Introduction
Camilo Arjona is opening the door for social development and peace building in remote areas of Colombia, many of which have no government presence, through his organization, Alas para la Gente (Wings for the People). By delivering much needed healthcare, Camilo is introducing key allies to the communities to bring more attention and resources to address the issues beyond healthcare.
The New Idea
Camilo Arjona and Alas Para la Gente (Wings for the People) are using highly effective, wide-scale medical brigades to enter rural, isolated communities in Colombia and introduce an array of allies that can support the residents in their economic and social recovery and or development. By using healthcare, a topic that most everyone can get behind, as a point of entry, he brings allies ranging from the government to the country’s top media to private companies and foundations to the table to pitch in with their respective resources. The communities’ healthcare needs are met while the Alas partners, in turn, are exposed to both the needs and assets of these areas.
Camilo, combining his talents as a pilot and a publicist with his deep-seeded social commitment, began Alas after participating in small-scale medical brigades and seeing the extent of the problem of rural communities without access to healthcare or other public infrastructure. He started Alas to be a resource-aggregator to provide large-scale medical professionals and supplies to off-the-grid communities. As his strategy developed, he saw the brigades as a tool for introducing these communities, often formerly or currently governed by paramilitary forces, to the entities that can assist them in overcoming their situation. Brigades of 35 medical specialists and tons of medicine and other supplies are collected and transported to these remote areas, thanks to the support of Alas’s many allies and based on a plan developed by the communities themselves. Then, the volunteers, partner organizations, and the public at large “meet” the communities and learn about their culture, economic poverty, and/or cultural and environmental wealth through strong media partnerships. As a result, perceptions about the communities are changing – they are not only seen as forgotten or abandoned conflict zones, but become personalized and even valued. In turn, the communities (and their leadership, regardless of politics), are meeting partners that can help improve their quality of life.
What began as a way to identify the needs of rural communities excluded from healthcare, channel the appropriate resources their way, and ultimately permanently fill the gaps in the healthcare system is just the beginning of the change Camilo is instigating. First, he recognizes that his infrequent medical brigades are not enough to sustain communities until the government steps in, so he is working on setting up Telemedicine Kiosks in the communities to provide more continuous access to care. Not only has the Ministry of Health and Protection begun to use Alas as tool to non-contentiously arrive in these communities, but also to survey the possibilities of further post-conflict intervention that extend beyond healthcare. After each brigade, Camilo issues a report card to local and national governments that can then be used to understand the local social situation. Camilo’s reputation has already made Alas a partner in the government’s post-conflict recovery plan, and other allies are taking his model beyond Colombia to Central America.
The Problem
In rural areas of the Colombia, quality of life indicators are lagging. Years of internal conflict due to paramilitary and narco-trafficking activity have these areas disconnected and struggling to cover their basic needs. Other communities are simply so remote that they are difficult to reach and remain outside purvey of government services. There are particularly worrying health statistics in these areas: high fertility rates, high infant and maternal mortality rates, low life expectancy, and high levels of malnutrition. This is in part due to lack of access to basic services such as potable water, electricity, and proper waste management which creates a less than ideal environment for a healthy population.
As far as capacity to deal with these health issues, there is not only a lack of infrastructure, but also a lack of human resources. In 2012, Colombia’s most developed cities had about 325 physicians per 100,000 people. In contrast, rural and remote areas had only about 50 medical professionals per 100,000 people. Furthermore, many residents in these parts of the country are of an indigenous background, with cultural practices that include traditional medicine as the primary means of health care.
Any outside intervention attempting to reach these communities or anyone from the communities trying to access outside resources faces several challenges. First, the locations of the communities might be topographically difficult to travel through due to rivers, jungle, and lack of roads. Second, armed groups are still present in or even governing some areas. Third, there is scattered or nonexistent state healthcare in rural parts of the country, meaning that the distance to reach or distribute resources more concentrated in cities can be quite far. Finally, the methods of these state healthcare providers that do exist are often not appropriate for the populations needing care – meaning they are not equipped to physically to reach the patients needing care, are not culturally suitable to the patients, or are slow and inefficient due to corruption and inefficient management.
