The Belen Project: A Collaborative Community Development Project for Belen, Iquitos, Peru

Read the 2009 report HERE!

The Belen Project has expanded into a wider network, called “Red por Belen” (the Belen Network) and, through the logistic support and guidance of the Pan American Health Organization, now includes the District City Hall of Belén, local and regional governments, the Regional Health Bureau (DIRESA), Pregnancy Education United Services of Peru (UGEL), The Wawa Wasi Program- Ministry of Women and Social Development (MIMDES), Municipal Defense of Child and Adolescents (DEMUNA), churches, and nongovernmental organizations such as La Restinga, La Canoa, Selva Amazónica, Doctors for Orphans, and Amazon Promise, as well as grassroots organizations such as community kitchens, Vaso de Leche (Glass of Milk), and the neighborhood civic associations of Pueblo Libre.  These organizations will provide a variety of comprehensive services including health care, literacy and microcredit initiatives, nutrition, pregnancy and HIV education,family violence prevention, and much more.

Our Goal: In collaboration with local citizens, governmntal and non-governmental organizations, to improve the health, education, and living conditions of children, families and citizens of Belen currently living in extreme poverty.

Special grassroots funding request ...

Historical Background

In August 2005, 30 clowns from Gesundheit! Institute (a US based non-profit organization dedicated to healthcare education and reform, and also international service and development) and Bola Roja Clown Doctors (a Peruvian hospital clown group with a focus on child advocacy), collaborated on a service mission to Iquitos, a city near the headwaters of the Amazon River. During the 2 weeks, on a visit to Belen, a profoundly poor riverside community, the plight of the residents there made a deep impression on the clowns. They decided to return to try to help in some way.

Iquitos (pop. 325,000) is the world’s largest city accessible only by air or by river. Belen (spanish for “Bethlehem”) exists at the edge of Iquitos, in the floodplain of the Itaya River (a tributary of the Amazon), and consists of 65,000 inhabitants, most of them poor, and many of whom live in extreme poverty, without electricity, none with clean water or sanitation. There also exists an estimated 60,000 people living across the river in outlying areas, also with no electricity, water and sanitation. Most homes will float or are built on stilts, as the river floods some 5-6 meters during February through July. Belen, a unique world community, has been referred to, in travel books, as the “Venice of Latin America”. In Pueblo Libre, a section of Belen on the waterfront, an estimated 14000 people, 30% under age 12, live in a busy river port, where charcoal, bananas, fish, and other goods are brought, mostly by canoe, to be distributed and sold throughout Belen. People there live in overcrowded conditions (90% of homes house 2 or more families; some homes as many as 5) and, in addition to malaria, dengue fever, water-borne illnesses, respiratory illnesses, tuberculosis, and HIV, there are problems associated with severe poverty; alcoholism, crime, prostitution, unemployment, child abuse and domestic violence. Years of deteriorating conditions in Belen have resulted in widespread frustration and hopelessness among Belen residents. Literacy is estimated at 30%.

In April, 2006, a small group of Gesundheit and Bola Roja volunteers returned to Belen. We met with Lucia Ruiz, a Belen public health nurse activist who had helped to bring about a meeting with 30 community leaders (public health nurses, teachers, school officials, elders, community leaders, concerned citizens) to identify the problems facing Belen and their solutions. After input from all members of the group, together they prioritized severity of problems along with the relative difficulty of proposed strategies to address these problems. Their conclusions:

Problems (from most severe impact to least)

1. Family and community violence
2. Unclean water
3. Lack of sanitation
4. lack of trash removal
5. Endemic illnesses
6. Juvenile pregnancy
7. Malnourished children
8. Overcrowding (3-5 families per house)
9. Erosion
10. Alcoholism, drugs

Solutions (from easiest to most difficult, factored along with seriousness of associated problem)

1. Sewage, sanitation development
2. Trash removal
3. Bridges
4. Raise morale (painting houses, community based work projects)
5. Malaria prevention
6. Family violence education/interventions
7. Potable water
8. Health care (availability of affordable medicine)
9. Sports
10. Anti-erosion measures
11. Increased and improved housing
12. Teen pregnancy prevention
13. Improved child nutrition

In August 2006, 50 volunteers began what is the prototype for the ongoing project in Belen. Over a 10 day period, the volunteers painted 90 homes with vibrant colors and designs and most importantly, did so with the assistance of the inhabitants themselves, many of them teenagers. The project, funded by Gesundheit! Institute, was facilitated through the generosity of Lan Peru Airlines, who provided in- country air travel for volunteers, and also 25 Lan Peru employees who joined in the painting. Airline Ambassadors, a service organization targeting the needs of poor and sick children throughout the world, brought schoolbooks and supplies for a school of 50 children and emergency medical supplies and equipment to their community. The volunteers also clowned in hospitals, hospices, special needs facilities, nursing homes, and throughout Pueblo Libre. Most significantly, we gained the confidence of Belen residents who were skeptical of promises of help. We were asked to return, and Belen governmantal and community leaders offered cooperation with any future projects.

