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Malaria: The view from Colombia

Climate, poverty and violence contribute to malaria's reach.

A Colombian asylum applicant takes care of her baby behind a mosquito net near the border town of Guasdualito, Venezuela, Dec. 9, 2004. (Jorge Silva/Reuters)

BOGOTA — With just under a quarter of Colombia’s population of 45 million at risk of contracting malaria, the disease is one of the country’s most pressing health problems.

Colombia is confronted with the same challenges — tropical climates and unsanitary living conditions — that face other countries suffering from the vector-borne disease. But here, there is the additional complication of Colombia's decades-long violent conflict that has drawn in left-wing guerrilla groups, right-wing paramilitary and government forces.

“The fact that there are migrations [of people] and an armed conflict contributes to infection,” said Jose Pablo Escobar, Colombia’s malaria adviser for the Pan American Health Organization.

But health officials and workers agree that the primary malaria factor is environmental. Much of the country is hot and humid.  According to health officials, five of the country’s 32 departments, or provinces — Cordoba, Antioquia, Choco, Valle and Cauca — are home to between 70 and 80 percent of the country’s malaria cases. All border the Pacific coast.

Some of these provinces are among the country's poorest, and many homes lack running water and forms of sanitation, helping to promote the disease. “It has to do with quality of life,” said Julio Padilla, coordinator of the National Malaria Program at the Ministry of Social Protection. Many families are too poor to invest in preventative measures, such as bug repellent, window screens or home fumigation.

Last year, there were 110,000 registered cases of malaria in Colombia, according to the National Institute of Health, but health officials believe the real number hovers around 150,000.

The country's armed conflict factors into the spread of malaria because when people are displaced due to violence, they can act as disease carriers, bringing malaria with them when they flee, according to health workers. Colombia has the world’s highest number of displaced people after the Sudan, estimated at between 3 million and 4.5 million people.

“I think if we didn’t have this problem of displacement, the conditions here would be quite similar to other countries,” said Pablo Chaparro, who manages the country’s information system on malaria at the National Institute of Health.

http://www.globalpost.com/dispatch/health/090506/colombia-malaria