Venezuelan migrants in Colombia: A neglected crisis

Medical needs of Venezuelan migrants overwhelm the capacity of the Colombian health system

Colombia 2019 © Esteban Montaño/MSF

NEW YORK, December 18, 2019—In recent years, more than 1.6 million Venezuelans have fled to Colombia—the second largest population movement in the world—but the international humanitarian response remains insufficient and people continue to live without access to adequate shelter or medical care, the international humanitarian medical organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.  

Every day people continue to leave Venezuela, joining the more than 4.7 million who have already fled the country’s political and economic collapse. Yet the international community is largely ignoring the dire situation of migrants and asylum seekers in Colombia and the humanitarian response remains severely limited, particularly in rural areas affected by armed conflict and criminal activity.

“In Venezuela my daughter was dying of malnutrition”

Unlike other countries in the region, Colombia has kept its borders open to Venezuelans, even though they don’t have the necessary resources to adequately cover the enormous needs alone.

“In Venezuela my daughter was dying of malnutrition,” said Juan Marcos*, a young father of three whose daughter was treated by MSF in Tame, Arauca department, for skin rashes caused by sleeping on the street. “Before I let a child die of malnutrition in Venezuela, I would a thousand times rather bring her here. At least someone will give her a cookie, so she can eat.” 

When they first arrive, many people are forced to sleep on the streets before moving to slums or overcrowded houses. This leaves them vulnerable to recruitment by armed groups, discrimination, sexual violence, or forced prostitution.

Poor living conditions and lack of access to clean water and sanitation services also have a direct impact on people’s health. Migrants and asylum seekers have access to some health care through the Colombian health system, but it is limited to emergencies, births, and vaccinations, and the needs extend far beyond what these services can address.

At the end of 2018, MSF established three primary health and mental health care projects for Venezuelan migrants in the border departments of La Guajira, Norte de Santander, and Arauca. As of November 2019, our teams have conducted more than 50,000 medical consultations. Although these consultations do not reflect the magnitude of the situation, they indicate the enormous difficulties these people face in accessing medical care, adequate food, housing, and protection.

“Venezuela is just fading, disappearing”

Treatment for patients living with chronic diseases—such as HIV, or kidney disease—is not covered by the Colombian health system. People suffering from these diseases require continuous treatment, and referrals to higher levels of care are often impossible. "In Venezuela, medical tests are expensive, everything is dollarized [i.e. sold in US dollars], and supplies are missing,” says Elías*, 51, who arrived in Arauca from Venezuela about 15 days ago and needs dialysis. “Machines don’t work properly; they break down and are no longer repaired. Medical and technical staff have also left the country."

People living with HIV/AIDS also have trouble accessing care. “I go to MSF’s mobile clinic for check-ups because of the disease,” says Jesus*, who lives in Saravena. The 27-year-old was diagnosed with HIV five years ago and stopped his treatment when he left his home in Venezuela two months ago. “I would like to have money right now to return for treatment in Venezuela, although I don't know if I’ve been taken off the register or if there would be medication. Then I would return to Colombia. Venezuela is just fading, disappearing. I also come to MSF because I have suffered a lot of abuse throughout my life and I need psychological support. At the moment, I can only get treatment for HIV in Cúcuta and going there by bus involves a lot of time and money.”

MSF will soon start providing treatment for HIV in Tibú and Tame, in collaboration with Aids Health Care Foundation Colombia.

Women face barriers to sexual and reproductive health care

MSF is also concerned about limited access to sexual and reproductive health care. Abortion was largely decriminalized in Colombia in 2006, though women face significant barriers—from social stigma to being turned away from health structures—when requesting safe abortion care within the health system.

The consequences of the Global Gag Rule are also being felt. This US policy, officially known as the Mexico City Policy, cuts off US funding for programs outside of the US that provide abortion-related services, including counseling and informing women about their reproductive choices.

About 68 percent of the total resources allocated in 2019 to the Venezuelan migration crisis in Colombia came from the US and, as a result of this policy, many organizations have curtailed abortion-related services to avoid losing vital US funding, reduced sexual and reproductive health services due to lack of access to funds from other sources, or have been forced shut down altogether. MSF is responding to high demand for these services, including safe abortion care. In MSF projects in the border departments, for example, approximately one in five consultations is related to this issue.

But much more needs to be done to address the needs. MSF is calling for a greater commitment from the international community to address this humanitarian crisis. Colombia does not have the resources to respond to this crisis alone and more funding and support is urgently needed.

*Patient names have been changed.