Today, Peru and Ecuador are good neighbors. But that has not always been the case. For more than half a century, a smoldering border dispute between the two countries caused mutual distrust that erupted in armed conflict in 1941, 1981, and 1995. During that time, hundreds of people died, economic and diplomatic relations were disrupted, and the quality of life for those living along the border was severely jeopardized by political strife.

That deadlock has now been broken by a historic peace agreement. Presidents Alberto Fujimori of Peru and Dr. Jamil Mahuad of Ecuador, meeting in Brasilia on 26 October 1998, signed a comprehensive diplomatic agreement that heralds a new era of good will and socioeconomic progress for both Andean nations.

"The time has come for us to make peace, not war," President Mahuad noted. President Fujimori agreed, saying: "From now on we are the architects of our own destiny."

Seven Latin American presidents, the King and Queen of Spain, a special envoy of Pope John Paul II, and more than 500 representatives from governments and institutions throughout the Western Hemisphere and around the world witnessed the moment in a show of solidarity and support.

Five days later, Dr. George A.O. Alleyne, Director of the Pan American Health Organization (PAHO), was guest of honor at the first meeting of the two countries' health ministers following the peace agreement. Held in the Peruvian border town of Tumbes, the significance of this gathering was clear: health would become the first bridge for peace between the two nations.

During his stay, Dr. Alleyne, along with Drs. Marino Costa Bauer of Peru and Edgar Rodas Andrade of Ecuador, visited health centers in the border towns of Huaquillas, Aguas Verdes, and Tumbes. As part of a bilateral agreement called "Integrating Borders through Health," the two Ministers reaffirmed their commitment to promote important joint projects during 1999. Dr. Alleyne pledged PAHO's support for border health activities, emphasizing the need to prioritize health during the peace process as a bridge to sustainable socioeconomic development in the area.

First on the agenda of the two health ministries was the clean-up of the Zarumilla International Canal. This gateway between Peru and Ecuador bustles with heavy commercial activity concentrated along both sides of the canal: Aguas Verdes in Peru, with 8,000 inhabitants, and Huaquillas in Ecuador with 45,000. The bridge connecting the towns is traversed daily by a cross-section of society: the young and the old, the rich and the poor, wide-eyed tourists, and local merchants plying their trade. They come in cars, trucks, vans, and wooden carts. But most cross on foot.

Reuters photo Victory in Brasilia: Posing in front of the Alvorada Palace in Brazil's capital, leaders of the world raise hands after the historic signing of a peace settlement between Ecuador and Peru that ends a half-century-old border conflict. From left to right: Vatican representative Cardinal Dario Castrillon, King Juan Carlos of Spain, Argentine President Carlos Menem, Ecuadorian President Jamil Mahuad, Brazilian President Fernando Henrique Cardoso, Peruvian President Alberto Fujimori, Chilean President Eduardo Frei, Bolivian President Hugo Banzer, and former special representative to U.S. President Bill Clinton, Thomas McLarty.

What the health ministers saw was an area struggling to maintain appearances despite decades of neglect and political uncertainty. Basic water and sanitation services were sorely deficient in responding to the heavy demands being placed upon them. At some point, the residents, too, had stopped caring about a clean environment and had become negligent in their personal attitudes toward disease prevention. Refuse was piled high in and along the canal banks, perhaps in the vain hope that the coming rains would wash it out to sea. Bilge water from shrimp boats, combined with wastewater from the factories along the shore, formed foul-smelling stagnant pools that provided an incubator for the larvae of disease-carrying mosquitoes.

The sight was enough to convince the three doctors of the need for immediate action. On 10 November 1998, local government authorities came together with industry and business representatives, and staff from the two health ministries and PAHO's country offices in Ecuador and Peru. Together, they agreed to clean up the canal and its surroundings and made an inventory of personnel and equipment that each group could contribute. The community must work alongside us, they agreed. The commitment of everyone was essential to keep the canal from becoming a refuse dump again.

In early December, after laboring from dawn to dusk for 10 days straight, the project's organizers and local residents achieved what was once thought impossible. Thousands of tons of refuse were collected. Dump trucks made more than 400 trips, removing mud and waste. The ground was leveled. Stagnant waters were drained. The entire length of the canal boasted a new, cleaner look. The residents of Tumbes and Aguas Verdes smiled and patted each other on the back. The first joint border health project was a success. Other border initiatives are in the offing.

One example of the spontaneous and creative spirit of cooperation that guided the Zaramilla Canal clean-up is provided in the following anecdote: one longstanding problem in Aguas Verdes was its lack of a sanitary landfill. So the Ecuadorian environmental engineers readily volunteered to allow all the solid waste removed from both sides and inside the canal itself to be transferred to Huaquillas's municipal landfill. Thus, a solution that a few short months earlier would have required years of political wrangling now became short work for the project's organizers.

Today, the Zarumilla International Canal is proudly showing off its new face-lift. But will it stay clean? Anxious to preserve all the good will and hard work that went into the project, stakeholders are now securing private and public sponsorship in a medium-term project to maintain the canal's cleanliness. At the same time, PAHO, through its offices in Peru and Ecuador, along with PAHO's Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS), based in Lima, Peru, is providing technical support and working with the Ministries of Health and other public sectors in both countries to develop a long-term program to bring essential health services to the people of Huaquillas and Aguas Verdes and stimulate the creation of healthier habits in homes, schools, and the workplace.

Change is definitely in the air all along the canal zone. In addition to the many new projects starting up, other preexisting ones will be strengthened. This provision was included in the Peruvian-Ecuadorian Good Neighbor Agreement on Border Integration and Development that was signed by Ministers of Foreign Affairs Fernando de Trazegnies Granda of Peru and José Ayala Lasso of Ecuador on the same day as the presidential accord in Brasilia. In giving priority to strong bilateral cooperation between the two countries, this document stresses the need to work closely together in disease prevention and health promotion activities, as well as in vaccination and environmental sanitation campaigns. Since both Ecuador and Peru suffered widespread damages from El Niño in early 1998, the agreement also calls on the governments to share resources in the development of emergency preparedness and disaster relief strategies, utilizing the technical expertise of PAHO and other international agencies in this area.

The agreement also urges both countries to update and strengthen bilateral agreements on the protection of plant and animal life and emphasizes the need for studies and environmentally sustainable projects to improve the living conditions of indigenous communities.

As Ecuador and Peru begin a new chapter in their national histories, they already have begun promoting the joint activities endorsed by the Ministers of Health at their first meeting last October: the exchange of epidemiologic information for effective disease surveillance and control, in-service training for local health workers, control of AIDS and other sexually transmitted diseases, reduction of maternal mortality, mental health services for populations affected by El Niño, the prevention of water- and foodborne diseases, and health programs targeted toward mothers, young schoolchildren, and adolescents.

During this time of transition and great hope, PAHO has pledged continuing support to help the citizens of Huaquillas and Aguas Verdes build a healthy border area as a historic, bilateral bridge to sustainable peace and human development.

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Jennie Vásquez-Solís is a print and broadcast journalist who heads the Social Communication Program at PAHO's country office in Lima, Peru.