For miles around, the devastation from flooding that destroyed the homes and livelihoods of thousands of Peruvians earlier this year is still starkly visible. Dozens of villages remain submerged in water. Adobe buildings stand crumbling in shallow water and roads lead into the water or are washed away entirely. Meanwhile, the victims of the region's worst flood in this century wage a daily battle to survive and rebuild their communities. Most live in tents or corrugated metal modules built by Peruvian and international relief organizations.
Relief workers say the worst is yet to come as the below-freezing winter season is now reaching the desolate, windswept Alti Plano region which straddles Peru's border with Bolivia.
An estimated 350,000 people were left homeless in Peru when Lake Titicaca flooded its shores in January and February, extending the lake as much as 10 miles inland in some places. Geologists predict the water will stay at its new levels for at least five years.
Accustomed to an independent existence, the region's farmers and their families now find themselves unable to support themselves.
Conditions in the roadside settlement of Santiago Muchochambilla near the edge of the lake are typical. ``We don't know what will become of us,'' says Simon Camaticuna Cani.
Cows, pigs, sheep, llamas, and dogs live outside the temporary modules on ground made muddy by the daily flow of people and animals. Fed with llacho, an algae collected during day-long treks on totora-reed rafts on Lake Titicaca, the animals are increasingly being sold to provide the families with money to buy food.
Relief workers and refugees say food rations given out by the government are insufficient and distributed irregularly.
``We are trying to make miracles with what we have,'' says Fernando Babilonia, a government relief coordinator. Each family receives a few kilos of flour, oil, soya-soup concentrate, and sometimes canned fish, rice, and noodles.
``The biggest problem we have to fight right now is infant mortality,'' says Edmundo Valencia, director of the Peruvian Red Cross in the city of Puno.
The Red Cross operates eight emergency tents in refugee communities. Observers say there are not enough antibiotics on hand or doctors to administer them. More than $5 million has been donated for the relief effort in the form of medicine, food, clothing, and housing materials by countries including the United States.
But Jos'e Ahumada Vasquez, one of those in charge of a government commission established to find a long-term solution, says the difficulties for refugees are reaching a critical point now. Some 25,000 tons of food will be needed to maintain the flow of rations through December, he says. Foreign countries have pledged to contribute 7,500 tons of that.
On a windy and dusty plain in the barren hills above Puno, four communities of refugees live in tents that house up to three and four families each.
Andres Ticona G'omez, a spokesman for one of the settlements, says his people are anxious for land and work. ``We never asked the government for help before,'' Mr. Ticona says. ``We were always self-sufficient. . . . Now we need land.''
The 11-month-old government of President Alan Garc'ia P'erez has promised to implement a new land reform program in the Puno department, the Peruvian state directly affected by the flooding, with the aim of increasing agricultural production. It is not clear whether flood refugees will be given land.
While the need for land reform has taken on new urgency -- because of the thousands of landless and jobless flood victims -- the government will not actually decide on the reorganization until at least August, Mr. Ahumada says.