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Colombia

Democratic Republic of Congo

: Canadian Portfolio

The conflict between guerrilla groups and government forces has been going on for 40 years in Colombia. Paramilitary groups that were supposedly demobilised have re-emerged in many areas across the country. Many people have moved from rural areas to towns to escape the insecurity, but end up living in poverty with little access to care. MSF has been providing healthcare to those affected by the conflict as well as treating people with Chagas disease and offering maternal care.

Conflict

Armed conflict escalated in Nariño, and according to official figures there were 12,400 displaced people between January and September, by far exceeding the country’s response capacity. MSF mobile teams worked to improve access to healthcare for people affected by the armed conflict and provided treatment to those who were displaced. MSF conducted more than 5,000 medical consultations overall.

Maternal care

More than 2,600 babies were born under MSF care in the main hospital in Quibdó, the capital of Chocó department, in 2009. Since this is the referral hospital for complicated obstetric cases, 60 per cent of the deliveries involved Caesarean sections. MSF also provided training for hospital staff, and medical equipment. Elsewhere teams set up fixed health posts to supplement mobile clinic activities. By maintaining a regular presence in some isolated villages on the riverbanks, MSF is able to offer better-quality medical care, improve patient follow-up and stabilise emergency cases before referring them. Overall, 6,300 consultations were carried out.

Emergency response

In the Tumaco municipality southwest of Colombia, the river Mira overflowed its banks in February, disrupting the lives of 30,000 people. Teams provided emergency healthcare in the most isolated areas and supplied medicine to the main hospital in Tumaco town.

Back in 2007 MSF opened a trauma centre in Buenaventura is response to increasing attacks in the shantytown. As the situation evolved the centre broadened out its services to cover all primary healthcare needs and introduced a mobile clinic service. However by 2009 demand for the facility had decreased so the mobile service finished and efforts concentrated instead on the health centre, which in 2010 may be relocated to another area where the needs are greater.

Healthcare provision

MSF runs a boat-ambulance that serves riverbank villages. In 2009 more than 14,500 riverbank consultations were carried out. In December, the fixed health post and mobile clinic activities on the San Juan river were handed over to the municipality and MSF was able to focus its activities on the Baudo river.

More than 6,300 consultations were carried out in the department of Norte de Santander, where MSF managed two clinics and several rural mobile clinics. These included sexual and reproductive healthcare, mental healthcare and care for survivors of sexual violence. Nearby in the Bajo Atrato area, MSF also provided healthcare services including nutrition surveillance, and mental healthcare to a vulnerable and isolated community. MSF handed over the mental health centre it was running in Florencia, the capital of the department of Caquetá, last year, although teams continue to conduct mental health consultations in other administrative centres and provide mental health support in rural areas.

MSF provided more than 8,000 consultations in the Cauca and Putumayo departments, including medical and psychological healthcare and promotion and prevention consultations. The programme supported the health network in both departments by training staff, supplying materials and refurbishing medical facilities. At the end of the year, MSF handed over the activities in Cauca to the local authorities.

The disease Chagas is endemic in most Latin American countries and, if left untreated, can lead to serious health problems and eventually death. The Arauca department in the northeast of the country on the border with Venezuela has one of the highest rates of Chagas in the country, with an estimated eight per cent of the community infected. MSF carried out nearly 15,000 consultations via mobile clinics in rural and urban areas last year.

Teams also provided healthcare with a focus on sexual and reproductive health, as well as mental-health care and assistance to victims of violence.

Patient story

Manuel, 40, shop-owner in a rural part of the Nariño district

‘Our life here is quiet; nothing usually happens. However, a few months ago, several uniformed men arrived looking for a criminal they thought was in the district. They entered the houses kicking the doors open and forcing people out. Everybody was very scared; nobody understood what was happening. They seized me and took me to the bush because they thought I was collaborating with the criminal. They threatened me with a gun and then a chainsaw to make me talk. I cannot remember how long I was detained, but I could not make them understand that I didn’t know anything. When I was released I left the area because I was scared. Nearly all of us fled, but what could we do so far from our land? Some people returned, but I couldn’t, I was frightened. Then, when I saw MSF was coming, I returned and managed to talk through my experience with them.’

MSF has worked in Colombia since 1985.