The handwritten, felt-tip markings on the wall map show the current position of the three main guerrilla groups, the main paramilitary organisation and the armed forces in the area surrounding Quibdo in Colombia.
Such maps, which would seem more appropriate for a ministry of defence than a medical aid office, are as important to Médécins sans Frontières (MSF) in Colombia as any vaccine or stethoscope.
Colombia is in the middle of two wars. Civil war has engulfed the country for the past 40 years. However, the lesser-known, but now more destructive, war of street violence has over the past year caused more deaths than the conflicts in Iraq, Afghanistan and the Middle East combined.
In a world league table of violence published last month, Colombia came tops, with a murder rate 60 times that of Britain.
It is the civil war that has brought MSF to Quibdo. The fighting has displaced nearly three million people nationally as they flee the violence, and few areas have been more affected than the Choco region, of which Quibdo is the capital. There are about 40 000 desplazados (displaced) here, many without identification documents, living in poverty on the fringes of the city.
Quibdo is a sticky assignment for MSF, literally and metaphorically. It is the wettest region of the country and one of hottest politically. The city, with a population of 140 000, seems more Caribbean than Colombian, with a mainly black population. Music, both the local chiribia and the national salsa, echoes from every store and café.
Although the two main guerrilla groups, the Revolutionary Armed Forces of Colombia (Farc) and the National Liberation Army (ELN), are nearby, this is the territory of the far-right paramilitary group the United Self-Defence Forces (AUC). Some of its members float through the city, their combat boots supposedly the giveaway. The scenario would provide ripe material for a novel written by a collaboration between Gabriel Garçia Marquez, Graham Greene and Joseph Conrad.
In any such novel, one of the characters would surely be based on Maria Theresa de Maghalaes Vilhena, or MTV — as she is known to her colleagues — the 55-year-old coordinator of MSF operations in Quibdo.
De Maghalaes Vilhena was born in Paris to Portuguese parents, but is now a Swiss national. She talks in a mixture of Spanish, English, French and Portuguese, punctuated by a combative grin that needs no translation.
She is a trained nurse and previously worked for the International Committee of the Red Cross in Gambon, Nigeria, Chad, Congo and Indonesia.
She believes strongly in the De Maghalaes Vilhena credo devoir d’ingerence (the duty to intervene). ”For me the right to intervene is very important,” she said. ”In a country where there is a massacre, intervention is right. I have a lot of respect for [the Red Cross], but sometimes they are not combative enough. I really believe that health is a right for everybody, a basic right.”
One of the aims of the MSF project in Quibdo is to ensure that the desplazados get the medical treatment to which they are entitled by law but from which they are often excluded by local bureaucracy. This involves door-to-door educational work through the barrios (slums) carried out by their staff, the renovation of two health centres and lobbying of local government.
There are risks in the area. Two MSF staff have been kidnapped, but both were released. Staff are advised to keep fit as, if kidnapped, they will be kept on the move on foot. ”You try to win respect of the kidnap group,” said De Maghalaes Vilhena of the instructions staff receive. ”You don’t say ‘You kidnap me — wait till you see what happens!”’
The displaced people who are served by MSF are disparate. Jaime Jumi is a member of the Egorokera tribe, one of the many displaced indigenous groups. He left his home in the Bojaya region seven years ago and now lives on the outskirts of Quibdo with his wife, Erlinda, and their six children.
”The guerrillas, the paramilitaries, the army are all the same, as bad as each other,” he said. ”They do what they like. If my daughter was fishing by the river they would rape her. We had to leave.”
Jumi longs to return to his home. He has found it difficult to adjust to life in a barrio and misses being able to fish and hunt.
”It is like living in a prison here,” he said. ”When a baby is born we bury the placenta in the land so the land is like our mother and father. We have to go back because the place where they bury the placenta is where we must die.”
Others have already decided they will never return. ”El Futuro” is the optimistic name chosen for an encampment where hundreds of the latest batch of desplazados are living. Whatever their future may be, their present is in muddy, ramshackle huts on the side of the hill and breakfast may involve standing in a long line for a bowl of yucca and plantain handed out by the United Nations High Commissioner for Refugees.
Elena Mena Cruz (67) and her daughter, Rosa Cruz (42), left Bojaya because of fighting. ”My nephew was killed and left four children,” said Cruz Elena. ”But we had to get away because of the fighting. We get no help from the government. The children have vomiting and breathing problems and the only doctors who come and see us are from MSF.”
”Many of them don’t know their rights,” said Rosiris Maturana, a Colombian member of the MSF team, of the displaced. ”Some of them don’t go for prenatal treatment. They think it is going to cost them money.”
The rains wash in again, turning the dirt roads into rivers. The MSF team have another half a dozen settlements to visit, another half a dozen duties to intervene. — Â