Based on the strong positive feedback from the local citizens of Pueblo Libre, we created an ongoing community development project in Belen, where volunteers from around the world, from Peru and Belen collaborate with Belen citizens to improve health care, education, and living conditions. The project will, in collaboration with other partner organizations, provide support for local initiatives addressing the community's most pressing needs.

Certain other essential elements of the project will involve significant material, technical and monetary assistance, such as infrastructure projects directed towards Pueblo Libre’s water and sanitation needs, and also architectural design and implementation of innovative structures supporting a healthy and vibrant community in this unique environment.. Gesundheit’s architect has made preliminary designs and is also interacting with Lima, Peru based architecture students and faculty to solicit proposals for our project.

The University of Peru Cayetano Heredia Department of Medicine has entered the project with plans to send medical students for clinical externships in Belen health clinics, providing healthcare for Belen's poor. The Pan American Health Organization, whose mission includes child health advocacy and the development of child friendly communities, will collect baseline and follow-up epidemiologic data to assess the effects of the project over the ensuing years. In addition, PAHO will serve as a resource base for sanitation and clean water initiatives, and will serve to cohere the various governmental and nongovernmental organizations now serving Belen. 

Objectives of the Belen Project

Belen Project volunteer services provide a) comprehensive healthcare to the district of Belen, Iquitos, Peru, and b) programs utilizing art, education, theater, and other modalities directed to inhabitants helping the community realize its own dreams for education, enhanced health and happiness. We also intend to develop, in collaboration with Belen Citizens, architectural and structural projects to address the water, sanitation , habitation and community space shortcomings facing Belen residents, support change through providing guidance and expertise in microeconomics and permaculture to enable the human community to direct its own development in sustainable and creative ways.

Specific Strategies of the Belen Project

We propose 3 strategies to help Belen achieve its goals.

1. Comprehensive health care Primary health care provided by Universidad Peruana Cayetano Heredia interns, precepted by faculty, and physician volunteers from the worldwide Gesundheit! network. Interactive public health education programs in hygeine, nutrition, teen pregnancy prevention, and other topics which would improve knowledge, enabling improved physical and emotional health for children and adults. Create friendly, loving, playful contexts for individual and community health care interactions

2. Human Services Develop prevention and education programs emphasizing domestic and sexual violence. Volunteer programs for children and teenagers in theater, dance, art, and craft making. Microeconomics, permaculture, libraries, sports clubs, community events. Educational scholarships for Pueblo Libre's for poor students, a library and integrated literacy program Provide intensives for teachers and administrators to up date teaching methods.

3. Structural/ Architectural Architecture designs for homes and community living spaces in service of a beautiful and vibrant Belen. Water/ sanitation assessment and implementation for Pueblo Libre Housing for volunteer staff A Belen Community Center, providing rooms and spaces for community activities, recreation for children Introduction of naturally occurring plants (bamboo, vetiver grass) to provide materials for building homes, bridges, public spaces. Painting every structure in Belen with beautiful colors

Brief Description of the Project Structure

Health Project

The health problems in Belen are serious. Tuberculosis, HIV, malaria, diarrheal illness, intestinal parasitosis, respiratory illness, mental illness and malnutrition are among the more serious problems facing Belen residents. The overall disease burden has its greatest impact on the very young and the very old. There are two public health clinics in Belen, under the direction of the Ministry of Health, providing primary care, vaccinations, house calls, nutritional assessments and interventions, and prenatal obstetric care. The health care workers are well trained and highly dedicated, yet underfunded and overworked. Interns and health professional volunteers can treat patients and assist in community health initiatives under the supervision of the Executive Committee Healthcare Coordinator and by faculty preceptors from the Universidad. The health center will also be the setting for development of programs for educating the community (for instance disease prevention, hygiene, drug and alcohol abuse, violence, dental care, teen pregnancy)

Volunteer Project

The Volunteer Project consists of varied coherent responses to the multiple needs of the Belen people, who, in addition to their many struggles with illness, lack of resources, lack of jobs, and lack of clean water and sanitation, have been consistently disappointed by broken promises and failed assistance efforts. We have gained credibility by virtue of our collaborative approach and the low cost, human intensive nature of our activities. Our volunteer work advocates no religious or political ideology. We clown around, play, have fun and make work part of the fun. We want to be helpful, and our fundamental desire is that health and happiness be possible for all.

