“At least here I can go to sleep knowing I will wake up next day,” says Carlos. We have just climbed the garbage dump of the city of Carthagena. “Look how we live and how we work.” He gestures widely to emphasise the severity of the situation. On one side of the dump we see the shanty town Nelson Mandela, on the other people are sorting their way through freshly unloaded garbage. Lorries come and go. We are forced to breathe through our mouths; the smell is offensive. “I left my house because of violence,” Carlos tells me as we stroll back to the settlement. “How could I possibly stay when I was threatened? I had a shop and land—I was reasonably well off. I was accused of supporting guerrillas, and it was better to go. There is killing every day; they do not hesitate. I have seen too many people killed. I have nothing, and I might be hungry every now and then, but I am alive.”
Summary points
Columbia is rich in resources, yet half its population lives in poverty
Killing, kidnapping, cocaine, and corruption are part of everyday life
The civil war between guerrillas, military, paramilitary, autodefensas, and drug barons has left hundreds of thousands dead and displaced
Innocent poor people in rural areas have suffered most
A plastic refuge
The Nelson Mandela settlement has been in existence for two years, and still new people arrive. There is no shade anywhere. The people erect makeshift huts of plastic and wood. The sun beats down on the plastic—the only protection against the heat and rain—making it toxic.
We speak to a couple who arrived three months ago. “We survive, but no more than that,” the man tells us. “I earn 5000 pesos (£2.45) a day by selling chips in town, but there are days when I don’t earn a penny.” He asks me to see his wife, who has chronic leg ulcers. She had consulted a private doctor in town who suggested further investigations. “It cost 100 000 pesos—how could we afford it?” In theory, everybody with insufficient income is entitled to free health care in Colombia, but his wife has not been helped. It is not a life threatening condition, but uncomfortable, to say the least. With cleaning, antibiotics, and proper bandages the ulcers would probably heal without further investigations. The couple fled the violence and they have no wish to return. “I was a farmer,” the man explains. “Look what I have now. There are days when we go without food.”
Kidnapping, killing, and corruption
Colombia is by far the most violent country in the world—in Bogota alone, five people are killed each day. Who doesn’t remember the fate of the unfortunate Colombian football player who scored an own goal during the World Cup? He was shot a month later in the middle of town. More than half of the world’s kidnappings occur in Colombia. “The root of all misery is poverty, but the ‘have nots’ cannot change their fate,” I’m told by a member of our Colombian team. “More so because the ‘haves’ are greedy and want even more, and they are prepared to fight for more wealth,” adds his colleague. Colombia is incredibly rich, yet half of its population lives in poverty.
The civil war has been explained to me 20 times, yet I still cannot grasp it fully. Without doubt the local population suffers. Guerrillas started their war—against poverty—some 50 years ago. The military proved incapable of beating the guerrillas and these days they are supported by the paramilitary and civil defence, who fanatically try to clear areas of guerrillas. Over the years, the guerrillas have lost their ideals, and the fight now is all about access to resources and money. Cocaine has a role in every part of society. People in Colombia know only too well that without cocaine (and corruption) the country would not run. Half the economy depends on cocaine.
Displacement
There are currently 700 000 displaced people in Columbia. They often settle around major cities such as Carthagena. The box describes the usual scenario leading to displacement.
Displacement—the typical scenario
The guerrillas invade a village in search of food and necessities. The population is forced to host them; if not, they are shot. Next day the paramilitary come, accusing the villagers of supporting the guerrillas. A few villagers are shot in public or the entire village is destroyed and the population is chased away. The area is “cleaned”—resources such as minerals, coca, and logging can be more easily controlled and exploited that way. Different groups murder people so that they can accuse their opponents of the murder ... and so the killing goes on. The local people move away, looking for a place where they can live without fear.
Cordoba
We visit the director of health in a district of Cordoba. Before we enter the building, Marco, our team leader, whispers, “His son was killed just a couple of months ago.” He notices my confusion and explains: “No, no, not by guerrillas. Right here, where we stand, by a drunkard. People have no respect for life. We Colombians are to blame, we can not blame the government nor the guerrillas. We have to solve it ourselves, teaching our children respect, to be humans.”