The Strategy
After volunteering as a pilot to deliver a few doctors and medical supplies to rural areas of Colombia, Camilo Arjona was determined to find a way to address these communities’ needs on a much wider scale. He began to envision how more permanent channels and partners could make this possible, and in 2007, he began Alas para la Gente (Wings for the People) to do this. This collaboration allowed Camilo to organize much larger health brigades with support from Colombian Air Force (FAC), private companies, laboratories, other citizen sector organizations, and the Colombia Health Ministry. Camilo’s goal is not only to provide doses of healthcare through these brigades, but to help communities take charge of their own health and wellness by first treating the symptoms, then building the infrastructure to keep them connected to health resources in the long term. Camilo sees Alas as an aggregator of solutions and outlet for professionals, companies, and others that want to contribute to the solution. He gives them recognition for the work they contribute, in turn encouraging more participation to bring more attention and resources to address the issues beyond healthcare.
Alas begins by identifying the populations most needing access to healthcare. The Colombian government classifies communities according to a “traffic light” designation. Green means the area has government presence; yellow means it has moderate state presence, and red means there is not any kind of state presence, and may even be dominated by paramilitary forces. It is in these “red” communities, the most vulnerable and isolated places, where Camilo chooses to start. His strategy is that by jumping the gap, gradually others will follow, ultimately bringing state interventions such as infrastructure and other public services.
After selecting a community needing support, Camilo begins working with local leaders to understand the conditions, needs, and existing resources, and develop an appropriate plan. One the other side, Alas begins to gather resources to schedule a brigade. About one month before the scheduled brigade, Camilo goes in person to help community leaders prepare. Because healthcare is a common and noncontroversial need, leaders and community members are willing to come together to problem solve, regardless of their political leanings and approval of or opposition to the Colombian government. So during his visit, Camilo brings together a local team of community leaders and other authorities to arrange logistics for the brigade. The team pulls together local resources – community health centers, schools, and councils – and Camilo describes the specialties and resources that the brigade is able to provide. Together they determine: the physical space for the medical appointments; the number of people in the community in need of medical attention; the type of health issues community members have; and a local volunteer support team to work with the brigade throughout their stay. The local leadership also takes charge of spreading the word about the brigade’s visit, organizes patients according to ailment, and arranges the brigade’s schedule accordingly.
When everything is prepared, the community gives their plan to Camilo, who in turn presents it to the Health Secretary of Colombia. In this way, he has communities “prescribe” their own treatment, and then he facilitates the remedy, bringing all resources to bear.
Once they have the community’s plan, Alas coordinates the volunteers and medical supplies in partnership with a number of allies. The volunteer physicians are from various specialties. The has a register of over 50 regular volunteers includes, General Practitioners, internists, ophthalmologists, pediatricians, gynecologists, urologists, orthopedists, dermatologists, surgeons, anesthesiologists, and those practicing alternative medicine, but they are also always recruiting new volunteers as well.
Partners provide the actual supplies and medicine. A number of private companies and labs make donations, usually adding up to literally tons of supplies sent with each brigade. In turn, Alas is careful to publicize these groups’ support, boosting their socially responsible profile. For example, Camilo has negotiated a special section in the online portal of Colombia’s leading newspaper, El Tiempo. It publishes regular stories about each brigade, giving voice to patients treated in the local communities and highlighting their situation, but also prominently mentioning the partners of Alas that make the treatment possible.
Alas also determines how to get the volunteers and supplies to the site, which may be accessible by boat, plane, or on foot. The FAC always has a plane available for Alas to use and volunteers ready to transport the brigades. Camilo also has his own plane (donated by the government) which he uses for the preparation visits to the community before the brigades. The Army is also ready to assist in transport and provide any security if necessary, once the local government or authorities are in agreement with Camilo’s action plan.
The brigades usually last 3 days, and in that time, the 35 medical volunteers are able to see hundreds of patients. They attend to the most urgent cases as well as those that can be resolved with treatment on the spot. For anything else requiring more specialized attention or longer-term treatment, the patients are referred to the closest hospital. For example, the community of Chaparral is located 160 km from the capital of the department of Tolima, in the central part of Colombia. In one brigade, Alas conducted 835 consultations and performed 895 procedures. The partners involved in supporting that particular brigade included the FAC, the Ministry of Health and Social Protection, the Colombian Army, the University of Antonio Nariño, The Servioptica Foundation (related to a leading ophthalmological company), the local city government and hospital, and the Murillo Toro Education Institute. After a brigade visit to another remote community, a patient commented that, “It is good that they have realized that we exist. We have very little access to medicines and medical attention, and this was an opportunity we had to take advantage of.”
