In a report presented by Doctors without Borders in Madrid on Tuesday, the international NGO called for state mental health services to be adapted to meet the needs of Colombians internally displaced by the Andean nation’s armed conflict.
The report, titled “Three times victims,” examines the impact of the civil conflict in Colombia on the mental health of people living in the department of Caqueta, located in south west Colombia. The report found that issues such as social and institutional stigma and neglect after moving into new communities, are linked to the development of serious mental health problems in the displaced community.
The study focused on 5,064 patients between March 2005 and September 2009, of whom 49.2% were directly exposed to the conflict through violence, forced recruitment, displacement, restricted mobility or murder of relatives.
The report says the population suffers from three problems – “violence, silence and neglect” – and emphasizes the difficulties faced by those displaced by government troops, guerrillas and paramilitaries.
Teresa Sancristoval, who presented the report alongside fellow Doctors without Borders representative Carmen Martinez, spoke of the “appalling reality” endured by Caqueta’s displaced population.
“On the one hand, people are exposed to the violence perpetrated by the different armed groups, and on the other hand authorities and society fail to provide them with the attention they deserve. The consequences of this situation for mental health include severe psychological suffering that should be addressed by authorities,” Sancristoval said.
Martinez said that the victims of Colombia’s conflict “are so stigmatized that they dare not speak of their suffering” and suffer from a “sense of helplessness” which “prevents their social integration and recognition and sense of belonging,” and stops them from rebuilding their lives.
Sancristoval added that the displaced are regarded with suspicion in the places where they settle and consequently become victims for a second time, this time as a result of what Martinez termed “marginalization and social exclusion.”
The report indicates there is a “lack of social integration” in the displaced community which leads to difficulty accessing jobs, housing, education and health, which in turn makes it harder to get over their difficult living conditions.
Matinez said that “domestic violence is also rooted in the conflict,” explaining that mothers’ aggressiveness and neglect towards their children is considered “as something natural.”
The NGO diagnosed several mental health problems in the Caqueta population, including depression, acute stress, traumatic stress and adjustment disorders in those who had been displaced.
Doctors without Borders criticized the Colombian government for failing to address these problems. According to the report, the Andean nation only spends 0.1% of its total budget on mental health problems.
Colombia has the second largest population of internally displaced persons in the world, after Sudan. Latest estimates from the U.N. say forcible displacement affects 3.3 million Colombians, around 7% of the population.