The Colombian Department with More Malaria Cases from Abroad
The porous border has loaded the inhabitants of the Colombian Amazon with the cases of its Venezuelan neighbors. Shortage and indifference has led patients to seek treatment even in Bogotá. Meanwhile in San Fernando de Atabapo, the transmitting mosquito has folded people back into their homes. But "God exists." So says a mural that receives visitors at the port.
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Following
the Guaviare River from San Fernando de Atabapo and at one hour's sailing is
Puerto Inírida, capital of the Guainía department and its most populated city. A
town founded 205 years after San Fernando de Atabapo, and that many say was
developed with Venezuelan gold.
The
only bleached in this place anchored in the middle of the jungle is a green
Santa Claus painted on the concrete stairs that you must climb to enter the
town. Everything looks clean and tidy. The first businesses have signs
announcing the purchase of scrap, gold, silver, copper, bronze and aluminum, and
of course, the purchase and sale of pesos and bolivars, transfers to different
banks in Venezuela. Three wheeler cars circulate along the asphalted streets and
you can see lots of stores, restaurants and even an acoustic shell in the
avenues.
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THE FIRST RELEASE HERE: "Malaria Spreads through the Remote
Amazon"
Puerto Inírida is the capital of the Guainía department in Colombia. This town was created in 1963, and is named after the Inírida flower that grows wild, and survives for more than a year without special care or risks. A convenient metaphor for a town founded 205 years after San Fernando de Atabapo, and that many say was developed with Venezuelan gold. The place shows a thriving economy. Many residents of San Fernando de Atabapo travel to this place in search of better health services and to stock up.
Photograph: Minerva Vitti
Puerto Inírida is the capital of the Guainía department in Colombia. This town was created in 1963, and is named after the Inírida flower that grows wild, and survives for more than a year without special care or risks. A convenient metaphor for a town founded 205 years after San Fernando de Atabapo, and that many say was developed with Venezuelan gold. The place shows a thriving economy. Many residents of San Fernando de Atabapo travel to this place in search of better health services and to stock up.
Photograph: Minerva Vitti
Puerto Inírida is the capital of the Guainía department in Colombia. This town was created in 1963, and is named after the Inírida flower that grows wild, and survives for more than a year without special care or risks. A convenient metaphor for a town founded 205 years after San Fernando de Atabapo, and that many say was developed with Venezuelan gold. The place shows a thriving economy. Many residents of San Fernando de Atabapo travel to this place in search of better health services and to stock up.
Photograph: Minerva Vitti
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In
Guainía the department, the highest number of malaria cases is concentrated in
the municipal capital of Inírida, followed by cases from Venezuela, Vichada and
Barracominas. Venezuela and Vichada import 15 and 6 percent of the cases,
respectively, which implies an additional burden on this Colombian department in
number of cases, efforts to control the vector, treatment of patients, economic
burden, decrease in the quality of life, risk of mortality from malaria, and
finally in the epidemiological indicators locally.
As
a result, Guainía, in the Colombia department, has the most malaria cases from
abroad, mostly from Venezuela. By week 48 (November 27-December 3), the
epidemiological bulletin of the National Institute of Health - Directorate of
Monitoring and Risk Analysis in Public Health reported that Guainía had an
accumulated of 2,043 cases of uncomplicated malaria, 366 of which were from
Venezuela. By week 52, the Department Secretariat of Guainía indicated that this
department closed with 3,159 cases of malaria.
Tatiana
Córdoba, coordinator of the Program for Vector-Borne Diseases (VBDs) of the
Health Secretariat of Guainía, assures that 19 out of the 366 cases registered
up to week 48 are from San Fernando de Atabapo and the rest come from the gold
mines in Venezuela. The statistics turn dismal because they do not identify the
communities, they only record the country and if the patients come from the
mines. "In 2015, Venezuela was going through the most serious epidemic in its
history and it ended up affecting us. The fact that you do not have medication
makes people cross the river, and go where they can get a total
solution."
Carlos
Eric Azcarate, public health monitoring coordinator in the Health Secretariat of
Guainía, says that there have been many cases of complicated malaria in
children, pregnant women and the elderly, because they take the treatments
without knowing if they have the disease. In the end, a problem that occurs in a
rural area in Venezuela becomes urban in this department.
Tatiana Córdoba, coordinator of the Program for Vector-Borne Diseases (VBDs) of the Health Secretariat of Guainía
Photograph: Minerva Vitti
Nelson Evelio Palomar Hernández, Departmental Health Secretary.
Photograph: Minerva Vitti
Construction of a 34.5 kv electric interconnection line between San Fernando de Atabapo (Venezuela) and Inírida, Guainía department (Colombia)
Photograph: Minerva Vitti
Coayare is one of the communities near Puerto Inírida where there are many cases of malaria. The majority of this population works in the mines.
