Life in this Region: Our Life and Work in the Urabá Region of Colombia
by Alan (Curt) Wands

March 1, 2005

My dear extended family, friends and colleagues,

A number of weeks ago I was hit by one of the more chilling moral/ethical issues that I have come across here. A mother approached me in Apartadó asking me for counsel on her 15-year-old daughter who has been diagnosed with HIV. The mother did not come asking for medications or alternative treatment. Her concern was for her other children she told me. I was prepared for her to ask me about how HIV might be transmissible to her other children through daily life at home, or perhaps on how to counsel her other children to avoid risk factors like using IV drugs or having unprotected sex. However this mother's quandary was different. She explained that the paramilitary forces had heard that her daughter was HIV positive and that they were planning on coming to kill her daughter in the home. “Should I move my other children to sleep in another room, so that they might not be killed when the paramilitary come to kill my daughter at night?” was what this distraught mother wanted to know. The harshness of her reality I find devastating. Imagining the terror of waiting for the nighttime stomping of boots, the brutal entry of armed men, hooded –or not– to avoid later identification, the shots fired whether directed or indiscriminate, were all part of a nightmare she awaits with the certainty of a ticking clock. This is the vision of social cleansing that the paramilitary bring to Colombia. The paramilitary's contradictory activity in growing, processing and smuggling tons of cocaine and heroin, is stunning in their lack of allowance for what they perceive as social deviance (including drug addiction!) Whether it is children sleeping on the streets, alcoholics, drug addicts or other societal burdens (one can read into this the journalist, priest, health worker or other social change agent), the paramilitary are the judge, jury and executioner.

The paramilitary are being demobilized in many part of Colombia, although in our area of the Lower Atrato the “Elmer Cardenas Bloc” of paramilitary are not participating as of yet. While I do believe that demobilization is hopeful in that fewer people are organized to kill one another, a true peace process is long off. Pacification of this region was been somewhat obtained with the killing of thousands of civilians, so the military and their allies feel they can relax their guard and allow for their death squad proxies to be disbanded. Their replacement by “Peasant Soldiers” (Soldados campesinos) is just another way to keep civilian society militarized and divided. Meanwhile the preponderance of U.S. government provided weapons in this region is astounding, at the same time as we struggle to get even the most basic of medications and training in health and education into this region. The violence of this war will not truly end until the violence of the enforced poverty is addressed, and this is a long way off. “Pacification” and peace are truly different concepts.

Around the same time as the mother came to talk with me in Apartadó, I was asked to examine some of the street children there. I found four of the children under the age of 12 years old to have positive RPR blood tests. Now, this blood test can indicate a number of illnesses, the most common ones in our region being syphilis, the sexually transmitted disease caused by the Treponemun pallidum spirochete, or its cousin “yaws” caused by the Treponema pertenue spirochete that can be transmitted by mere contact with broken skin or open lesions. The treatment was given before I could verify which causal bacteria created their condition, which would have been unlikely to ascertain regardless. Three out of of four of these pre-adolescents were already sexually active and had to be counseled on “safer-sex” practices. Life on the streets for an orphan displaced by the war here can be traumatic.

There are times I find it difficult to write with depth and integrity the hopes and struggles, the lives and deaths, the joys and sufferings I share with people here. It seems so easy to move in the flow of life on the river; without roads, or traffic, reliable phones or access to email. The trips to Apartadó became fewer toward the end of 2004 as I become more enmeshed in the life of the displaced of the communities in this region.

VISITS TO THE U.S. AND FRANCE

However in November it was time to leave the region and return to the U.S. for a bit with my companion, and now wife, Julie Bourdoiseau. Julie and I had met when I first returned to the Atrato River in 2004 while she worked with the Promoters for Peace and Reconciliation to provide an international presence as a measure of security in some of the same communities I have been working with. Julie studied geopolitics in Bretagne France, and has spent time in Honduras as well as Boznia-Herzegovnia. Her light and liveliness in this difficult region were immediately apparent, as well were her draw to people and their draw to her. Her faith guides her life and direction and we quickly found bonds in many aspects of our lives and beings. In December we had a private, deeply faith filled blessing of our commitment in Santa Ana, for which we will be ever grateful.

The contrast, for both Julie and I, between the conflictive life in Colombia with the often blind and super-patriotic war footing in the U.S. is dramatic. The ever-present flag, the banners to “Support Our Troops” and the constant barrage of pro-war news are incapable of conveying to me the misery and suffering behind the nationalistic imagery. And Colombia is barely a footnote in the news. George Bush “visited” Colombia just before Thanksgiving by spending a matter of hours on a fortified island off the coast and protected by 15,000 Colombian troops, paid for by the U.S.

