Tourists travelling through Bolivia’s Lake Titicaca region on a once-in-a-lifetime visit to South America marvel at ‘some of the most dramatic and beautiful scenery in the world’. ALT’s strategic plan maintains that problems of contamination and pollution around Lake Titicaca are confined to the Puno region. In the Lake Titicaca region the increased demand of campesinos for water to irrigate cash crops of onions and beans have intensified inter-family and inter-community antagonism. The departure of energetic, potentially innovative, educated young men and women from the Lake Titicaca region has had a dramatic effect on traditional farming practices and gender roles. When fixing land sale prices in the Lake Titicaca region, the Agrarian Superintendency currently distinguishes between land adjacent to the lake and land above the through-road. In more isolated areas, life in many farming communities continues much as it has done since the early days of agrarian reform.