Colombia 1997-1998

Aid scattered to communities Violence still dominates the mortality and morbidity statistics in Colombia where the population is subject to the vagaries of the armed forces, guerrillas, paramilitary groups and drug traffickers. MSF is extending its work in the extremely violent UrabÃ?¡ region to cover a further 40,000 people. Many are victims of violence, including IDPs and indigenous peoples, traumatised by their experiences and with little or no access to basic health care. Mobile health brigades travelling in dug-out canoes provide emergency aid and basic medical care to scattered communities along the Atrato river. They also asses their mental health and the state of the health system, and are setting up an early warning system. Projects in Silvia and Tierradentro, Cauca Department, aim to improve the rural indigenous population's access to health care. Activities include mother-and-child health, vaccination programmes, supplies of drugs and medical material and training for community health workers, traditional birth attendants and nursing assistants, as well as the construction, refurbishment and equipping of healthcare structures. In the marginalised and violent Agua Blanca district of Santiago de Cali, MSF runs a rehabilitation healthcare programme for victims of violence, including psychological assistance. This includes a home visit system for recently discharged or chronic patients, physiotherapy, educational programmes for victims, their families and professionals, and for schools, where the focus is on prevention. MSF continues an integrated reproductive and maternal healthcare programme aimed particularly at adolescents. This provides a range of prenatal, post-natal and family-planning services, including psycho-social care and a support group for very young mothers. In mid-1998, MSF launched an urban health project in the slums of BogotÃ?¡.