Rural Colombia - Colombia's cycle of violence

Since 1999 there have been 17 massacres in this town alone, each of them with 15 dead or more. There have been 500 people buried in the cemetery since 1999. If that represented one tenth of the dead, we would be happy. The majority is missing. There are places in which there are people buried without a cross or anything to identify the site. In other places there are two or three people buried under the same cross. We would need a cemetery several stories high to bury all the dead.
— A community member, Norte de Santander province


Far from the relative safety of major urban centres, guerrillas, paramilitaries, and the Colombian army fight a longstanding war for territorial control in the rural zones. Control of land also means control of legal and illegal resources (such as oil reserves and coca crops), control of trade and trafficking routes, and ultimately control of the civilian population living there.

As a result, in most of the rural areas in which MSF works people endure tremendous levels of violence and intimidation.

The impact of the struggle for control exerted by armed actors is compounded by geographic isolation and social exclusion of these populations. Largely because of the ongoing conflict, local health authorities rarely extend services into areas beyond state control.

To see a doctor, most people must travel substantial distances (often four to eight hours, and less commonly up to several days) through territories controlled by different armed actors.

The price of conflict

The protracted nature of the ongoing conflict, which has lasted for more than four decades, means that the majority of the Colombian population has been born into the conflict. For communities in rural areas of strategic importance in which different armed actors struggle for territorial control, regular and direct contact with armed actors is a fact of life rather than a choice.

A community easily becomes identified with the armed groups operating in the area, leading to a dangerous stigmatization. Being identified as a party to the conflict increases individual and community vulnerability to violence, impacting on safety and people's freedom of movement. People tell MSF they do not want to get involved; they just want to live in peace with their families. However, despite Colombia entering into a new phase of negotiations including the demobilization of paramilitary groups, people still raise the same fears and pressures as if little has changed for them. One community member, later murdered, told MSF how vulnerable he felt:

"There are people here who don't get out of town, because they feel they might get them on the road, or that there might be paramilitaries in civilian clothes, so they are afraid. I retired from my position as community leader because the paramilitary started to say we were traitors.

"One day a Colonel from the army called me "guerrillero", and I told him "With all my respect, Colonel, if the guerrillas send someone looking for me, how can I refuse to see them?" A guerrilla commander asked me to join them and, when I refused, he accused me of being a paramilitary... what can I do now? If I stay they will kill me, if I go I would be somehow admitting that what they say is true..."


Armed actors on all sides control the divide between rural and semi-urban communities, making "free passage" and "access" conditional on the agendas of those involved in the conflict. In some rural provinces where MSF works there are people who have spent up to five years without leaving their rural community to visit a city for fear of being perceived as belonging to or collaborating with armed groups. Those who do travel regularly to and from rural areas (e.g. to buy supplies or seek health care) run a greater risk of becoming identified with an armed group and possibly targeted by others as a result. These concrete risks increase feelings of personal vulnerability, and consequently have an impact on the mental well being of those seeking assistance.

The violence and control affecting the community leads to a gradual breakdown of society. In areas where coca trade exists, the black market economy thrives and prostitution flourishes in response to the demands of a floating, armed population. Many small towns and communities have become transit points for those travelling into and out of controlled areas. The armed actors within the conflict, the displaced, merchants, black marketers, sex workers, organized criminals, coca traders, labourers and paid informants all contribute to an unstable population.

As within any violent environment, fear quickly permeates society breaking down historic and community bonds of trust and raising new thresholds of suspicion.

"You don't know who your neighbour is, with whom you live, who lives next door, where they are from, what they do.

People keep silent in order to survive; they keep quiet and cry over their lost ones in silence... Many have died for calling things the way they are; many have disappeared for knowing too much...
— Rural community member