I haven’t worked in Latin America (proper) since 1997 when I worked with Witness for Peace and NCOORD looking at issues in Nicaragua and Guatemala and this trip to Colombia marks my return to the context. In 1999 I lived in Guatemala for a little while mostly to study Spanish (and drink beer, and dance meringue, and go to movies with my friend Jamie). I always wanted to return to work here but there are so many capable locals who can do the work that they don’t really need many folks from the US to come down. On top of that, the US has played such an active role in many of the conflicts (overthrowing the Chilean government, supporting the Argentine dictators, overthrowing the Guatemalan socialist leader, Arbenz on behalf of the United Fruit Company, waging war in Panama, Nicaragua and El Salvador, and our continuous attempts to over throw Castro in Cuba) that American do-gooders aren’t that welcome. In particular, Colombia has “suffered” from particular attention by the US government. Our insatiable appetite for cocaine has made the route from the coca fields from Coca right up the Central American peninsula quite dangerous. There’s money to be made there and the overlap between political battles between the government of Colombia waging a war against terror against left wing guerrillas with the aid of “paramilitary” groups combined with the money to be made in a land grab to run cocaine, grow bananas, pineapples, avocados, coffee, and tobacco has made life hard for the peasants (indigenous people, people of African descent, and mixed “mestiza” population) who work the land and try to scratch out a living. The US government spends a lot of money arming the government of Colombia to “fight narco-traffickers and terrorists” with little to show for the 1.7 million USD dollars per day that the US Government gives to the army but the longest running civil war in the world and the most internally displaced people in the world (an IDP is a “refugee” who has not crossed an internationally recognized border).
In fact the US influence here is so strong that I’m supposed to pretend I am Dutch or any other nationality besides American. I’m an attractive target for political guerrillas to trade with the Colombia government and I can put the teams here in danger because the patients will fear that I’m a spy from the government and the paramilitaries. While my experience in Lebanon with Hezbollah taught me that its better not to lie as they usually know already what nationality you are, I’ve resolved to say “I live in Amsterdam, the Netheralnds” and “I flew here from Holland” – all of which is true. It’s hard though because my Spanish isn’t great nd we’re not supposed to speak English in front of strangers including in bars or restaurants or in the clinic in front of patients. I mostly stand around listening eagerly and hoping to catch a few words. My dormant Spanish has made a creaky comeback and I can chat to an extent as long as the other person doesn’t speak too quickly. My vocabulary is good by my grammar sucks. I mostly limit myself to banal observations about how hot it is or how delicous the frijoles I'm eating are.
After 10 years of focusing primarily on Africa with some focus on Haiti, Nepal, and Sri Lanka – I’ve finally made it back to South America. I’m learning a lot here. Many of the issues that plague the people of Latin America also plague the people of Africa, Asia, Eastern Europe, and the poor in North America… in particular, the disease of the poor are the ones that have the most restrictions on how you can treat them. One that I found particularly interesting is Leishmaniasis also known as Kala Azar. It appears to be a larvae from a but that when you are bit, injects parasites into your blood and you have wounds that won’t heal on your legs and arms and you can get parasites in your spleen, liver, and bone marrow. The bugs that carry this disease in Colombia live in rotted wood. In Colombia, we mostly treat women and children with this disease because they are the ones who are gathering wood or water and going out into the jungle the most. However, in many of the mountainous areas of Colombia, there are also a high number of Leishmaniasis cases.
The disease is very stigmatized and known as the Guerrilla disease. Therefore the government requires mandatory reporting of anyone who has this disease (violating their right to privacy) and strictly controls access to the medicine used to treat it. As we see mostly women and children, we are trying to lobby the government to drop this stigmatizing treatment of these patients and let us treat them so they can go on with their lives. While I have seen access to healthcare controlled for certain ethnic populations (poorly staffed and run health clinics for the Acholi in Uganda or the Ogadenis in Ethiopia), this is one of the first times I’ve encountered a disease linked to political issues.