Epidemiologic profile of the population displaced by the internal armed conflict of the country in a neighborhood of Cartagena, Colombia, 2000.

Abstract

Colombia faces internal displacement as a consequence of internal armed conflict. From 1985 to the present, it is estimated that 1,500,000 people have been displaced. A transversal descriptive study aimed at characterizing the health situation of this highly vulnerable and continually growing population was carried out in Cartagena between September and December, 2000. The sample size was calculated to meet a 2% precision, 40% of maximum expected prevalence, design effect of 2 and 15% of information loss, total sample size 1.600 home's interviews. Single-stage sampling with replacement was done by clusters. To socioeconomic, sanitary conditions, morbidity and mental health variables was done univariate analysis, determining frequencies, central trend and dispersion, as well as a bivariate analysis to determine X2 or Fisher exact test, p values and stratified analysis. The study found severe deterioration in socioeconomic conditions, high exposure to violence (80% was exposed to violence before displacement and murder cause 60% of deads in teenagers and adults after displacement but even children under 4 years-old was affected by this phenomenon), family disintegration, bad sanitary conditions, high prevalence of tracing diseases in all ages (80% of under 5 years-old had respiratory symptoms, 30% diarrhoea and 32% purulent lesions in skin), school desertion (20% children between 5 and 11 years and 16% teenagers), late schooling, poor performance at school, high proportion of working children (4% children between 5 and 11 years and 20% teenagers), low affiliation to social security systems (only 20% under 5 years-old children and 50% adults), low coverage and access to health services, among many other factors whose interaction affects this population's physical and mental health. We found that is difficult to make an early detection of internally displaced populations and thus provide adequate health care when such displacements are recent or involve individual persons. Results show that is essential to implement a surveillance system based on community leaders to increase efficiency, access and opportunity in health care for displaced populations.