The secluded coastal village of Negritos is situated in the northwestern dry forest of Peru. Nearly
forty people, spread among eight interconnected families, call this place home.

Pablo Marchan (94) is the patriarch of an extensive family and a man with an active routine.
Every morning at six, he rises to read the Bible, feed the goats, water the farm, start the engine
that draws water from the well, and tend to the horses — all before the day has barely begun. He
is Melva’s husband and the father of their nine children.

Melva’s behavioral changes occurred gradually. First, she began preparing breakfast several
times a day, followed by an obsession with eating sugar. She snook away from home obsessively,
looking for sweets in any neighboring house. She began experiencing episodes of violence and
suicidal thoughts. She said she had grandchildren, despite claiming having no children of her
own. The family became aware that something was going wrong.

“Evil… they said it had been done to her,” recounts Pablo Marchan, raising his voice slightly,
“and they urged on me taking her to other well-known healers. So, I took her, and she came
back sicker”.

“The doctors who saw my Melva — here in Tumbes and in Piura — all kept saying the same
thing: that there was nothing wrong with her, that it was a normal part of aging. Another
doctor told me that what my wife had was nothing but pure grief over the loss of the livestock,”
says Pablo.

One of Melva’s sisters appears to show more severe symptoms. Teodosa seems dissociated from
everything, she doesn’t look at you, she doesn’t speak to you, she eats dirt, and at times it
becomes necessary to lock her in a room. The sister who cares for her must manage both her
care and the household. Her story suggests that she has a very advanced, undiagnosed case of
Alzheimer’s that began at the age of 50. Her sister wept and said she wished God would take
her. It was hard to hear, but it strengthened my sense of responsibility to do something
meaningful with this work — to do justice to people who receive so little care and support.

Aurora, the third sister and matriarch of a large family, has not been diagnosed either. Like her
sisters, she too shows signs of fading memory, losing her way with unsettling ease. Her family
have quietly taken up the task of caring for her in turns, not because anyone has told them to,
but because what they have seen in their aunts has made them watchful, and afraid.

According to the research, “Dementia in Latin America: Epidemiological Evidence and
Implications for Public Policy,” released by the online publication Front Aging Neuroscience,
“the prevalence of dementia patients in Peru reaches 7 out of every 100 people over the age of 65
(it is estimated that there are 200,000 cases throughout the country), with Alzheimer’s disease
being the main cause.” I found myself thinking about the risk factors for dementia in remote
communities: low literacy, poor water quality, chronic malnutrition, histories of violence,
depression and anxiety, and little to no access to health care due to poor roads and geographic
isolation