(Alan) Curt, Julie and Gregory Wands-Bourdoiseau in Colombia
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Seeking a Feasible and Survivable Health Program

In the Peace Communities of Urabá, Colombia[1]

 

Alan Curtis (Curt) Wands

email: cwands@igc.org

 

Dedicated to Margarita, Alicia, Ramon and Francisco, that one day your efforts and real names may be revealed so as to bring you the honor and appreciation you so richly deserve.  Should their efforts and real names be known by those perpetrating war here their future would likely be dramatically shorter.[2]

 

Hot, humid days like today on the Atrato river in Colombia, South America can seem a world away from the frigid heart of our northern government which controls too much of the destiny, the lives and frequently the deaths of so many here.  The vast majority of people I have talked and worked with over this month are tired of 39 years of war, of living in fear, of being displaced from their home and lands, of grieving another violent death, of waiting for peace. Some have lost hope and abandon their communities to the army’s para-military units or to the guerrillas who then cultivate coca or poppy in the fields.  Dugout canoes ply the rivers, transferring the remnants of once-united communities toward muddy burgeoning villages, already teeming with thousands of others mired at the bottom of the economic ladder.  Tonight I feel grief as I witnessed a moment in the lives of several 10 and 12 year old children on a horse drawn cart as they plodded through the dusty evening street with their few belongings clutched in hand or piled in the back.  Plastic buckets, a mat to provide some softness from the cement or dirt floor, a few dishes, a bag of clothing, a feed bag with what food is left are all that are visible.  No worried parents or concerned adults are in their sight or probably in their world.  I find it can be difficult to console, to try to instill hope among those that have been betrayed and lost so much.

 

And yet, here in this tropical river valley and throughout this country, there are Colombians who strive for justice, who risk their lives to oppose war, who have faith that the light of their lives will illuminate the path for others living in darkness.  Our team of 50 accompaniers is comprised of Afro-Colombians, Indigenous Tules and Emberas, mixed Hispanic and a smattering of internationals, including one person from the U.S., myself.  Our gender make-up is evenly divided and ages range from the mid-twenties to those in their fifties.  This team carries out projects of hope, often by merely sharing the tenuous edge of life here with those whose existence is precariously in the balance.[3]

 

As we break into small teams for this 20 day trip I find myself fortunate to be part of this particular team going to the Peace Community of Costa de Oro (The Gold Coast.)  Margarita, is deeply Afro-Colombian with a smile as wide as the river itself.  She comfortably breaks into song at any moment just as easily as she walks in to help cook at the fire of any home we are in.  People along the riverbanks tend to recognize her first and excited children shout greetings that carry over the water and above the noise of our boat’s sputtering motor.  Her deep laugh carries even farther over the waters.  Margarita has lost two of her brothers in the past 4 years.  After they were killed she took in their three children to raise as her own, along with her own daughter.  Alicia the second member of our team is making her first trip to Costa de Oro.  She recognizes that her work with youth may be made more difficult by the fact that Edwin, the previous “Youth Promoter” in this community was shot to death by the FARC guerrillas in front of the village youth three days after Christmas in 2001.  Alicia’s own mother was shot to death four years ago, leaving Alicia as the primary care-taker of her nine siblings.  In spite of her apparently soft-spoken nature, in front of youth groups she becomes a dynamic leader that would make a U.S. summer camp an a joy to see her lead.  Alicia braves the river she does not know how to swim in, so as to serve the youth of these communities.  She apparently has become more inured (at least to external appearances) to the more daily fear of armed individuals we encounter during this entire trip.  Ramon, the third member, is our boat driver, though he admittedly does not know how to drive a car.  He is the one who guides our leaky wood dug-out canoe with a 25 hp outboard motor through the currents and constant obstacles of the river, through the thick mesh of tangled water weeds where the river turns to streams, and through the army “check points” of U.S. provided piranha boats (“Made in Boston” clearly painted on the side,) each with 50 caliber machine guns.  Ramon has grown up as an orphan in this Atrato river valley and is known and loved by all who encounter him.  I find that the strong clasp of his hand brings an instant sense of warmth and sharing.  He and I share in common our 11½ shoe size and our slight build of 6’ tall each.  After so many years working with Mayan people in Guatemala it is quite a shift to be able to share boots and clothes with someone my size!  People in the communities have taken to calling us twins, just with different mothers, bringing laughs from many as his black Afro-Colombian skin and my white Scottish-Irish paleness contrast like night and day. 

