By María Victoria Correa, El Colombiano, April 29, 2020
(Translated by Eunice Gibson, CSN Volunteer Translator)
In at least 90 municipalities in this country, places that are far from the large municipal centers, there is coronavirus. But beyond this pandemic that has expanded all over the world, in these places there are other evils that are deeply rooted: hunger, absence of public services and, worse, the lack of a hospital or a health center. Their local leaders don’t know what which they should ask for, food or medical supplies.
Besides that, there are other realities that combine with the sickness: first, isolation is not carried out one hundred percent. Worse, the great majority of the towns (pueblos) are living in an absolute carnival when the subsidies are being delivered. It has made some leaders get tough: they establish a curfew so that the people don’t leave their houses.
The second thing is that some mayors and governors are selling the resources and, according to the control agencies, they are paying double or triple the normal cost of supplies. And if that were not enough, in some municipalities there isn’t any potable water to promote hand washing, as in Quibdó, where, fortunately, it has rained and people have stored some water in their homes.
In general terms then, it’s about Tumaco, Buenaventura, Leticia, Riohacha, Quibdó, Ciénaga, Valledupar, Sencelejo, and Montería, among others, where the daily struggle is to keep from dying of hunger, to have clean water, and for the hospital to have supplies and doctors. In these municipalities, you can count the mechanical ventilators on the fingers of your two hands. On the buses there are no campaigns for respecting a meter of distance, like in the big cities. No. On the buses everybody that can fit gets on, even on the top.
To take care of this emergency in the municipalities, the government is operating at two speeds. For one side there is Luis Guillermo Plata, manager for attending to Covid 19. For the other side, there is the National Unit for Risk Management and the President’s High Council for the Regions. During last month that agency has delivered food and supplies in some provinces, such as Risaralda, La Guajira, Boyacá, and Casanare.
Out in the regions.
Eugenio Rangel Manrique, the Mayor of Villa del Rosario, a municipality that borders on Venezuela, near Cúcuta, in Norte de Santander Province, explained that for him the management of the migrants is the most complicated.
“Our hospital is a first level hospital. Here there is an activated emergency room. We don’t have ICU beds in this municipality, but we are near the Erasmo Meoz Hospital in Cúcuta. With regard to the subject of the migrants, I have to say that it is a difficult situation. There aren’t as many coming on the paths any more, but now we are dealing with the overcrowding. We have about 400 houses in which nearly 7,000 migrants are living. The Army helps us control the situation; I complain every day and nobody answers,” said the Mayor.
On the other side of the country, in Leticia, the doctors all quit. According to statistics from the Colombian Association of Hospitals and Clinics (ACHC in Spanish), Amazonas Province has 167 hospital beds in the whole province and has nothing for intensive care. The medical personnel in San Rafael Hospital announced a massive resignation last April 20.
Rosemery Lozano, a pediatric and gynecology nurse in Leticia, told Colprensa that she is worried about the situation she and the other health professionals are in. She asks that the emergency in Amazonas Province be attended to.
“The panorama, unfortunately, has been rather precarious, considering that the hospital has exceeded its capacity, and for many years it’s the only center for attention that we have in the province. In this situation, there aren’t enough beds; they are needed in pediatrics and in emergency. We have to add to that the fact that there are peaks at some times in the year for other sicknesses, such as dengue. There are only four ICU beds for adults, two for pediatric, and one neonatal,” she added.
Meanwhile, in the Municipality of San Diego, Cesar Province, the Mayor, Carlos Mario Calderón, is annoyed because the community does not obey the quarantine. “We have prepared to confront the pandemic, we have an isolation ward, and we are making daily campaigns of disinfection and using loudspeakers. We also have an isolation room that is ready to take care of a case.” San Diego is a municipality where 8,000 people are living.
He explained that they had issued nearly 55 municipal violation tickets to people who didn’t comply with the quarantine, “but the people are not aware of what a problem we are experiencing. This has been handled with folklorism and in fact, we have not had 100 percent isolation; they have not been prudent. Now I’m really worried that we have hundreds of people asking for food. We are poor. We have received 1,200 food packages from the provincial government to help.”
In the meantime, Jesús Delgado, Secretary of Health in Quibdó, explained that in his municipality there are 20 ICU beds that could be increased to ten more. For isolation beds they rented 132 from three hotels so as to be able to isolate the cases that may appear.
“It worries me that there could be an overflow of infected patients. In case that happens, the system would collapse and we don’t have the capacity to respond to that. We have everything to be able to isolate, but not to attend patients whose condition is critical. I also worry that we don’t have the resources to carry out the contingency plan that we drew up. The cost would be 14,000 million pesos (about USD 3,500,000). We don’t have that. And we only have twenty ventilators.”
It should be noted that the capital of Chocó Province has a population as high as 130,000 inhabitants and that the only hospital, the San Francisco de Asís, is not only collapsed, but in a serious financial crisis.
Carlos Humberto Lebreros, specialized physician at the hospital, told Colprensa that they have their hands tied in this emergency. “The capacity of laboratories and operative capacity is very weak, due to the fact that no money comes to the hospitals. These days we have seen the delivery of personal protection supplies, given the number of cases we have had since last week,” he explained.
