Mirla Milagro remembers when she and her children ate three meals a day in Venezuela. She gave manicures and cleaned houses, and they got by. Their medical needs were all covered by the Venezuelan health system. When the clinics started experiencing stock-outs of medicines and supplies, volunteer doctors from Cuba stepped in.
But after a while, there seemed to be no medicine anywhere, and if they were available, they were too expensive. Food became difficult to get. It really got bad. She sends her mother money for food whenever she can. More than 4 million Venezuelans have left their country since its economic and political collapse, and Colombia is hosting at least 1.
In Riohacha, the migration is visible—people asleep in the parks and on the beach, formerly empty spaces now filled with shelters made of plastic sheeting and discarded materials, and people everywhere begging or selling whatever they can. Many of these Venezuelan migrants arrived by bus or on foot from Maracaibo, formerly the economic center of western Venezuela, close to the Colombian border. She cried when she found out. The next day, at her request, MSF provided Milagro with a safe medical abortion—five pills to take over two days and directions to stay in bed and rest and come back for a check-up afterwards.
When she returned, MSF also provided her with a five-year contraception implant. Abortion has been largely decriminalized in Colombia since , though women face significant barriers—from social stigma to being turned away from health structures—when requesting safe abortion care within the health system. Milagro was at risk for both complications during delivery and unsafe abortion—two of the biggest causes of maternal mortality around the world. While public hospitals are legally required to provide emergency care to whomever needs it, those services are limited to immediate lifesaving treatment, vaccinations, and deliveries.
This leaves a lot of essential health needs unmet, including for women, which is why MSF has made sexual and reproductive health care—services that prevent maternal deaths and injuries—a major focus of our response to the migration crisis. One key strategy to preventing maternal deaths is providing contraception—not just condoms, but a variety of methods that fit the needs of the individual woman and give her control of their use.
