Diagnóstico De Salud Ambiental Humana En La Provincia De Espinar-Cusco

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Diagnóstico De Salud Ambiental Humana En La Provincia De Espinar-Cusco DIAGNÓSTICO DE SALUD AMBIENTAL HUMANA EN LA PROVINCIA DE ESPINAR-CUSCO Fernando Osores Plenge Mg, MD Perú - 2016 INDICE Resumen 1. Introducción 2. Objetivo 2.1 General 2.2 Específicos 3. Metodología 4. Marco teórico 4.1 El ser humano y los metales pesados 4.2 El ser humano y los metales pesados 4.3 Vulnerabilidad / susceptibilidad a metales tóxicos 4.4 Los cuatro metales tóxicos de mayor importancia para la OMS 4.5 Arsénico 4.6 Cadmio 4.7 Mercurio 4.8 Plomo 4.9 Observación sobre el talio y el manganeso 4.9.1 Talio 4.9.2 Manganeso 4.10 Aspectos toxicológicos 5. Situaciones de exposición a sustancias químicas según la OMS 6. La actividad minera y su impacto en la salud 7. Contexto del caso Espinar 7.1 Ubicación geográfica 7.3 Demográficos 7.3 Administración sanitaria, agua y desagüe y otros servicios básicos 7.4 Socio - económicos 7.5 Nutrición 7.6 Mortalidad 8. Evidencias de la contaminación/exposición a metales pesados 8.1 Proceso minero en Tintaya y exposición a metales pesados 9. Estudio de salud CENSOPAS 2010 9.1 Reseña 9.2 Resultados 9.2.1 Plomo 9.2.2 Arsénico 9.2.3 Mercurio 9.2.4 Cadmio 10. Estudio de salud CENSOPAS 2013 en el contexto del Monitoreo Sanitario Ambiental Participativo realizado en la Provincia de Espinar 2012-2013 10.1 Reseña 10.2 Resultados 11. Monitoreos de ANA, DIGESA, OEFA, INGEMMET Y SENASA 2012-2013 en el contexto del Monitoreo Sanitario Ambiental Participativo realizado en la Provincia de Espinar 2012-2013 12. Otros monitoreos ambientales 12.1 Estudio de Impacto Ambiental de la Planta de Óxidos MAGMA- TINTAYA 12.2 Estudio de Impacto Ambiental de la Planta de Óxidos – Addendum año 2000 12.3 Estudio de Impacto Ambiental de la presa de relaves “Proyecto Huinipampa” 12.4 Estudio de línea de base ambiental de la cuenca Cañipía 2004 12.5 Estudios de monitoreos Tintaya (1996-2011) y Antapaccay (2012- 2015) 12.6 Estudios OSINERGMIN 12.7 Estudios participativos junio y agosto del 2002, noviembre del 2005 y junio del 2010 12.8 Estudio proyecto Antapaccay – extensión Tintaya 12.9 Informe de Monitoreo Nº13-IM-067: Mejoramiento De La Calidad Medio Ambiental Del Distrito de Espinar- Municipalidad Provincial de Espinar-Cusco 12.10 Informe N° 008–2014–MPE-GGEA-MECAAM-RSC 12.11 Monitoreo Ambiental Participativo en la Provincia de Espinar- Elaboración de una línea de base en el ámbito del Proyecto Xstrata Tintaya 13. Otros Eventos relevante 13.1 Se crea Mesa de Diálogo de Espinar ante protestas de población 13.2 Estudio IPEN 2013 13.3 Estudio IPEN 2015 14. Acciones de salud planteadas por el Estado 14.1 Acciones y planes de salud DIRESA Cusco 14.1.1 Plan 2013-2014 DIRESA CUSCO/ R.D. N° 1456-2013- DRCS-DGDP 14.1.2 Plan 2015-2017 DIRESA CUSCO/ R.D. N° 531-2015- DRCS-DGDPH 14.2 Documento Técnico: Plan de acción de salud para la provincia de Espinar – Cusco 15. Espinar en el contexto de la experiencia minera global 16. Análisis integrado 17. Discusión 18. Conclusiones 19. Propuestas de lineamientos de políticas de salud pública y ambiental 20. Referencias bibliográficas DIAGNÓSTICO DE SALUD AMBIENTAL HUMANA EN LA PROVINCIA DE ESPINAR-CUSCO RESUMEN La población del distrito de Espinar convive con la minería moderna aproximadamente hace 40 años. Esta situación, ha tenido y tiene un impacto contaminante no medido adecuadamente, con repercusiones en la calidad ambiental y en los riesgos a la salud de los habitantes espinarenses. impacto en la calidad ambiental y en la salud de los habitantes. Si bien el Estado discute el origen de la contaminación, lo que es cierto es que existen estudios en los que se demuestra la gravedad de la contaminación y la presencia de metales pesados en las personas. Pese a las protestas sociales en Espinar, como la ocurrida en el 2012, la respuesta del Estado ha sido mínima. Hasta la fecha no ha asumido su responsabilidad en la protección de la salud de las personas. Considerando que la contaminación es un problema público de salud ambiental de Espinar, el que se repite en otras zonas mineras, en donde el comportamiento del Estado es el mismo, y ante la ausencia de una política pública que permita enfrentarlo, organismos de la sociedad civil que trabajan en Espinar nos propusimos alcanzar al debate propuestas de lineamientos para hacer frente, de manera más eficaz, a la problemática de salud ambiental por contaminación de metales pesados. Para ello, un primer paso ha sido evidenciar la afectación del derecho a la salud en la población de Espinar ocasionada por contaminación con metales pesados y mostrar los indicios sobre las fuentes de exposición, utilizando una metodología de revisión sistemática de información de fuentes primarias y secundarias. A partir de dicha sistematización, se han generado y rescatado evidencias, a su vez se a considerando la política comparada, y finalmente la formulación de propuestas de lineamientos de política. 