The Effect of Conflict and Displacement on the Health of Internally Displaced People: The Colombian Crisis

Main Article Content

Juliana Andrea Barrera Ramirez
Hernan Dario Franco

Abstract

ABSTRACT

Decades of violence in Colombia led to the relocation of millions of rural families into urban areas, where the violation of human rights and abuse add to the struggle to meet most basic needs. Lack of housing, economic instability, poor access to healthcare and educa­tion impact their overall health. Unfortunately, implementation of laws created to alleviate the crisis has been unsuccessful, as armed groups target aid efforts through violence and threats. While the role of physicians is limited, advocacy and collaboration with other organizations can help improve the health and well-being of this population.

 

RÉSUMÉ

Des décennies de violence en Colombie ont mené au relogement de millions de familles rurales vers des milieux urbains, où la viola­tion des droits de la personne et les sévices exacerbent la lutte pour subvenir aux besoins fondamentaux. Le manque de logement, l’instabilité économique, et l’accès restreint aux soins de santé et à l’éducation ont un impact sur leur santé globale. Malheureuse­ment, l’établissement de lois conçues pour alléger la crise s’est révélé sans succès, puisque des groupes armés ciblent ces efforts d’aide humanitaire avec de la violence et des menaces. Bien que le rôle des médecins soit limité, les activités de plaidoyer et la collaboration avec d’autres organismes peuvent aider à améliorer la santé et le bien-être de cette population.

 

Article Details

Section
Commentary
Author Biographies

Juliana Andrea Barrera Ramirez, University of Ottawa

MD Candidate

Faculty of Medicine, University of Ottawa

Hernan Dario Franco, University of Ottawa

MD Candidate

Faculty of Medicine, University of Ottawa

References

1. IDMC. Capacity-building on law and policy-making on internal displacement [Internet]. [Updated 2015 May; cited 2016 Feb 14] Available from: http:// www.internal-displacement.org/global-figures/.

2. Richards A, Ospina-Duque J, Barrera-Valencia M, et al. Post-traumatic stress disorder, anxiety and depression symptoms, and psychosocial treat¬ment needs in Colombians internally displaced by armed conflict: a mixed-method evaluation. Psychol Trauma: Theory, Research, Practice and Policy. 2011;3[4]:384-393.

3. IDCM. Colombia: Internal displacement in brief. [Internet]. [Updated 2013 Dec 31; cited 2016 Feb 14] Available from: http://www.internal-displace-ment.org/americas/colombia/summary/.

4. IDMC. Displacement continues despite hopes for peace. [Internet]. [Updat¬ed 2014 Jan 14; cited 2016 Feb 22] Available from: http://www.internal-dis-placement.org/americas/colombia/2014/displacement-continues-despite-hopes-for-peace.

5. Ferris E, Mooney E, Stark C. From responsibility to response: assessing national approaches to internal displacement. The Brookings Institution- London School of Economics Project on Internal Displacement. [Internet]. [Updated 2011 Nov; cited 2016 Feb 21] Available from: http://www.brook-ings.edu/~/media/research/files/reports/2011/11/responsibility-response-ferris/from-responsibility-to-response-nov-2011.pdf.

6. ODI. Protracted displacement: uncertain paths to self-reliance in exile. An¬nex 8- case studies: Colombia, Darfur, Jordan and Uganda. [Internet]. [Up¬dated 2015 Sept; cited 2016 Feb 14] Available from: http://www.odi.org/ hpg/protracted-displacement/.

7. IDCM. Colombia IDP figures analysis. [Internet]. [Updated 2014; cited 2016 Feb 14] Available from: http://www.internal-displacement.org/americas/ colombia/figures -analysis/.

8. ORMET. Poblacion desplazada y mercado de trabajo. [Internet]. [Updated 2014 Feb 13; cited 2016 Feb 14] Available from: http://www.co.undp.org/ content/ colombia/es/home/presscenter/articles/2014/02/13/ormet-po¬blaci-n-desplazada -y-mercado-de-trabajo.html.

9. Albuja S, Ceballos M. Urban displacement to urban alienation. Forced Mi¬gration Review. 2010;34:10-11.

10. Roberts B, Odong VN, Browne J, et al. An exploration of social determinants of health amongst internally displaced persons in northern Uganda. Conflict and Health. 2009;3:10.

