PATIENTS ASSOCIATIONS AND THE CONTROL OF LEISHMANIASIS IN PERU

American mucocutaneous leishmaniasis is an important health problem in Peru, particularly in the mountainous Cuzco Region, where 25% of all new cases reported in 1989 were located. Cases have increased consider ably since the beginning of the 1980s, when large-scale seasonal migra tion to endemic zones occurred, particularly the forest area of Madre de Dios, following the discovery of new gold deposits there, and the d eterioration in the economic situation in Peru. Following the lack of official response from the Peruvian government, hundreds of people suf fering from leishmaniasis in the Cuzco area formed self-help associati ons with the objective of obtaining the drugs needed to treat their di sease. The major achievement of this spontaneous movement, which was s upported by several public and private institutions, was to encourage sick people, particularly patients with mucosal lesions, to emerge fro m isolation. As a result, the prevalence and incidence of the disease have now considerably decreased in the region.