The clown volunteer is the most significant working role in the Belen Project. The clown activates community participation. Volunteers embody the animating principles of Bolaroja and Gesundheit! models for care- human interactions which are persistently fun, creative, playful, friendly, loving, cooperative, caring, generous, happy and thoughtful. All programs will express these vital features, including health care volunteer programs, whose volunteers will be given the experience of treating patients as friends and neighbors.

Most importantly, it is our experience that change is best accomplished by assisting individuals within communities in following their visions for what they need and want; by providing tools, assistance, resources and friendship. We deliver aid and assistance directly and accurately to the persons and communities in need. Belen people know their problems better than we do. It is our aim to assist them in timely and specific ways, and, always to recognize that the fate of Belen is most essentially in the hands of its people.

Structural/ Architectural Project

Painting houses has beautified Belen’s commercial center, Venice Street, and Blasco Nunez. Beautifying surroundings elevates the human spirit, and enables cooperative interactions in families, schools and communities. Beautification of existing structures as a foundation for revitalizing poor neighborhoods has shown great success in other communities around the world (see Las Penas in Guayaquil Ecuador). We plan to paint, eventually, every house in Pueblo Libre.

Pueblo Libre citizens have inadequate community spaces to get together. Existing structures are available on an inconsistent basis, and meetings in the street are interrupted by vehicle traffic.

The Community Center will provide a setting where citizens can meet, have fun, organize and explore, on an ongoing basis, problems affecting their community. We will then network with volunteers from both inside and outside Belen to develop activities and resources specifically addressing the needs and potentials of children, teenagers and existing and potential community activists. Programs can include sports, dancing, theater, art, literacy, agriculture, empowerment workshops, microeconomics, and more. Belen residents will develop volunteer networks among its own population, creating a network of cooperative, community oriented citizens.

Gesundheit’s architect, Dave Sellers, will work with students from Universidad Ricardo Palma, a architecture university in Lima, soliciting design proposals for innovative community-friendly structures in harmony with Belen’s unique environment. With flooding 5 months of the year, the “Venice of Latin America” can be transformed into a beautiful thriving child-friendly community with only a modest cost in the building of walkways, play spaces, bridges, community centers and other public structures. With the guidance of the Pan American Health Organization, the design will include the use of easily available low cost materials, the production of which can be linked with sanitation projects.

A community center will be renovated from an existing structure in Belen, to provide space for community functions, meetings, recreation and a base for community development. This is a crucial step forward to enable Belen residents to guide their own development. No such structure currently exists.

Project Updates

At this time, donations have enabled us to activate the volunteer program, but not on a residential basis. We envision a volunteer staff living in Iquitos when funding permits. Until that time, the Project will involve collaboration between local organizations and volunteers, and non-resident experts and volunteers, in the areas of health, education and living conditions. The Municipality of Belen has showed great cooperation in working with the entire Belen Project team. Currently there are water and sanitation projects being studied by international and national partnerships, with the goal of providing clean water and sanitation to Pueblo Libre. In lieu of this, sustainable grassroots projects are being researched and pilot projects will be introduced to Belen citizens. What follows is a list of project highlights up to the present.

Belen Project August 1-14, 2007In August 2007,70 volunteer clowns from 12 countries, and Belen residents, street children and a few spontaneous tourist volunteers, painted all 148 homes on Blasco Nunez, a major street in Belen. Bola Roja provided workshops in art, music, crafts, movement, tie-dye t-shirts and play to over 400 children. Gesundheit! financially underwrote a conference involving governmental and non-govermental organizations, citizen groups, and various organizations providing care and relief for Belen. Led by PAHO officials, it resulted in the creation of a network of care and a plan for bringing success to Belen's dreams for the future of its community. Through Airline Ambassadors and clown volunteers, humanitarian aid was delivered to schools, clinics, and a shelter for abandoned children, The mission culminated in a parade through Belen. Beginning at the riverside end of Blasco Nunez, hundreds of clowns and Belen citizens, and the children, (many wearing tie-dye t-shirts they made in one of the workshops), marched up and down Blasco-Nunez and Venice Street to the site of a collaborative mural, all in a pouring rain. We also met with community leaders concerning the sanitation project, and came to an understanding that the solution to this frustrating and complicated problem required the active participation of Pueblo Libre residents. We also developed a "Planting Seeds" fund that give educational scholarships to 70 children, and organized the street boys and girls into a group "Los Papagayos", who painted, clowned, and developed a photographic project. Connections were made with local health department leaders, and plans were made to develop a framework with UPHC to bring medical students to Pueblo Libre within the next year.

