Riverboat brings medical care to Ecuador's isolated refugee communities

News Stories, 2 September 2008

© UNHCR/A.Escalante
The River Health Boat visits an isolated refugee community along the border with Colombia.

MONTEPA, Ecuador, September 2 (UNHCR) It takes the people of Montepa, a small riverside community in northern Ecuador, several hours by boat to reach the nearest doctor. While many people suffer health problems in the steamy jungle, the river journey is a luxury that most in this deprived area cannot afford.

But now the doctors and nurses will be coming to the patients in Montepa and other settlements on the San Miguel River, where around 40 percent of the inhabitants are Colombians who have fled the conflict in their country.

In late August, the regional health authorities launched a mobile health service with the support of the UN refugee agency and the nearby municipality of Lago Agrio. The floating clinic, dubbed the "River Health Boat," will ply permanently between 28 communities along the river, bringing urgently needed medical care to people suffering from malaria and other health problems of the tropics.

Manned by a full-time crew, one doctor and two volunteer health workers, the vessel will carry medicine and UNHCR-donated equipment for conducting general medical check-ups, dental care and emergency treatment. The local municipality has agreed to pay all fuel costs.

The service is sorely needed. "The tropical climate and lack of infrastructure in this part of the country are causing many diseases that, without adequate timely attention, can turn life-threatening," noted Yolanda Gómez, who has been working for the health authorities in Sucumbíos province for 30 years.

The floating health service is already making a big difference to local communities, including the Colombians who have sought shelter in this area, most of whom belong to the indigenous Quichua group.

Eduardo, a 40-year-old Colombian, and his wife were among those in Montepa who were at first surprised, and then delighted, when the River Health Boat arrived in Montepa on its maiden health round on August 21.

His four children, two of them born in Ecuador, got their first medical check-up for years and the whole family was tested for malaria and given medicine and vitamins. A medical file was opened for each family member, which the river doctors will refer to when they next visit Montepa in two months time.

Aside from much-needed medical care, the health boat also brought some good news for Eduardo and his family UNHCR officials let him know that they were eligible to apply for asylum in Ecuador and he could register the birth of his two youngest children with the local authorities. Many Colombians do not come forward to register as refugees due to fear, ignorance or extreme isolation.

For the UN refugee agency, support of the floating clinic is a natural part of its efforts to help the tens of thousands of Colombians believed to be in Ecuador, mainly in northern border areas.

"UNHCR has not forgotten that victims of the armed conflict arrive in this region every day," Luis Varese, the agency's deputy representative in Ecuador, said here during the maiden voyage. "Together with the Ecuadorean government, we will continue our efforts to improve living conditions for everyone."

There are around 18,000 registered refugees in Ecuador. The government estimates that up to ten times that number may be in need of international protection.

UNHCR has three field offices in northern Ecuador, where it provides international protection, legal information and assistance to refugees and others living in a refugee-like situation. In cooperation with the local and national authorities, civil society and other partners, the agency delivers humanitarian aid, basic infrastructure and income generation programmes to improve the living conditions of refugees and host communities.

By Xavier Orellana and Andrea Escalante in Montepa, Ecuador

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Indigenous people in Colombia

There are about a million indigenous people in Colombia. They belong to 80 different groups and make up one of the world's most diverse indigenous heritages. But the internal armed conflict is taking its toll on them.

Like many Colombians, indigenous people often have no choice but to flee their lands to escape violence. Forced displacement is especially tragic for them because they have extremely strong links to their ancestral lands. Often their economic, social and cultural survival depends on keeping these links alive.

According to Colombia's national indigenous association ONIC, 18 of the smaller groups are at risk of disappearing. UNHCR is working with them to support their struggle to stay on their territories or to rebuild their lives when they are forced to flee.

UNHCR also assists indigenous refugees in neighbouring countries like Panama, Ecuador, Venezuela and Brazil. UNHCR is developing a regional strategy to better address the specific needs of indigenous people during exile.

Indigenous people in Colombia

Colombia: Life in the Barrios

After more than forty years of internal armed conflict, Colombia has one of the largest populations of internally displaced persons (IDPs) in the world. Well over two million people have been forced to flee their homes; many of them have left remote rural areas to take refuge in the relative safety of the cities.

Displaced families often end up living in slum areas on the outskirts of the big cities, where they lack even the most basic services. Just outside Bogota, tens of thousands of displaced people live in the shantytowns of Altos de Cazuca and Altos de Florida, with little access to health, education or decent housing. Security is a problem too, with irregular armed groups and gangs controlling the shantytowns, often targeting young people.

UNHCR is working with the authorities in ten locations across Colombia to ensure that the rights of internally displaced people are fully respected – including the rights to basic services, health and education, as well as security.

Colombia: Life in the Barrios

Panama's Hidden Refugees

Colombia's armed conflict has forced millions of people to flee their homes, including hundreds of thousands who have sought refuge in other countries in the region.

Along the border with Colombia, Panama's Darien region is a thick and inhospitable jungle accessible only by boat. Yet many Colombians have taken refuge here after fleeing the irregular armed groups who control large parts of jungle territory on the other side of the border.

Many of the families sheltering in the Darien are from Colombia's ethnic minorities – indigenous or Afro-Colombians – who have been particularly badly hit by the conflict and forcibly displaced in large numbers. In recent years, there has also been an increase in the numbers of Colombians arriving in the capital, Panama City.

There are an estimated 12,500 Colombians of concern to UNHCR in Panama, but many prefer not to make themselves known to authorities and remain in hiding. This "hidden population" is one of the biggest challenges facing UNHCR not only in Panama but also in Ecuador and Venezuela.

Panama's Hidden Refugees

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