News Gun violence in Colombia A city in Colombia tries to address the root causes of gun violence. Sophie Cousins reports. Fabián Parra was 11 years old when he A collaboration between the met- Since 2015 there has been an 80% joined a street gang. That was in 2011. ropolitan police and Universidad del decline in homicides in the eight Co- The gang dealt drugs and sometimes had Valle’s Instituto de Investigación y De- munas targeted, murders dropping to defend its territory with guns. The sarrollo en Prevención de la Violencia from 396 in 2015 to 81 in 2018. “I’ve territory was a small part of Comuna y Promoción de la Convivencia Social been involved in this type of work for a 18, a neighbourhood in Cali, Colombia, (Cisalva, Institute for Research and long time and I have never seen such a a city of 2.3 million people. Development in Violence Prevention reduction in homicides,” Gutiérrez adds. “When I was 16, a kid from another and Promotion of Social Coexistence), gang tried to shoot me,” Fabián says. “I the TIP programme has been providing fired back and hit him in the foot. After- comprehensive psychosocial support for It is imperative wards his friends came looking for me. around 1400 youths from eight of Cali’s that we directly They were going to kill me, so I had to most violent neighbourhoods, including “ leave the neighbourhood.” Comuna 18, since 2015. engage the young The year Fabián left Comuna 18, “Youths come into the programme people involved in it was already becoming a safer place. voluntarily, referred by police trained violence. According to police records there were in community relations, or by one of María Isabel Gutiérrez only two gang-related homicides there the 56 community leaders employed by ” in 2016, down from 11 in 2015. the programme,” Gutiérrez, who is one The decline in the Comuna 18 of the programme’s founders, explains. Not everyone is convinced that a homicides was part of a city-wide trend “We work with these young men programme focused on treating individ- established in 2013. Before that year, and women using an integrated psy- uals is the best approach to tackling gun Cali had about 2000 homicides per chosocial approach including indi- violence. “It may be possible to change annum. In 2018 there were 1209. That vidual counselling, health care and an individual’s behaviour or lifestyle, but still represents around 50 murders per access to addiction treatment where the evidence suggests that population- 100 000 people, which is twice the rate this is required. But we also work at wide initiatives are more effective,” reported for Medellín, a comparable the family and community level, help says Dr Alexander Butchart, a violence Colombian city, but it is a significant youths complete their education and prevention expert at the World Health fall nonetheless. find work, and give them opportunities Organization in Geneva, Switzerland. Dr María Isabel Gutiérrez, a pro- to play sports, and participate in music At the top of Butchart’s list of effective fessor of epidemiology at the School and theatre.” prevention initiatives is the implementa- of Public Health at the Universidad When youths are judged to be at tion and enforcement of laws that restrict del Valle in Cali, Colombia, credits risk of quitting the programme or get access to firearms. “Several studies show the Tratamiento Integral a Pandillas into trouble, the Cisalva and police team that ease of access to guns is an important – Jóvenes sin Fronteras (TIP, Compre- spends more time with them in their driver of gun violence,” he says, citing hensive Treatment Program for Gangs, neighbourhood. “It requires a lot of recent studies of firearm and non-firearm Youth Without Frontiers), as one reason commitment, but the programme really homicide in South African cities, which for the decline. works,” says Gutiérrez. demonstrate a close association between the intensity of efforts to enforce that country’s firearms control act, and trends in firearm-related homicide rates. While there may be compelling arguments for focusing on gun control in Colombia, it would be difficult to overstate the size of the challenges faced, including the number of unregistered firearms in circulation (around 4.2 million according to a recent estimate published by the Graduate Institute of International and Development Studies, Geneva) and the lack of effective law enforcement in much of the country. As daunting as the challenges may be, gun control has already been tried in Cisalva Institute Communications Cisalva Colombia. In Cali, in 1993, mayor Ro- drigo Guerrero, banned the carrying of Young men decorate masks as part of a Jóvenes sin Fronteras characterisation activity guns on weekends and holidays. The ban Bull World Health Organ 2019;97:733–734 | doi: http://dx.doi.org/10.2471/BLT.19.021119 733 News was enforced with