Three-Time Victims: Colombians Continue to Face Violence, Neglect, and Stigma as a Result of Long-Standing Conflict

Victims of the on-going conflict in Colombia not only suffer from the
direct consequences of violence caused by the conflict but also from
social and institutional stigma and neglect, according to a report
released today by the international medical humanitarian organization
Doctors Without Borders/Medecins Sans Frontieres (MSF). In the report,
titled "Three Time Victims," MSF documents how violence, stigma, and
neglect impact the mental health of people living in Caqueta Department
of southern Colombia, and calls for mental health services to be adapted
to the needs of this vulnerable population.

"Our teams witness the appalling reality endured by most of the
population in Caqueta," said Teresa Sancristoval, head of MSF operations
in Colombia. "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."

Between March 2005 and September 2009, MSF saw 5,064 patients in its
mental health project in Caqueta. Of these patients, 49.2 percent had
been directly exposed to the conflict, caught in the fighting between
armed groups, as well as violent incidents involving threats, injuries,
forced recruitment, displacement, movement restrictions, or killings of
family members.

The victims of the conflict not only endure the consequences of direct
violence, but also face social stigma. "In Colombia, the stigma
surrounding those affected by the conflict forces them to keep silent
about their condition and suffering, which prevents their social
integration and recognition and sense of belonging," said Maria
Cristobal, MSF mental health officer in Colombia. This prevents people's
access to employment, housing, education, and health.

In addition to direct violence and social stigma, victims are often
excluded from receiving state support through social services. This
institutional neglect can be clearly seen through the scant recognition
of the forced displacement phenomenon in Colombia.

"The Colombian government should live up to its responsibility in terms
of tending to the needs of these people," said Sancristoval. "Based on
our experience in Caqueta, we can say that offering mental health care
with limited resources in conflict contexts is possible and that this
care can effectively improve patients' conditions."