Displacements, restrictions on mobility and lack of access to basic goods and services such as healthcare: These are the main consequences of the escalation of the conflict in southwestern Colombia, which is causing a growing humanitarian crisis.
"The impact on the mental health of these people is enormous. The fear of renewed fighting and the lack of adequate shelter prevent some populations from leaving their municipalities, in spite of their fear", said Pierre Garrigou, general coordinator of Doctors Without Borders/Médecins Sans Frontières (MSF) in Colombia. "The fighting has also led to massive displacements in some places", he adds.
Renewed violence and the end of a ceasefire
The killing of 11 soldiers by rebel groups last April led to a renewal of bombings by the Armed Forces. In one of these bombings, 26 guerrillas were killed. On May 22, the leading Colombian rebel guerrilla group FARC announced an end to the unilateral ceasefire, causing an intensification of the conflict between the two sides, with fighting, harassment, bombings and explosive devices planted in populated areas.
In May and June, a total of 525 violent incidents were recorded throughout the country, 75 per cent of which occurred in the southwestern departments, according to data from the UN Office for the Coordination of Humanitarian Affairs (OCHA).
MSF responds to increased needs
MSF teams already working in the area have been responding to the increased humanitarian needs. About 1,800 people have been provided with mental health care, including individual and group attention, psychosocial activities and training in psychological first aid.
In the municipality of López de Micay, where many displaced people have arrived, MSF teams also distributed hygiene and cooking kits, as the living conditions in the shelter sites are very precarious.
One MSF patient, who arrived with her four children and was treated for symptoms of acute stress, described her recent ordeal. "When the bombing started,” she said, “I fell to the floor. I heard them running around the yard. The children started crying, everything sounded so close by. When they started shooting the children were crying and said to me, 'Mum, mum, are we going to die?' And I told them to be quiet, and we stayed on the floor until dawn. I don't want to remember that horror, but every day the memories come, they close the door and there I am in pain. Where we are now, we're just a pile-up. I ask myself how long we're going to be here, sleeping on the ground."
Deploying an emergency team
Garrigou explained that MSF would continue to expand its response to meet the growin humanitarian needs. "A mobile emergency response team is already on the ground to strengthen our regular teams in the area,” he said.
The team – comprising a psychologist, a doctor and a logistician – is currently in the rural area of Tumaco, assessing needs following a recent attack on the trans-Andean pipeline, which occurred in a rural area and affected 301 communities in the river Mira area. Furthermore, in the urban centre, where in the last month there have been 41 violent incidents, 150,000 inhabitants have been left without water supply.
MSF has been working in the Cauca and Nariño departments of Colombia since 1985. In Cauca, MSF teams provide individual and group therapy in hospitals and communities. It also provides training to community leaders, health promoters, midwives and teachers so that they can provide psychological first aid when they are caught up in violence events.