Doctors Without Borders/Médecins Sans Frontières (MSF) calls for an increased response to mental health needs and comprehensive care to help people deal with effects of prolonged violence.
NEW YORK/BOGOTA, AUGUST 17, 2017—Violence remains a major problem for many people in Colombia despite the peace deal the government and FARC-EP signed last year, according to a report released today by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).
The increased presence and influence of criminal organizations and other armed groups in the port cities of Buenaventura and Tumaco has led to a high number of threats, targeted killings, kidnappings, disappearances, sexual violence cases, harassment, extortion, and restrictions on people’s movements, which has significantly impacted people’s physical and mental health.
"These types of violence are having a clear impact on the physical and mental health of people living in Buenaventura and Tumaco,” said Juan Matias Gil, MSF’s head of mission in Colombia. “Although the violence and the needs of patients seen by MSF in these cities cannot be directly extrapolated to the rest of the country, they can be considered as a plausible reflection of the reality in both urban and rural areas across many provinces of Colombia.”
The MSF report, "A la sombra del proceso" ("In the shadow of the peace process"), outlines the impact of violence in the two cities and examines medical data gathered by MSF teams over two years. Based on information from consultations by MSF doctors and psychologists with 6,000 patients in 2015 and 2016, the report shows that exposure to violent events or the risk of violence has led to intense mental suffering among the general population, with symptoms including depression (experienced by 25 percent of patients), anxiety (13 percent), and post-traumatic stress disorder (8 percent).
The report calls on the Colombian government to increase mental health services, which are largely inadequate.
“There is a shortfall in the provision of mental health services at the primary level, despite the significant needs of the population and despite the existence of a legal framework on care and assistance for the victims of internal armed conflict,” Gil said.
When comprehensive mental health services are available only in larger cities, rather than at local health centers, people have difficulty getting the care they need. For example, there is no psychiatrist in Buenaventura.
“If a person needs psychiatric care, he or she must go to Cali, two and a half hours away by road,” said Brillith Martínez, an MSF’s psychologist in Buenaventura. “Most people who live here cannot afford the trip, so many of the victims are left without comprehensive treatment.”
Additionally, MSF is calling on the government to strengthen and implement additional services for those who have experienced sexual violence, including increasing the number of psychologists in primary care settings. The report shows that only nine percent of rape survivors seen by MSF were treated within 72 hours of the incident. Delaying post-rape care limits the effectiveness of medical treatment and increases the risk of sexually transmitted diseases and unwanted pregnancies.
Based on what its teams have witnessed in Colombia, MSF appeals to the Colombian state to remain committed to current laws that aim to strengthen and implement psychological and sexual violence care, as well as strengthen psychological care and care for survivors of sexual violence at the primary level.
MSF has worked in Colombia since 1985 providing primary and mental health care, as well as sexual and reproductive services for people affected by the armed conflict in more than 20 provinces. In Colombia, MSF has also provided training to health promoters and community leaders, supported a number of hospitals, provided care for Chagas patients, and responded to outbreaks of yellow fever, malaria, and chikungunya.