COMPLEX EMERGENCY IN COLOMBIA

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COMPLEX EMERGENCY IN COLOMBIA

• Workshop on PAHO/WHO Corporate Capacity Building
  for Disaster Risk Reduction
• Dr. Pier Paolo Balladelli
• 21 - 23 February 2007, Miami Florida, USA

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Colombia - Humanitarian SituationBackground

• Conflict started 44 years ago on an ideological
  basis
• Shifted into great economic interests through
  narcotraffic
• Three main illegal groups FARC ELN AUC
• Civil society involved often as shield, or in the
  middle between official military forces and
  illegal groups.
• Human rights degradation, displacement with lack
  of access to social services as a result of
  combat, air bombings, antipersonnel mines
  massacres, seizing population centers, selective
  murders, kidnappings, trapped populations and IDP.

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Total Numbers of Internally Displaced People
(IDPs)

• 1896160 people (432344 families) according to
  official data (registered at SIPOD-Accion
  Social)
• 1463735 individual displacement
• 432224 as a result of mass displacement
• 2940000 according to NGOs (CODHES) without
  individual verification. It includes
  displacements for gliphosate air spray

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IDPs Social Health Profile

• Illiteracy 23 among displaced population vs 7
  national average
• IDP adolescent mothers 35 (PAHO 2003) / 57.8
  (Profamilia 2005) vs 19 national average
• 48 IDPs covered by health protection system and
  52 beneficiaries of state subsidies.
• Mortality rate 6 times higher then national
  average
• 75,7 of families in food insecurity
• Complete immunization 2 under 4 yr (PAHO-2003)
  - 9 (Fupad-PILAS 2005)

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Colombia a country with an advanced legal
framework for IDPs

• Law 387/97 Creates national system for
  assistance to IDPs resources, structure,
  responsibilities, etc.
• Sentence T-025/2004 of the Constitutional Court
  introduces urgent measures to guarantee rights of
  IDPs and urges MPS accomplish with existing laws
  and decrees on assistance to IDPs.
• The Constitutional Court is following up on
  progress on a regular bases concerning Government
  mandate for fulfilling rights of IDPs.

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Trends in GoC Resource Execution for IDPs
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Health Sector Challenges IDPs

• Many governmental partners (Accion Social, ICBF,
  etc) with a sound network to protect IDPs but
  with challenges in database.
• Ill access to the protection system
• low execution rates of national resources
  earmarked for IDPs
• Health determinants below average
• Special IDPs groups (Indigenous, Afro-American,
  etc) with additional burden.

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Relocation of PAHO/WHO FOs in Colombia
Coveragefrom 8 to 15 Dpts
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Achievements

• a. Platform for analysis and policy/implementation
  decisions among authorities and allies at
  national and peripheral level (IASC
  coordination)
• b. Institutional strengthening on competencies at
  National and Departmental level (based on
  national law and the protection system)
• Outputs
• Improved Coordination Synergy among HA actors
• Enhanced Institutional Decision Making Abilities
• Improved IDP quality access to health services /
  Improved Sanitary Conditions
• Increased Disaster Preparedness and Response
  Capacity
• Improved Network re Refugees Health in
  Neighboring Countries

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Main Partners in Humanitarian Assistance -
Colombia

• From the Colombian Government
• Ministry of Social Protection
• Accion Social Presidential Office for
  Humanitarian Assistance and International
  Cooperation
• Governors and Municipality Authorities
• Ministry of Environment, Housing, Water and
  Sustainable Development
• Colombian Institute for Social Welfare (ICBF)

From de International CommunityPRM- US State
DepartmentCIDA-CanadaECHO-EUUNs (WFP UNHCR
UNICEF OCHA CERF)OIM FUPAD USAIDICRC
International Plan MSF
From the Colombian Civil SocietyPAHO/WHO
Collaborative CentersUniversities (Antioquia,
Javeriana, UIS-Santander)CODHES IDPs
ASSOCIATIONS
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Platform for Coordination among Partnersat
National and Peripheral Level

• Tools
• National (since 2004)) and Peripheral Health
  Committee, now re-built into IASC. Situation
  rooms, IDPs Committees.
• Outputs
• Synergy among HA actors Institutional
  Strengthening (especially targeting increases
  national funds execution), Mass displacement
  situation analysis, Surveillance, Advocacy,
  Technical Guidelines, Civil society empowerment.

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Access to Health Services

• Enhanced Institutional Execution Analysis
  Decision Making Abilities
• Promote new epidemiological registers (SIVIGILA)
• New epidemiological bulletin Strengthen analysis
  capacity
• Early Warning System - EWS
• SIGA extension

• Community Empowerment
• Path to Health
• an access route for IDP Health Care

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IDP Baseline Information (Norte de Santander)
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PAHO/WHO Web Page

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WEB PAGE VIEWS 2001-2006

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SIGA

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Path to Health
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Training
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PWR with IDPs can help advocacy and contributes
to visibility
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Execution of national resources earmarked for
IDPs (Valle)
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Improved health determinants good sanitary
conditions for IDP

• Healthy housing (guidelines water filters dry
  latrine emergency sanitation kits etc)
• Healthy Schools
• Partnership is critical for achieving healthy
  housing!

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Family Temporal Shelter
WATER FILTERS

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Increased disaster response capacity

• Human resources capacities
• Community risks maps
• Emergency preparedness training
• Develop or update emergency plans
• Health center preparedness guide
• Resources mobilization
• Emergency contingency plans
• Social communications strategies

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Emergency Preparedness (Galeras Volcano, Floods
2004-2005)
SOCIAL COMMUNICATION
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Improve refugees health in neighboring countries

• Human resources training
• Epidemiological surveillance and control
• Health conditions monitoring
• Reference centre

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Bi-National Commissions Health Analysis and
Response in bordering areas

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Lessons learnt re Management1. Making of PED a
cross-cutting issue at PWR

• Lessons from Coordination Committee and IASC
  suggest CT platforms to GoC
• Tool kit uses strategies and instruments from a
  variety of technical areas and domains
• It obliges an inter-programmatic style of work
• It helps understand conduct CT in a
  decentralized country (municipality MDG)
• It impacts MDG and helps build specific
  competences and management mechanisms for the
  national protection system..

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Lessons learnt re Management2. Building an
Integrated Approach of HQs and PWRs

• Starting from Analysis and Planning in
  identifying priorities and ways of working
• Creating understanding and synergy in dealing
  with partners (Government Donors UN NGOs
  Centers of Exc)
• Dealing with multi-country strategy approach
• Team building and impact analysis

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Lessons learnt re Management3. PAHO/WHO seen as
a resource for better coordination and as a know
how partner

• Thematic platform the most durable and precursor
  of IASC (since 2004)
• Mix of Government, UNs, bilateral, NGOs, local
  partners (each meeting with national and
  departmental sections)
• Alliances many times do nor imply resource
  counterpart from PAHO/WHO but only know how
• Civil society participacion is key to success.

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Humanitarian Assistance the CHALLENGES

• Find a balance between institutional
  strengthening and substitution in acute
  situations
• Find a balance between emergency response and
  piloting new tools
• Can PED FOs be considered an opportunity for
  decentralized TC?
• Is development TC for IDPs to be considered as a
  PED issue?
• Can reintegration of ex combatants humanitarian
  assistance be dealt together?
• Exit strategy Feasibility of MoU with resources
  from the Government. Case-study Santander
  Cordoba.

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IDPs in Quibdo Colombia Feb 2007