25 MSF workers are assisting people affected by the August 15 earthquake. MSF is delivering mental health services and medical care, distributing relief items, and providing clean water and sanitation. Teams are working in Pisco, in more remote affected areas to the east, and recently in Guadalupe, a suburb of Ica. "I was totally shocked by what I saw in the town of Guadalupe... In the town centre, 95% of the houses have been destroyed or severely damaged, and people are living in the streets in terribly unhygienic conditions... No aid has come to Guadalupe, even though it is on the Pan-American Highway," said MSF Emergency Coordinator Luis Encinas, who led the team that went to Guadalupe on August 25. The town of 12,000 inhabitants is located 100 km southeast of Pisco in the suburbs of Ica city.

Ica was badly affected but the situation there is slowly improving and hospitals have the capacity to respond to the main medical needs. However, the situation in Guadalupe is extremely precarious. Around 10,200 people have been affected by the 8.0-magnitude quake that hit the central coast of Peru on August 15. Guadalupe's only health centre has seen a 250% increase in the number of consultations. MSF doctors immediately offered medical care to patients in need, and donated drugs, medical equipment, and blankets.

"We met a woman who was squashed under a wall with her child in her arms when her house collapsed," said Dr. Loreto Barcelo, MSF's medical head. "The woman broke her foot and the little girl suffered multiple pelvis fractures. However, the child was only given a plaster cast and then discharged within 48 hours. The mother, who needed orthopaedic surgery, was probably not even treated because the health staff was overwhelmed." Today, while the rest of their family spends nights in the street fearing another earthquake, the woman and her daughter are helpless and bedridden in the only part of the house left standing.

The earthquake has also had terrible consequences for people's mental health. "After more than 10 days without receiving aid, sometimes living with up to 40 people in one tent, these people feel abandoned, and not recognized as victims of the earthquake," said Zohra Abaakouk, who is responsible for the MSF mental health program. "But they try to organise themselves as best they can, despite pains, sleeping troubles, fears or anxiety." To alleviate the suffering of these people and to prevent a worsening of their mental states, a team of MSF psychologists immediately started providing psychosocial support. They hold group sessions, called charlas, and offer individual consultations as needed.

Families are living in cold and unhygienic conditions in makeshifts shelters made of cardboard and bed sheets, in front of their destroyed houses. They have no latrines, no drinking water and no place to wash themselves. MSF will provide them with access to water, bathing facilities and latrines. In addition, distribution of blankets and other basic relief items will start this week.

Luis Encinas expressed his concern: "Almost two weeks after the earthquake in Peru, the situation of the victims is hardly mentioned in the international media and, on the ground, several aid organisations are starting to leave the area. However, the needs remain huge in the region and MSF teams continue to see populations in desperate need of assistance, and who have been forgotten. This situation is unacceptable. Action is urgently needed to prevent these people from living in such unacceptable conditions."