 

I find these individuals who are going to provide solace and relief provide me with a profound sense of hope.  With all that has been inflicted on each of them by the harshness of this war, each maintains an open heart and provides their service with a joy that resonates to those around.  Our path is constantly filled with stories, song, jokes, and laughter to balance the other moments of silent tension that surround the encounters with armed soldiers.

 

And so here I am, the red-headed fourth member of this team.  My own hope on this trip is to reconnect with the community Health Promoter, Francisco, who I met in October 2002 during a brief visit to this community.  Hopefully by listening and participating in his health tasks I will get a better sense of the needs and difficulties encountered by this community.  The Doctors of the World and the International Committee of the Red Cross (ICRC) and the government health ministry visits are few and far between.   None have visited this community for over three months often because of various armed forces not authorizing entry.  The army also checks lists of medications sent to these communities and denies or approves the transport of the medications as they deem fit.  Para-military units prevent the transportation of supplies as they wish at any given moment seemingly identical to the army’s efforts.  Guerrillas frequently confiscate medications and supplies, and at times take even the boats themselves

 

Arriving at Costa de Oro is a challenge in itself.  Our team gathered on a hot dusty afternoon at the “bus” station.  Our bus is a jeep that seats nine.  Margarita carries over 100 baby chicks that raise a cacophony of peeps from the boxes balanced on her lap the entire way.  The first ½ hour down the main road brings us past hundreds of soldiers congregated at a local base outside of Apartadó.  The next 3½ hours involve up to 15 people being carried by our jeep, some riding on the roof, down dirt roads that at times appear to convert into cow paths.  Several stops by young men in green uniforms, with no identifying insignia, bringing a guaranteed silence by those inside our vehicle.  Apparently these are the para-military who have free reign under army guidance in this zone.  At one stop several of these young soldiers stop us and place several young girls, each around 12-15 years old, in our jeep.  The girls get off at the next stop of soldiers a few miles down the road. 

 

We arrive at the town of Rio Sucio.  The Pastoral/Social office of the Catholic Church and the Claritian missionaries here is made obvious by the white flag hanging from the second floor.  My evening is filled with medical visits to a group of newly displaced people from Opogodó who have chosen to leave a guerrilla controlled region.  They come from a community near Bojayá.  On May 2nd of 2002, the FARC guerrillas chose to aim a gas cylinder bomb at a group of para-military soldiers who were occupying the town.  Instead they hit the church where community members had taken refuge, killing 117 including at least 48 children and injuring 114 others.  Now the people in Opogodó felt they were in too much danger to continue in this same zone and have come to the difficult and complicated town of Rio Sucio.  One young woman I examine is trying to breast feed her one month old daughter while having severe tonic-clonic movements of her extremities.  She reportedly has had four seizures over the past month.  Her pupils do not dilate to light and her hands and feet remain hyper-extended.  I worry about the type of malaria in this zone (Falciparum,) and/or a tumor or other cerebral lesion that might be causing these neurological difficulties.  We refer her to a nearby government clinic where I hope she will be referred for further testing.[4]  The rest of the several dozen people are treated for their various environmentally related illnesses like amebas, worms, bacterial dysentery and respiratory infections.  Others have illnesses that reflect the anxiety and depression to be expected with this change from a jungle environment controlled by guerrillas to an overcrowded town run by para-military.

 

By 6:30 am the next morning I am helping Ramon jam cloth strips into the long, narrow splits in the wood of our dugout to reduce the amount of water that will flow in as we continue upriver.  By 8 am our team is saying our goodbyes to the two other river teams as they head off to their communities.  One team will go to a community in guerrilla controlled territory where boats with armed personnel silently pass by at night, while the other team will go a community recently occupied by the para-military (Truando Medio) leaving people there afraid to talk about the sudden negative change in their world.  We continue our own voyage with a 3½ hour trip up-river, bailing out murky tropical water as we go.  We pass by the five piranha boats at the army check point in Domingodó without incident and continue to Curbaradó where we visit with the priest at his communal house here.  This building was overtaken by para-military AUC soldiers last year while the priest and nuns were out at a regional gathering.  When allowed to return to their building 6 months later, para-military graffiti was painted throughout.  Evidence of their occupation and writing is still evident inside the building.  The nurse in town, the only regional clinic in the area, hears I am in town and requests that I come look over an eight year old boy with an acute abdomen.  There is no electricity nor running water during this time of day here, though a generator provides electricity in the evenings) and regardless there is no laboratory to do basic lab tests.  The young boy is in acute pain and does have symptoms consistent with appendicitis, so we get an IV into him with broad spectrum antibiotics in case his appendix bursts.  He must now be taken down river, retracing the steps we have just come from.  He won’t make it to the hospital until tomorrow, but the nurse will accompany him the entire route.  This leaves the community without the nurse.