Photograph: Minerva Vitti
Riverside communities near Puerto Inírida
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Another
problem that hospital "Manuel Elkin Patarroyo" of Puerto Inírida is facing is
the provision of health services to Venezuelan cases for other diseases. People
even arrived for car accidents. Nelson Evelio Palomar, Departmental Health
Secretary, indicates that patients from San Fernando de Atabapo and Puerto
Ayacucho are referred by doctors from Venezuela. "We cannot take care of them
because the health system here is different. The person must have a social
security for Colombia or else pay, unless it is an emergency. The big problem is
that many patients from Venezuela arrive in critical condition. It is necessary
to send them to Bogotá or Villavicencio and we do not have resources. We have a
child hospitalized for two months in Bogotá; we are giving shelter and food to
the child’s companion. All the patients that we refer have identification
problems. They are received due to the emergency, but it is a complication when
they are discharged and we have had to give them one more month of shelter and
food. It has reached to a point where the patients are brought virtually in
secret and they pray that they are received there. Attempts have been made with
the consul and the Ministry of Foreign Affairs with no
success."
International Cooperation
An
electrical antenna that emerges from the Guaviare River can be seen from San
Fernando de Atabapo as a promise of the Electric Power Interchange Agreement
between Corporación Eléctrica Nacional (Corpoelec), the national power company
in Venezuela, and the Institute of Planning and Promotion of Energetic Solutions
(IPSE) for non-interconnected areas in Colombia. The agreement was signed in
2011 by Presidents Hugo Chávez and Juan Manuel Santos, and consisted of a
construction project of a 34.5 kV electric interconnection line between San
Fernando de Atabapo (Venezuela) and Inírida, Guainía department (Colombia). The
idea was to bring energy with an optimal and low cost service to the jungle and
peripheral populations of both countries. Today, this antenna only provides
electricity to the 15 houses in Amanaven.
"San
Fernando de Atabapo has been the backyard of Puerto Inírida. People travel there
to stock up. I have not seen people having a December with light," says
Cristóbal Colón Suárez, vice consul of Colombia in San Fernando de Atabapo, who
practically does not leave the official residence because "to see Macondo, I
rather read about it."
Magda
Magris, director of research and coordinator of Caicet's Malaria research unit,
recalls that there used to be binational meetings between Colombia and Venezuela
to carry out epidemiological surveillance at the border. In fact, they had
binational agreements for borders and joint projects for vaccination, but not
for malaria.
Amanaven is a Colombian town that belongs to the Vichada department in Colombia. In this place of few houses, located on the Guaviare River, you can buy gold, gasoline and food. Here, Ancísar López, a nurse with 40 years in the place, attends selling treatment for malaria and other diseases, in an informal activity.
Photograph: Minerva Vitti
Amanaven is a Colombian town that belongs to the Vichada department in Colombia. In this place of few houses, located on the Guaviare River, you can buy gold, gasoline and food. Here, Ancísar López, a nurse with 40 years in the place, attends selling treatment for malaria and other diseases, in an informal activity.
Photograph: Minerva Vitti
Amanaven is a Colombian town that belongs to the Vichada department in Colombia. In this place of few houses, located on the Guaviare River, you can buy gold, gasoline and food. Here, Ancísar López, a nurse with 40 years in the place, attends selling treatment for malaria and other diseases, in an informal activity.
Photograph: Minerva Vitti
Amanaven is a Colombian town that belongs to the Vichada department in Colombia. In this place of few houses, located on the Guaviare River, you can buy gold, gasoline and food. Here, Ancísar López, a nurse with 40 years in the place, attends selling treatment for malaria and other diseases, in an informal activity.
Photograph: Minerva Vitti
Amanaven is a Colombian town that belongs to the Vichada department in Colombia. In this place of few houses, located on the Guaviare River, you can buy gold, gasoline and food. Here, Ancísar López, a nurse with 40 years in the place, attends selling treatment for malaria and other diseases, in an informal activity.
Photograph: Minerva Vitti
Amanaven is a Colombian town that belongs to the Vichada department in Colombia. In this place of few houses, located on the Guaviare River, you can buy gold, gasoline and food. Here, Ancísar López, a nurse with 40 years in the place, attends selling treatment for malaria and other diseases, in an informal activity.
Photograph: Minerva Vitti
From a pharmacy in Amanaven, Ancísar López, a nurse with 40 years in the place, sells treatment for malaria and other diseases, in an informal activity.
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Conversely,
Tatiana Parra insists that if in Puerto Inírida they knew about the actions
taken in Venezuela, they could work together to solve the malaria problem: "You
are the coordinator of malaria there and I am here. We say 'let's make a
brigade' and leave at the same time to search for patients of the mosquito and
provide some personal protection elements such as mosquito nets, repellents and
educational campaigns. We do it at the same time, you take this side and I the
other. It is useless for me to take actions if you wait until next year, because
your people is coming and infecting my people. If you do not have medicine I'll
lend you and then you'll give me back. We need mutual help between countries,
but it does not exist."
This
is the border, porous, and while expecting actions that break some parts of this
cycle of infection to stop malaria, the runway at the San Fernando de Atabapo
airport struggles to not to be swallowed by the weed; homes resist the humidity
of the Amazonian climate; puddles and grass grow disproportionately; the locals
from Atabapo wait for the light poles to work; and the Colombian, Brazilian, and
Venezuelan miners walk in this no man's land.
Afternoon
falls and darkness takes over saved for the 1st Company of Border Detachment No.
94 and a naval post, which do have electricity, and the Atabapo river
illuminated by the lights of Amanaven. The curfew imposed by the mosquito that
transmits the parasite that produces malaria forces people into their homes.
But, in San Fernando de Atabapo, "God exists." So says a mural that receives
visitors at the port.
