Belén District is one of thirteen districts of the Maynas Province. Belen (Spanish for “Bethlehem”) exists at the edge of Iquitos, in the floodplain of the Itaya River (a tributary of the Amazon), and consists of 65,000 inhabitants, most of them poor, and many of whom live in extreme poverty, without electricity, none with clean water or sanitation. There also exists an estimated 60,000 people living across the river in outlying areas, also with no electricity, water and sanitation. Most homes will float or are built on stilts, as the river floods some 5-6 meters during February through July. Belen, a unique world community, has been referred to, in travel books, as the “Venice of Latin America”. In Pueblo Libre, a section of Belen on the waterfront, an estimated 14000 people, 30% under age 12, live in a busy river port, where charcoal, bananas, fish, and other goods are brought, mostly by canoe, to be distributed and sold throughout Belen. People there live in overcrowded conditions (90% of homes house 2 or more families; some homes as many as 5) and, in addition to malaria, dengue fever, water-borne illnesses, respiratory illnesses, tuberculosis, and HIV, there are problems associated with severe poverty; alcoholism, crime, prostitution, unemployment, child abuse and domestic violence. Years of deteriorating conditions in Belen have resulted in widespread frustration and hopelessness among Belen residents.