Faces of Granizal | Open Hands Initiative

"Faces of Granizal: Health, Displacement & Diplomacy" is a photographic exhibit that celebrates Colombia's transformation. It is witness to the country's journey towards peace through the perspectives of the people of the rural community of Granizal, giving voice to their experiences as families, neighbors, and displaced individuals. Having been forced to leave everything behind, they labor to recreate homes, roads, markets, sanitation and water systems, health centers, and schools. With limited resources and government assistance and protection, and while living on contested land, they have reestablished infrastructure and a space for peace and prosperity.

Please tap the photos for details about each image.

When I decided to study medicine, I dreamed about being able to contribute to the transformation of vulnerable populations. Ultimately, being able to work with the people of Granizal in the last few years, has changed my life. Seeing first hand how the community is often forgotten, their suffering and efforts, the lack of protection… it has reinforced my commitment to community work and the desire to work to create a more just and dignified life for vulnerable communities. For me, Altos de Oriente and Granizal, don't just represent the chance to work in public health, but they provide an important space for learning, personal growth, and inspiration. They represent hope, despite adversity.
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DR. MARCELA GARCÉS
UNIVERSITY OF ANTIOQUIA, SCHOOL OF MEDICINE

On the surface, Altos de Oriente looks like many rural towns in Colombia: dusty unpaved roads up the mountains, houses made of wood and exposed brick, and warm and welcoming locals. What Altos de Oriente has achieved in the last two decades without help from the State is remarkable. Most fled violence and arrived with nothing. They built cardboard shacks that, with their hard work, have turned into wooden and now brick houses. The community has organized itself to tackle its problems and to create progress. Its leaders have figured out ways to provide water and electricity, and systematically help new arrivals get established. Nonetheless, Altos de Oriente's problems are many and include poor water quality, public safety, limited access to education, lack of economic opportunity, and difficult access to healthcare. I was inspired by and proud of how much Altos de Oriente has built with so little. I can only imagine what it will achieve once it receives the recognition and help from the government to which its residents are entitled.
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DR. ANDRES PATIÑO
HARVARD UNIVERSITY

Having been displaced for 16 years, I've seen the good and the bad. But I'm proud to know I can overcome obstacles and that I'm resilient. My husband's murder was very hard on me. Coming to a new city, with nowhere to live, with three small children, without a job, losing everything, was hard. But I feel I have conquered. I like to empower myself, and I'm always looking for ways to grow. That's what I'm doing as a leader.
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MARÍA GLADYS MÚNERA
COMMUNITY LEADER & FOUNDER OF REGALO DE DIOS VILLAGE

In populations where human rights are a major issue, it's even more important that trust is there and that it's there on so many levels. Cultivating that trust means listening to the community and not falling prey to intervening within a community and imposing what we think is best for them. Through the PCCPH Project and direct engagement with Altos de Oriente, we started to really understand the community when we listened and asked questions in a way that focused on the issues that they saw, through their eyes.
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DR. GREGG GREENOUGH
HARVARD UNIVERSITY

I think the best way local and international organizations can help the community is to support the projects and issues that the community has articulated and prioritized. This support can be financial, technical, in kind, but it should always be in ways that further the community's goals and in a way that they see best fit to do so.
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DR. JAIME GÓMEZ
UNIVERSITY OF ANTIOQUIA SCHOOL OF MEDICINE

Granizal has taught me that even in the worst circumstances, you cannot lose hope. Ten years ago, Granizal was invisible. It couldn't even garner the attention from the lowest levels of municipal government. But the indifference of government officials and lack of political will just motivates us more. The PCCPH visitors not only increased access to health services, but brought the media with them. I think we are fortunate for these visits that allow the entire world to know that Granizal exists, and that every day residents fight for their health because this community and its families need support to ensure that their basic human rights are guaranteed.
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KEYLA LOPERA
COMMUNITY LEADER

Accurate and complete demographic data provides invaluable information in understanding a community's health and social conditions--a crucial factor in designing effective public health initiatives. A preliminary census mapping activity was undertaken during our Health Fair where community members were taught how to map their neighborhoods. During the Fair, students, program leaders, and community members canvassed the settlement, mapping and surveying the land. This activity has since been expanded to a comprehensive census mapping project, which will allow community members, governments, and other organizations to develop targeted health initiative based on real data.

