The Right to Health of Venezuelans in Colombia: From Policy to Practice (Part 2)

[Rocío Quintero is a Legal Adviser for the ICJ’s Latin American Programme, based in Colombia. She tweets from. @___Dew___. Timothy Fish Hodgson is a Legal Adviser for the ICJ’s Africa Programme based in South Africa. He tweets from @TimFish42.]

As part 1 of this blog illustrated, the Colombian government has taken policy measures to ensure that the right to health of Venezuelans has been protected in the context of COVID-19. In Part 2, we explore the difficulties in the implementation of those measures and their possible connection with the returning of Venezuelans during the COVID-19 pandemic.

Although there is no official data, Colombian authorities have estimated that at least 36,000 people have returned to Venezuela using the main crossing point between Colombia and Venezuela since mid-March. In fact, the Colombian government reported that over 600 Venezuelans left Colombia in just one day in April 2020. In the context of a failing healthcare system in Venezuela, on the face of it, this requires explanation. The inadequacy of measures to protect the Economic, Social and Cultural Rights (ESCR) of Venezuelan migrants, asylum seekers and refugees is one possible reason for this surprising trend.

The right to health and the social determinants of health

The UN Committee on ESCR has explained that the right to health is a broad right, the realization of which must take account of a “wide range of socio-economic factors that promote conditions in which people can lead a healthy life”. It therefore includes a right to the “underlying determinants of health, such as food and nutrition, housing, access to safe and potable water and adequate sanitation”.

Indeed so central are protection of the social determinants of health to the realization of the right to health that the Committee lists the following as “core obligations” in terms of the right which are of “immediate” effect: provision of “minimum essential food which is nutritionally adequate and safe, to ensure freedom from hunger to everyone”; and ensuring “access to basic shelter, housing and sanitation, and an adequate supply of safe and potable water”. In addition, these social determinants of health are also self-standing ESCR in terms of the International Covenant on Economic, Social and Cultural Rights.

COVID-19 is therefore not only a right to health issue and, as the Committee itself has acknowledged in its statement on the pandemic, “the COVID-19 pandemic vividly illustrates the importance of the indivisibility and interdependence of all human rights”. The challenging situation of Venezuelan migrants, refugees and asylum seekers in Colombia provides a concrete example of the importance of the realization of all ESCR to the fulfilment of the right to health. It seems that it may well be the case that Venezuelans are going home because they find themselves between a rock and a hard place: stay in Colombia without support for their basic needs such as food and housing or return home and risk their ability to access COVID-19 related healthcare services.

Access to food, social security and housing for Venezuelans

Venezuelans migrants, refugees and asylum seekers in Colombia are among the population who has suffered the most during COVID-19. Particularly, from the beginning of the national quarantine in Colombia, which started on 25 March 2020, Venezuelans have struggled to access sufficient food and to guard themselves against being evicted from their homes. The plight of Venezuelans is a combination of several factors.

Arguably, the most important factor to consider is related to the precarious living conditions of Venezuelans in Colombia even before the COVID-19 crisis. The majority of Venezuelans who live in Colombia have informal jobs working, for instance, as street vendors, hairdressers, labourers, or clerks. In general, these jobs do not provide any economic safety net or social benefits. In other words, they depend on working every day to afford to buy food and pay for their accommodations.

Consequentiality, the compulsory quarantine has resulted in a loss of income and diminished their ability to provide food and shelter for themselves and their families. Unlike in countries like South Africa where informal food trade has been declared an essential service, in Colombia essential goods can only be sold in supermarkets, marketplaces or other similar stores.

Furthermore, the quarantine also diminishes the possibility of street vendors having customers in the first place. This is because it restricts people from the streets and public places, as one Venezuelan street vendor told a local newspaper. Similarly, although some Venezuelans have been able to keep their jobs, as an example working as delivery persons, many others have lost their jobs in restaurants, beauty salons, hotels, and other non-essential businesses.  

A second factor is that some Venezuelans have not been able to obtain economic assistance created by national and local authorities. Unfortunately, despite significant efforts, such assistance has not been provided promptly. Moreover, lacking documentation, some undocumented migrants in Colombia, have struggled to access such social and economic assistance. Similarly, humanitarian aid has also been affected during the quarantine. The Norwegian Refugee Council, for example, has reported that some humanitarian organizations have been reduced by one-third of their activities.

Thirdly, some of the positive non-economic measures (protecting ESCR such as access to housing and basic services) set out in such as policy are not being applied. This is the case of the moratorium on evictions during the quarantine, which has been ignored by landowners. In some cases, the landowners have cut off the electricity, gas, and water services to force people to leave. Some do not have any family support in the country and therefore do not have any housing alternatives when they are evicted and are rendered homeless. The Coordination Platform for Refugees and Migrants from Venezuela has indicated: “the number of Venezuelans living on the streets has tripled in some areas due to eviction as a result of individuals being unable to pay rent in the wake of the movement restrictions.”

Lack of clear, transparent communication from local and national government

Making matters worse Venezuelans in Colombia have not always received clear information about which authority is in tasked with protecting their rights and ensuring that they have access to basic services. A good example of this are statements made by Bogota’s Mayor, Claudia López Hernández that the national government must take over care for migrants since Bogota can only afford to help Colombian nationals. Contradicting this, President Iván Duque Marquez has indicated that local and national authorities must work together and have common responsibilities regarding the right of migrants.

These mixed messages from the authorities might contribute to creating more uncertainty among migrants. As reported for a local newspaper, after the Bogota Mayor’s statements, some migrants decided to leave the country since they believed they would not receive any help. At the same time such mixed messages risk exacerbating prevailing xenophobia actions against migrants, as was noted by a Colombian-Venezuelan civil society organisation.

Conclusion: Failures to guarantee Venezuelans’ ESCR in Colombia

It follows from the considerations set out above that ESCR of Venezuelans in Colombia are not being guaranteed properly during COVID-19. In particular, the lack of access to other ESCR including the rights to food, housing and social security, have made it less likely that Venezuelans will stay in Colombia and access healthcare services which may well be available to them. Instead a significant number of Venezuelans have decided to return home, increasing their risk of getting infected or carrying infection home, in the hope of covering their immediate needs of food and shelter.

It also should be noted that the conditions of the return of some Venezuelans might expose them to additional health risks. Some Venezuelans, including pregnant women and children, have been compelled to travel home on foot, a journey that can take weeks. Others are returning to Venezuela using irregular and dangerous crossing points to avoid the medical check-ups on the border.

Regrettably, the situation, once they cross the border, is not any better. Along with the deplorable conditions of the health system, the migrants who use the humanitarian corridors are placed in quarantine in ill-equipped facilities. In that regard, it has been reported that returnees have to sleep on the floor or in overcrowded places with poor sanitation.

The plight of Venezuelans in Colombia shows the clear importance of adopting a comprehensive approach to guarantee the right to health that includes a focus on other human rights. This is true both for Colombia and other Latin American countries. Without provision of housing, food and social assistance, Venezuelan migrants will remain vulnerable to violations of their healthcare rights even if they are able to have equal access to testing, screening, treatment services for COVID-19.