The Kiss of Death

(sharp). They often make them the butt of jokes, such as “Tarijefios are so lazy that their dogs bark lying down.”

^{Figure 28.}

^{Jose Beltran teaching children and adults about Chagas’ disease. (Photograph by Joseph W. Bastien)}

“Tarijefios have a sense of humor and a relationship with vinchucas,” Jose Beltran said, “best expressed in the following riddle”:

Quien es? (Who is?)

Un capitan flautero (A capital flute player)

saco de clerigo, (cassock of priest)

ladron por su gusto, (thief for pleasure)

medico por su deseo, (doctor for desire)

[answer:] La Vinchuca.

“A pointed analogy of musicians, clerics, thieves, and doctors for vinchucas with their needle-nosed proboscis, black-capped shell, thirst for blood, and blood-letting therapy” (Beltran, interview 5/17/97).

I spent several days traveling with Jose Beltran in his pickup truck and visiting homes, neighborhoods, and communities.[63] Jose was born to share ideas. Along the road, he stopped a stranger and, using a flip chart, gave him a short lesson about Chagas’ disease. Jose later told me that he had missed this person on his previous visit. “You can’t miss anybody, you have to go house to house to talk with people.”

“Now, I have to spend more time educating and motivating peasants,” Jose added, “because people have to invest more into improving their houses.” By 1997, Pro-Habitat no longer had funds to improve houses and had adopted a credit plan to loan people money to fix their houses. Loans vary from U.S. $100 to $500 at 12.5 percent interest per year. Jose believed this to be a superior plan: “Providing credit is more sustainable than giving them supplies, we don’t have the money to fix every house, and if we educate correctly and motivate them, then they will want to invest in their homes and keep them nice,” he said.

Local experience gained from the Chuquisaca project as well as assistance from Vector Biology and Control Project (VBC), CDC, and SOH were used by SOH/CCH to implement similar pilot projects in the departments of Cochabamba and Tarija between 1992 and 1994. By 1994, approximately 3,100 houses in fifty-two communities had been improved in the three departments of Chuquisaca, Cochabamba, and Tarija (SOH/CCH 1994:54; Bryan et al. 1994). The average direct cost to the program in 1991 for each house improved was U.S. $251 in Cochabamba, $217 in Tarija, and $217 in Chuquisaca; but sums were reduced considerably for 1992 and 1993 (SOH/CCH 1994:17). A large percentage of project monies was spent for administrative offices, vehicles, consultants, and educational material—U.S. $4 million ($2.5 million from U.S. Public Law 480[64] and $1.5 million from CCH[65] (SOH/CCH 1994: 9)— which was about $1,300 per house.

One general criticism of the SOH/CCH pilot projects is that to satisfy project goals for fast results and monies to be spent during an allotted time, houses were hastily built and little education about Chagas’ disease was provided. Some of these houses were not maintained; in others, the people moved their corrals alongside the houses and they became infested again. “Everybody wants a new house without much personal investment,” Jose added, “and some have moved back to their run-down houses, and they use the new houses to show off during fiestas.” He included Sensano’s project in his criticism.[66]

I asked him, “How do you educate Tarijenos about house hygiene?” He replied:

My pedagogy is participatory education, basically. Peasants who listen to me are not receptive subjects of what I teach them. But they participate in reflecting on the visual charts, so that they understand what I want to communicate. This presents excellent results, as you saw last night (Beltran, interview 5/17/97).

Well into midnight the night before, I had observed him teaching in Rancho Norte, a project community of about sixty families. The schoolroom was crowded, with the men standing back against the wall and women scattered around the room, seated on school benches. I sat with the women, exhausted from travel and interviews. Jose continually moved his body, raising his arms. He showed one elderly lady a picture, then pointed to a vinchuca illustration on the flip chart and asked her if she knew who “this fellow” was. She was confused. A few hands were raised, but Jose skated across the room to question someone about to doze off. “A vinchuca,” the person quickly answered.

“And where do vinchucas live?” Jose continued.

“In the cracks and ceilings of our houses,” someone answered.

“Have we invited them to eat with us?”

“No,” the old lady answered, “they are very ugly and shit on the walls.”

“They bite us and take blood from us,” Jose added. “What happens if we see them full of blood and we squash them?” Everyone laughed at this, because they have squashed the bugs and seen blotches of blood.

A lady with thin arms, face wrinkled and leathery, wearing a derby hat, asked him about vinchucas coloradas (red vinchucas). She was the lady who at first had been slow to answer, because it turned out that she was not sure which type of vinchuca was illustrated. Jose picked up her skills, “I’ll bet you $100, if the gringo loans it to me, that anyone can smash a vinchuca colorada and not find blood.” The lady adds that these vinchucas are different from the bad vinchucas, whose bodies are black with orange marks on the sides.

Jose showed a slide picturing the harmful vinchucas, and then reminded them not to harm the good vinchucas, showing a keen sense of respect for beneficial insects. It was clear that peasants distinguished vinchucas as blood-eating, plant-eating, and insect-eating reduviids. Other educators have broadly declared war on all vinchucas, indiscriminately killing nectar and predator vinchucas. I wondered if insecticides also discriminated. Jose’s pedagogical method emphasized the necessity of listening to the peasants, discussing matters with them, and letting them arrive at the solution.

To top off the evening in Rancho Norte, Jose showed the people a model of a house that they could build. They crowded around him, as he pulled off the roof to show them the floor plan. He began with simple questions:

“How many walls do you need for two rooms?”

“Four,” they answered.

“No,” he replied. He asked a promotor (CHW) to count the walls.

“Three,” he answered.

“Counting the end wall,” Jose continued, “the middle wall separating the two room, and the end room which begins another room. See, you save a room with this design.”

“Notice the porch that extends in front of the rooms. There is a roof over this so you can work outside and not get wet if it rains or, if the sun is shining, you don’t get hot,” Jose added. “You can work preparing food and crops here. Look how open it is to let the air circulate. Your present rooms are dark with small windows. See how the air can circulate through the house. This is healthy and helps prevent tuberculosis.”

“When you cook, where do you have to bring your food from?” Jose asked.

“We carry it across the patio to the eating room,” someone answered.

“Yes,” Jose replied, “and if it is raining, you get more soup!” They laughed at this.

Toward the end of the meeting, Jose asked me to say something, so we discussed Julio, who had recently died in Rancho Norte from Chagas’ disease. I asked if they were taking care of his children and widow, and people replied that they had plowed a plot of land for them. Then I asked how many thought they had Chagas’ disease. Six people out of thirty raised their hands. They had been diagnosed with