Letter to OECD Secretary General re: Colombia's accession

Washington, D.C, October 27, 2017

Mr. Ángel Gurría
Secretary General
Organisation for Economic Co-operation and Development (OECD)
2 rue André Pascal,
Paris -- FRANCE

Mr. Kenneth Swinnerton
Chair of the Employment, Labour and Social Affairs Committee
Organisation for Economic Co-operation and Development (OECD)
2 rue André Pascal,
Paris -- FRANCE

Dear Secretary General and Chair,

As the OECD discusses Colombia’s accession to the organization, I’m writing to urge you to take in consideration a troubling situation in the country: the malnutrition crisis that in recent years has claimed the life of scores of Wayuu indigenous children.

Based on the information available to Human Rights Watch, the three pending committees for Colombia’s entrance to the OECD will discuss Colombia’s compliance with the organization’s legal instruments in November. If the committees consider that the country fulfills the relevant OECD requirements, Colombia could join the OECD early next year.

One of the committees pending review is the Employment, Labour and Social Affairs Committee. Under the 2013 accession roadmap for Colombia, the committee will evaluate, among other factors, whether Colombia has “financially and socially sustainable policies” including to “support … families with children,” and “measures designed to assist people without work and other vulnerable groups to combat poverty.”^[i] Human Rights Watch, based on our own extensive research, believes that the crisis faced by the Wayuu and the inadequate steps the government has taken to adress it should be seen as relevant considerations in the course of those deliberations.

As the process of accession continues, we urge that you and the Employment, Labour and Social Affairs Committe take the Wayuu crisis into consideration. In particular, we urge the OECD and its members to secure a committment by the Colombian government to take serious and concrete measures to address the crisis, including by urgently putting in place measures to ensure that Wayuu people are able to secure sufficient quantities of water and food.

The Crisis

With a population of at least 270,000 people, the Wayuu are Colombia’s largest group of indigenous people.^[ii] The vast majority of them live in the partially desertic northeastern province of La Guajira.^[iii]

For several years now, the Wayuu in La Guajira have faced a malnutrition crisis, resulting in high death rates, especially among indigenous children under five years old. Between January 2013 and August 2017, 208 children under five died in La Guajira due to malnutrition, according to official figures.^[iv] Of these, 193, that is over 90% percent, were indigenous, most of them Wayuu.^[v] (Figures could be significantly higher since government bodies, including the Human Rights’ Ombudsman Office and the Inspector-General’s Office, believe there is a high rate of under-registration.^[vi])

The Wayuu people are disproportionally affected by malnutrition. Between 2014 and 2016, deaths of indigenous children comprised over 85% of all malnutrition deaths in La Guajira, although, according to the latest official figures available, Wayuu people only represent 38% of the population in that province.^[vii] Nationwide, Wayuu children who die of malnutrition amount to roughly 12% of the deaths of children under 5, although Wayuu people represent less than 1% of the national population, according to the latest available figures. ^[viii]

On visits to La Guajira in August 2016 and June 2017, Human Rights Watch documented that the crisis is caused by extremely limited access to food and water compounded with high levels of poverty and equally limited access to basic services. According to Colombia’s Constitutional Court, corruption and mismanagement play a significant role in the limited public services offered in the province, including water.^[ix] The Wayuu people’s struggle with food insecurity is due to high levels of poverty preventing them from purchasing sufficient quantities of food, as well as limited access to water preventing them from growing enough food to augment the shortfall. Limitations in access to water for hygiene also affect peoples’ health, causing diarrhea and other sickness which could further foster malnutrition. Wayuu leaders also attribute partial blame for the crisis to the control exercised by former paramilitary groups over more profitable sectors of the local economy, as well as a decline in the availability of food obtained from Venezuela due to the humanitarian crisis in that country, both of which they say are driving up the cost of food.^[x]

In December 2015, the Inter-American Commission on Human Rights (IACHR) requested that the Colombian government take precautionary measures, including immediate ones, to address the “emergency” of Wayuu children in Uribia, Manaure, Riohacha, and Maicao, four municipalities in La Guajira.^[xi] Following the decision, Colombian high courts ordered the government to address the situation in multiple rulings.^[xii] In January 2017, the IACHR expanded the measures to cover pregnant women and those breastfeeding their children.^[xiii] Still, the number of malnutrition deaths continues to be high. According to official statistics, 81 indigenous children under five years died of malnutrition in La Guajira between January 2016 and August 2017.^[xiv]