 

We continue up-river another 45 minutes until we come to an inconspicuous dirt landing with a flag of the Peace Communities.  Here we beach our dugout.  The para-military have prevented community members, or ourselves,  from continuing up this river any further (Ramon already knows this unwritten rule.)  We are soon met by four members of the Costa de Oro community who accompany us as we hike an hour through the jungle with our equipment, gas and the boat engine.  The trudge through the thick jungle cover is beautiful but steamy and filled with mosquitoes.  Monkeys throw branches down on us and holler as we pass their territory and huge iguanas scatter to get off the path as we pass.  We arrive at a smaller stream where the community’s dugout has been left and we mount the engine, connect the gas and we’re off again.  The sweat cools from our jungle trek as we rapidly pass through the narrow stretches of this jungle stream.  Exotic birds are everywhere and we sight a tapir scampering from the bank of the stream.

 

After an hour and a half we arrive at Costa de Oro.  Part of the village is comprised of Indigenous Embera speaking people and part is Spanish speaking.  Children and adults shout and laugh on the banks as they welcome us.  We’ve arrived. 

 

This community of homes was constructed over the last year and a half from wood boards, each shaped by chain saw from the trees that had been in the village center.  The now-cleared center serves as a soccer field with the homes around the edge.  Plantain, yucca, and rice make up the majority of the crops in this area with the diet substantially improved by papaya, pineapple, coconut, bananas and fish from the stream.

 

Over the next four days Francisco and I do exams on most of the 130 people in this jungle village.  We have diagnosed diabetes, malaria, dengue (a tropical viral fever,) urinary tract infections, parasitic, bacterial and fungal infections of the skin, an infant with hydrocephalus, an adult with probable skin cancer.  We are able to treat only four patients due to the lack of medicines.  The people with malaria continue with splitting headaches, muscle pain and sweating.  Those with fevers in this tropical heat writhe in heat during the night, cooled only by water cooled rags and the basic analgesics available.  Those with urinary tract infections continue to burn every time they urinate.  The diabetic woman continues to urinate every hour, have blurry vision and have a loss of feeling in her toes, her blood sugar many times the maximum it should be.  Mothers to worry about their children with diarrhea as they continue to lose weight from fluid and nutritional loss in spite of using oral rehydration salts.   We do what we can as we perform surgical incision and drainage of deep abscesses (can it really be only a month ago I was with my colleague/friend Amy Smith in the Bay Area doing the same process for people addicted to IV drugs?), and splint a fractured tibia (the parents don’t want her to make the trip back to Rio Sucio to have it cast.)  Several community members have cataracts.  As night settles early in a community with no light other than that provided by candles, I find myself distraught over the unremitting suffering which could so easily be alleviated.  The only dramatic break in these reflections are the occasional Black-Hawk hell-icopters that fly over the community in the dead of night.  No Life-Line emergency flights to the local trauma unit are these craft.  Everyone in the village awakens for these incidents, and early morning finds small collections of people recounting the night’s scare.  Regardless, these are more tranquil times compared to a year ago. 