In the photograph, a man sells cotton candy on the roadside. Unemployment is a severe impediment to the community's development and well being. The local economy of Granizal remains in its infancy. Job markets in Bello or Medellin remain mostly inaccessible due to high transportation cost and limited access to educational and vocational training. The highest education attained by nearly half the population of Altos de Oriente is primary school with only 29% of the population attaining secondary education. Only a quarter of the community's working population engages in income generating activities, the majority of which is informal. Thanks to University of Antioquia's support, many community members are now receiving access to educational courses and programs. The younger generation of community members, however, are working hard to break these economic barriers. The availability of schools and relative peace have allowed those born and raised in Altos de Oriente to access schooling regularly. A number of the youth are the first in their families to attend college.

When I came back to Granizal after seven years, I was overwhelmed by the love and desire of its people to develop a just and equitable community. I'm amazed to see how much they have accomplished in so little time, and how community projects have superseded the needs of the individual. Pipe (sitting with me here) represents what Granizal has achieved. I met him when he was a toddler, as I was just starting to work with the community. His healthy childhood development and well-being is a testament to how the community is working to create an environment where its members can thrive. The community leaders have helped provide nutrition programs, recreational activities for youth, and opportunities to develop important life skills. Granizal provides a perfect example of how post-conflict programs can be implemented and how displaced persons can rebuild their lives.
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LAURA PULGARÍN
UNIVERSIDAD DE ANTIOQUIA FACULTAD DE MEDICINA, EMBAJADORA ESTUDIANTIL

I have been drawn to public and global health since I took my first trip abroad. My experience with the people of Altos de Oriente only cemented my belief in the good and the incredible strength of the human spirit. We endure unbelievable suffering and cruelty. Somehow, we manage to not only survive, but to grow and inspire ourselves and those around us. The people of Altos de Oriente have inspired me to continue to work hard to gain the skills to make a positive mark in the world of global health.
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DR. NIRMA BUSTAMANTE
HARVARD UNIVERSITY

What I would like to see in 10 years, after we all have a proper sewage system, is legalization. The problems I think we should prioritize, at least in the short term,is to create businesses or microbusinesses. There are so many obstacles that young people face in this community and creating employment for young people is one solution. If our youth are kept busy, they keep their minds active. Even a sports program is a good way to keep young people engaged.
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ESTEFANÍA MONTOYA AGUDELO
STUDENT
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Advances in telecommunications have allowed developing settlements, such as Altos de Oriente, to leapfrog certain infrastructure requirements. Mobile phones are widely used in the community and are a more affordable means to access the internet. Like many young people across the globe, the community's youth use their mobile phones to connect with friends on social media, play games, watch videos, etc. Mobile phones also serve as a valuable tool for monitoring health and wellness. In addition to mobile phones, community members can also access the internet via a small internet café located within the community center. In the coming months, telemedicine services will also be made available to the community, which can be accessed at the internet café.

The biggest need: a road. The first car that comes, it's not on a fixed timetable. It comes at 4:30 in the morning. Sometimes it comes up, sometimes it doesn't. The next one comes at 7am. Sometimes it comes, sometimes it doesn't. There's another one at 8am and another at noon, but not always. Another, it won't come if it's raining, because it washes out the roads. And if it's really raining, we won't have a road for about 15 to 20 days.
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DON LEO
COMMUNITY MEMBER
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The roads throughout Granizal are unpaved and can often become treacherous in bad weather. Buses provide the only means of public transportation to reach Medellin, the closest urban center. The buses do not always run on time and the fares are quite costly for community members. A roundtrip ticket to Bello, which must first stop in Medellin, costs about 5,000 pesos and takes more than two hours. Because that time can mean life or death in an emergency, the Health Fair provided first aid training for community leaders to help mitigate health emergencies.

