Colombia’s Afro-descendant population represents approximately 12% of all internally displaced persons (IDPs) in the country. Thousands of Afro-descendant communities and families have been forced to leave their lands, moving to peripheral urban areas in cities such as Bogotá, Medellín and Cali. Other communities remain confined to territories controlled by illegal armed groups and drug cartels.
The displaced Afro-descendant population already faced difficulties in terms of living conditions, racism, marginalisation and exclusion, all of which affect their access to health services, work and education. Since the start of the COVID-19 pandemic, their food security, nutritional status and livelihoods have been drastically affected. Poor access to drinking water and sanitation facilities have made it impossible for them to comply with hygiene recommendations – washing hands regularly – to prevent COVID-19 infection.[1]
Their response has been two-fold: to develop community strategies to mitigate the risks of contagion, and to seek solutions in traditional medicine.
Strategies of protection
Some communities have established a monitoring system to control people’s movements, seeking to contain the spread of the virus in communities whose access to health services is limited both by scarcity of services and by lack of transport options. In rural riverside areas, the displaced communities appoint a member of the community to buy food and water each month in neighbouring host communities. Designated cleaning areas have also been set up for disinfecting clothes and for handwashing, and they have banned people from entering their communities who are from elsewhere.
Beyond the immediate benefit of protecting the community, such systems have also helped trigger a re-evaluation of forms of community organisation and ancestral knowledge possessed by the Colombian Afro-descendant people.
Drawing on traditional medicine
Access to drinking water is a historical and structural problem for the Afro-descendant population, and this situation is compounded by the absence of comprehensive health systems and the overcrowded conditions in which displaced people live. For the displaced, overcrowding and the consequent difficulty in following social distancing advice represent a serious obstacle to the prevention of and response to COVID-19.
Afro-descendant leaders have put into practice some lessons from pandemics such as Ebola which affected African populations without access to drinking water, and have dug wells to access underground water. This knowledge about well digging has also been replicated in Afro-descendant populations in Ecuador and Honduras and in the Quilomba communities of Brazil.
At the same time, traditional medicine has emerged strongly in the communities’ attempts to defeat the virus. Herbs and other plants are used for medicinal purposes and to make disinfectants to mitigate the symptoms of the virus and to prevent it spreading. The knowledge and application of traditional medicine that these people have applied during this pandemic has altered their own perception of the continuing value of traditional medicine.
In 2020, more than 28,500 Afro-descendant people had to leave their homes, fleeing from clashes between armed groups. As the displaced resettled in neighbouring lands, they shared their knowledge about the use of plants and trees for medicinal purposes, such as the matarratón (Gliricidia sepium), whose flowers are either boiled for consumption or used in baths and are believed to help stimulate the immune system. According to Tulia Martínez: “Our grandmothers taught us the healing properties of certain medicinal plants. This knowledge has helped us … to mitigate the effects of malaria, influenza, chikungunya and other diseases.”
There is no scientific evidence that using or consuming such plants can protect people against COVID-19. However, traditional Afro-descendant medicine is one of the few tools they have to try to alleviate the symptoms or prevent infections.
In the context of deepening racial inequalities due to the impact of COVID-19 and its intersection with other factors, displaced communities emphasise their need to use traditional medicine. They also stress that it is not possible to ensure comprehensive, equitable, quality and timely health-care services for them without recognition of their ancestral customs and cultural traditions, which are typically under-acknowledged by the national health system. The Colombian State needs to incorporate traditional medicine into its systems and to strengthen its intercultural competence through the incorporation of Afro-descendant health professionals.
Remaining challenges
The extreme vulnerabilities that affect displaced Afro-descendants have made them particularly vulnerable to both transmittable and non-transmittable diseases such as cancer, diabetes, heart disease and chronic respiratory diseases. This makes them even more at risk of serious consequences from COVID-19. Representatives of the Afro-descendant populations have stated that these risk factors have not been recognised by the State when preparing and implementing hygiene measures to confront the pandemic. This population is demanding that the State prepare protocols for special care for Afro-descendant people with COVID-19, protocols that take account of their underlying conditions.
Another important demand is the creation of a statistical information system with data disaggregated by race, gender and age. This would make it possible to measure the disproportionate effect of racial inequalities among displaced populations, which will in turn facilitate the design of appropriate strategies for the surveillance, prevention and control of the pandemic in this population.
For this purpose, it is essential that the State open up institutional spaces with the displaced populations for consultation and participation; this would allow intercultural dialogues with a view to incorporating traditional medicine in the response to COVID-19. A policy of affirmative action in intercultural health could be beneficial when facing future pandemics and could also contribute to redressing centuries of discrimination, marginalisation and exclusion.
Angela Yesenia Olaya Requene yesenia-olaya@fas.harvard.edu
Academic Coordinator, Certificate in Afro-Latin American Studies, Afro-Latin American Research Institute, Harvard University
[1] Economic Commission for Latin American and the Caribean (2021) People of African descent and COVID-19: unveiling structural inequalities in Latin America
https://repositorio.cepal.org/bitstream/handle/11362/46621/1/S2000728_en.pdf