An Aponte Indian child shows signs of skin disease after government spraying of area crops, part of an effort to eradicate coca and poppy plants. This community was sprayed twice in 2000.
People have been left in an extremely vulnerable situation, especially in the countryside, where massacres, kidnappings, extortion, and roadblocks are an everyday fact of life. Health care centers have been destroyed or lack the medical staff, drugs, and material necessary to offer adequate care. The exodus of displaced people continues toward urban areas, where they are also confronted with violence.
The climate of insecurity was brought home to MSF in July 2000, when an MSF volunteer was kidnapped in the department of Choco. The volunteer was released unharmed and unconditionally in January 2001, but MSF projects in that area were suspended indefinitely. MSF continues its other programs assisting vulnerable people in rural and urban areas.
Violence affects the countryside in a particularly crude manner, generating high numbers of displaced people. Nearly two million people have been pushed from their homes since 1985, with over 300,000 people displaced in 2000 alone, according to a Colombian human rights group (CODHES). MSF works with displaced people and residents in some of the most affected areas, or "expulsion zones," primarily the Magdalena Medio region and the departments of Cordoba, Sucre, and Bolivar in the north and Caqueta and Putumayo in the south.
In these areas, mobile clinics reach isolated villages. Teams treat recurring ailments, including acute diarrhoeal diseases and respiratory infections, malaria, and skin diseases. Preventive activities include vaccinations, nutritional surveillance, prenatal care, reproductive health, and prevention of malaria and dengue fever. MSF also works to improve water and sanitation facilities.
Many of the displaced people gravitate to urban areas, settling on the outskirts and creating so-called "invasion slums." These marginalized urban areas lack basic services. In Bogota and Florencia, the capital of Caqueta, MSF runs two primary health projects for displaced and vulnerable populations. Teams provide medical assistance, with a special emphasis on preventive care, vaccination, and mother and child health care. MSF also works to improve sanitation facilities and access to clean water.
Since July 2000, MSF has run a social-medical program in Bogota for sex workers and their families in collaboration with the Education and Work Foundation, a local NGO. Activities include medical consultations, drug donations, and the set-up of a creche for the children of women assisted by this program.
In Cali, MSF runs a rehabilitation and violence prevention program in the district of Aguablanca. The team assists victims of violence and their families, providing physical and psycho-social rehabilitation services. A sexual and reproductive health project for young people in Cali was turned over to the municipal health authorities in late 2000. Two MSF workers continue to do follow-up for women with high-risk pregnancies.
MSF teams also run small-scale emergency interventions due to floods, epidemics, or displacements. In May 2001, MSF ran a vector control and epidemiological surveillance program and distributed mosquito nets in the Pacific department of NariÃ?±o, which was badly affected by a malaria epidemic. Following a request from Cali officials, MSF supported a diptheria vaccination campaign in Aguablanca between November 2000 and April 2001.
MSF has had a continuous presence in Colombia since its first intervention in 1985 to assist people in Armero, following the eruption of the Nevado del Ruiz volcano.
To learn more about MSF in Colombia, see "Colombia: The human face of conflict," a photo essay which begins on page 11.
International staff: 25
National staff: 110