Colombia

Although over 95% of the population is registered with the Colombian social security healthcare system, health services often can’t be accessed due to complex geographical conditions, lack of adequate infrastructure, shortages of healthcare staff and the presence of armed groups in these areas.

In the isolated rural parts of Putumayo, Amazonas, Nariño, Cauca, Valle del Cauca and Chocó Departments, the nearest health centre is sometimes several hours away on foot or by dugout canoe.

A rise in suicides and suicidal thoughts and behaviours in the indigenous communities of Antioquia, Chocó and Cauca is also deeply concerning.

According to Colombian NGO the Consultancy for Human Rights and Displacement (CODHES), 97% of cases of sexual violence in the context of armed conflicts and forced displacements remain unpunished. Members of armed groups continue to use sexual violence to intimidate the population and members of other groups they’re in conflict with. Formally reporting an incident in such circumstances is often very difficult. The primary victims are women and girls, especially those of African descent and from indigenous communities.

In addition, the absence of legal recognition and protection of LGBTIQ+ rights can be a barrier to people openly and freely expressing their gender identity and sexual orientation. This makes it more difficult to provide an appropriate response to their healthcare needs.

Abortion up to 24 weeks was decriminalised in Colombia in 2022. Despite this historic decision, access to safe abortion is still plagued by obstacles.

One of the main problems is a lack of awareness of the legal situation and a restrictive interpretation of it by the authorities. Healthcare staff also receive insufficient technical, legal and human rights training. In addition, accessing pregnancy termination is made even more complicated by severe social stigma and lack of information and facilities offering abortion services.

Colombia is the main host country for Venezuelan migrants, with over 2.8 million people from Venezuela in the country. Only 20% of them have access to health and social services and they are particularly at risk from sexual exploitation networks, drug trafficking and forced recruitment.

In addition, in 2024 around 400,000 people crossed the Darién Gap, a swampy jungle region on the border between Colombia and Panama which is known as one of the most dangerous migration routes in the world.

Migrants who make the crossing risk their lives. It takes between four and ten days, during which people are exposed to disease, physical and sexual violence and extortion by criminal groups.

In healthcare facilities in Nariño, Cauca, Valle del Cauca, Chocó and Amazonas, Médecins du Monde focuses on protecting survivors of sexual violence, supporting them to set up self-help groups and ensuring comprehensive care.

Workshops are organised for communities, healthcare institutions and community leaders on issues such as domestic, gender-based and sexual violence and how to identify and report incidents and provide support.

In addition, all the healthcare professionals in the teams in Colombia receive training which covers providing information about how to access abortion and follow-up care, performing medical abortions up to 12 weeks of pregnancy and referring patients to public services after 12 weeks.

Médecins du Monde also provides financial support to Causa Justa, a feminist collective that campaigns for sexual and reproductive rights. This helps the collective to continue its activities and supports the effective implementation of the new regulatory framework in Colombia.

In response to the unprecedented humanitarian crisis in the Darién Gap, Médecins du Monde is working locally to provide access to primary healthcare, sexual and reproductive healthcare, and mental health and psychosocial support.

We also give people who are about to travel through the Darién jungle essential information about preventive self-care. The final camp before the crossing is in Las Tecas (Acandí), where all the migrants stay for at least a day before entering the jungle. No other humanitarian organisations are present here, but Médecins du Monde runs a health post which is open seven days a week.

Since June 2024, we have also been working in Panama, in the first camps reached by people after they cross the Darién Gap. The healthcare services offered are similar to those provided on the Colombian side, but with more focus on treatment, as well as care for those who have experienced gender-based violence.

In the Pacific region Médecins du Monde is currently working in partnership with an Italian-Colombian foundation which uses a hospital boat to provide health services to priority areas in Antioquia, Chocó and Cauca Departments.

Primary healthcare is provided, including sexual and reproductive healthcare and mental healthcare. The Médecins du Monde teams are setting up intercultural health centres, improving epidemiological monitoring systems and providing training to community health workers in collaboration with university medical schools.