 

Francisco, the health promoter is an amazing man.  He has taken over after the previous health promoter, Petrona, was shot by FARC guerrillas the day before the youth promoter was shot.  Seven other community members were either shot or disappeared by para-military forces over the following three months.  Since that time, the guerrillas withdrew farther from this community making this a less contested territory for the time being.  Francisco takes his work seriously, tending to anyone who shows up at his door.  Unfortunately he was never trained in requesting medicines nor in administrative tasks.  The doctors who trained him do not allow him in on the exams they do, so he does not have the advantage of improving his skills.  Yet, when the trained professionals leave this community he is the one in charge of the health of the people here.  The midwives have not received formal training and are in need of learning to differentiate uncomplicated pregnancies from the complications that can be prevented.  All of these village health workers are dedicated to providing volunteer health care on a community level that would shame those of us who claim to provide service to our communities (how many of us do this without financial compensation?!)  On the fifth day, an expected delegation from Notre Dame arrives and they bring the medications ordered by my dear friends and supporters at Concern America (thank you for all that effort Denis and Marianne!)  Even now I weep with relief as I recall Steve Moriarty disembarking from the dugout announcing that the medicines were indeed carried by this visiting delegation.  A few hundred dollars in medicine… a few hundred dollars… saves so much pain and suffering.  Over the last two years almost $2,000,000,000 (that’s two billion dollars) in mostly military destruction was what the U.S. government provided to this country. 

 

Late one evening, after the daily soccer game, while swatting mosquitoes together, Miguel, one of the community leaders lamented that several children have been taken in past years from this community to join with one armed group or another.  He recalls that many children who grew up with this community and played soccer together are now in the differing armed groups killing one another.  The following day, when the Notre Dame delegation left, they took the mother of one of these children-now-soldiers down river so that she could see her son for the first time in two years.  He was taken four years ago, “recruited” by the para-military.  He is now 14 years old.  People’s course of events appear to change as constantly as does the flow of the river running by.  In an instant the current can wrench apart people who were side-by-side a moment ago, leaving those who were friends, colleagues and companions today on opposite sides of the river tomorrow. 

 

I am constantly astonished that people in this community respond so favorably to this U.S. citizen in their midst.  But people here are very clear, perhaps with a more astute clarity that people in our own country, that a people’s process is usually different from that of our governments.  Certainly I hope that as more people know the reality of people here our empathy will cause our people to mobilize in the millions to stop support for military options, close U.S. military programs like the School of the Americas, to participate in protests and civil disobedience and to stop paying the taxes that support the inhumane efforts here. 

 

I jointly affirm from this remote Peace Community in this Atrato river valley that we, as peace loving Colombians and U.S. citizens, have an enormously daunting task in front of us.  Our task is to transform those enmeshed in death dealing and violent prone institutions, whether they be the President of the U.S., the recently arrived Green Berets here, or those in the army, para-military or guerrillas.  As David Chevrier, the prophetic minister of Wellington Avenue UCC in Chicago intones in a clear voice to the congregation there, we must all recall that we have far more in common than we have in conflict.  And as the eminent Vietnamese Buddhist peace advocate Thich Naht Hahn reminds us, these soldiers are our friends who are killing our friends.  A hard and crucial lesson to maintain as we head down the river in a few days, an infant with an enlarged hydrocephalic head embraced in our arms as we face those with violence carried in their arms and in their hearts. 

 

Alan Curt Wands, PA-C

From the Peace Communities or Urabá

Colombia, South America

March 10, 2003

 

Curt Wands is a Physician’s Assistant working among the Peace Communities of Urabá, Colombia

Curt Wands
email: cwands@igc.org 

 

 



[1] The Peace Communities a collection of several dozen communities in the Chocó and Antioquia departments of Colombia dedicated to maintaining a civilian identity, territory and autonomy.  They are committed to non-participation in the armed conflict on behalf of the army, para-military or guerrillas.  They non-violently resist; recruitment of their children, provision of supplies, logistical support, or information to any of the armed groups.

[2] Lamentably the names of the community members had to be changed to safeguard their continued mission and lives.

[3]Among the more hopeful projects in this region include the following:

Accompaniers for Peace and Reconciliation who travel for 20 days of the month to remote communities who are at risk for guerrilla, para-military or military attacks.  My own work training health promoters and providing medical service is with these teams.

The Return to Joy project brings appropriate toys, puzzles and dolls to young children so that they may have some semblance of childhood.  Play therapy is utilized to help children express themselves.

Youth, Builders of Peace which organizes adolescents and gives them formation on options for life other than the ever-present armed units that dominate life in this region. 

Sponsors of these projects are largely through the Catholic church in the region, with support from the European Union, Caritas, UNICEF and others.  The only U.S. government support visible is through the gunboats, helicopters, M-16s, grenades, uniforms and other war materiel in this zone.

[4] I later discovered that she was not given lab tests, treatment, nor referred elsewhere.  She is to receive further help later this week.

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