Colombia

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Key medical figures:
• 36,200 outpatient consultations
• 3,600 individual and group mental health consultations

Colombia

The testimonies of 4,400 Médecins Sans Frontières (MSF) patients revealed that 67 per cent of people in Colombia seeking mental health support had experienced at least one violence-related event.

The Colombian armed conflict has inflicted a heavy toll on people’s health. In addition to the historic confrontation between the military and FARC and ELN guerrillas, new paramilitary groups and drug-trafficking cartels have appeared in recent years, creating different dynamics of violence. Most armed activity is registered in the southern  departments of Caquetá, Cauca, Putumayo and Nariño, where civilians witness massacres and are subjected to threats, extortion, displacement, injuries caused by mines, torture, sexual violence, forced recruitment and other human rights violations. Medical and psychological support is critical in such a context, yet healthcare access in these geographically  remote areas is limited. MSF has a long-standing programme of mobile clinics and health posts to provide healthcare and mental health consultations to people in need. Basic  medical care, a referral system for emergencies, sexual and reproductive health services including family planning, antenatal care, immunisations and check-ups for children and all  available.

In July, MSF published The Less Visible Wounds: Mental health, violence and conflict in southern Colombia, a report based on the testimonies of patients treated in the mental  health component of the above programmes in 2012. The report drew attention to the debilitating effects of the violence and the fact that people caught up in armed conflict and  other forms of brutality lack critical state support to address their psychological needs.

Focus on tuberculosis (TB)
TB has emerged as a major public health concern, particularly in the crowded seaport of Buenaventura, where 9.5 per cent of new cases are found to be drug-resistant. MSF works  in two health facilities, and teams oversee an additional 15 medical stations. In 2013, 218 drug-sensitive TB patients began treatment, and 47 patients were included in the  programme for drugand multidrug-resistant TB. In addition to providing support to the national strategy for TB detection and treatment, MSF started advocacy initiatives and  discussions with partners and authorities to introduce bedaquiline as a treatment for patients with extremely resistant forms of the disease. Workshops and negotiations are ongoing.

Programme closures
In February, given improvements to the health system in the area, MSF closed a project focused on reproductive healthcare in Buenaventura. In December, activities in rural  Nariño were handed over to local health institutions due to better availability of healthcare.

No. staff end 2013: 180 | Year MSF first worked in the country: 1985

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