Image of two Quechua standing on the horizon of a large, dry fieldIan Horne recently visited the Puno region of Peru, to ascertain how widespread the issue of anaemia is there, and to begin to find ways of combatting it.

‘I travelled to Ayaviri, partly to encourage churches there and to give training on healthy nutrition with womens’ groups,’ says Ian. ‘However, I also wanted to investigate the high – and increasing – rates of anaemia in these regions.’

Anaemia can lead to irreversible effects on brain and cognitive development in toddlers. Puno has the highest rate of anaemia in Peru: 70 per cent of children under the age of three years are anaemic. Why, when Puno is the biggest producer of quinoa in Peru and one of the major cattle-producing regions (both meat and quinoa are rich sources of iron)?

Map of Peru with Puno region markedIan, who has a degree in nutrition, was helped in his research by Eron Quispe, a farmer and influential Christian leader in the Church in Puno, who took Ian on a number of field trips to better understand the situation. Ian also interviewed key people, such as a nutritionist from the NGO sector who lives in Ayaviri, and a lecturer from the state university.

‘The causes of anaemia are complex,’ says Ian. ‘However, what I saw and heard confirmed the presence of two endemic factors: poor hygiene and limited agricultural possibilities.’ Coupled with these are big changes – in the climate and in eating habits.

Poor hygiene

‘My observations confirmed the statistics that many households in Puno do not have sanitation or access to potable water,’ comments Ian. ‘Poor hygiene promotes diarrhoea, infectious diseases and the presence of gut parasites, all of which can deplete iron in the body.

Image of Ian Horne with Quechua friends in Puno‘Also, farms are generally small (less than three hectares). This size, together with the harsh climate of the puna (terrain over 3,500 metres), means that farmers are limited in the crops they can grow. So it’s a struggle to provide sufficient food and income for the family, based solely on agriculture.’

The Peruvian government is trying to deal with the anaemia problem by distributing a vitamin and mineral powder, rich in iron, for mothers to sprinkle on the food of their young children. But in Ayaviri Ian uncovered many problems with this programme, including poor administration and coverage, plus mistrust from Quechua mothers, many of whom quickly give up using the product.

Changing patterns

The highlands of Peru are one of the areas of the world most affected by climate change.

‘Agriculture is becoming more precarious as the climate becomes more unpredictable and water sources dry up,’ says Ian. ‘This means that people find it hard to meet all their food needs.’

Image of members of a Quechua church sitting in the buildingBut changing agricultural practices are having an impact too. On several trips, Eron showed Ian how the best land in Ayaviri is dedicated exclusively to the production of alfalfa and oats for feeding cattle. Also, farmers are now focusing on cattle-raising and quinoa production for export. Small animals (guinea pigs, chickens, etc) and local crops (kiwicha, tarwi) are no longer being farmed. The nutritious iron-rich foods are being sold to generate income and are no longer eaten at home.

And then there’s dietary changes. Rural Quechua families are eating more processed foods and abandoning traditional and highly nutritious subsistence crops such as tarwi, cañihua and mashua. Ian notes: ‘Visiting the local market, we saw how families are tending to buy lots of cheap energy-rich foods like rice, oil, and pasta, and other ultra-processed foods like fizzy drinks, factory-made cakes, and biscuits. Their diet is becoming less diverse and nutrient-rich.’


As a result of his visit, Ian has come up with several immediate ways of trying to help, born out of his core calling of helping needy people to be spiritually and physically nourished, and enjoy greater fulness of life.

Image of two Quechua children holding a lamb in Puno, Peru‘I am developing a programme with the womens’ groups in Quechua churches. This will provide in-depth training on preventing anaemia and on nutrition for health, as well as materials to help strengthen their devotional life.’

Ian serves on the board of ATEK, an organisation that has promotion of the Quechua scriptures at the centre of its holistic outreach. ATEK has recently extended its work into the Puno region. ‘There’s a big opportunity,’ comments Ian. ‘We’re planning to develop training materials in Quechua on anaemia prevention and other key nutritional issues to use in the churches. We’ll start with the church, but look to the church in turn to reach out to the community, sharing their nutrition expertise as part of their service in the community.’

Then there is reaching a wider audience. ‘We plan to produce audio recordings in Quechua on these issues to broadcast on radio stations throughout the region that will also include Christian testimony. As most people can’t read Quechua, this is the way to reach many more people.’

And beyond that, ‘I intend to write on the issue, hoping to have a wider influence.’



Anaemia is a condition where the level of haemoglobin (a key component of red blood cells that transports oxygen around the body) has fallen below a critical level because of lack of iron and other causes.

When a child suffers from anaemia during the first two years of life, the brain doesn’t develop properly and the child is left with permanent cognitive and motor impairment. In Peru, anaemia is a ‘silent enemy’ that is limiting the development and potential of many children.

Anaemia in pregnant women is also a big concern because it can make them more susceptible to complications in pregnancy, and their babies are more likely to be low-weight and start life with anaemia themselves.


Please pray

  • Pray for wisdom for Ian to know how best to support the churches in tackling the anaemia problem, and that God can use this as a witness to the local communities.
  • Pray that many Quechua will grasp the need to change their dietary and agricultural habits, and seek ways of living that will help to eradicate ana