centers. All prenatal patients are supplied with maternal multivitamin and mineral supplements.

Postnatal/Neonatal Health

Qhalis monitor all postnatal and neonatal patients, visiting new mothers and babies frequently during the first 40 days of a child’s birth. Frequent visits during the critical postpartum period have contributed significantly to the reduction in mortality and morbidity rates. During their visits, qhalis provide newborn care, maternal education, and assistance with household chores. Qhalis help new mothers complete medical checkups via the Ministry of Health postnatal program. All postnatal women are placed on a multivitamin, micronutrient supplement diet until their child reaches one year of age.

Reproductive Health

Aided by the Ministry of Health, DESEA nurses distribute contraceptives in program areas, with qhalis supporting women in making healthy birth control and child-spacing choices using educational resources that do not require literacy. This collaborative approach has greatly improved reproductive health outcomes and family planning. Qhalis also identify newly pregnant women to ensure that they receive immediate access to prenatal vitamins. Women of reproductive age who plan to become pregnant or who are not using birth control are also provided with a multivitamin, micronutrient supplement.

Ministry of Health Height & Weight Program

DESEA Peru staff work in conjunction with the Ministry of Health and municipal government nurses to ensure that children under 36 months participate in a monthly height and weight monitoring program. As part of this effort, qhalis assist with patient registration and administration for periodic Ministry of Health campaigns and make frequent home visits to ensure that children and families are benefitting from their daily vitamin and iron supplements.

Medical Campaigns

DESEA Peru facilitates visiting medical specialists from Canada and the United States who offer medical services directly in project communities. Peruvian Ministry of Health staff also participate in these campaigns, often learning new techniques and treatment options. Maternal, child, and elderly healthcare are key areas of focus during these initiatives.

School Health Program

The school health program aims to enhance students’ learning potential by promoting health and wellbeing. As an example, improved nutrition and improved drinking water treatment decrease parasitic infection rates and anemia. Children with anemia are susceptible to illnesses such as pneumonia and diarrhea, leading to diminished energy and concentration in the classroom, as well as to more missed school days.

Hemoglobin Testing

DESEA nurses conduct semiannual hemoglobin testing campaigns to screen all school-age children for anemia. Children identified as having moderate to severe anemia receive iron supplements, and their families are supported at home by qhalis and nurses. In addition, all school-age children receive treatment for parasites twice yearly.

PVC Water Filters

Schools in program areas are supplied with at least one PVC biosand filter to provide clean drinking water. DESEA nurses and qhalis instruct students on the importance of safe water which, in turn, supports adoption of the biosand filters in their homes.

Dental Health

DESEA organizes annual school dental campaigns that include dental evaluation and treatment by Peruvian dentists, dental health education, and distribution of toothpaste and toothbrushes. Qhalis assist the dentist with patients who require dental extractions and cavity repairs.

Hygiene and Sanitation

Yearly handwashing instruction and practice are carried out in every classroom. DESEA supplies soap and towels for school use, and qhalis monitor handwashing practices at schools throughout the academic year.

The Vitamin Program

With 90% of the Andean campesino population’s diet consisting of potatoes, anemia due to poor nutrition is a leading cause of the high rates of maternal and child mortality. Stunting (below average height for age), caused by persistent malnutrition, is a significant health issue throughout Peru, and reaches epidemic proportions in rural areas of the Andes. Stunted children are more susceptible to disease, tend to do poorly in school, and earn less as adults than their well-nourished peers.

Other consequences of chronic malnutrition include a weakened immune system, impaired cognitive function, increased risk of obesity, elevated blood pressure, and shortened lifespan. Mothers who suffer from the condition tend to birth stunted children as a result of their nutritional deficit.

Thanks to an ongoing vitamin donation program by Vitamin Angels, DESEA Peru is helping to curb many adverse health outcomes of malnutrition. Andean women of childbearing age, as well as those who are pregnant or lactating, now have access to daily multivitamin and micronutrient supplements. In addition, children between 6 and 59 months are maintained on a daily multivitamin. To ensure the continuity of vitamin usage and its ensuing benefits, qhalis perform monthly home visits to each participating family.