11. Vidal R, Atehortua C, Salcedo J. Local government responses to internal dis¬placement in urban areas: a study of Bogotá and Cali, Colombia. The Brook¬ings Institution- London School of Economics Project on Internal Displace¬ment. [Internet]. [Updated 2013 May; cited 2016 Feb 21] Available from: http:// www.brookings.edu/~/media/research/files/reports/2013/05/ municipal-authorities-colombia/idp-municipal-authorities-colombia-may- 2013-executive-summary.pdf.

12. Ibanez AM, Moya A. Vulnerability of victims of civil conflicts: empirical evidence for the displaced population in Colombia. World Development. 2010;38[4]:647-663.

13. IDMC. Girl, disrupted. [Internet]. [Updated 2014 Mar; cited 2016 Feb 14] Available from: http://www.internal-displacement.org/publications/2014/ girl-disrupted.

14. Caceres DC, Izquierdo VF, Mantilla L, et al. Perfil epidemiologico de la po¬blacion desplazada por el conflict armado interno del pais en un barrio de Cartagena, Colombia. Biomedica. 2002;22[suppl. 2]:425-444.

15. Puertas G, Rios C, del Valle H. Prevalencia de trastornos mentales com¬munes en barrios marginales urbanos con poblacion desplazada en Colom¬bia. Revista Panamericana de Salud Publica. 2006;20[5]:324-33.

16. Avila Cadavis JD, Escobar Cordoba F, Chica Urzola HL. Prevalencia de ansie¬dad y depresion en alcoholicos hospitalizados para desintoxicacion en Bo¬gotá. Revista Facultad de Medicina de la Universidad Nacional de Colombia. 2005;53[4]:219-225.

17. Lilly MM, Pole N, Best SR, Metzler TM, Marmar CR. Gender and PTSD: what can we learn from female police officers? Journal of Anxiety Disorders. 2009;23:767-774.

18. Johnson H, Thompson A. The development and maintenance of post-trau¬matic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: a review. Clinical Psychology Review. 2008;28[1]:36-47.

19. Roberts B, Ocaka KF, Browne J, Oyok T, Sondorp E. Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda. BioMed Journal of Psychiatry. 2008;153[2]:219-225.

20. Mogollon-Perez AS, Vazquez Navarrete ML. Opinion de las mujeres des¬plazadas sobre la repercucion en su salud del desplazamiento forzado. Gaceta Sanitaria. 2006;20[4]:260-265.

21. Mogollon-Perez AS, Vasquez ML. Factores que inciden en el acceso de la poblacion desplazada a las instituciones prestadoras de servicios de salud en Colombia. Cadernos de Saude Publica. 2008;24[4]:745-754.

22. Webster PC. Health in Colombia: a system in crisis. CMAJ. 2012;184[6]:E289- E290.

23. Ferris E. The role of municipal authorities. Forced migration review. 2003;34:39.

24. Paredes Zapata GD. Terrorism in Colombia. Prehospital Disaster Medicine. 2003;18[2]:80-87.

25. Médecins Sans Frontières. International Activity Report, 2014. [Internet]. [Updated 2014; cited 2016 April 10] Available from: http://activityreport. msf.org/country/colombia/.

26. Médecins Sans Frontières. MSF psychiatrist on mental healthcare in Colom¬bia. [Internet]. [Updated 2014; cited 2016 April 10] Available from: http:// www.msf.ca/en/article/msf-psychiatrist-mental-healthcare-colombia.

27. Médecins Sans Frontières. New access for MSF teams in Bajo Atrato region, Colombia. [Internet]. [Updated 2014; cited 2016 April 10] Available from: http://www.msf.ca/en/article/new-access-msf-teams-bajo-atrato-region-colombia.

28. Médecins Sans Frontières. Colombia: MSF provides metal health care and other support following the latest upsurge in violence. [Internet]. [Updated 2015 July 9; cited 2016 April 10] Available from: http://www.msf.ca/en/ar¬ticle/colombia-msf-provides-mental-health-care-and-other-support-follow¬
ing-the-latest-upsurge-in.

29. Médecins Sans Frontières. The conflict has worsened in the Caquetà, thus making our more difficult yet more relevant as well. [Internet]. [Updated 2014; cited 2016 April 10] Available from: http://www.msf.ca/en/article/ conflict-has-worsened-caquet%C3%A1-thus-making-our-work-more-diffi¬cult-yet-more-relevant-well.