Wayuu children are also suffering from long-lasting negative impacts on their development. An official report by the Colombian National Institute of Family Wellbeing (Instituto Colombiano de Bienestar Familiar, ICBF) found, based on a survey of over 14,000 children under four years in Wayuu communities, that only one in five were of normal height for their age—indicating that the majority of children show signs of stunting, which is associated with malnutrition.^[xv]

Limited access to safe water has forced Wayuu people to rely on unsafe water sources, including “jagüeys” —unprotected dug wells where Wayuu people traditionally gather rain water—, and wells and watermills with salty water, for consumption, cooking, hygiene, laundry and washing.^[xvi] Use of these water sources has led to communicable diseases, including diarrhea which further aggravates malnutrition. Doctors and nurses told Human Rights Watch that vomiting, diarrhea, and rashes were among the most frequent illnesses they found in Wayuu communities.^[xvii] According to official figures, 11 indigenous children under five years died of acute diarrhea in 2015 in La Guajira, 21 in 2016, and 10 between January and August 2017.^[xviii]

Scarce government action

Human Rights Watch visited La Guajira in August 2016 and June 2017 to analyze the government’s response to the crisis. We interviewed over 80 people, in La Guajira and Bogotá, including indigenous leaders, doctors, nurses, government officials, and prosecutors, and reviewed judicial rulings, government data, and official reports. As detailed below, our research found serious shortcomings in many of the plans and actions taken by the government.

Similarly, in August 2016, Colombia’s Constitutional Court found “no concrete evidence that the policies, plans, and programs implemented by the State have achieved positive results” to protect Wayuu children.^[xix]

1. Access to health services

Health services are very limited in Wayuu communities in La Guajira. A December 2015 government survey of over 1,400 communities found that only 1% had a health post.^[xx] Another government survey of more than 6,500 children under five concluded that almost 30% did not have health coverage and more than 70% did not attend health or nutrition programs.^[xxi]

A promising policy put in place by the national government to address these shortcomings is “extramural groups” which are formed by a doctor, a nurse, an auxiliary nurse, and a social worker, and visit communities that are far away from main cities in La Guajira.^[xxii]

The government reports that the 17 groups it has established in the province have attended to over 15,000 children between July 2015 and July 2016.^[xxiii] However, these groups rarely visit communities carrying medication, doctors, nurses, and local residents told Human Rights Watch.^[xxiv] Apparently by design, doctors in the groups are only supposed to diagnose people in the communities and prescribe medicines for them. ^[xxv] This means that people in remote communities still have to find their way to the main cities in order to treat their illnesses. A doctor and three nurses who work at extramural groups told Human Rights Watch that the lack of medicines severely limited their capacity to address malnutrition in the communities.^[xxvi]

Human Rights Watch received multiple allegations that local Institutes of Health Services (Instituto Prestador de Salud, IPS) —privately-run clinics in which the government delegates health services for poor people— routinely fail to provide medicines prescribed by “extramural groups.” A lawyer from a leading Wayuu indigenous group showed Human Rights Watch dozens of prescriptions that had been rejected by local institutes.^[xxvii] A doctor and three nurses who work for extramural groups told Human Rights Watch that they often receive complaints from community members that local IPS do not provide the medicines they prescribe.^[xxviii]

2. Access to food

The government has put in place promising strategies to improve access to food for Wayuu communities. Their implementation on the ground, however, has serious shortcomings.

One strategy implemented by the ICBF are the “community units of attention” (Unidades Comunitarias de Atención, UCA).^[xxix] The ICBF hires private firms which are, in turn, in charge of providing food and hiring community members to feed kids under five during the weekdays. Human Rights Watch visited 6 UCAs in different municipalities in La Guajira and interviewed the people in charge. In most cases, locals told us that the food was insufficient for the children and they often ran out. ^[xxx] In some cases, people in charge showed us food that they had recently received that was clearly rotten.^[xxxi]

Another promising program involves the provision of so-called “integral solutions,” consisting of a water well, a barn, and a vegetable garden.^[xxxii] Human Rights Watch visited four of them in different municipalities in La Guajira; three were not operating adequately. In one, the container gathering the water was exposed to the elements, so the water was foul and infested with insects. Community members told Human Rights Watch that they drink that water because it is the only source available to them. ^[xxxiii] In another community, the “integral solution” only provided salty water.^[xxxiv]

