Colombian Red Cross: Building capacity in hard to reach communities

Published: 3 April 2014 11:39 CET

“During the 1950s and 1960s, the Pan-American Health Organization adopted a public health strategy to fight dengue, which successfully reduced, and in certain cases eliminated, the disease in the Americas. However, with time this momentum was lost. Today, dengue cases have gone from practically being non-existent to countries like Brazil, Mexico and Colombia being counted among the top ten most endemic countries in the world,” explains Walter Cotte, Under Secretary General, International Federation of Red Cross and Red Crescent Societies (IFRC).

In Colombia alone, the caseload has gone from 5.2 per 100,000 in the 1990s to 18.1 cases per 100,000 in the past five years. Dengue has become a major public health issue. The increase in cases is a result of a combination of factors such as population growth, unplanned urbanization, lack of environmental sanitation, increased long-distance travel and ineffective mosquito control.

In 2013, the Colombian Red Cross, with the support of the IFRC’s disaster relief and emergency fund (DREF), responded to the dengue outbreak in the country. The funding made available through DREF enabled the National Society to provide healthcare and supply educational and promotional materials for prevention and care to 61,811 people.

The municipality of Guapi in Cauca department was among the affected areas reached during the 2013 outbreak response. Increased insecurity in the municipality has had dire consequences for the 30,000 inhabitants, 82 per cent of who do not have access to safe drinking water. The municipality has no waste disposal or wastewater treatment plant in place. The majority of waste is dumped directly into the river or the ocean. The river is further contaminated as a result of coca production and illegal mining. Rainwater or water taken directly from the Guapi river is used by the urban and rural population to meet the daily water consumption needs. All these factors together leave the population extremely exposed to preventable diseases like dengue.

Rubiela Restrepo Cardona, a volunteer with the Colombian Red Cross works in a mobile health unit. Rubiela presented his first symptoms of dengue while on mission to the municipality of Guapi. When his diagnosis could not be confirmed by the first-level hospital, the Colombian Red Cross Society transported Rubiela by air and land to get him to a better-equipped clinic where he spent 12 days recovering from dengue.

While there is a first-level hospital and primary healthcare institutions in the municipality and there is awareness of diseases like dengue, there are limited facilities available for testing and diagnosis. Further, it is difficult for rural inhabitants to access healthcare services, since transportation costs are high. The population of Guapi can only be reached by sea and air; and the rural inhabitants via the banks of the Guapi river and its springs.

Given the difficulties in accessing healthcare facilities, community health workers and volunteers alongside communities and individuals are instrumental in ensuring that measures to control dengue are successful and sustainable in the long-term. However changing mind-sets requires time. Using the community-based health and first aid (CBHFA) approach, the Colombian Red Cross has helped raise awareness and build capacity in communities and schools among 5,000 people in the municipality of Guapi.

The Colombian Red Cross is implementing CBHFA and working together with the Ministry of Health and Social Protection and the National Health Institute to raise awareness about dengue. While it is important to respond to outbreaks it is only by implementing long-term community-based initiatives that there will be a change in attitudes and practices, making it possible to reduce the incidence of not only dengue but also other preventable diseases.

“Using participatory approaches is extremely effective and increases ownership. Community health workers and volunteer presence in each community not only enables us to deliver preventive health and care services but also fosters community action. This is particularly the case in communities that are hard to reach due to a combination of insecurity and remoteness of location,” shares Dr. Juvenal Francisco Moreno Carrillo, Director General of Health at the Colombian Red Cross.

The main activities carried out by the Colombian Red Cross to prevent and control dengue include:

  • Training volunteers in the CBHFA approach including controlling epidemics

  • Raising awareness on dengue prevention and identifying early warning signs

  • Epidemiological surveillance coordinated with community-based health systems

  • Links with statistical systems that allows handling reliable statistical data

  • Communication strategy ¨No standing water¨ used to raise awareness among internal and external audiences using promotional videos, radio spots, advertising guidelines and disseminating messages through social networks to prevent dengue.

Stopping dengue from spreading is our collective responsibility. Only by investing in long-term community initiatives, we will be able to put an end to the silent suffering caused by dengue. Read more on