Peru : CARE OPG water health services project

should be willing to authorize projects aimed solely at improving the accessibility, quantity, and quality of water to the exclusion of other health interventions. This and other lessons found in this report were learned in an AID-funded CARE project to provide piped water, vaccinations, health education, and sewers in Peru's Ancash Department. For a $20 fee and less than 15 cents per month, 2,600 households in the smallest villages received piped water from 29 gravity-fed water systems which supplied 60 liters of potable water per day. The impact was pronounced. Not only did use of piped water for drinking, cooking, and bathing increase, women were relieved of the burden of spending 3 hours each day collecting water and so had more time for productive activities such as weaving. Unexpectedly, women also made inroads into the male-dominated social structure by participating in the village juntas which conducted many project activities. Because the project produced lasting tangible benefits, villagers' predisposition to community action was stimulated. On the other hand, the vaccination program was cancelled; there was no indication that health education improved health, and, because of higher installation costs and fewer perceived benefits, only five sewer systems were built. The project also showed that: (1) development projects often upset the status quo and cause conflict among implementers; (2) private voluntary organizations can be a valuable resource in specialized projects; (3) when a project's purpose is to provide drinking water, perfunctory evaluations attempting to attribute health impacts to the project should not be conducted; (4) since imported materials often become a limiting factor, use of local construction materials, even when more expensive, should be encouraged to enhance a project's sustainability and to support local industry; and (5) where voluntary participation in community projects is traditional, food for work can be counterproductive. The evaluation methodology and persons contacted; the project budget, design, and chronology; water system diagrams and statistics; and recommendations for the Government of Peru are appended.