Chocò I – Colombia Development of primary health care and woman health services in Bajo Atrato

For more than 40 years, Colombia has been experiencing a complex armed conflict which has caused the death of approximately 250,000 people so far. The origin of the conflict has its origins in a series of political, economical and social contradictions including national and international interests which heavily affect the local and regional dynamics of the conflict.

In 2002 only, according to calculations, the civil war cost the government around 4,7 billion dollar, which is 5,8% of GDP.
The corrupting power of drug trafficking, the internal armed conflict between the Colombian Armed Forces, far right-wing paramilitary group, Marxist guerrilla of FARC (Fuerzas Armadas Revolucionarias de Colombia – Revolutionary Armed Forces of Colombia) and Guevarist guerrilla of ELN (Ejército de Liberación Nacional – National Liberation Army) have dramatically affected civilian population, which in this conflict has suffered the highest number in deaths, missing people, people forced to leave their homes, and victims of several violations of Human Rights and International Human Rights.
In 2008, Colombia was reported to be the country with the highest number of victims of anti-personnel mines; military forces often do not defend war-related interests only. This reality leads to the conclusion that forcing people to leave their homes (almost 3 million people in Colombia, which makes it the country with the highest figure in the world after Sudan) is a real target of the war rather than its consequence.
It has been also found that violence is especially aimed at weakening and dismantling social organisations, in particular those considered non functional to orders established at the different local levels.
War and criminalisation of social protest in the country (since 1986 approximately 4000 trade unionists were killed) has tragically weakened the existing social framework. Rural communities, natives and Afro-Colombians are found to be – as well as belonging to the poorest sectors of Colombian society – the groups which are the most vulnerable to violence and the consequences of forced abandonment of their homes.

The project

The main target of this project is improving, in two-year time, health conditions of rural population in Bajo Atrato (Chocò Department – Colombia). The project’s specific target is to develop primary health care services within the communities of Bajo Atrato by offering quality services able to meet the population’s needs, with a particular focus on women’s health. Beneficiary communities are in a permanent-human-crisis zone within which civilian population – mostly forced to leave their homes- is particularly vulnerable because of the violence of the Colombian internal conflict and its own historical condition of socio-economical alienation.
Direct beneficiaries of the project are approximately 10,000 people belonging to 24 communities where health promoters are trained by the project’s team in the area of Rio sucio and Carmen del Darièn.
The project’s activities can be divided in 4 wide areas of intervention: infrastructures, health prevention and promotion, treatment, training.

The activities planned for the project’s first year are the following:

• Setting up of 4 community health areas;
• equipment and diagnostics upgrade for 14 health promoters (prs);
• implementation of community activities of health prevention and promotion;
• implementation of treatment community activities;
• training on reproduction and sex health addressed to 25 community obstetricians (parteras);
• implementation of continuous training activity for 14 health promoters;
• carrying out community visits aimed at supporting and supervising health promoters.

The following outcomes are expected:

1. Communities and health promoters have infrastructures and equipment required for primary health care activities.
2. opulation can access and benefit of health prevention and promotion community services.
3. Population can access and benefit of treatment community services.
4. Health promoters and community obstetricians (parteras) have been trained on treatment, health prevention and promotion activities at a theoretical and practical level.

The on-going intervention is a coherent continuation of the previous project (Community health project in the conflict area of Bajo Atrato) and doubles the beneficiary population (thanks to a promoters empowerment strategy) and is specifically oriented to promote woman’s health, the vulnerability of whom significantly emerged during the previous project. The previous intervention allowed health promoters to be trained and was oriented to health community services development.

Location:
48 communities
Municipalities of Rio Sucio and Carmen del Darièn
Chocò Department , Colombia

Partner
Health department of social pastoral care body in Apartadò, Municipality of Cascina, Concern America.

Project’s duration:
24 months (start in April 2011)

Period
2011

Cofinanced by:
Region of Tuscany, Municipality of Cascina, MEDU.

News from the project