Bolivian Citizens Against Violence

The Pan American Health Organization (PAHO) is supporting an antiviolence program in Bolivia that has shown positive results from citizen participation in violence prevention efforts.

The program is based on Community Orientation Units (COUs) that act as liaisons between the community and government agencies, providing information and referrals and conciliating cases of violence that do not involve formal charges.

Members are drawn from existing neighborhood councils or other base organizations and receive training in areas such as forms of violence and abuse, risk factors, human rights, self-esteem, effective communication, conflict resolution and conciliation techniques.

The program also establishes systems for community surveillance of violence, which include risk maps, public suggestion and complaint boxes, monthly action meetings, and basic data collection. These activities support and are coordinated with the work of law enforcement and public health agencies.

Bolivia’s first COU was organized in the PAHO Centennial District of El Alto, La Paz. An evaluation of its initial experiences showed the following results:

• Some 60 percent of cases of abuse can be resolved within the community, without requiring institutional action.
• Word-of-mouth communication among members of the community is an effective way for individuals to learn what their rights are and where to go to resolve problems involving violence.
• The COUs provide an effective way for communities to inform government agencies about danger zones and the most common forms of violence, and can collaborate effectively with those agencies to develop cost-effective actions.
• Members of COUs increase their levels of self-esteem and develop positive behaviors.

Based on these results, the COU model was incorporated in 2003 into the programs of Bolivia’s Ministry of Health and its National Confederation of Neighborhood Councils. There are now 37 COUs working in four departments: Cochabamba, La Paz, Santa Cruz and Tarija. The goal is to organize 18 COUs per department throughout the country by the end of 2005.

Violence, both domestic and other forms, has emerged as a significant public health problem in Bolivia. Domestic violence affects an estimated 5-6 women and 1-2 men of every 10 married or commonlaw couples. One in three children suffers from child abuse. Personal safety is considered a major public concern.