Inca trail porters: The health of local tourism employees as a challenge for travel medicine

Abstract

Background: Trekking is an activity that forms part of the increasing adventure and outdoor tourism. High altitude trekking in the Himalayas or Andes has been popular for some time. For longer treks, porters are employed to carry necessary equipment. Porters' working conditions are unfortunate and subsequent health problems considerable. Although Himalayan porters have received some attention in the press and research literature, porters on the popular Inca Trail in Peru have been neglected. In light of the growing awareness of health problems of local tourism employees, the purpose of this study was to describe Inca Trail porters' working conditions and their reports on their related health status to provide baseline information for further research and strategies for improvement. Method: For this descriptive study, 101 Inca Trail porters were interviewed (August/September 2001) using a structured interview schedule. Results: Porters were between 17 and 68 years old; estimated body weight ranged from 50 kg to 76 kg. The usual portering job lasts for 4 days with 9 to 10 hours of carrying per day. Estimated weight of loads ranged from 20 kg to 45 kg. Major concerns were lack of fuel, clothes, shelter, and equipment but foremost the lack of sufficient food provisions. A third described their general health as poor or very poor and attributed this to work. Health complaints included respiratory infections, kidney problems, or rheumatism. Thirty-eight porters recalled injuries while on the trail and over 90% had fallen ill on the job with cold, "majurki," and stomach pain due to lack of food or cold food being named most often. Porters' demands for improvement included increased pay and appropriate and sufficient food. Conclusions: The porters' working conditions and subsequent health problems need to be addressed. A range of stake-holders is responsible for the porters' conditions and are in a position to improve current situations. Specific responsibility for health care lies with travel health professionals and local health authorities since the health of host communities has been acknowledged as an important area within travel medicine.