Where nobody goes
Unloading relief parcels along the Atrato
The ICRC mobile health units in Colombia
provide emergency assistance and basic health care for people
living in municipalities affected by armed conflict, where
threats and attacks have forced many doctors and health-care
workers to leave.
It is 10:13 in the morning and the Apartadó ICRC sub-delegation
mobile health unit (MHU) team is ready to set off from Turbo,
a small municipality in Antioquia on the Gulf of Urabá.
They will travel by boat, along the Atrato and the Opogadó
rivers, to Baquiaza, a small community of Emberá natives
living in a remote region of Colombia.
The logistics are impressive. A 175hp twin-motor craft, which
reaches a speed of 36 knots (70 kilometres) an hour, carries
a doctor, a nurse, a dentist and his assistant, a water and
sanitation coordinator and the MHU coordinator. The boat is
piloted by a seasoned sea wolf who knows every twist and turn
of the rivers and all the secrets of these turbulent waters.
In addition to the medical team, the boat carries a whole
battery of equipment, including a generator - electricity
is rare in this part of Colombia - a complete set of dental
equipment and cold boxes containing vaccines and medicines
to treat the most common diseases in this area.
After a seven-hour journey along the Atrato River, the team
must change boats, because the Opogadó has become very
shallow in many places. The medical team, along with the equipment
and supplies, are now transported by canoe and, although it
is powered by a 50hp motor, the members of the crew have to
jump out and give it a push from time to time.
After many hours on the river, tackl-ing the difficulties
imposed by nature, the MHU team arrives at its first destination,
Baquiaza. In no time at all, the boxes of equipment and supplies
are unloaded and promptly converted into a doctor's surgery
and a fully equipped dentist's surgery.
After a day's work in the community - vaccinating children,
checking on pregnant women, examining children whose skin
has been affected by the river water and monitoring the rainwater
treatment projects - the team packs up and sets out for its
next destination: Mesopotamia. The programmes carried out
by the MHUs also include health promotion and prevention activities.
After a long journey along the Opogadó, the ICRC team
reaches Mesopotamia, an Afro-Colombian community with health
needs similar to those of dozens of other municipalities in
Four years ago, all the inhabitants of Mesopotamia fled from
their homes because of the armed conflict. Two years ago they
returned to their lands and tried to reconstruct what had
The people of the community begin to arrive very early to
be treated by the medical team. The water and sanitation coordinator
meets with local authorities to decide on locations for the
community's new water tanks. She also reminds them how important
adequate water treatment is to the health of the people in
the community. The day's work involves treating children who
have had minor accidents, vaccinating new-borns and examining
elderly people with a variety of complaints.
In 2001 the mobile health units provided medical and dental
treatment to 18,220 individuals and vaccinated 15,733.
As the boat driver concentrates on the difficulties of navigating
the river, the MHU team discusses the details of their next
mission, which will take them to another destination in this
part of the country in two days' time.
One of the biggest problems for the civilian population living
in areas affected by armed conflict and for displaced people
is access to basic health-care services.
The armed conflict and geographic isolation suffered by thousands
of Colombians have led to a breakdown in the health system.
One consequence of this has been a surge in the incidence
of immuno-preventable diseases in the areas most seriously
affected by the conflict.
The MHUs are focusing their efforts, in coordination with
local authorities at all levels, on providing primary health
care (general medicine, dentistry, health promotion/prevention
activities, vaccination and water treatment and sanitation)
In 2001 and the first part of this year, the ICRC mobile health
units and the municipal authorities provided primary health
care in various parts of the country. The projects are being
carried out by four National Societies - Canadian, German,
Norwegian and Swedish - which are providing the required funding
and human resources. It is important to note that armed groups
have allowed the MHUs to provide medical attention to the
civilian population affected by the conflict in the four regions
in Colombia where they are operating.
Acceptance of the ICRC medical mission has made it possible
to frame strategies to provide primary health care and carry
out health promotion and prevention activities, and the involvement
of local authorities and communities has permitted a continuous
expansion of these activities.
The internal conflict in Colombia started in 1948, interrupted
by sporadic lulls. According to various sources, about 300,000
people have died and more than 1.5 million have been displaced.
The ICRC has been permanently based in Colombia since 1980.
It presently runs 17 offices throughout the country.
In Colombia, armed conflict results in humanitarian needs
that require a rapid response. Tens of thousands of people
are forced to abandon their homes and to seek greater security
in towns or rural areas. No part of the country is unaffected.
Since they are often forced to leave without warning, these
people have to drop everything and flee with nothing but the
clothes on their backs. They lose their means of subsistence
and are unable to meet their basic needs such as food. The
ICRC strives to provide emergency humanitarian assistance
that is both effective and in proportion to the population's
priority needs. Assistance is closely linked to the protection
work carried out all over the country.
Since 2001, the ICRC has reinforced its role as a neutral
intermediary between all parties to the conflict while developing
medical programmes in affected areas, visiting detainees and
working to secure greater respect for international humanitarian
law by all parties to the conflict.
Carlos Rios is an ICRC communication delegate based in Colombia.
Top | Contact
Us | Credits | Current
issue | Webmaster
© 2002 | Copyright