Colombia: Assisting civilian victims of increasing violence

The two million people displaced by conflict since 1985 are one measure of the human toll. These are often society's most vulnerable - subsistence farmers, women, children and ethnic minorities - and their health is seriously affected. There are high morbidity and mortality rates from communicable diseases (such as diarrheal diseases and respiratory infections) as well as high levels of chronic malnutrition. MSF continues to assist people affected by the violence, in both rural and urban settings. Taking primary care to rural communities Following the breakdown of peace talks, MSF organized mobile medical teams to provide primary health care to displaced people and residents in rural areas of San Vicente del CaguÃ?¡n, a formerly demilitarized area retaken by the government in February 2002. The abrupt power shift left health posts unattended, hospital medical brigades suspended and people afraid to risk traveling to seek medical care. MSF's intervention was expected to last about six months but has been extended until the end of 2002 at least. In other rural areas, periodic forays by medical teams continue to be one of the only chances for people to see a doctor. In Magdalena Medio region and in the departments of CÃ?³rdoba, Sucre, BolÃ?­var, CaquetÃ?¡ and Tolima, MSF medical teams offer basic care to communities isolated by the conflict or with difficult access to health facilities. Activities include vaccinations, nutritional follow-up, prenatal checkups, family planning, mental health care, prevention of diseases such as malaria and dengue fever, and improving water and sanitation facilities. A new primary healthcare program and malaria control project started in May 2002 in El Charco, in NariÃ?±o department. To tackle the measles epidemic in the Sierra Nevada de Santa Marta in Magdalena department, two MSF teams collaborated with local health authorities to vaccinate 5,000 people in March 2002. Medical support for IDPs and victims of violence Most of Colombia's displaced end up in slums known as invasiones, perched on the edges of big urban centers and lacking any infrastructure or services. MSF runs primary healthcare projects emphasizing prevention, mother and child health care, and vaccinations in the slums of Soacha, just south of BogotÃ?¡, and Florencia, the capital of CaquetÃ?¡ department. Water and sanitation activities were phased out in November 2001, and MSF expects to turn over its Soacha clinics to the local hospital in late 2002. In Cali's impoverished Aguablanca district, MSF runs a physical and psychological rehabilitation and prevention program for victims of urban violence - most of whom have suffered injuries, such as paralysis, as a result of gun violence - and their families. A one-year medical and social program assisting sex workers and their families in BogotÃ?¡ finished in July 2001. Speaking out for the displaced During the second half of 2001, MSF carried out research on both access to health care and forced displacement in Colombia. The resulting report was submitted to the presidency of the European Union in May 2002 to highlight the magnitude of the humanitarian crisis and the need to increase pressure on the Colombian government to assume responsibility for the plight of its displaced people. MSF has worked in Colombia since 1985. International staff: 30 National staff: 110