The Kiss of Death

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4. U.S. Public Law 480, according to which funds in host-country national currency derived from the sale of U.S. agricultural products are retained in the host country for use in development-assistance projects.

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5. The five-year, $20 million Community and Child Health Project from 1989 until 1994 was funded by USAID, whose objectives were maternal and child health, primary health care, improvement of water and sanitation facilities, agricultural sustainability, and family planning. In 1991, Chagas’ disease control was added, mostly through the efforts of Dr. Joel Kuritsky and President Jaime Paz, who during his inaugural visit to Washington, D.C., asked President George Bush for additional monies to combat Chagas’ disease.

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6. Project personnel are prone to criticize people doing other projects, although Beltran’s remarks reflected the opinion of other observers. He is considered the foremost expert on Chagas’ control in Tarija.

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7. For an outline of procedures, see Table 2: Production of Educational Materials, and Table 3: Phases of Educational Process (SOH/CCH 1994:36-37).

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1. Pilot projects were supported by the Bolivian Secretariat of Health (SOH) and the USAID Community and Child Health Project (CCH). The SOH/CCH Chagas’ Disease Control Program lasted from 1991 to 1994, cost U.S. $4 million, and sponsored housing-improvement projects in Tarija, Cochabamba, and Chuquisaca, improving 3,135 houses (see SOH/CCH 1994).

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2. Dr. Oscar Velasco is mentioned in Chapter 5. He is a Bolivian medical anthropologist and is presently director of Project Concern in Potosi. Velasco and I also designed the CHWS program and the articulation of biomedicine and ethnomedicine in the Department of Oruro (see Bastien 1992).

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3. Marco Antonio Prieto is director of Centro por Estudios por Desarollo Chuquisaca (CEDEC). His criticism was primarily directed at the project in Chuquisaca, which, of the three pilot projects, attempted most to become integrated with the culture.

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4. Dr. Pablo Regalsky is director of Centro de Comunicacion y Desarollo Andino (CENDA) in Cochabamba.

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5. Dr. Evaristo Mayda suggested the triangle diagram. Dr. Mayda is director of Project Concern Cochabamba and has been a leader in integrating ethnomedicine and biomedicine in the Department of Cochabamba.

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6. Melogno is director of Fundacion de Programas de Asentamientos Humanos, a housing project in the Alto Beni. He was interviewed on May 13, 1997.

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7. SOH/CCH allocated a dollar amount to this volunteer activity as a form of cost-sharing; thus, when a household matched the money donated, their share was calculated according to what they would have earned if they had been paid. Cost-sharing was helpful in negotiating for matching funds from institutions.

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8. All are native Bolivians, except for Regalsky, who was born in Buenos Aires but who speaks the Quechua language fluently and has done fieldwork among the Quechua of Ragaypampa. Quechua leaders work with him on matters concerning the new laws and popular participation. He has been an advocate for Quechuans for ten years.

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1. The SOH/CCH projects were directed by biologists from Vector Biology Control and a medical doctor and epidemiologist from the Centers for Disease Control, with only token considerations from anthropologists,