By Valerie Cortés, EL ESPECTADOR, September 21, 2020

(Translated by Eunice Gibson, CSN Volunteer Translator)

Kidnappings, sexual abuse, and murders were some of the attacks on health workers in the midst of the conflict. Now the Truth Commission is going ahead with the historical reconstruction of this episode, and the Health Ministry is working to prevent it from happening again.

Today, the world pandemic has put in evidence like never before the fact that the health workers are one of the pillars of human life. Doctors, epidemiologists, nurses, aides, bacteriologists, among other areas, have been recognized by the government and by the citizens as “heroes and heroines”. Nevertheless, for decades many of them were victims of the violence that engulfed the countryside, some places poorer than others, but always vulnerable and in dispute. There, after a battle or trying to free the kidnap victims, there was always someone there from the health sector and their stories are just now beginning to be uncovered.

The Truth Commissioner, Saúl Franco, is a physician by profession and he has just recently collected statistics, testimony, and stories from the health workers. He’s trying to reconstruct these episodes to capture them in the final report that he will present to the Commission for Clarification of the Truth of the Conflict next year. “This country has very little awareness of the impact of the violence on the health workers,” he pointed out.

In the International Human Rights Law (DIH), which governs internal conflicts, the collection of health workers, hospital infrastructure, medications, and transportation is called Medical Missions. After the great wars of the 20th Century and up to now, governments have committed, or have been urged by the World Health Organization (OMS) or the International Committee of the Red Cross (CICR) to protect Medical Missions that are in the midst of the conflict. In Colombia, not until 2012, by Resolution 4481 did the Health Ministry adopt the Medical Mission Manual, which establishes the rules for the use of emblems and the protection of missions that travel in rural areas in ambulance boats, in SUV’s, or by mule in their journeys of prevention.

According to data compiled by the Commission, between 1958 and 2019, there were 2,419 violations of the Medical Mission rules in this country. “This is an extremely serious thing, because it implies that violations were frequent. Of this total, the principal damages were to life or physical integrity. We know that there were more than 826 murders of health workers during the war,” stated Franco.

So far in the study, we see a worrisome pattern: the nurses and the health promoters were systematically targets of violence.

In different regions of the country, for example in César Province, the armed groups had with them nurses who took care of patients that were in their ranks, forcing them to do things that they didn’t want to do, abortions in some cases. After that, they raped them. “It was another part of the job,” they insisted, as they pronounced the sentence.

Between 1978 and 2019, 84 rural health promoters were murdered. The promoters are health personnel who mainly work in the towns (veredas); some of them are campesinos trained to carry out prevention campaigns for rural health. They perform vaccinations, pregnancy tests, and help the women get to a health center. “They were very defenseless people, vulnerable, and the armed actors wanted to control them and put them at their own service,” Franco said.

In the same manner, the most violations of rules protecting medical missions were in the provinces where most of the conflict was concentrated: Antioquia, with 281 violations, Nariño, (145), Caquetá (126), Arauca (124), and Norte de Santander (121).

However, in 39% of the violations against the medical missions, those responsible are not known, which makes it difficult to do justice. Of the violent acts where the identity of the actor is known, in 33% (631) it was the guerrillas, and in 19% (363) it was the paramilitaries, in 2.5% (61) government forces, and in the remaining 6.5%, there was joint action between legal and illegal armed groups.

In the ‘90’s, when the FARC guerrillas had strengthened their presence in the countryside, according to the documentation by the National Center for Historical Memory, they took over hospitals, attacked medical missions, and used unconventional weapons with biological material such as feces in land mines.

Likewise, the paramilitaries were the perpetrators of reprehensible crimes: for example, the massacre at Caracoles (Arauca Province). There the Conquerors of Arauca Bloc, part of the AUC (United Self-Defense Forces of Colombia) took over the health center and tortured and murdered eight people there and later raped the women who had come to recover the bodies of the victims.

“Besides all that, the health workers had to suffer stigmatization and threats just to carry out their medical work. That didn’t happen just on an individual level, but also to the organizations of health workers,” Franco explained. One of those was the National Labor Association of Health and Public Service Workers (Anthoc in Spanish). Angel Salas, who belongs to the Association, suffered forced displacement and death threats. He told how since 1994, Anthoc has been registering violations of the human rights of health workers, and those increased between 1998 and 2006.

Julio Castellanos, Director General of San Ignacio Hospital in Bogotá and member of the National Committee for the Respect and Protection of Medical Missions, also expressed an opinion: “We come from a history of attacks by armed groups or by the government itself on Medical Missions, which have been affected by violent incidents. Now, with the Covid-19 virus, the attacks are even coming from the general population.”

Castellanos said that the attacks are still going on in the territories most affected by the violence, and because there are no doctors and the dispute is about control of territory, “the population is unprotected because there is less ability to move around and the health brigades can’t get to those regions.” Now the Minister of Health is working hand in hand with the International Red Cross Committee (CICR) to protect health workers in Colombia and prevent violence against Medical Missions.

For its part, the Truth Commission, hoping to advance and make violations of Medical Mission rules more visible, is putting on a program next Thursday, September 24 beginning at 10:00 a.m. The program is called “The impact of the armed conflict on health,” and will be transmitted on the Commission’s official network. A representative of the Health Ministry, Unicef, and the United Kingdom’s Ambassador to Colombia, Colin Martin-Reynolds, will take part.

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