The Asso Qosqo, an Italo-Peruvian non-government association(NGO), is proposing to set up a pilot project for the prevention and the control of sexually transmittable diseases(STDs), including the HIV virus, in the Inka region. This Peruvian health district contains a number of internationally renowned tourist zones (Cuzco, Machu Picchu, Valle Sagrada) and is characterised by a variety of highly diverse sociological, climate and environmental conditions(woodland and plains dwelling rural communities, mining cities, river ports etc.)

The project is to be considered as localised and is a complementary element of the very recent plan, drawn up in April ‘96, by the Peruvian Ministry of Health. In this plan the government recognises the state of national crisis, as far as the prevention and control of the STDs/HIV are concerned, and outlines the strategies and procedures to be followed, in what is an absolutely top priority intervention; indeed in some areas, such as Lima-Callao, STDs and HIV have reached epidemic proportions.


The project sponsors have selected the high risk Inka region, where the situation has been close to explosion for some time, as an important opportunity for a high-quality intervention in technological, medical and human terms. This would permit the project to:

- graft a highly innovative and successfully locally tested model, at local level, onto the Peruvian social structures and realistic reality.

- to develop over time an efficient structure, modelled on the requirements and the specific resources of the different situations, which would come to be self-managing and which would generate similar resources in the rest of the country.

- to test on the ground, within well-defined deadlines and in an important geographical area , an intervention model which would prove to be a crucial resource not only for the whole of Peru, but also to the rest of the world; for all the areas where the difference between developed countries, according to the 20th century western model, and other cultural realities (developing countries, niche societies etc.)have reached crisis levels, could benefit from this peruvian experience.

The project which is concerned with the entire Inka region, and by necessity based in the urban environment of Cuzco, proposes an operational model which strictly follows the tenets of the central strategy and utilises the local public infrastructure (sanitary offices, analysis centres, etc.) . However, it is envisaged that the model would operate in an autonomous manner, complete with, generally speaking, non-government employees, utilising/creating alternative resources to complement those in the public structure.

Fundamental to the project is the recognition of the dual nature of the environment where the plan is to be implemented:

- STDs/HIV are social diseases more prevalent in socially disadvantaged areas of low resistance;

- in particular, the HIV virus is a disease with particular cultural connotations, more so then other STDs and the other potentially fatal diseases.

The objective, therefore, is to create a support structure which is:

- immediate and easily accessible
- free
- confidential
- in a certain sense ‘active’, by this is meant, the capacity to reach and touch in a tangible manner the target group, comprising of the: misinformed, demotivated and isolated(or even demonized) sections of the population.

The intervention identified by the project, is structured in different phases, to be implemented in a five year span.

First phase: founding of the Intervention Centre

By necessity the seat is to be located at Cuzco, as a result of its urban environment and literate population with access to fundamental resources (internet nodes, analytical laboratories, public organisations).

The first step is the training of the primary team, in the multi-disciplinary tasks associated with the project: informative, technical intervention, monitoring, social assistance, etc. The team will establish a base in the Centre so as to immediately manage not only the key activities, but also to create the groundwork -technical, human and organisational- in preparation for successive developments.
On completion of the training of the primary team, the Centre will supply:
- free help-line for counselling
- free access to a station for screening/counselling, with the characteristics as indicated above
- development of an internet site for the research, organisation and the diffusion of the information relative to the STDs/HIV and other activities associated with the group.

Second phase: general and territorial operating system

This phase, to commence immediately, which however requires time to both develop and adapt to the specific local situations, foresees:

- promotion of local voluntary groups to support the activities of the Centre

- creation of direct contact and intervention which focuses on with some of the crucial social population categories (youths 13-25 years; child-mothers; prostitution, whether it be institutionalised or not, the homosexual community; carriers of STDs, sanitary workers, etc.)

Third phase: transferring of experience
The objective of this phase is to transfer the technical instruments, and the specific skills developed and tested in the Centre, to the diverse territories that comprise the Inka region. The method identified for this transfer is that of the creation of development missions: mobile unit, equipped with technical instruments and personnel, locating for a certain period of time(two-three weeks) in a specific situation in the Region. This unit would then reproduce, in the decentralised environment, the technical-operational models already tested in the urban environment, and where necessary, adapt them to the local situation. This phase of the intervention model can definitely offer the most, with, implications, for global use(Peruvian and world).

The final objective of the intervention is not to create a pyramid structure, but a grid structure in which the most decentralised and isolated user, or hygiene inspector, can access, with ease, the contact points. Through which it should be possible to receive, for all types of requirements, an immediate response, of a high standard in clinical, technical, informative and human terms.

A further and more profound objective is to create a ‘virtuous circle’ of a cultural nature:

- from a need/query to contact with a human response.

- from experience acquired -in individuals, in groups in communities- to the emergence of a diverse culture, comprising of co-operation, efficiency, and a flexible approach to problem solving, leading to the elimination of local fears.

In this manner the challenges presented by the emergence of STDs/HIV could become, for both the user and in general, the opportunity to ensure both social and human development.

The necessary resources
- Human resources: project co-ordinator, operative secretary, contagious disease specialist, psychologist, two GPs, social workers, two qualified nurses, administrative technician
- Materials: fully equipped base, communication and computer equipment, vehicles, materials for the treatment centre, informational and didactic material.
- Accounting: administrative and technical auditing
- External: teachers, administrative, technical consultants

The project is to be carried out in a five years period, with a total cost of approximately US $ 2.000.000, of which around US $ 600.000 is budgeted for the first year.