random pat-downs a security and criminal policy expert at half of homicides,” he says. “And while and searches at checkpoints. the Fundación Ideas para la Paz (FIP, that half is obviously very important, it “The ban was launched in response Ideas for Peace Foundation), a research is not the whole story.” to the data generated by a fatal injury foundation based in the capital, Bogotá, surveillance system, which was insti- believes that the restriction of Colom- tuted by the mayor and collected data bia’s anti-gun violence initiatives to from a range of institutions including municipal programmes is one of the We need a the police, hospitals and the district reasons the country continues to experi- national“ strategy based attorney’s office,” explains Dr Andrés ence high rates of violent deaths. on reliable data. Villaveces, an epidemiologist at the Na- According to the FIP, after a steady Jerónimo Castillo tional Center for Injury Prevention and decline in homicides between 2000 and ” Control, Centers for Disease Control 2017, with violent deaths reaching their and Prevention in Atlanta in the United lowest number (11 381) in 42 years in For Castillo, the whole story needs States of America. 2017, there was a 4% increase in 2018, to include not just the gangs, but the Among the findings generated by with 12 311 deaths reported nationwide. socioeconomic circumstances that give the system was the that men between 15 Castillo points to numerous drivers rise to them. “The fact that the highest and 25 were most likely to be involved of this negative trend, including porous urban homicide rates tend to be re- in fatal injuries, 80% of deaths were borders (which facilitate the flow of il- ported in the poorest neighbourhoods caused by firearms, roughly a quarter legal arms), and a post-conflict context is not a coincidence,” he says. of the victims were intoxicated, and in which diverse criminal groups are Addressing urban poverty was cen- that most murders occurred over the emerging, including former members tral to mayor Guerrero’s other important weekend with payday weekends being of the Fuerzas Armadas Revolucionarias anti-violence initiative, Territorios de particularly lethal. de Colombia (Revolutionary Armed Inclusión y Oportunidades (TIO, Terri- “In Cali, paydays fall at the end Forces of Colombia) and the Ejército de tories of Inclusion and Opportunities), of every month or every fortnight; the Liberación Nacional (National Libera- which was launched in Cali in 2012. Tar- surveillance revealed a significant spike tion Army). geting the city’s 11 poorest districts, TIO in violent deaths on the weekends fol- “Crime prevention policies have focused on improving schools, housing, lowing them,” Villaveces explains. been developed by local mayors, but we health care and transport. The fact that The firearm ban was introduced need a national strategy based on reli- the current mayor of Cali is continuing along with a ban on the sale of alcohol able data to really tackle the problem of the programme suggests that its value after 01:00 during the week and 02:00 gun control,” Castillo says. has been noted. Fridays and Saturdays. According to Vil- Castillo believes that the lack of Gutiérrez believes that the TIO and laveces, the firearm ban was associated reliable national data not only makes TIP programmes are complementary. with a 14% reduction in homicides in policy formation difficult, it gives rise “It is vital to invest in the urban fabric Cali between 1993 and 1994. to unhelpful policy biases, which can in to counter disenfranchisement and As effective as Guerrero’s initia- turn lead to misallocation of resources. marginalisation,” she says. “Violence is tive may have been, like the TIP pro- “For example, there is too much focus driven by multiple factors and we have to gramme, it was only implemented at placed on criminal gangs, when in cities try to address them all, but it is impera- the municipal level. Jerónimo Castillo, such as Bogotá they account for just over tive that we directly engage the young people involved in violence if we really want to make a change.” The TIP programme directly en- gaged Fabián Parra when he returned to his neighbourhood. “I really got involved in different activities as a joke at first,” he says. “Then I started writing and singing rap songs and acting too. It completely changed my life.” With the support and encourage- ment of the TIP team, Fabián also went back to school. He is currently study- ing for his high school diploma and is hoping to study communications at the Universidad del Valle. Gutiérrez points out that it is not just Fabián’s life that has changed, the neigh- bourhood around him has changed also. “Fabián has become a role model for a lot Cisalva Institute Communications Cisalva of the kids who face the same challenges he did,” she explains.