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EL ESPECTADOR

A Hospital In Bogota, Mirror Of Colombia's Civil War Scars

Bogotá's Central Military Hospital has seen the worst of decades of civil war in Colombia — from severed limbs to longstanding traumas, Amid prospects of peace with the FARC guerrillas, its work begins a slight, and welcome decline.

Veterans at Colombia Independence Day celebration
Veterans at Colombia Independence Day celebration
Jaime Florez Suarez

BOGOTÁ — For the first time in decades, the trauma and injuries ward in Bogotá"s Military Hospital has empty beds. A more peaceful breeze seemed to blow through the building, which had witnessed decades of conflict between the Colombian state, communist guerrillas and motley groups of armed gangs.

The trauma ward used to be full of young soldiers with broken bodies and severed limbs. Today, it caters more to the needs of older veterans dealing with heart or kidney conditions. That switch has come about as a result of peace talks between the government and the Revolutionary Armed Forces of Colombia (FARC).

The hospital reflects this transition to peace from the country's long history of conflict: War with Peru in the 19th century, the Bogotazo — when Bogotá residents ran riot in 1948 after a politician was shot — mafia bombings, guerrilla and paramilitary killings. Each violent turn left its mark on this imposing, gray building in the form of the wounded who were brought in and the healed patients who made it back home.

One exchange in 2000 is emblematic of the challenges the hospital has faced in the past: "We're sending you a soldier with a grenade injury, Dr Uribe," one person informed him.

"No problem," responded Dr. Ricardo Uribe Moreno, who is head of the trauma ward. "Send him in."

"I don't think he understood right," the first person said. "The soldier has a grenade inside him."

That soldier had accidentally shot his grenade launcher and lodged the unexploded bomb inside his leg. Dr. Uribe's colleagues urged him to cut off the soldier's leg due to the risk that the grenade would explode. But Dr. Uribe still decided to try to extract the bomb.

You can be saved

Doubts persisted as to who would help operate. Dr. Uribe asked around and an aide volunteered. "I'll do it, but under your guidance. And if the grenade blows up you'll have to save my life," the aide said. The building was evacuated before the operation, which turned out to be a success. The doctors saved a soldier's leg, and their own lives.

News spread that even in the most dire cases, there was a team that could save you. And it wasn't the last such operation involving an explosive. Dr. Uribe led eight more extraction procedures, including one on the hospital's helicopter pad amid gusts of wind.

Dr. Uribe is one of the founders of the trauma ward, whose team includes specialists, surgeons and nurses who had adapted to the crude nature of violence. They were at the front lines of war and accustomed to seeing the worst injuries. The team is briefed on the condition of patients before they are evacuated from war zones, and prepare their response accordingly.

The trauma team members are experts in damage control. "You have to take decisions like a fighter pilot in an emergency, or it'll be too late," said Dr. Uribe. As a result of this fast thinking, 97 per cent of injured patients entering the trauma ward survive.

Between 2003 and 2007, the hospital would, on average, receive at least four patients with serious injuries a day, as the government had ordered troops to leave their bases and seek out guerrillas in the forests. Fighting had intensified. "I became used to adrenaline while attending to this war," said Uribe. "I get bored on holidays."

The hospital adapted to the changes in warfare being used in conflict. Once armed groups began using anti-personnel mines, one building inside the hospital complex started to churn out artificial limbs. In the 20th century, those appendages were wooden. Now, they are synthetic with implanted software for better mobility and coordination. Often, the limbs are inscribed with a personal touch for the soldiers — the logo of their favorite soccer team or a picture of their girlfriend. The patients are then taught how to use their artificial limbs.

In the hospital gym, a young soldier with an amputated limb watched an old man try on an artificial leg — the latter's condition a result of diabetes. The present building — not the hospital — is 54 years old and seems to have become a symbolic antechamber to Colombia's future. It will not only treat injuries but would also start to heal other types of scars left by war.

The number of patients with gunfire wounds have dropped dramatically, followed by the numbers of amputees from mine explosions. But the hospital expects to receive more amputation cases as Colombia proceeds to clear its territory of landmines. Some have estimated this could take 30 years. Dr. Uribe approached the elderly man struggling with his limb, and puts his hands on his shoulder. "Well done. You're as tough as old boots," he said. The patient looked exhausted.

The hospital's work is far from over, given war's enduring effects: there are amputees who need to change limbs every three years, veterans who turned to drink and drugs, families broken under pressure. There are soldiers with kidney problems brought on from drinking dirty water in war zones and those with heart troubles caused by leishmaniasis — a parasitic disease found in the jungle. The fighting may end soon, but the scars will last longer.

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Society

In Northern Kenya, Where Climate Change Is Measured In Starving Children

The worst drought in 40 years, which has deepened from the effects of climate change, is hitting the young the hardest around the Horn of Africa. A close-up look at the victims, and attempts to save lives and limit lasting effects on an already fragile region in Kenya.

Photo of five mothers holding their malnourished children

At feeding time, nurses and aides encourage mothers to socialize their children and stimulate them to eat.

Georgina Gustin

KAKUMA — The words "Stabilization Ward" are painted in uneven black letters above the entrance, but everyone in this massive refugee camp in Kakuma, Kenya, calls it ya maziwa: The place of milk.

Rescue workers and doctors, mothers and fathers, have carried hundreds of starving children through the doors of this one-room hospital wing, which is sometimes so crowded that babies and toddlers have to share beds. A pediatric unit is only a few steps away, but malnourished children don’t go there. They need special care, and even that doesn’t always save them.

In an office of the International Rescue Committee nearby, Vincent Opinya sits behind a desk with figures on dry-erase boards and a map of the camp on the walls around him. “We’ve lost 45 children this year due to malnutrition,” he says, juggling emergencies, phone calls, and texts. “We’re seeing a significant increase in malnutrition cases as a result of the drought — the worst we’ve faced in 40 years.”

From January to June, the ward experienced an 800 percent rise in admissions of children under 5 who needed treatment for malnourishment — a surge that aid groups blame mostly on a climate change-fueled drought that has turned the region into a parched barren.

Opinya, the nutrition manager for the IRC here, has had to rattle off these statistics many times, but the reality of the numbers is starting to crack his professional armor. “It’s a very sad situation,” he says, wearily. And he believes it will only get worse. A third year of drought is likely on the way.

More children may die. But millions will survive malnutrition and hunger only to live through a compromised future, researchers say. The longer-term health effects of this drought — weakened immune systems, developmental problems — will persist for a generation or more, with consequences that will cascade into communities and societies for decades.

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