The Hispano-American Health Link Foundation (EHAS) is a largely European-funded research organization that has worked since 2004 to provide voice and data access as well as infrastructure to isolated areas of Latin America. The organization’s focus is on providing sustainable low-cost Internet and networking technology solutions to improve quality of life and life expectancy in rural communities. With a focus on healthcare, EHAS aims to connect underserved populations in developing countries with the medical resources of urban hospitals and treatment centers via telemedicine through their project TUCAN3G.
Peru is highly centralized country where around 9 million Peruvians out of a total population of 31.1 million live in the capital city of Lima. Peru is building a 13,000-kilometer-long backbone fiber network across the country, which will connect 180 provinces over 22 states. There are three major challenges for telecom operators in this area, namely high costs due to rough and undeveloped terrain, predominately low-income households, and large geographic regions with very low customer density. The mobile broadband penetration rate is also very low; about a quarter of the population has no mobile phone at all, whereas the urban population often has access to a multiple phone. As of 2010, a second-generation (2G) mobile network covers 95 percent of Peru while a third-generation (3G) mobile network covers 65 percent, with the major areas uncovered being from the Peruvian Amazon and other low-density inhabitants. It is likely that costs and low device penetration rate are holding back higher penetration rates as well. The majority of the connections are in the city of Lima and other coastal cities/towns. Only satellite covers the mountainous and jungle regions of Peru. In fact, compared to 30 percent of urban households who have Internet access, only 1 percent of rural households have access.
The government has taken some initiatives to help connect more people to the Internet through initiatives like auctioning for the Amazon Integration Project, where the license to provide broadband coverage to 70 rural communities in the northern Amazonian region of Peru was being granted. Also, an initiative called NapoNet, which is a collaborative effort between partners in Colorado and the Peruvian state of Loreto to bring services for health, education, and commerce to indigenous communities along the middle and upper Napo Rivers of the Maynas Province of the Loreto Region of (Amazon) Peru.
|31,161,167||Fixed broadband subscriptions (%)
|Population density (people per sq.km)
|24.25||Mobile cellular subscriptions (%)
|Median household income
|N/A||Individuals using the Internet (%)
|Education (Mean years of schooling) (UNDP, 2013)||Male: 9.6
|Individuals using the Internet by Gender (%) (ITU, 2016)||Male: 48.3
In its early pilot projects, EHAS deployed access for public health establishments with mixed backhauling in unlicensed bands using Wi-Fi for Long Distances (WiLD) technologies. This was meant to provide affordable communications services for isolated health posts to connect to urban medical centers.
In recent years, TUCAN3G, one of EHAS’s initiatives in the Napo River basin in the Peruvian Amazon, has begun partnering with telecom companies to enhance the sustainability of its networks. The objective was to deploy 3G access points connected to the existing WiLD network in order to provide affordable communications services for widespread community use. The Napo network is significant in that it is experimenting with shifting EHAS’s emphasis from providing telecom access to regional government outposts to connecting entire communities.
The link between sustainability and community is key: by facilitating relationships between large mobile service providers and smaller regional ones, the project is hoping to incentivize the continued participation of telecom corporations that have ignored these sparsely populated, low-income areas. By growing the user base, TUCAN3G aims to make the rural network a worthwhile interest for urban-centric corporate profitability and thus maintain connectivity in these underserved communities.
TUCAN3G started expanding to all the communities of the Napo river in 2016 with support from the Development Bank of Latin America. This new phase is known as the Napo project.
|Technology||3G voice & data
Femtocells (low-cost, low-power, self-organizing mobile stations)
|Training provided||No training provided|
|Year of program
|2013||Cost to users||$15 for the least expensive phone
18 soles per month for the least expensive plan
1 plan/1 device is usually shared between several users
|Geography||Jungle; extremely challenging terrain||Total cost of program||Towers in jungle areas cost up to $20,000
Femtocells cost $1,000 on average
|User profile||2,000 users across 15 communities||Associated organizations||Development Bank of Latin America
Polytechnic University of Catalonia (UPC)
Pontifical Catholic University of Peru (PUCP)
Rey Juan Carlos University (URJC)
Telecommunications Investment Fund (FITEL)
Telefónica del Perú (TdP)
Telefónica International Wholesale Services (TIWS)
Public health – The overarching philosophy behind the TUCAN3G project is that greater access to telecommunications technologies will greatly improve the healthcare of rural Latin Americans. The project has not been deployed long enough in the Napo River region to have yet yielded definitive data, but similar projects elsewhere have shown positive effects of telemedicine in rural communities.
Family and cultural cohesiveness – The Napo network’s emphasis on individual users has yielded positive results in long-distance family relationships. Users can, for the first time, communicate with family members who have left the village to live and work in cities in Peru or abroad. Villagers who would have not been able to connect with loved ones and because of geographic and economic limitations now have the opportunity to do so.
Economic utility – Mobile coverage has also been shown to boost the villagers’ economic resources, with some users connecting with vendors in larger towns or cities to sell their crops or other goods.
Profitability – The greatest challenge in providing 3G mobile coverage to rural communities is that the profitability is so insignificant to major providers that they have little interest in investing in or maintain the network. TUCAN3G is attempting to overcome this obstacle by partnering with smaller regional backhaul providers to connect these communities to the larger core network.
Maintenance – The isolation of the communities in question means that access to regular maintenance is somewhat limited. Researchers and professionals deploying the technology more often than not rely on local inhabitants to survey and maintain basic infrastructural elements.
Geography – The geography of the particular area being served dramatically affects infrastructure costs. A tower in low-lying areas (like a jungle river basin) can cost up to $17,000 more to build to a sufficient height than one in a mountainous area.
Community involvement – The project demonstrated that, given the tools for communication and outreach, a previously unconnected and isolated community can make quick and effective use of them. Other such projects may benefit from informing the communities about the possibilities brought by communication and connectivity. From there, it is quite easy for the new users to take advantage of these possibilities and adapt them to their own needs.
Medical personnel – Experience has shown that telecommunications infrastructure is of greater priority than other kinds (transportation, etc.) to potential visiting medical personnel. In Peru, final-year medical students choose a yearlong regional assignment to complete their studies and have been shown to prefer, for example, isolated jungle communities with mobile coverage to Andean regions with developed roads but no mobile or Internet access. Thus, mobile network coverage may help attract in-person medical care as well as provide opportunities for telemedicine.
Health outcomes – Although data is still forthcoming for the Napo network, a similar project in Guatemala may provide insight about the potential impacts, where the telemedicine approach was shown to have had a significant impact on community health and on maternal mortality in particular.
Project website: http://www.ict-tucan3g.eu/
Martonez-Fernandez, A., Vidal, J., Simo-Reigadas, Javier, Prieto-Egido, I., Augustin, A.,
Paco, J., & Rendon, A. (2016). “The TUCAN3G Project: Wireless technologies for isolated rural communities in developing countries based on 3G small cell deployments.” IEEE Communications Magazine.