Water Insecurity in a Rapidly Growing City in Arequipa, Peru: Narratives, Conflicts, and Opportunities for Change

Household water insecurity (WI)—difficulty accessing sufficient and safe water for domestic use—is a critical public health crisis in Peru, where nearly half the population (48.2%) experienced WI in 2024, with women disproportionately affected (55.6% vs. 40.6% among men) due to their traditional responsibility for securing and managing household water. This gendered burden is expected to worsen with climate change-driven shifts in precipitation patterns and prolonged droughts. These dynamics are starkly evident in Majes, a rapidly growing urban and agricultural area in southern Peru's Arequipa region, where the population faces severe WI challenges following implementation of the Majes-Siguas Special Project (PEMS)—a large-scale irrigation initiative launched in 1982 that redirected water from high Andean zones to transform over 60,000 hectares of desert plateau into arable land. While this project attracted thousands of migrants and increased the district's population from 25,000 to over 120,000 in two decades, rapid growth has not been accompanied by proportional investments in infrastructure or effective water governance. Water distribution is markedly unequal: older neighborhoods have daily potable water access, central areas receive service only two hours weekly, and remote peri-urban zones—home to recent migrants and low-income families—depend on weekly government distribution points where residents must carry water home in containers. Sixteen high Andean communities within the same watershed have also been adversely affected by water diversion, with some regaining access through negotiations while others remain excluded and continue struggling for water justice. 

This project aims to conduct a rigorous qualitative investigation of household WI in Majes and three affected Andean communities within the same watershed, identifying structural drivers, gender-differentiated and health-related consequences, and generating community-informed policy recommendations. Using political ecology and social determinants of health frameworks, the study will characterize the structural determinants of WI from perspectives of urban residents, female heads of household, community leaders, local authorities, and health workers; map gender- and location-specific coping strategies; assess perceived impacts on physical and mental health, food insecurity, and livelihoods; and identify feasible solutions and implementation barriers. Through 26 in-depth interviews and eight focus group discussions—with at least two groups consisting solely of female heads of household at each site—combined with review of local regulations, water-management plans, and field observations, the project will examine how power dynamics and economic structures have shaped unequal water access and its cascading health effects. 

Expected outcomes include new evidence on coping strategies, structural determinants, and health impacts of WI disseminated through at least one high-impact scientific article and two bilingual policy briefs targeting municipal/regional authorities and community leaders; strengthened interdisciplinary partnership between the University of Michigan and Instituto de Investigación Nutricional with advanced qualitative training for two early-career Peruvian scientists; and preliminary data to develop a competitive large-scale grant proposal for rigorously evaluating WI effects on health outcomes and designing community-based interventions. The project seeks to contribute to health equity by documenting women's leadership in collective coping strategies, foregrounding their voices in defining problems and co-creating inclusive solutions, and informing equitable, climate-resilient water-governance policies that address the interconnected needs of both peri-urban and Andean communities sharing this critical watershed.