Children aged under five have made up most of the hundreds of victims of a severe snap of cold weather sweeping southern Peru.
So far this year at least 409 people have died of pneumonia and illnesses triggered by the cold weather.
Most of the dead have been children younger than five years old and people aged over 60. Poor countryside communities living at more than 3,000m above sea level are the worst hit and doctors say malnutrition, extreme poverty and poor living conditions are another reason so many are dying.
On Saturday Peru’s government called at state of emergency in 16 of the Latin American country’s regions.
Most of the areas affected are in the mountainous south, where temperatures regularly drop below zero centigrade at this time of year.
The emergency declaration, which lasts 60 days, covers districts in the regions of Ancash, Apurimac, Arequipa, Ayacucho, Cusco, Huancavelica, Huanuco, Junin, Lima, Moquegua, Pasco, Puno and Tacna, where temperatures have dropped to -24 C (-11 F) over the last couple of days.
Even jungle regions, Madre de Dios, Ucayali and Loreto are covered by the declaration.
The state of emergency means regional authorities can start using emergency funds to give out medicine, blankets and shelter to those most affected.
The Peruvian army has also been called on by Defence Minister Rafael Rey to help communities most vulnerable to the cold.
Its capital, Lima, last week recorded its lowest temperatures in 46 years at 8C, and the emergency measures apply to several of its outlying districts. In Peru's hot and humid Amazon region, temperatures dropped as low as 9C. The jungle region has recorded five cold spells this year, according to reports from the BBC
In the highlands of Puno region local public health services have officially logged 288 cases of pneumonia, mostly amongst children. Dr Freddy Pásara, regional chief of immunizations, told the website, 'Living in Peru', that 18 people have recently died from this illness, due to a lack of vaccines and medicines.
“We have vaccines against pneumococcus and seasonal influenza, and are vaccinating health workers against AH1N1 influenza.” said Dr Pásara, stressing that they do not have vaccines against other germs that may induce pneumonia too.
The Peruvian Red Cross has been monitoring the cold wave since it started and launched a month long campaign to help the communities in the Andes mountains. Weather experts predict the cold weather will carry on until September, and reach its coldest next month.