I left Colombia at age 10 because kidnappings were rampant and there was a direct threat on me. My Colombian childhood was truncated as I became an immigrant in another country. With a focus on assimilation, my formative years turned to survival and struggle. The sacrifice my family had to endure for the American dream was real and palpable. Fast forward… I revisit Colombia to explore a country I feel I am from but don't really know, separated by the violence, but reunited by this project. These Colombian communities, born and raised, but now displaced and unaccounted, are struggling for identity and basic human rights. As I reflect on my own identity, I can't help but to truly appreciate and understand their challenges. As a Colombian-American, and now partner in their struggle, I am hopeful and optimistic of the opportunities that lie ahead for my country and people, including the many 10 year old boys and girls who can stay and grow up to be the leaders of a new and peaceful Colombia.
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DR. CHRISTIAN ARBELAEZ, HARVARD UNIVERSITY

The PCCPH Project in Altos de Oriente included hosting a Health Fair to address issues identified and prioritized by the community. The Fair included a first-aid training course, a deworming clinic, a workshop on accessing health information online, and a census mapping activity. In the photograph, student ambassador Liliana teaches Community Leaders about accessing the internet and using technology.

I was tasked to man the laptop stations to help the people of Altos de Oriente with computer literacy and direct them to health information online… [T]he internet was spotty at best. But even if the internet was fully functional, the first visitor to my station had never created a Word document, saved files on a computer, or knew how to recover or delete files. I live in an environment that necessitates and provides access to learning, resources, and opportunities online. The people of Granizal also live in an environment that requires finding out about their school closings, health warnings, and government advisories – all available online. Access, however, is left to those intermittent times the laptops at the community center are set up and powered. Our visit to Altos de Oriente was a reminder that for whatever tools we make or programs we devise, they are only as great as how well they reach those who need them.
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NICOLE ESPY
HARVARD UNIVERSITY, STUDENT AMBASSADOR

Despite living in Altos de Oriente, away from the Embera Katio (an indigenous community), I still feel connected to them and a member of their community. Despite this separation, the violence I've experienced, and the vulnerabilities I face living here, I have my family. And with them, I've been able to rebuild and move forward. I've even been able to open my own business -- a successful candy shop that I run.
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BLANCA IRMA ZAPATA ÁLVAREZ
COMMUNITY LEADER

I vividly remember the day I first visited Altos de Oriente: the bumps in the rocky dirt road as our bus scaled upwards, the warm smiles of the leaders who welcomed us like family, the hope and vitality that embodies the community as a whole. Upon returning to Boston, I took refuge in my memories of our visit. By the end of the week, I knew I wanted to return. Six months later, I had the incredible opportunity to return to Colombia for my Master's thesis, using family visits and interviews to characterize health barriers of the Granizal community. Building off the work that we started together in January and guided by the expertise of Dr. Jaime Gomez, I hope to support improved community access to health and education services in Altos de Oriente and the larger Granizal community.
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KATRINA KEEGAN
HARVARD UNIVERSITY, STUDENT AMBASSADOR
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In the photograph, Katrina provides medicine to one of the community's youngest members. Over 250 adults and children were provided deworming medication at our Health Fair. The community's lack of a proper sewer system and access to potable water have made parasitic infections common and frequent.

In the photograph, student ambassadors gather health data about the residents of Granizal, and for the first time, create a digital repository of their health and medical histories. Having these digital files available to the clinicians who work with the community will make it easier to communicate and share critical information in emergencies, as well as help paint a better picture of overall community health. By digitizing the records, they also make it possible to carry out telemedicine practices, greatly increasing access to health care and decreasing the burden of accessing medical services.

