Peru operates a unified national emergency number 105 for police assistance in most urban areas, though the system remains fragmented outside major cities. The fire service answers to 116, and ambulance services to 117, but response times vary dramatically by location. In Lima, average ambulance response exceeds 20 minutes in central districts and extends beyond one hour in peripheral neighborhoods. The Instituto Nacional de Defensa Civil operates a disaster response line at 115 that handles earthquakes, floods, and other natural emergencies. Tourist police operate a dedicated 24-hour line at 0-800-2-2221 specifically for foreign visitors, staffed with English and other language speakers. This service began in 1986 and maintains offices in Lima, Cusco, Arequipa, Puno, and Iquitos.
Emergency medical infrastructure concentrates heavily in Lima, which contains approximately 60 percent of Peru's intensive care beds despite housing only 30 percent of the population. The capital holds 89 public hospitals and more than 300 private clinics, with facilities like Clínica Anglo Americana and Clínica Ricardo Palma meeting international accreditation standards. Cusco maintains three hospitals capable of treating altitude sickness and trauma, including Hospital Regional and Clínica Pardo, but lacks advanced cardiac surgery capability. Arequipa's Hospital Goyeneche serves the southern region with 400 beds and serves as the referral center for everything south of Lima. Iquitos, isolated in the Amazon with no road connection to the rest of Peru, operates Hospital Regional de Loreto with 250 beds but limited surgical capacity. Medical evacuation by air becomes necessary for serious conditions in smaller cities and rural zones.
The Peruvian National Police, known as Policía Nacional del Perú, employs approximately 120,000 officers nationwide under the Ministry of Interior. Tourist police units, Policía de Turismo, staff stations in major destinations and airports with officers trained in visitor assistance and multilingual communication. These units focus on theft prevention, tourist scams, and providing directions rather than general law enforcement. Lima maintains its tourist police headquarters at Jirón Zela 823 in Lince district, operating continuously. Cusco's tourist police occupy a building on Avenida El Sol near the Plaza de Armas. Response effectiveness varies significantly, with Lima and Cusco units generally professional and English-capable, while rural police often lack resources and language skills. Officers cannot legally demand identification on the street without probable cause, though they frequently request it during traffic stops or disturbances.
Yellow fever vaccination becomes legally required for entry into most Amazonian departments, including Loreto, Ucayali, Madre de Dios, San Martín, and Amazonas, with proof on the International Certificate of Vaccination. Peru's Ministry of Health enforces this at domestic airport checkpoints when passengers connect to jungle destinations. The vaccine must be administered at least 10 days before travel to provide legal validity, and the World Health Organization considers one dose sufficient for lifetime protection as of 2016. Hepatitis A vaccination receives strong recommendation from Peru's Instituto Nacional de Salud given the country's intermediate endemicity, with approximately 1.2 cases per 1,000 population annually. Typhoid vaccination applies particularly for travelers visiting smaller cities and rural areas where municipal water treatment remains incomplete. Rabies exists throughout Peru in both urban dogs and jungle bats, with approximately 30 human cases reported annually, concentrated in Amazonian regions.
Altitude illness affects a substantial percentage of visitors to Cusco, which sits at 3,399 meters, and the Sacred Valley, ranging from 2,800 to 3,800 meters. Puno at 3,827 meters on Lake Titicaca produces even higher rates of acute mountain sickness. Symptoms typically emerge six to twelve hours after arrival and include headache, nausea, fatigue, and sleep disturbance. The Lake Louise Score, used medically to quantify altitude sickness, finds moderate to severe symptoms in approximately 40 percent of arrivals to Cusco who ascend directly from sea level. Acetazolamide, sold under the brand Diamox, reduces incidence when taken 125 to 250 milligrams twice daily starting one day before ascent. Peruvian pharmacies sell this prescription medication over the counter at approximately 40 to 60 soles for a two-week supply. Local treatment involves mate de coca, tea made from coca leaves, which contains trace alkaloids that may provide modest symptomatic relief though scientific evidence remains limited. Severe altitude illness requiring descent affects roughly two percent of visitors.
High-altitude pulmonary edema and high-altitude cerebral edema represent life-threatening progressions that require immediate descent and medical attention. HAPE symptoms include severe shortness of breath at rest, cough with pink frothy sputum, extreme fatigue, and chest tightness. HACE manifests as severe headache unresponsive to medication, ataxia, confusion, and altered consciousness. Both conditions can develop within 24 to 72 hours of arrival at altitude. The only definitive treatment is descent of at least 500 to 1,000 meters. Cusco hospitals maintain portable hyperbaric chambers called Gamow bags that simulate descent while arranging transport to lower elevation. The trek to Machu Picchu along the Inca Trail crosses Warmiwañusqa pass at 4,215 meters, where altitude illness regularly forces hikers to abandon the route. Acclimatization requires a minimum of two to three days at intermediate elevation before ascending above 3,500 meters.
Dengue fever transmission occurs in areas below 2,000 meters, particularly in the Amazon, northern coast, and central jungle regions. Peru reported 57,000 dengue cases in 2023, with Loreto, Ucayali, and San Martín departments showing the highest incidence. No vaccine is widely available, making mosquito avoidance the primary prevention through DEET-containing repellent and long clothing during dawn and dusk feeding periods. Malaria exists in low-level transmission in Loreto and Madre de Dios departments, with Plasmodium vivax accounting for approximately 90 percent of cases and Plasmodium falciparum the remainder. The Peruvian Ministry of Health recommends atovaquone-proguanil or doxycycline prophylaxis for travelers to these regions, though transmission rates have declined substantially since 2000. Chagas disease, transmitted by kissing bugs in adobe and thatch structures, occurs in rural areas below 3,000 meters, particularly in Arequipa, Moquegua, Tacna, Ayacucho, and La Libertad departments.
Tap water in Peru should not be consumed without treatment in any location, including Lima hotels. The Superintendencia Nacional de Servicios de Saneamiento reports that only 87 percent of urban Peruvians receive piped water, and of that water, treatment standards vary widely. Lima's water supply comes primarily from the Rímac River and undergoes chlorination, but aging infrastructure from the 1960s and 1970s allows contamination through pipe breaks and illegal connections. Bottled water brands like San Luis, Cielo, and San Mateo are widely available at prices from 1.50 to 3 soles per liter. Water purification tablets containing chlorine dioxide or iodine provide backup, requiring 30 minutes of contact time. UV sterilization devices like SteriPEN work effectively if water is first filtered to remove particulates that block ultraviolet penetration. Boiling for one minute at sea level or three minutes above 2,000 meters elevation remains the most reliable method.
Traveler's diarrhea affects between 30 and 50 percent of foreign visitors to Peru during trips lasting two weeks or longer, according to studies by Peru's Universidad Peruana Cayetano Heredia. The primary causative organisms include enterotoxigenic E. coli, Campylobacter, Shigella, and Salmonella species. Street food, raw vegetables washed in untreated water, unpasteurized dairy, and beverages with ice present the highest risks. Markets in Lima such as Mercado Central and Mercado Surquillo serve food throughout the day under variable hygiene conditions. Ceviche, Peru's national dish of raw fish marinated in citrus, carries risk when prepared with contaminated water or fish held at improper temperatures. Coastal cevicherías along Lima's Costa Verde or in seaside districts like Chorrillos generally maintain better cold-chain management than inland locations. Selecting restaurants with high customer turnover increases the likelihood that food is fresh and prepared in volume that discourages bacterial growth.