Programme de santé sexuelle et reproductive pour les personnes isolées et exclues des soin

Colombia

Emergency
54

years of armed conflict prior to the peace agreement signed in 2016

6.3 million

million people in humanitarian need and affected by violence in 2020

1,825,687

migrants from Venezuela in 2020

The need for a humanitarian mission in Colombia

In 2020, the re-emergence of humanitarian emergencies in numerous regions of the country was a cause for concern, as the level of humanitarian need continued to exceed the capacities of the local authorities and organisations to respond. Due to the security context, the geography of the region and the location of communities in remote areas, humanitarian access remains a challenge in the context of the Covid-19 pandemic. It is estimated that 6.7 million people are in need, of whom 5.7 million require humanitarian assistance. According to OCHA’s 2021 overview of humanitarian need, the socio-economic impact of Covid-19 has affected many more people who require social and economic support to re-establish their livelihoods.

Incidents linked to the armed conflict in Colombia are ongoing.

Incidents linked to the armed conflict in Colombia are ongoing: in 2020 the United Nations High Commissioner for Human Rights documented 66 massacres in which 255 people were killed, and this is in addition to the killing of 120 human rights defenders.

In the isolated rural areas of the departments of Meta, Guaviare, Nariño, Cauca, Valle del Cauca and Chocó the nearest health centre is sometimes several hours away on foot or by dugout canoe. In these conditions, accessing the most basic health services is extremely dangerous.

 

The priorities for a humanitarian mission in Colombia are to provide:

  • a medical assistance plan to address the healthcare shortfall in the context of the Covid-19 pandemic and, more broadly, to help people who are isolated and victims of the armed conflict
  • protection for the social and human rights of communities

 

The isolation of the people who live in these regions also leads to malnutrition and diseases linked to poor water quality. Widespread social control of women’s bodies by armed groups in various areas, sexual violence and other types of gender-based violence have a recurring and fundamental impact. There has also been a sharp rise in sexual violence against women human rights defenders.

Five ongoing internal conflicts in Colombia

According to the ICRC, there are five ongoing internal conflicts in Colombia: between the ELNinfo-icon (Ejército de Liberación Nacional), the EPL (Ejército Popular de Liberación), the AGC (Autodefensas Gaitanistas de Colombia), FARCinfo-icon dissidents who haven’t accepted the peace agreement and the Colombian army.

 

COLOMBIA: POLITICAL AND SOCIAL HUMANITARIAN EMERGENCY

Furthermore, the political and humanitarian situation in Venezuela is having enormous repercussions in Colombia, which hosts more Venezuelan migrants than any other country, with 1.9 million displaced people, representing 43% of the 4.2 million Venezuelans in the region (including dual nationals and people commuting between the two countries). Only 20% of them have access to healthcare services and social security. Migrants are particularly at risk from sexual exploitation networks, drug trafficking and forced recruitment.

 

FOCUS ON THE COVID-19 EPIDEMIC: ONE ASPECT OF MEDICAL ASSISTANCE IN COLOMBIA

Colombia has been severely affected by the Covid-19 pandemic, with more than 2.5 million confirmed cases and over 60,000 deaths. The response to the pandemic has placed a severe strain on health services, which have repeatedly collapsed under the pressure. As in many countries, travel restrictions and curfews have exacerbated the economic crisis and increased the vulnerabilities and inequalities that impede access to rights and, in particular, to healthcare. A significant rise in gender-based violence has also been observed.

MdM helps victims of conflict between the FARC and the Colombian government ©Andréa Lamount
MdM helps victims of conflict between the FARC and the Colombian government ©Andréa Lamount

Our humanitarian assistance in Colombia

Humanitarian assistance in Colombia must include a focus on care and treatment for victims of violence, with a healthcare plan and access to vital resources.

 

Offering a rapid response to violence

Since the peace agreement, Médecins du Monde has redirected its activities towards rural areas in order to provide an emergency response in the event of peaks periods of violence in Colombia, especially during attacks by paramilitary groups, large-scale displacements and communities being confined to their homes. In partnership with two other international NGOs, Médecins du Monde deploys a team made up of doctors, psychologists and social workers and specialists in nutrition, hygiene and sanitation, and child protection.

Médecins du Monde provided training to the MIRE Humanitarian Consortium (an intersectoral emergency response mechanism) to enable it to deliver global and multisector services covering health, emergency education, WASH (water, sanitation and hygiene), protection, shelter and nutrition.

Médecins du Monde’s humanitarian action in Colombia is largely concentrated on emergency primary healthcare, especially general medicine, sexual and reproductive healthcare and mental healthcare for the groups most affected and victims of the conflict. This allows the humanitarian mission for Colombia, together with the Consortium, to prioritise the most serious emergencies. The idea behind this approach is to work with the local authorities and involve existing institutions with the aim of establishing sustainable action.

