Living Precariously in Colombia's Conflict Zones

Largely fuelled by a fight over control of the narcotics trade, Colombia’s decades-old civil war often makes headlines, but its impact on the civilian population of the country is rarely the focus of attention. Over the years, as many as 3.8 million people have been driven from their homes by violence brought on by government troops, paramilitary, and rebel forces battling for territorial control, ranking Colombia third in the world after Sudan and the Democratic Republic of Congo for the largest number of internally displaced people.

Armed groups have a stranglehold on roughly half of Colombia’s rural areas, depriving civilians of access to health care by making roads impassable, forcibly conscripting children into militias, and murdering those suspected of collaborating with rivals. These civilians are equally treated with suspicion of potentially “collaborating” with armed groups by Colombia’s armed forces and often face harsh reprisals as a result. In desperation, families flee their homes for urban slums with little more than the clothes on their backs; and when they arrive, looking for work and shelter, they often find conditions that are as threatening as those they fled.

Their new homes are overcrowded shacks without adequate facilities. The living conditions can lead to respiratory infections and diarrheal disease, but there is little access to health care.  There are also very few internally displaced persons who have the option of returning safely to the homes they were forced to abandon.

MSF has a presence in 13 of Colombia’s 32 departments, working in isolated rural areas through mobile and stationary clinics and in urban areas where displaced families have gathered. Teams provide medical care ranging from vaccinations to reproductive care and emergency services, and offer psychological care to victims of violence. As the conflict in Colombia rolls into its sixth decade and armed groups continue to target civilians in their war for control, many Colombians