Gendered geographies of care: women as health workers in an indigenous wellbeing project in the Peruvian Amazon

This article examines how women as primary gatekeepers for well being became involved as health promoters in a local indigenous health care project in the Amazonian region of Madre de Dios, Peru. Here, I provide a case study of the processes and transitions that the project underwent from its inception to its eventual inclusion of indigenous women health promoters into its programs among indigenous communities from the mid 1980’s through the early 1990’s, at a time when western primary health care was even less accessible then it is today. The article begins with an overview of Madre de Dios and a general discussion of the links between health and gender. It then calls attention to women’s invisibility in daily primary healthcare and examines how and why women were initially neglected in health care delivery strategies while examining the progression and extent of their involvement, their role in health resource management, and the difficulties they faced as leaders vis-à-vis broader political structures such as the native federation and local government. Overall, the project succeeded in broadening the definition of health to include ideas of well-being, ‘living well’ and conservation as a set of relationships with the environment and its care - areas in which women undeniably hold key positions. In examining geographical natural resource maps by charting ideological and gender-based practices upon it, this article discusses a gender balanced approach to processes legitimizing indigenous healthcare practices. This research suggests that the overlooking of women’s roles in community health is embedded in local and global gendered politics of health care that tend to ignore that care practices are embedded in daily social relations. Furthermore, the problems that the omission of women as health promoters raises offers a general critique of the indigenous health agent approach to healthcare in Amazonia.