"Christmas in Iquitos" Volunteer Project December 16-24,2007 25 volunteers provided workshops in art, stilt walking, theater and dance for hundreds of Belen children. Clowning in local hospitals, nursing homes and orphanages. Pilot projects for sanitation were developed and meetings with local activists deepened the collaborative structure of the Belen Project.

August 1-12, 2008 Volunteer Mission Plans 90+ clowns from 12 countries brought together by Bolaroja and Gesundheit, joined with PAHO, Save the Children, Selva Amazonica, La Restinga, Teatro Vivo, the municipality of Belen and Belen citizens in "Healthy Belen 2008." This was the Project’s first festival, whose theme was "Defending Joy: It is our Right!", and was centered in Pueblo Libre. With significantly more collaboration with Pueblo Libre citizens, we painted all 133 homes on Calle Miramar and 33 more homes surrounding the festival field We offered workshops to children in dance, music, theater, art, and more. We painted a large mural at the entrance to Pueblo Libre, designed by local citizens. We clowned every day, in hospitals, nursing homes, orphanages, and on the street. There was a daily play fair, involving thousands of children on the festival field.

There were free health screens, free movies on the festival field, community gatherings and discussions, and a Big Show near the end of our time there, featuring children's projects, local talent and music, followed by a big parade through Pueblo Libre, with a marching band, and hundreds of clowns and children.We made new friends, and deepened old friendships. We created new partnerships and alliances, and collaborate on re-visioning the future of Belen. Amazon Promise, (an NGO with much experience in providing health care to the urban and rural poor in this region) provided free health care to Pueblo Libre citizens in the festival field.

As we worked and played this year in Belen it became clear that art, in the form of collaborative creative play improvisational theater), painting of houses and murals, music, dance and art education enables community participation in other spheres, specifically health education and cooperative problem solving to address community problems. PAHO is evaluating this project as a potential model for working collaboratively in poor neighborhoods throughout Latin America . (see “Art, A Bridge to Health in Belen, Iquitos, Peru” at youtube). For more details of the 2008 Belen Project, see http://www.patchadams.org/en/clown_trips/peru_august_2008 .

August 4-18, 2009 Belen Project

The Fourth Annual Belen Project brought more than 90 volunteers from eleven countries to Iquitos.

We noticed a significant increase in the number of homes painted entirely by residents of Belen. The paint itself was made available through the inspiration and actions of Wendy Ramos, director of Bolaroja in engaging the Facebook cyber-community in a last minute donor campaign made necessary by the failure of promised corporate sponsorship. Due to the generosity of individual donors on Facebook, 300 gallons of paint were donated, and 131 homes have been painted in beautiful colors.

The mural team, in close collaboration with community members and La Restinga, painted a complex series of murals and re-established gardens in a public terraced stairwell connecting upper and lower Belen. During the process of reclaiming an ill-used and filthy public space, neighbors and families and clowns and La Restinga worked together to make this a friendly and beautiful place.

Workshops in art, dance, drumming, and puppet-making were much more effective this year due in large part to the availability of space in the Sachachorro elementary school, a much more pleasant space for teaching than in years past. Hundreds of workshop participants were able to engage their creative talents under the guidance of La Restinga, Bolaroja and Gesundheit! instructors. There was even a well-attended handwashing workshop. Clown volunteers played with the hundreds of children who were unable to attend the workshops. La Restinga also led large group playfairs in the festival field. Clowns visited hospitals, a prison, a hospice, a nursing home, a psychiatric facility, a family HIV shelter, orphanages, and public spaces throughout Belen and Iquitos.

Community outreach efforts in micro-credit, literacy, clean water helped us identify existing programs and resources to enable a more precise future aid and assistance. Ninety tons of garbage was collected and removed from lower Belen in one day, partnering community volunteers, the Municipality of Belen, PAHO, and the clowns. Sector 4 of Pueblo Libre won 1st prize for the cleanest sector.

