(Lima) -- Hundreds of impoverished Peruvian women and children are dying unnecessarily every year, due to discriminatory reproductive, maternal and infant health care, Amnesty International (AI) revealed in a new report published today.

"Effective maternity and infant health care in Peru seems to be a privilege of the rich. Impoverished women who are at grater risk of health problems during pregnancy and birth and marginalized children who face higher risks of illnesses during the first years of life are the ones who receive the least protection," said Guadalupe Marengo, Amnesty International's Americas Deputy Director.

According to official statistics, during 2000 alone, 71 of every 1,000 babies died at birth in Huancavelica, one of Peru's poorest provinces -- almost five times more than in the country's richest city, Lima, where 17 of every 1,000 babies died that year.

Although Peru established the Seguro Integral de Salud (SIS) in 2002 to provide free health care for all citizens, Amnesty International's report also reveals that due to hidden fees associated with health care, such as travel and prescription drug costs, many Peruvians are barred from these theoretically universal services. Exacerbating this situation, cultural and bureaucratic barriers, which are particularly salient in rural, indigenous communities, also combine to prevent citizens from accessing the care provided by the SIS.

"The cultural insensitivity demonstrated by many medical professionals in Peru discourages indigenous women from going to hospitals. To avoid discrimination, these women often opt to give birth in their homes, dramatically increasing childbirth risks and contributing to an alarming number of deaths," said Larry Cox, Executive Director of Amnesty International USA.

The World Health Organization estimated that 410 out of every 100,000 women died in labor in Peru in 2004. This figure is surpassed only by Haiti, Guatemala and Bolivia -- the three poorest countries in the Americas.

In addition, the AI report demonstrates that because of bureaucratic fees and red tape, many of the children born in homes rather than hospitals are denied birth certificates, constituting a violation of the international human right to identity. More importantly, because birth certificates are required to receive Peru's free health services, thousands of impoverished children are precluded from receiving the care they need in the future, perpetuating the unequal access to healthcare.

Published to coincide with the National Health Conference, at which Amnesty International will present its report findings, the report highlights insensitivity toward the childbirth and health care traditions of indigenous populations as merely one example of the larger problem of the widespread cultural and socio-economic discrimination suffered by even the few who are able to access health services.

"If you go [to the health center] badly dressed they make you wait longer, and the ones who arrive later but better dressed go first ... if you complain, they treat you worse," said a woman from the town of Iquitos, Amazon region.

Similarly, Fidencio, a farmer from Huanuco, in central-east Peru, was charged a $30 fine at his local health center for allowing his son to be born at home rather than in a hospital. Fidencio would have to sell around 1,000 kilos of potatoes to raise the money. Failing to pay the fine, he was denied his son's birth certificate. The boy now has no official identity and is therefore barred from the host of services to which Peruvian citizens are entitled.

In its final report, Peru's Truth and Reconciliation Commission, set up to investigate the country's human rights violations, cited discrimination and the absence of economic, social and cultural rights for the poor -- particularly women and indigenous peoples -- as one of the main causes of Peru's 20-year internal armed conflict.

"Discrimination against marginalized women and children is a long-standing problem in Peru. The new government has the chance to change the situation by setting the country's priorities right: they must guarantee human rights for all without discrimination," said Marengo.

Amnesty International called on the new Peruvian authorities to:

• Ensure non-discrimination and distribution of information regarding the free maternity and infant health services available to marginalized people;
• Guarantee that impoverished women in rural areas are not fined for giving birth at home;
• Ensure that all children have access to birth certificates; and to
• Guarantee adequate labor conditions and human rights training for health professionals.

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See a full version of the report Peru: Poor and excluded women -- denial of maternal and infant health (report is in Spanish). To get a copy please contact Rachel Horowitz at 212/633-4258.

Contact: Wende Gozan, 212/633-4247, or Rachel Horowitz, 212/633-4158

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