Finally, the Health Official Delgado also made clear that the quarantine is not respected. “Here it’s difficult to control; the only days that we are able to close everything are Saturdays and Sundays. In the rest, it’s been difficult and the people go out in spite of the restrictions.”
Look at the graphic with the information for the 90 municipalities in Colombia:
Amazonas Leticia 40 1 48% 26.99
Antioquia Apartadó 4 2 92% 14.44
Montebello 2 1 58% 15.51
Frontino 1 1 71% 34.06
Santa Rosa 2 1 71% 9.18
San Pedro 1 1 46% 6.59
Donmatías 1 1 89% 6.1
Atlantico Soledad 66 1 98% 7.97
Puerto 4 1 94% 9.05
Polonuevo 1 1 83% 13.08
Ponedera 1 1 91% 22.84
Santo Tomas 1 1 87% 14.56
Baranoa 2 1 87% 14.19
Malambo 7 1 94% 12.82
Galapa 1 1 96% 13.49
Sabanagrande 4 1 95% 15.92
Province Municipality Cases Hospitals Potable Water Needs
Bolívar Turbaco 13 1 76% 17.14
Arjona 4 1 75% 26.74
Calarmar 1 1 52% 40.01
Boyacá Santana 4 1 73% 14.8
Olcatá 1 1 94% 5.97
Tunja 7 2 98% 3.6
Toguí 14 0 68% 25.14
Caldas Viterbo 2 1 0.93% 8.86
La Dorada 32 1 94% 12.54
Chinchiná 4 1 96% 7.89
Manizales 12 3 96% 6.18
Villamaría 3 1 93% 6.88
Caquetá Florencia 2 2 90% 14.45
Casanare Yopal 10 2 89% 11.5
Cauca Popayán 17 3 96% 8.8
Timbío 2 1 93% 16.61
Miranda 6 0 84% 9.13
Santander de 1 1 82% 12.02
Cesar Valledupar 43 1 88% 17.69
San Diego 2 1 79% 21.94
La Paz 1 1 70% 28.38
Codazzi 1 1 79% 28.42
Bosconia 1 0 85% 31.48
Chocó Quibdó 10 1 25% 72.74
Unión 1 0 20% 52.31
Córdoba Montería 17 1 88% 18.62
Sahagún 1 1 74% 24.92
Lórica 2 2 69% 33.1
Tierralta 1 1 42% 55.83
Cerreté 1 1 87% 24.63
Ciénega 1 1 64% 36.71
Cundinamarca Villapinzón 6 0 88% 8.64
Province Municipality Cases Hospitals Potable Water Need
Cundinamarca Sopó 4 1 97% 2.83
Zipaquirá 13 2 98% 3.11
Huila Neiva 73 2 96% 7.51
Palermo 3 1 78% 12.6
La Guajira Riohacha 5 1 69% 36.01
Magdalena Santa Marta 135 1 78% 14.23
Fundación 1 1 85% 25.16
Bananera 2 1 49% 28.51
Ciénana 23 0 82% 28.44
Nariño Ipiales 52 2 84% 10.34
Tumaco 18 1 31% 27.52
Pasto 18 2 98% 8.11
Cumbal 3 1 85% 15.15
Contadero 1 0 88% 16.34
Cumbitara 1 1 83% 19.57
THE CONTEXT OF THIS INFORMATION
As related by a patient
My name is Ancizar Pérez. I live near Montería. It all began
on March 24 when I started feeling bad. It wasn’t much. I had a fever during
the night. On March 31 I was in a town (vereda) in Tierralta, doing some work.
That day I was already feeling really bad. The fever got higher. I started
coughing and I broke out in a rash. I went to the emergency room of a hospital
in Montería and they told me that I had a viral infection. They prescribed
acetaminophen. That same day I asked them to test me for coronavirus because I
had been to several different municipalities in Córdoba, but they told me it
wasn’t necessary. I was approved for five days off work. During that time my
health got worse. The fever went up. The cough got worse. I started to vomit. I
lost my sense of taste. I had to make myself eat. As a precaution, I stayed in
my room and I only left it to take a bath. From April 1 to April 5, my physical
condition continued to get worse, I looked worn out, and I lost weight. I felt so
weak I could only walk by holding onto the wall. I went back to the hospital.
They recommended acetaminophen again, and approved another five days of
disability. I decided to go to the Mayor’s Office and I called the help line.
There they asked me if I had had contact with a person who had coronavirus. How
should I know? But they told me again that I wasn’t eligible for a covid test.
I kept on being careful and I stayed isolated. On April 13 I went to the
emergency room again and the first doctor that saw me took care of me. The
difference was that on that day they decided to give me the test. After four
days I found out I was positive. They waited 17 days to diagnose me, time that
I could have been with nearly fifty people, and a few days before I got sick I
had traveled in several municipalities, such as Tierralta, Cereté, and Lorica.
 Cases of coronavirus
 Percent with access to potable water
 Percent of basic needs not available