I open a door marked “Health” and find myself looking into the eyes of six smiling girls. The room is barely four metres square, and I instantly apologise for disturbing their meeting. “Not at all, not at all, we are secretaries, just working. The director is next door,” they chorus. Marco explains, “There is little industry here and people like a job with the government, it is handed out as a political favour. That is how you end up with five secretaries.”
The director is very enthusiastic about cooperating over a joint project for the people living in the isolated area of Manso. One third of the population has been displaced because of the violence. Forty community health workers had been trained and although they have been displaced too, they continue their work. We are unclear about the return of the 1500 displaced people and discuss plans for dealing with this in the next period.
Rio Sucio
The next day we travel to the heart of Uraba, the most violent area in Colombia. We set off early by boat from the port of Turbo, to reach Rio Sucio, the main village along the river Atrato. After three hours we reached the place that deserves its name—dirty river. It is decrepit, muddy, and hot—yet the people are busy at the river side, washing clothes and bathing. Latrines have been built along the water, on poles. Children dive from the shore; pigs and horses wander about on their own.
We first visit the parish priest, who is used to passers by. He shows us a letter of complaint written by the community. They are angry that only displaced people get support. It is a common problem: displaced people get attention, while the local population are given nothing. Sometimes people try to be registered as displaced so that they can benefit from things like free food.
We slither through the mud to the hospital. It is difficult to determine whether the hospital has just been looted or is still under construction. It is deserted except for a nurse, who sits dressed in white in front of the building, ready it seems for work. Why remains a riddle. “The doctor is out for the weekend,” she explains “but you can have a look.” She cannot be bothered to leave her chair. Morale is low. The doctors, however, spend only one obligatory year in remote rural areas after qualifying. I heard that one doctor was threatened because he worked too hard.
I am told that this hospital has been given US$2m in aid. “But look what is left; the money was siphoned off.” We see an incubator and ultrasound equipment stacked away in a corner. New, never used ... but there is no electricity anyway. The administration office has a fax machine, although the area has no telecommunications services. The place looks deeply depressing.
Without the staff’s cooperation, making any sort of investment here seems pointless. Yet the hospital plays a pivotal role in the health chain of the area. What can we do? We plan to start with some clinics for the village. If we support the village and get some credibility, we can slowly test the cooperation of the staff and the village council.
The dentist is at home, next to the hospital. She kindly invites us in. “I have been stuck here for a month’s holiday,” she says bitterly. “But I cannot work. My predecessor took all the equipment with her.” The room is empty except for a brand new television and a fan. The Dutch team is playing in the World Cup today, and we studiously try not to hear the result so we can enjoy the video tape at home in the evening. We go as far as to hide our nationality for the day, so that we don’t risk provoking the Colombians.
Back in the village, in the baking heat, we pay a visit to the Indian guest house. A meeting is arranged instantly, inside. Without a fan the heat is unbearable. Sweat drips not only from my face but from my hands while I make some notes. Travel schedules for the next visit to communities up river are discussed and revised. Every time, a new problem arises—local festivals, the leader being absent, the full moon. At last a tentative date is set. They will send word by canoe so we do not arrive unexpectedly.
Turbo
Eventually we hurry back to Turbo. The waves in the bay of Uraba are certainly bigger than in the morning. In Turbo we visit the Colosseum, where some 400 displaced people have been gathered for the past 16 months. Another 3000 displaced people from the Atrato river area have found homes with local residents. The local Turbo community is unhappy about the displaced population: they sleep in the local sport facilities. There is little privacy and no ventilation. I ask a man for his story, but he is irritated by the question. “Which organisation do you work for?” he asks me in return. Obviously he has seen a number of aid workers over the months. He shows us around. The people hang about doing nothing. Little has changed in the year they have been here. The government is trying to repatriate them to their communities, but the displaced people are not always enthusiastic. They would like to receive guarantees about their security, which the government is most willing to give but which in reality do not exist.
The words of my companion still echo through my mind: “It is not poverty, but above all the greediness of the rich that causes the conflict.” Indeed, greed will provoke more misery in Colombia for the years to come. We reach home with a sense of anticipation, still unaware of the result of the football match. Proudly we are handed the video tape, the result clearly marked on the cover: “Hollanda-Belgica/0-0.”
Figure.
Alongside the riverbank in Rio Sucio is a chain of rafts, which are used as a toilet, for bathing, and for cleaning clothes, dishes, and foodstuff