In a March 2016 report, the Human Rights Ombudsman’s Office found that many food programs in La Guajira were not being implemented and those implemented had “limitations regarding the quantity and quality” of food.^[xxxv] Similarly, in September 2016, the Colombian Supreme Court ruled that government’s actions to address the crisis “have not been efficent, nor acted with the urgency needed to address the evidently grave malnutrition situation.”^[xxxvi]

3. Access to water

Access to safe water sources is scarce in La Guajira, due to weather conditions and gravely limited public services. A 2015 government survey in three municipalities found that less than 7% of the Wayuu communities had piped water and that more than 89% of the households did not treat the water they consumed.^[xxxvii]

The national government has announced multiple plans and projects to improve access to water for the communities, including a February 2017 national intervention on the water services in the province.^[xxxviii] However, Human Rights Watch research on the ground indicates that programs are insufficient.

In over 20 communities that we visited, several residents said that they struggled to have access to water and had to rely on unsafe sources, often at far away distances. In most of them, the government did not provide water to locals nor had it recently created water wells. In a few communities, the government brought water in trucks, but it frequently ran out before the government sent more, locals told Human Rights Watch. ^[xxxix] In June 2017, Human Rights Watch visited three water wells the government recently built. Two of them were not working at the time and several residents told us that they had not operated for most of the time since their inauguration.^[xl]

In September 2017, the Human Rights Obmudsman’s Office, a government body, said in a report that it did not find evidence that the government’s measures had improved access to water.^[xli]

4. Prosecution of corruption

Corruption appears to play a significant role in the limited public services offered in the province, including water.^[xlii] The Attorney General’s Office has opened investigations into at least 35 cases of corruption concerning the provision of water, food, or education.^[xliii] These include, amongst many others, an investigation on possible corruption in the execution of a 90 million USD World Bank loan to improve the quality of water supply and sanitation services in urban and peri-urban areas of La Guajira.^[xliv]

The Attorney General’s Office has achieved mixed results in prosecuting corruption in La Guajira. While prominent local government officials –including five recent former governors—have been arrested for corruption, progress in laying charges and reaching verdicts remains very slow.^[xlv] Out of 1,125 investigations into allegations of corruption in La Guajira since 2007, prosecutors have only achieved convictions in seven cases.^[xlvi] The Attorney General’s Office was unable to confirm if any of them involved the public supply of water or food.^[xlvii] Prosecutors in Bogotá are investigating 15 alleged cases of corruption concerning the public provision of water, food, or education committed over the last decade. They have charged people in three cases and have yet to achieve a single conviction.^[xlviii]

5. Statistics

A key shortcoming in the government’s reaction is the lack of consistent and coherent statistics to assess the extent of the crisis. While the government took a significant step in 2014 and 2015 by carrying out surveys in La Guajira municipalities affected by malnutrition, the statistics available continue to have serious flaws and, as Colombia’s Constitutional Court has noted, limit the government’s response to the crisis.^[xlix] Shortcomings in official statistics include the following:

• Colombian authorities do not have a specific record of how many Wayuu people or children have died of causes associated with malnutrition.^[l]
• Authorities only publish information about deaths “likely” caused by malnutrition while there is no clear procedure to confirm the cause of the deaths.^[li]
• Authorities do not have updated information on how many Wayuu people live in La Guajira or in Colombia. Although the Wayuu crisis has received considerable attention in Colombia, at least since 2015, authorities from the Health Ministry told Human Rights Watch in November 2016 that they did not have information to calculate the mortality rates of Wayuu children.^[lii]

I hope the OECD and its members can take this information into consideration as they discuss Colombia’s access to the organization. By securing a committment by the Colombian government to take serious and concrete measures, the OECD could play an important role in helping address this critical crisis.

Sincerely,

José Miguel Vivanco
Human Rights Watch

CC:

Nicola Bonucci, Director for Legal Affairs

Mr. Bernhard Weber, Bureau member of the Employment, Labour and Social Affairs Committee

Mr. Miguel Fernandez Diez-Picazo, Bureau member of the Employment, Labour and Social Affairs Committee     

Ms. Marie-Hélène Amiel, Bureau member of the Employment, Labour and Social Affairs Committee 

Mr. Stéphane Kunz, Bureau member of the Employment, Labour and Social Affairs Committee

Mr. Shinichi Akiyama, Bureau member of the Employment, Labour and Social Affairs Committee

Mr. Dan Grannas, Bureau member of the Employment, Labour and Social Affairs Committee 

Ms. Kathryn Mandla, Bureau member of the Employment, Labour and Social Affairs Committee