IEEE Technology and Society Magazine - March 2015 - 22

Figure 3. Volunteer in interaction with locals and their
social organization at the pre-implementation (bottom-up
socialization) stage.

operated in the region for a period of 25 years. A lack of
other sources of income such as tourism and export of
produce provides high levels of uncertainty for the future.
None of the areas enjoyed any type of digital communication at the time of the projects.
Two of the poorest remote villages in the area are Balsapuerto and Varadero, inhabited by approximately 1500
people each, including adjacent areas. See Fig. 1. Each
village has a health center served by an inexperienced
doctor and supporting health personnel. San Juan is a
800-inhabitant village served by a medical technician.
Balsapuerto and Varadero are strategic for the region
and nearby villages, and reachable only by boat from
Yurimaguas, which is the nearest town with a hospital,
telephony, and Internet service. Balsapuerto is located
at 113-km (70-mile) boat trip from Yurimaguas. The boat
trip to Varadero can take up to two days, and to Balsapuerto more than three days, when river levels are low.
Travel and patient evacuation are practically impossible
when rivers are below certain levels or during rainy season when electrical storms make it dangerous to traverse
the rivers. Such transportation problems have complicated the evacuation of sick villagers and resulted in many
preventable deaths. While there is a proposal to construct
a road in the coming years, the plans are uncertain due
to the overly high cost of building roads over swamps and
unstable land. Opposition to those roads due to fears of
deforestation has also been an important issue.

Partnership and Collaboration in
the Peruvian Amazon Initiative
The multi-stakeholder composition and the multidisciplinary nature of these interventions - which
seek to better human conditions and empower all
stakeholders - require appropriate frameworks and
partnerships to ensure the success and effectiveness
of the interventions. Fig. 2 illustrates the relationship

Figure 4. Utilizing the newly deployed telemedicine services
in the village of Balsapuerto.

of all stakeholders that have taken part in the Peruvian
Amazon initiative for the last five years. The core of
the initiative has been partnership and collaboration
at different levels. These qualities enabled self-sustainability beyond the implementation phase, expansion of
infrastructure and services, and replication and transfer
of knowledge and know-how to other similar projects in
other parts of the world. A similar distribution of stakeholders can be expected in projects in other regions.

Top-Down and Bottom-Up Socialization
The Alto Amazonas Health Network's leadership along
with their rural health personnel have been the most
important stakeholders, properly socialized by the main
partner1 (GTR Group, see Fig. 2). The former is led by
leadership and personnel very well aware of the local
health challenges; they are also aware of how technology
can contribute in improving such challenges. In this context, we define "top-down socialization" as the process
of making high level regional political and health sector
authorities aware of the following: 1) the benefits that
appropriate (i.e., sufficient bandwidth) telecommunications will bring to their communities in the short, medium, and long term, 2) the importance of taking an active
role in the implementation and economic sustainability
of the project, through their personnel, or through other
means; and 3) the possible benefits that such projects
will bring to them, including possible positive professional and political benefits. The informal allusion to these
possible benefits has shown to be an important instrument that can help in the ownership of the initiative,
thus having important implications on the sustainability
and overall success or failure of the initiative.
1
"Main partner" or "principal partner" is the main local or national organization that is expert in long-distance data communications, rural health
betterment through ICTs, sustainability, and top-down and bottom-up
socialization.

IEEE TEchnology and SocIETy MagazInE

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MARCH 2015

Table of Contents for the Digital Edition of IEEE Technology and Society Magazine - March 2015