Amazon Promise provided another free clinic in Belen, and treated over 200 patients. Belen Network organizations did HIV screenings and prevention education, provided free legal assistance to Belen residents, nutrition and sanitation education, and domestic violence prevention. Through fundraising from PAHO employees and private donors, Gesundheit! Institute (via La Restinga) purchased a house in Sector 6 of Pueblo Libre in Belen for development into a community center (address: Orellana 134, Caserío Sector 6, Pueblo Libre, Distrito de Belén, Iquitos). The Belen Project has expanded into a wider network, called “Red por Belen” ( the Belen Network) and, through the logistic support and guidance of the Pan American Health Organization, now includes the District City Hall of Belén, local and regional governments, the Regional Health Bureau (DIRESA), Pregnancy Education United Services of Peru (UGEL), The Wawa Wasi Program- Ministry of Women and Social Development (MIMDES), Municipal Defense of Child and Adolescents (DEMUNA), churches, and nongovernmental organizations such as La Restinga, La Canoa, Selva Amazónica, Doctors for Orphans, and Amazon Promise, as well as grassroots organizations such as community kitchens, Vaso de Leche (Glass of Milk), and the neighborhood civic associations of Pueblo Libre. These organizations will provide a variety of comprehensive services including health care, literacy and microcredit initiatives, nutrition, pregnancy and HIV education, family violence prevention, and much more.

Funding Goals and Sources

Up to the present, Gesundheit! Institute has provided most of the funding, through donations earmarked for the Belen Project, for house painting and mural projects, as well as transportation, food and lodging expenses for Gesundheit staff for the April 2006 and 2007fact finding trips, and the August missions. Bola Roja has also provided significant support for the project as well, in addition to organizing the missions, coordinating communications, and providing workers, clowns and joy. Airline Ambassadors donated school supplies and emergency medical supplies. Lan Peru donated in-country airflights to Iquitos for most of the August 2006 volunteers.

$4500 in paint supplies was sufficient to cover 90 homes in Pueblo Libre August 2006. Paint was donated by Vencidor, a Peru- based corporation, sufficient to paint 145 homes in 2007, and the 166 homes August 2008.

The greatest operational cost in our volunteer program is travel expenses, roughly $1000 per volunteer to fly from the US to Iquitos and back. Currently, volunteers pay for their own transportation, lodging and food. Volunteers currently stay in local hotels. We are exploring housing our volunteers in a group home, functioning like a hostel.

Expenses for August Missions

Travel: $35,000 (35 volunteers @ $1000 each)
Paint and supplies: $8000 for 145 homes)
Lodging: $10,500 ( 35 volunteers @ $25 each night for 12 nights)
Food: $4,200 (35 volunteers @ $10 each day for 12 days)
Water: $1050 ( 35 volunteers @ $2.50 each day for 12 days)
Transportation, local ($1260 for 35 volunteers @ $3.00 each day, to worksite
Workshop supplies (estimated $1200 for materials, refreshments, etc)
Estimated Gesundheit cost of an August Mission- $ 60,000
Per volunteer cost - $1500.

Community Center

Estimated purchase, renovation and legal costs: $35,000.

Scholarships for Indigent Children

$45 provides uniforms books, materials and tuition for one year, specifically targeting children working in the streets to help support families.

Belen Project Partners

Bolaroja Clown Doctors: bolaroja@terra.com.pe ;www.doctoresbolaroja.com
Gesundheit! Institute: patchadams.org ; jawkneemail@comcast.net
Pan American Health Organization: www.paho.org
Universidad Peruana Cayetano Heredia: www.upch.edu.pe
Airline Ambassadors: www.airlineamb.org
Selva Amazonica: www.selvaamazonica.org
La Restinga: larestinga.tripod.com
Amazon Promise: http://www.amazonpromise.org
Doctors for Orphans http://doctorsfororphans.org/home

How to Help

Be a volunteer! We bring volunteers to Belen for clowning, teaching workshops, healthcare, architecturaldesign, water/sanitation development projects, microeconomics, language education, literacy, permaculture education, and many other elements of community development. We can assist you in bringing a group to Belen to make your own 1-2 week mission. The smallest donation will help. Donations can be made for specific elements of the project. You can sponsor a child ($45 for school books, clothes and tuition per year).You or your organization can sponsor a volunteer for a 2 week mission ($1500), a house to be painted ($50) or a neighborhood to be painted ($8000). We can help you direct your donation to specific children, volunteers or volunteer projects. Your donation supports the effort to improve the lives of poor children in a troubled corner of the world. This is one way to build a world based on friendship, generosity and fun, one child at a time.

Donate online: special grassroots fund raising request

Send a check. Gesundheit! Institute is a 501-c3 not-for-profit organization, promoting health care reform and justice, centered in West Virginia, USA. Contributions are tax- deductible. Make checks out to “Gesundheit! Institute”. Please indicate “Belen Project” on donations for this project, and mail to:

Gesundheit! Institute Global Outreach Attn: Patch Adams 6855 Washington Blvd. Arlington, VA 22213 Telephone: 703-525-8169, fax:703-532-6132

For inquiries, email John Glick, MD at jawkneemail@comcast.net or call 540-421-6421.