Between March 2020 and March 2021 the MIRE Humanitarian Consortium was involved in 73 humanitarian emergencies arising as a result of armed conflict, Covid-19 and natural disasters.

MdM consultation in Nariño @André Lamount
MdM consultation in Nariño @André Lamount

Working on gender-based violence: a humanitarian emergency in Colombia

Médecins du Monde also focuses on protecting survivors of sexual violence, supporting them to set up self-help groups and ensuring they receive holistic care and treatment that respects their rights at the healthcare facilities in Meta, Guaviare, Nariño, Cauca, Valle del Cauca and Chocó. The projects include workshops for communities, healthcare institutions and community leaders on issues such as domestic violence, gender-based violence and sexual violence and ways to identify and report incidents and provide support.

 

Caring for the Venezuelan migrants

Médecins du Monde supports many people throughout the country at different points on their migration journey. In 2020 projects to provide assistance to migrant groups centred on Bogotá, Soacha, Cali and Ipiales, on the border with Ecuador. The aim was to support the groups most at risk (minors and victims of sexual and labour exploitation) and to ensure migrants in transit receive healthcare and psychosocial support. In 2020, 45% of primary healthcare services were provided to migrants and over 60% of sexual and reproductive health consultations were for migrant women, demonstrating Médecins du Monde’s commitment to this group.
 

Covid-19: prevention and emergency medical assistance in Colombia

Médecins du Monde has taken action to combat Covid-19 by incorporating it into our biosecurity protocols and integrating isolation and prevention measures into our programmes. A procedure was drawn up for the referral of suspected cases to health centres. All our project teams ran workshops with the local population and community leaders on prevention and identification of positive cases of Covid-19.

We also implemented two emergency medical assistance projects in Colombia, in the Amazon region (the departments of Amazonas, Guainía and Vichada) to support the medical services and help with controlling the epidemic in indigenous communities through prevention and health promotion activities. This region was particularly badly affected by the virus, with high rates of cases and deaths.

 

Advocacy: a major humanitarian activity in Colombia

In the field, teams are working in partnership with the Salud Paz network, which brings together medics and academics who are actively defending the right to health for all. Working with the Health Peace Network, Médecins du Monde took the initiative to present a report to the Truth Commission. This involved compiling experiences and lessons learned during our more than 30 years of involvement in Colombia, focusing on work carried out in the Atrato Medio basin areas (Bojayá and Chocó), the La Macarena special management area (Meta) and the indigenous reservations of the Awá People (Ricaurte and Tumaco, Nariño). The report shows that the right to health is linked to other human rights being guaranteed and exercised, such as the rights to housing, food and work.

Additional advocacy at the heart of our humanitarian work in Colombia: involvement in the ‘Table for women’s life and health’, a collective which works to defend sexual and reproductive rights, particularly to ensure access to abortion.

During 2020, Médecins du Monde supported the Causa Justa movement, comprising 80 feminist civil society organisations, to bring a petition to the Colombian Constitutional Court for abortion to be removed as a crime from the Penal Code and for its complete decriminalisation in Colombia. 

Maintaining a difficult peace in Colombia requires a long-term humanitarian mission

On 24 November 2016, after 52 years of armed conflict, a peace agreement was signed between the Colombian government and the FARCinfo-icon. While the overall situation does show some signs of improvement, “the worst humanitarian crisis in the Western hemisphere” has led to 220,000 deaths, 40,000 disappearances and 6 million people being displaced.

The violence continues in Colombia and at least five other armed groups (ELNinfo-icon, EPL, FARCinfo-icon Dissidents, Clan del Golfo and Autodefensas Gaitanistas de Colombia) are still inflicting terror and death on the civilian population. Much remains for Médecins du Monde to do in Colombia in order to restore access to healthcare in rural areas affected by the conflict and to reintegrate the guerrillas into civilian life.

 

In 2020

In response to the humanitarian emergency in Colombia, we:

  • supported 18,986 beneficiaries
  • provided 16,277 primary health consultations
  • provided 8,443 sexual and reproductive health consultations
  • provided 5,418 mental health and psychosocial support consultations
  • advised and/or provided legal support to 260 people

our institutional support

History
1987
Doctors of the World starts working with the Apaporis Indians.
1994
Launch of a programme for street children which ended in 2000.
1997
Intervention in the region of Chocó affected by the armed conflict. Closed in 2011.
2003
End of the intervention in the region of Meta affected by the armed conflict.
2010
Beginning of the intervention in the region of Nariño.
2016
Peace agreement signed with the FARC and beginning of the adaptation of activities.
2017
End of mobile health services in Guaviare.
2018
Launch of rapid response to violence after the signing of the peace agreement.
2020
Projects to provide assistance to migrant groups centred on Bogotá, Soacha, Cali and Ipiales, on the border with Ecuador

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