In the future the MSF teams will try, step by step, to enter deeper into this area in order to reach populations even further isolated by the conflict. Also the number of services will be expanded with mental health and dental care.

A team of eight MSF workers has recently returned from a three-day health care visit in the communities of La Campana and Los Cedros, in the district of Norte de Santander - one of the most insecure regions in Colombia. This MSF team has been active in the area since February this year, carrying out vaccinations following the regular 'enlarged progamme of immunisation' (EPI) schedule and vaccinating against yellow fever.

This health visit was the first where, next to vaccination and promotion and prevention activities, consultations were done and medication distributed. A total of 242 patients were seen by the team.

Norte de Santander is one of the most insecure areas in Colombia. It is a strategically important area, bordering Venezuela and very suitable for coca growing. The fighting between the different guerrilla and paramilitary groups and the army increased during the past three months when the army started an operation named 'Holocausto' to eradicate coca-growing.

The fighting, along with threats by different groups, selective killings, road blockades and other events have caused high levels of displacement and has almost totally blocked access to any health service over the last year and a half.

The existing health care facilities are based in areas held by paramilitary groups, while the population lives in areas held by opposing guerrilla groups. As the population is often suspected of having ties with the guerrilla groups, it becomes risky or difficult for them to go to the health facilities - some three to four hours away by foot.

In the future the MSF teams will try, step by step, to enter deeper into this area in order to reach populations even further isolated by the conflict. Also the number of services will be expanded with mental health and dental care.