Improving the Health of IDPs in Colombia

In Colombia, PAHO/WHO, in collaboration with several partners, has been engaged in an on-going project to improve the health of internally displaced populations (IDP). Due to continuing violence and conflict within the country, large portions of Colombia’s population flee their homes, thus encountering many physical and mental health challenges as a result of violence, loss of productivity, poor sanitation and lack of access to health services. Because the Colombian health system is quite decentralized, the Ministry of Health requested PAHO/WHO to provide support at field level in order to improve coordination and implementation.

For the last ten years, with the support of many donor agencies, PAHO/WHO provides technical cooperation and collaborates with local, departmental and national health levels as well as supports the implementation of activities to ensure sustainable improvements for IDP. The main focus is to increase displaced populations’ access to health care services, improve sanitary conditions, enhance local institutions’ capacity, and strengthen disaster response capacity.

There have been great strides in registering displaced persons for the state managed health insurance coverage as well as reducing barriers to accessing health care, such as not knowing where to find doctors and not being registered in the health care system within a Department. In order to overcome these and other challenges, community members have been recruited to aid in educating the public on how and where to access health care. Additionally, a national “Access Route to Health” strategy has been implemented for IDPs, health providers and health authorities, and it was created jointly by the Ministry of Health, PAHO/WHO, the UN High Commissioner for Refugees, and the Ombudsman’s Office. The current project helps build community capacity and uses printed material, videos and radio clips to educate the public.

A health round table meeting gathering all stakeholders related to IDPs.

In order to improve coordination and communication between NGOs and Government Agencies and to bring together the multiple actors within Colombia to discuss IDP-related projects, PAHO/WHO organized “health round tables”. These meetings are organized on a monthly basis at national level, and they are also being developed at departmental level promoting online participation using a virtual meeting environment program. Local officials are now incorporating IDP health issues in new local development plans for the coming years and receive PAHO/WHO’s technical cooperation for the development of contingency plans for mass displacements at departmental level.

Towards improving IDP sanitation conditions, two key strategies were employed. The first includes constructing low cost and easily transportable model homes which contain many features that help maintain healthy living conditions, such as separate bathing and sleeping quarters. One key project activity is the distribution of water filters, since clean water has a dramatic and important impact on health and remains one of the most significant non-structural changes for a family. Recently, 1,130 filters were delivered to families in a critical Department.

In order to facilitate the monitoring of available resources for IDPs, the project developed the SIGA software, a tracking system for the execution of funds earmarked for IDP’s health expenditures and epidemiologic information. SIGA was field tested and has already been adopted in 54 municipalities of 5 Departments. Recently, PAHO/WHO, with local partners, organized 26 SIGA training workshops that directly benefited over 1,000 health personnel and community leaders.

Example of data obtained using SIGA.

PAHO/WHO provided technical cooperation for the creation of Immediate Response Teams (ERI) to implement rapid assessment, coordination and response to mass displacement and natural disasters and to strengthen Colombia’s response capacity. Three ERIs are currently active in the same number of departments.

In collaboration with key partners, PAHO/WHO continues to assess the situation in order to improve IDP’s health. Future areas of work include responding to needs in Ecuador to accommodate the displaced populations that have crossed the border as well as further incorporating psycho-social and mental health response elements.

All of this progress was possible thanks to the active participation and collaboration of key partners as the Ministry of Health and Social Protection, Social Action, Ministry of Environment, Foreign Affairs, Colombian Institute for Family Wellbeing, USAID, U.S. State Department, CIDA, ECHO, AECI, UNHCR, UNICEF, IOM, WFP, OCHA, Red Cross and many NGOs.