It was deeply moving to be with 16,000 people protesting the U.S. army/government “School of the Americas” (SOA/WHISC) in Georgia. A three-hour litany of names of thousands of the victims of “graduates” is unfortunately the only indictment of the war crimes perpetrated by the U.S. and Latin American military through this atrocity of an institution. This years protest felt even more important to us, in light of our bringing perhaps the smallest participant via our new little life growing in Julie's uterus.   As I write this letter months later, on this day  in particular it seems an important day to recall this event, as one of the speakers protesting that event in 2002 was just killed days ago. It was just last week that Luis Eduardo and I were discussing how to reinvigorate the health committee in the San José de Apartadó “Peace Community.” While I left to the capital of Bogotá this week he left for more distant communities in the areas outlying his own. According to eyewitnesses, Lusi Eduardo, along with his 17 year old companion and his 11-year-old son were apparently killed by an army patrol of the Army's 11 th Brigade. Their bodies, along with two other children (18 months old and 2 years old) and three more adults were found in a remote region near San José, having been killed a week ago today (February 21.) All of the adults were cut into pieces and mutilated. The children were “merely” shot. It is a great likelihood that many in the Colombian Army's 11 th Brigade were trained at the U.S. “School of the Americas.” This project needs to be shut down so that more civilian leaders are not killed by their own military. Julie made the 7-hour horse trip up (with our now 4-month-gestation baby) accompanying several dozen members of the community in their grief, to recover the bodies. After over 20 years in zones of conflict, and the brutality in Central America I never get used to losing a friend or an acquaintance, nor do I get used to the unfathomable brutality that war generates. I pray I never get used to this. Luis Eduardo certainly was aware of the risks he ran. The light and hope his life was testament to, and the ultimate sacrifice he gave, far outweigh the more than two million dollars a day in projects of death that the U.S. government continues to fund here.  It makes the time in France and the U.S. with our families and communities take on even greater importance as we returned to this work only a few weeks ago.

MARIA . . . AND ANDRES

In Chocó, Colombia where we live, the lives of those displaced by the war reflects only the base line results of these policies. The community of Montaño on the Atrato River is home to 840 people, almost all of who have been uprooted from their original communities over the past 7 years of violence. A number of months ago several of the Accompaniers for Peace and Reconciliation went to visit this community and I took the opportunity to join them so as to supervise the work of the 4 health promoters who work here.

One of the many cases I saw in this last year was of a young boy I have not previously written about. I first saw him in the community of Montaño, at the rough-hewn house we ate our meals in. Here a 3 ½ year old Afro-Colombian boy occasionally wandered in without speaking. His belly was bloated from parasitic worms, he had diarrhea, was in a state of 2 nd degree malnutrition, and his skin was a patchwork of fungal infection and bacterially infected pustules. Both of his parents had been killed and he wandered from house to house eating voraciously of whatever food might be shared. He could speak fewer than 15 words, but his comprehension was much higher. I did the best I could with the health promoters, but with the lack of parenting and attention his life outlook was bleak. Maria, one of the accompaniers in the visiting delegation and I lamented the bleak outlook this child had. I left the community with an all-too-common mix of grief for orphans like the one I had met, and yet with hope because there is a fledgling attempt by the health promoters to improve the health of people in communities like Montaño.

In Río Sucio I ran into Maria, who had been on that trip weeks earlier. With her typical bright eyed smile she asked me to visit her sick son, Andrés. Now, I have known Maria for over two years and I know her only son and the struggles she has had as a single mother. She herself was in a relationship where she had to hide and flee from her abusive husband just to save her own life. The confusing part for me in her request was that her son was not named Andrés. As her smile and laughter became more contagious I realized something was afoot. We went to her simple wood board home and there I met her new son Andrés. He was newly named as no one had really remembered the name this 3 ½ year old orphan had been bestowed previously. She had returned on a trip to Montaño and could not bear to see this young child drift aimlessly into further malnutrition and neglect. Community leaders there had instantly agreed that she should “adopt” the boy, and she brought him home in the boat she arrived on. He was registered as Andrés Mauricio and was baptized a week later with Maria as godmother and myself as godfather. I was, and am overwhelmed by this miracle of daily life on the Atrato.

