Decreased Productivity

Economic and social costs of Chagas’ disease are huge for Bolivians and other peoples of Latin America. Chagas’ disease helps creates a downward spiral of productivity; it is a debilitating disease at all stages. At its early stages parasites sap vital nutrients and dispel toxic waste products; at its later stages diseased organs totally disable workers. Most notably, peasants suffer fatigue, especially those working at higher altitudes, where they often must stop farming their plots or leave the work to relatives and children. The inability to work results in decreased crops, which causes malnourishment that leads to increased susceptibility to Chagas’ disease.

Even more costly, many adult victims die during their most productive years. Children are left without mentors and families without breadwinners. Remaining members of the community then must assume responsibility for the survivors. For this reason, Chagas’ disease is a major obstacle to development in Latin America. The World Bank considers it the fourth most serious health problem in Latin America (after respiratory and diarrheal illnesses and HIV infection), as measured by years of life lost adjusted for disability (see Figure 31). From a cost‑benefit analysis, it is cheaper to build a house for every Bolivian family than to cover the cost of Chagas’ disease to the economy from loss of production (not including the loss of animals).

^{Figure 31. Disease burden in Latin America in disability‑adjusted life years (DALYs), from five tropical diseases. (From World Development Report 1993: Investing in Health. World Bank.)}

Agrarian productivity also has declined in the Altiplano because of environmental and economic factors. Vast deforestation of the Altiplano caused widespread loss of other vegetation and water shortages. Insect populations shifted from wooded areas to houses. Highland peasants moved to lower, more disease‑infested regions of the Alto‑Beni and Santa Cruz. Bolivian peasants are having problems competing against large‑scale commercial farmers. Rural Bolivia lacks electricity, secondary‑education facilities, and adequate health care. These factors also have discouraged children from taking over the family farm. As a result, rural‑to‑urban ratios have plummeted from 74‑26 percent in 1950 to 42‑58 percent in 1992.

Life in urban areas is not much better for Aymara, Quechua, and Guarani Indians who go from being independent agriculturalists to becoming dependent and low‑paid jornaleros (hired workers). Many are not even that lucky–unemployment in Bolivia is at 20 percent and rising. Bolivia is a poor and unhealthy country.

Transported pathogens have a distinct advantage with the migration of people in generally being able to colonize and reproduce in new territories. Seasonal migration can lead to a biotic exchange of pathogens between regions, exposing populations to diseases from many regions. In other words, Chagas’ disease, AIDS, tuberculosis, and malaria accompany these movements and spread back and forth from home territories to colonized or work areas. Globalization brings colonization not only of humans but of insects, parasites, and viruses. Chagas’ disease in Bolivia provides a microcosmic illustration of what is happening on a global scale.