#hertielove
16.11.17

How healthcare offered a promise of trust in the Colombian peace process

When the government needed a health strategy for former combatants, Camilo Sánchez Meertens had the right skills for the job.

When the Colombian government and rebel FARC fighters declared a cease-fire after some five decades of civil war, many combatants hadn’t seen a real doctor in years. If one were hit by a bullet in battle, each rebel unit had a fighter with medical knowledge who would immediately treat and bandage the wound. Other medical problems were treated with similar urgency ­- or not at all.

One of the first measures in implementing the peace deal was to grant rapid medical access to those who were very ill or pregnant. Since late 2016, the Colombian health system estimates it has granted around 16,000 medical procedures to former fighters.

Camilo Sánchez Meertens, who received his Master of Public Policy in 2014, was working for the Colombian Ministry of Health when the High Commissioner for Peace called looking for a liaison to develop a health strategy for former combatants. Camilo, who was already helping prepare policies for a possible post-conflict era, was chosen for the job.

The idea was that healthcare could be a conduit for reincorporating the former guerrillas into mainstream society, and also to help close the gap between rural and urban Colombia. “I think we all underestimated the importance of health for guaranteeing a sustainable peace. Why is that?  Because healthcare is maybe the best way to build trust,” Camilo says. It is through the healthcare system that former fighters have their first contact with the Colombian state outside the military. “This involves the whole society and has an immediate effect,” he says.

The main governance challenge, however, arose from the fact that former fighters were accustomed to operating in a system where there was no state. Even though the quality of medical care was now vastly better, the new patients were not used to waiting for treatment – making an appointment, taking diagnostic exams, getting a referral, consulting specialists, scheduling surgery, for example. “There are different governance structures in the formal healthcare system,” he says.

Camilo found that success in his new job rested largely on communication – meeting with people both inside and outside the government to explain the system, the benefits and the policy choices. “I am lucky that I was properly trained for that at the Hertie School,” he says. I think I also learned a particular skill in communication – be smart at condensing in three pages what the major issues are.”

Camilo frequently looks back on his time at the Hertie School for inspiration in his job, especially in his understanding of how the public and private sectors and civil society interact. “We need them all,” he says – the private sector to create jobs in rural areas,  state services that won’t turn a profit but fill gaps the private sector can’t, and civil society in its watchdog role. Input from all three is necessary to ensure policymakers have the right incentives, he says.

 “I think in a culture like Colombia, governance has to take place via meeting people physically – especially when it comes to a peace deal,” says Camilo. “A lot of public policymaking involves getting in touch: meeting former commanders, explaining what you want to do, dealing with agencies, with civil society. From a strictly operational view, maybe this is inefficient, but in terms of trust-building, it is absolutely necessary.”

The Hertie School Alumni Council honoured Camilo with its annual Alumni Achievement Award in 2017, which celebrates an outstanding alumna or alumnus on their innovation and dedication to the principles of good governance.