Professor Steven Orozco Arcila joins us from the University of Antioquia in Colombia. He teaches a range of subjects including public health, primary care and health promotion. In this episode we explore how conflict has affected the provision of healthcare in rural areas of Colombia.

Episode summary:

01.00  Prof. Orozoco Arcila’s professional background

04.10  How does conflict impact the health and wellbeing of people?

08.20  How has the prolonged conflict affected the country?

10.30  What happens when healthcare workers are sent to work in rural conflict areas?

11.30  Is the conflict more prevalent in rural or urban areas?

12.50  How have rural areas been affected by the conflict?

14.20  Do people move to more urban areas due to the conflict?

15.45  How is this affecting the healthcare system in Colombia?

18.20  Can the country address the challenges?

21.00  What happens after the conflict has ended in an area?

Key messages:

Colombia has the longest internal conflict in the world.  Armed actors have control of many rural areas of the country for a long time, controlling movement, economic opportunities, and when people can access health services.

Health workers often do not want to work in these areas as their life is in danger and they are under pressure from illegal actors.

Attacks on medical missions happen in these rural areas, health personnel have been murdered.

Illegal actors are blocking the transit of supplies and can also take these supplies.

Lower vaccination coverage and higher prevalence of infectious disease in areas where conflict is more prevalent.

Constant presence of paramilitary in territories including in the hospital.  Seeing many people wounded and killed, health personnel were displaced.

Rural service is a mandatory step to be able to attain medical credentials.

Conflict is more intense in rural areas as this is where the natural resources and strategic corridors are.

Conflict has produced approximately 9 million casualties, about 80% of them in rural areas.  About 9 million people have been displaced within the country.  More than 34 000 people were kidnapped, there are 190 000 missing people.  Most of this is concentrated in rural areas.

People are coming to the cities without any possessions, they usually contribute to an increase of poverty and unemployment in the cities.

Weak presence of the state in rural areas in relation to education, health and other public services.  This is increasing inequalities.

Weak health systems in rural areas of Colombia.

In areas where the conflict has ended the communities can live better and start their lives again.

Drug trafficking is the main cause of the ongoing conflicts.

Farmers in conflict areas were made to produce coca leaf, when the conflict ends, crops will be destroyed but no new opportunities or support is provided, this can fuel new cycles of violence.

Email: steven.orozcoa@udea.edu.co

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