To bridge to more long-term care, Camilo is also setting up telemedicine centers in some of the communities that have received brigades to provide the follow-up for communities that do not have easy access to hospitals and medical specialists. Three are already established for a pilot phase, and Camilo has started these partnerships with the local governments and a telemedicine company. Through a virtual hospital and free of charge for the patient, the telemedicine kiosks allow consults with specialists via satellite internet, in real time. Going forward, the government would pay for the service, the department of telemedicine at the National University of Colombia (a pioneer in the field) would provide support, and the governor or mayor and local Health Center in each region would coordinate other logistics of the kiosks.
However, more than just healthcare, the objective of Camilo’s brigades is to expose the government and other actors to the conditions in the communities and introduce them to the communities as potential allies to prepare the way for more permanent infrastructure and resources for the communities’ wellbeing. After each brigade, Camilo submits a report card to the local and national Health Departments. The reports give updated social, health, and more qualitative statistics about the environment, in turn helping the government to know what infrastructure and services are needed. In this way, he is enabling the government to keep its finger on the pulse of these isolated areas, but also to introduce the idea of collaboration with the government in areas still maintained by paramilitary forces. To help the public learn about these locations and dispel stereotypes, Camilo has several important media allies. In addition to his partnership with El Tiempo, Camilo works with City TV to run a 20 minute program after each Alas brigade. These features share about the work of Alas and its volunteers, but also to spread awareness of the cultural and environmental richness of the communities that receive brigades.
Hoping to use these stories to change perceptions and draw attention to the rural communities, Camilo also wants to increase visitors to the areas, which would boost local economies and protect natural resources. He is constantly recruiting other partners, and is currently concentrating on those that could help local residents develop such an eco-tourist economy in order to generate jobs and attract other resources.
Camilo and his “traveling hospital” now conduct 10 brigades per year, and the team includes over 50 medical professionals and 4 paid staff. Each brigade on average conducts 1500 consultations and sees between 800 and 1500 individual patients. In the last decade, Camilo has facilitated medical care to about 70,000 people across Colombia. Camilo leads as the organization as its director, but he has never taken a salary. Looking to scale, he is formalizing his traveling hospital as a public intervention strategy with the Colombian government, through the Department of Social Prosperity of the Presidency of the Republic and the National Territorial Reconstruction and Consolidation Politics, the government’s agreement to generate institutional capacity to protect the rights of territories historically effected by armed conflict and narco-trafficking. This will allow the brigades to enter with medical care, but have the state follow and introduce infrastructure, schools, and economic development projects.
Inside Colombia, in the short term, Camilo is working on scaling to 10 brigades per year in each of 4 quadrants of the country for a total of 40 brigades. Each quadrant will be coordinated by a local Alas office to work with regional volunteers and supplies. Camilo sees local coordinators in charge of these offices acting as replicators who can train other coordinators. Camilo is already thinking outside of Colombia as well, thanks to his partners. For example, in an alliance with the Millicom (a multinational telephone company) and Shakira (a native Colombian but globally famous pop star), Alas is working in Guatemala to export theirs and other successful models to develop early childhood healthcare centers. There are plans to spread this to other Central American countries if the work is successful.
The Person
Camilo grew up in the countryside of Colombia, where he experienced rural life and came to understand some of its hardships. He was always interested in communication, and he demonstrated an artistic side from an early age. He learned photography from his father, and he also painted as a child. He even started the ambitiously named Alfa and Omega newspaper in elementary school. After finishing high school, Camilo had the opportunity to go to the US, where he had his first contact with publicity firms and studied graphic design.
Back in Colombia, Camilo continued his professional pursuit of publicity, production, photography, and film. He worked his way up in publicity firms, continuing to develop and broaden his skillset in different media. At one firm, he began as the radio and television director but advanced to work with clients and develop strategy and messaging. Seeing the power of communication, he went on to found his own business, Somos Comunicaciones (We Are Communications), which he still maintains today. However, over the last decade, Camilo has spent much of his time working to achieve better living conditions in the marginalized communities in Colombia.
Also a pilot, Camilo was able to participate in the Air Patrol, a program for pilots with private planes to carry small medical brigades to remote areas. Through those trips, he better understood the country-wide rural scene and its complex issues and saw that a much wider-scale solution was necessary. A turning point for Camilo came with the decision to work to increase the number of brigades to reach more communities. In 2007, he founded Alas para la Gente to do this. Thanks to his skill as a communicator and publicist and entrepreneurial leadership, he has been able to involve many public and private allies in his vision.