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Public Health context
In Colombia, in the majority of remote places the absence of human, technical and financial resources makes it practically impossible to locally solve the health difficulties of the inhabitants principally those requiring specialist medical attention, as these patients have to be remitted to the larger cities dramatically increasing the health costs.
In children the main difficulties are infectious diseases, principally Upper Respiratory Infections (URI) and Acute Diarrhoea Illness (ADI).
After trauma, the main cause of morbid mortality in the adult population is the degenerative chronic diseases and, in women, the pathologies associated with the reproductive period are to be highlighted.
The greatest difficulties in young adults is the unemployment and sub employment, as this leads to precarious living and the exposure to social and environmental factors that lead to a deterioration in their health.
Rural poverty and violence derived from the armed conflict, among other factors, have favoured the displacement of large groups of the population towards the marginal zones of the larger cities.
Paediatric Consultation
in Bahía Cupica
(Pacífic Coast of the Department of Chocó)
The national maternal mortality rate shows a tendency to reduce, but this indicator has not moved in the expected manner and there are still serious differences in its behaviour in the different population groups. In the rural and least favoured urban populations, the adolescent pregnancy rate is still too high (19%) as also is the prenatal and infant mortality as well as induced abortions.
It is also important to remember that, in spite of the fact that it is highly preventable, in Colombia the cancer of the neck of the uterus (32 deaths per 100,000 persons) and the mortality (10.1 x 100,000 women, is constantly increasing. It is known that the Cervical-Uterine smear tests at regular intervals are highly effective as an early warning of the disease, as it can reduce the mortality by up to 60%.
On the other hand it is estimated that at the moment there are around 126,900 blind people with cataracts and each year a further 25,380 people join this group. The estimated loss in productivity, rehabilitation and education of the blind is a heavy burden on the social services. At least 50% of the blind are for cataracts that are operable and 30% preventable via promotion and prevention programmes. On the basis of this the prevention and cure of blindness could result in a considerable financial gain and a better quality of life.
The promotion of Visual Health is a fundamental part of the total care, as it permits the prevention of optical disease and the reduction of blindness. Early detection of visual deficiencies can improve the academic performance and reduce school desertion.
Even considering the latest National Report on Oral Diseases published in 2000 that shows improvement in the oral health indicators it is difficult for them to consider social inequalities. The most affected are the poor living in rural areas, unschooled and with a very low level of instruction. The most common oral diseases are dental caries, periodontal diseases and preventable pathologies.
The PAC-ANTIOQUIA programmes take to the inhabitants of the more remote and less favoured areas health services that can improve their quality of life. |