1. INTRODUCCIÓN La población de la provincia de Espinar, Cusco, Perú, con una población de 69 a 70,000 personas, convive con la minería moderna contemporánea desde aproximadamente hace 40 años. Esta situación, ha tenido y tiene un impacto contaminante no medido adecuadamente, con repercusiones en la calidad ambiental y en los riesgos a la vida y la salud de los habitantes espinarenses. El Gobierno peruano aún sigue discutiendo sobre el origen de la contaminación por metales pesados en Espinar, si esta se debe por la liberación de metales al ambiente por la actividad antropogénica y/o por la mineralización natural de la zona. Sin considerar que la población de Espinar tiene metales pesados tóxicos, que ponen en grave riesgo su salud por exposición crónica, como se ha reportado en estudios oficiales del gobierno. A pesar de lo mencionado, hasta la fecha el gobierno no ha implementado las medidas idóneas en políticas de salud ambiental en Espinar para corregir esta seria problemática. Uno de los mencionados estudios oficiales se realizó en el 2010, en donde se estudio la exposición puntual a cuatro metales altamente tóxicos en la población de los distritos de Espinar y de Héctor Tejada. Dicho estudio develo que todas las personas muestreadas tenían niveles detectables de estos cuatro venenos en sus cuerpos: arsénico, mercurio, plomo y cadmio. Sin embargo, los resultados de este estudio solo fueron hechos públicos y entregados a la población entre fines del 2012 y segundo trimestre del 2013. Esta situación de incertidumbre, por ocultamiento a la población de resultados médicos de importancia para la vida, fue uno de los factores que desencadeno la indignación cuando la población de Espinar tomo conocimiento de la falta de información y transparencia, lo que finalmente derivo en una legitima protesta social en mayo del 2012. Esta protesta social en el distrito de Espinar, tuvo un saldo de tres muertos y decenas de heridos, y origino por parte del gobierno la necesidad de convocar mediante Resolución Ministerial N° 164-2012-PCM, a una “Mesa de Diálogo para solucionar la problemática socio-ambiental existente en la provincia de Espinar". En este contexto, el gobierno realizo un segundo estudio de exposición puntual en el distrito de Espinar en enero 2013, parecido al estudio del 2010. En este segundo estudio se excluyó a la mayoría de comunidades previamente evaluadas durante el 2010, que debían ser monitoreadas y servir de comparadores. Solo se evaluó a dos comunidades: Huisa y Alto Huancané, a las que se les hizo creer que solo se le realizaba el dosaje de 06 metales cuando en realidad se analizaban 16 metales, la mayoría de estos metales con evidencia científica casi inexistente en relación al impacto en la salud humana por exposición crónica. Lo mencionado, no solo aumentó la incertidumbre en las comunidades, sino que las sometió a un estrés injustificable, al no obtener respuesta del verdadero significado para su salud de los 17 metales analizados. Cabe indicar, que el Ministerio de Salud (MINSA) solo tiene guías clínicas estandarizadas para 4 de los 17 metales que fueron analizados en las Comunidades de Huisa y Alto Huancané. A pesar de las protestas sociales en Espinar, como la ocurrida en el 2012, la respuesta del gobierno ha sido mínima. Hasta la fecha, el gobierno no ha asumido su responsabilidad en la protección de la salud de las personas. Es importante mencionar que la contaminación en Espinar es un problema de salud pública y ambiental que se repite en otras zonas mineras del Perú. Siendo el comportamiento del gobierno en estos casos, similar a lo que viene ocurriendo en Espinar. La ausencia de aplicación de políticas de salud públicas y ambientales para enfrentar esta problemática, ha sido el motivo por el cual los organismos de la sociedad civil que trabajan en Espinar, se han propuesto alcanzar al debate propuestas de lineamientos para hacer frente, de manera más eficaz, a la problemática de salud ambiental por contaminación de metales pesados. Para ello, un primer paso ha sido evidenciar la afectación del derecho a la salud en la población de Espinar ocasionada por contaminación con metales pesados y mostrar los indicios sobre las fuentes de exposición, utilizando una metodología de revisión sistemática de información de fuentes primarias y secundarias. A partir de dicha sistematización, se han generado y rescatado evidencias, a su vez se han considerado experiencias internacionales, y finalmente la formulación de propuestas de lineamientos de política. 2. OBJETIVO 2.1 GENERAL: Formular propuestas de lineamientos de política y estrategia para hacer frente de manera eficaz a la problemática de la salud por contaminación de metales pesados. 2.2 ESPECIFICOS: Evidenciar el riesgo de afectación a la salud de la población de Espinar ocasionada por la contaminación de metales pesados y determinar algunos indicios sobre fuentes de exposición.
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