Meanwhile, over a third of the community of Montaño is prepared to return to their traditional land in Chicao within the coming weeks.   Over 350 people  fled a paramilitary takeover of their community in 2002.  Many went to the community of Montaño, while others dispersed to other villages. The infrastructure of the community has been completely destroyed, from the basic electricity system to the school and cooperative buildings. In spite of the continued risk of paramilitary violence on the members of Chicao, they have decided to return to attempt to rebuild their community. Reconstruction of villages like Chicao is a challenge, particularly with the paramilitary still ever present. Fortunately for the people of Chicao, Biunny, one of the better health promoters of our group will be returning. She has had several years of courses and practice and is capable of diagnosing and treating the majority of illnesses and injuries she encounters. Her own struggle as a single mother of two children has not prohibited her from continuing to work daily in the prevention and treatment of illnesses. We met after the last course to pack medicines for an initial health post for the community, which she will manage. I realize while packing these medicines, gauzes and sutures, what potential risks there are in a return such as this, as well as hope. The striving for civilian society is a light of hope in this time, in this place.

Support for Organizing and Training

Another sign of hope has been the formation of “COAPIBAS” the health promoter association formed at the last course. COAPIBAS, is the Spanish acronym for the "Interethnic Committee of Associated Health Promoters of the Lower Atrato", a quite lengthy title they have given to their fledgling organization, but it is the name that they chose and for that I was very pleased. They elected a governing body to help guide the course of their work over the coming months and years. Hopefully COAPIBAS will give them a greater voice in governmental and non-governmental decisions made on the health care in their communities. For me, the most exciting part of the process was hearing the dialogue about building civilian society by the Health Promoters from so many different situations. Whether the community is ethnic Indigenous Emberá or Waunann, mestizo or Afro Colombian, or whether they are under the military domination of the paramilitary, guerrilla, or army, these women and men are taking the encouraging step of making decisions about health care, by health care workers. Steps like these make our work in this difficult area worthwhile!

Clinical work continues to be a challenge. With none but the most rudimentary of laboratory work available, diagnosis is a constant test of clinical acumen. Over the past weeks that has meant trying to manage a diabetic in ketoacidosis and kidney failure while he lies semiconscious on a pad on a wooden floor, placing an inter-osseous IV into a 3 year old boy who was burned over 90% of his body, or aiding a 72 year old with advanced pneumonia. Even in a clinical setting in the U.S. many of our cases would be overwhelming, but in this environment it seems we work against impossible odds at times. Still, as more health promoters are trained, we begin to see improvement in the overall conditions and the early treatment of infectious diseases.

Malaria is one of those diseases that appear exotic and remote, yet it is the cause of millions of deaths a year in developing countries like Colombia. In the community of Pueblo Nuevo I encountered over three dozen people with the 103 ° fevers, shaking chills, splitting headaches and muscle pains of malaria. The symptoms are bad enough, but if this happens to hit a child under three years old, or an elderly person it can quickly become deadly. In Pueblo Nuevo last year 1-2 children a month died from this malady. While malaria is treatable with medications, and preventable with mosquito netting and repellants, these methods often fall by the wayside if the community is displaced or fleeing the violence such as this one is. Since the malaria parasite is spread from one person to another by a nighttime bite of the anopheles mosquito, the more people that are infected, the more it is likely that others will become infected and further the epidemic.

As we head further into 1995, there is much to celebrate in the lower Atrato River; Health Promoters are learning and advancing in their base of knowledge; the organization of COAPIBAS is providing a structure for public health run by community members; we are growing in terms of team-building with Julie helping in administrative work. We now have an office for our health work in Río Sucio, a boat to be used just for our project, thanks to the support from so many individuals and organizations we look forward to having the funding to accomplish our initial goals. Certainly the work of Concern America has been a blessing to people in this war-torn area, and a gift to those of us privileged to work with and through them.

During weeks in the U.S. we have been fortunate to be with family and people of faith who are working to change the course of empire consolidation in the U.S. It is a wonder at times to take hot showers and eat a variety of foods, turn on a tap to get running water or turn on a radio to get a Pacifica station other than the propaganda of the Voice of America or army or guerrilla programming. Yet, the people in Colombia have much to teach us in the advantages of materially simpler, and more community oriented lives. Both Julie and I offer prayers of thanks in this season for the ability to have a foot in each of these worlds, for being able to be pieces of this bridge of peace in time of lust for war and vengeance in the U.S. and Colombia. We thank each of you for your part in being a constructive and not destructive force in this world we continue to try to hold together and uplift.

We ask that you continue your efforts to build projects of life, to keep the people here in your thoughts, prayers and actions, and for all of us to work to end the cycles of violence so deeply embedded in the U.S. government's actions against this beleaguered people.

In Peace and Service,

Curt Wands