Helping others is not about receiving accolades or getting something in return. It's also not about giving people a hand out. I do what I do because people are in need and I can help them. I am currently involved in an organization called, 'A Roof for My Country'. We build homes for people who rent or have land, but can't afford to build or repair a home. Our services our voluntary. We provide food and drinks to those who build the homes. I am in charge of cooking for 124 people who are volunteering their skills and time to build these homes in our community. It's very beautiful to see a family happy because they no longer need to worry about patching leaks and such, but can live in a sturdy home and sleep easy at night.
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MARÍA DOLLY SANTA VALENCIA
COMMUNITY LEADER

I want people outside of Granizal to know that we are humble people, hardworking, fighters, and that we have rights just like all other people do. Many times we will be waiting for the bus in the valley and people tell us, 'Oh, you're the ones who live in the mountains, you with the dusty yellow shoes.' It's always the same. They see our shoes covered in dustbut I say, for one to live well and to have a good community, you don't need to have shiny shoes.
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MARÍA DOLlY SANTA VALENCIA
COMMUNITY LEADER

Despite a bitter history, the scars and bruises left from the war, and years of government neglect, the people of this community love life. The people, families and communities all have their own projects, and have not given up belief that there's a better future to be had for them and for future generations. They are fiercely resilient. The way they develop and carry out academic, cultural, economic, and political projects stemming from their needs and benefiting their community is incredibly admirable.
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DR. CARLOS VALLEJO
UNIVERSITY OF ANTIOQUIA, SCHOOL OF MEDICINE

In terms of government support, they only offer us help when they are up for reelction, so that we vote for them.. They tell us a lot of things that they will do, but as soon as they are in office, they forget about this community. Our neighborhood has many residents with disabilities, many children that suffer from malnutrition (not all of them eat every day), and many elderly depend on others to survive. Quite simply, there's a lot of poverty. As for the children, we need a lot of help in treating diarrhea and other sicknesses they contract because the water is not clean, and on top of that, there's no way to get them to a doctor for treatment.
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BLANCA NELLY MONSALVE
COMMUNITY LEADER

How would you like to see Granizal in 10 years?
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- I see an advanced village, progressive, like any other neighborhood. I see it being modern, full of nice houses, with many communities, with everything, really. Well, one hopes...
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BLANCA LÍA ALZATE RESTREPO
COMMUNITY LEADER

People-to-people exchanges that enable individuals from different cultures to work together to tackle common challenges, such as the health diplomacy exchange we led between Harvard University and the University of Antioquia, provide a meaningful opportunity to build trust and form enduring friendships across borders. Through this and similar work, we hope to catalyze greater international cooperation by countering division with a vision for shared progress, development, and prosperity for all. Beyond health, the United States and Colombia can learn much from each other, particularly on issues such as conflict resolution and civic participation.
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JAY SNYDER, CHAIRMAN, OPEN HANDS INITIATIVE

THE EXHIBIT

The "Faces of Granizal" exhibit first appeared at the Museum of Modern Art in Medellin, Colombia in december 2016 and convened members of local governments, multilateral organizations, academia, the private and non-profit sectors, as well as the media.

After 52 years of armed conflict, the Colombian government and the Revolutionary Armed Forces of Colombia (FARC) signed a historic peace agreement and permanent ceasefire, marking the end of one of the world's longest running wars of modern times. The conflict leaves behind a human toll of nearly 200,000 civilian casualties, 25,000 missing, and more than 6,000,000 displaced persons.

At this critical juncture--the dawn of post-conflict Colombia--an opportunity exists for Colombia to redefine its global narrative and for the international community to deepen its engagement with the people of Colombia.

The Open Hands Initiative, with its mission to create greater understanding and goodwill among nations, responded to this momentous shift by creating platforms for ordinary Americans and Colombians to connect. We invite you to join us in looking beyond limiting narratives to discover the Colombian reality now.

Colombia is an upper-middle income country and a leading economy in the region. It is home to highly innovative and progressive cities; and its creative urban design, impressive track record on healthcare, and leadership in environmental stewardship is globally recognized and admired.

Altos de Oriente is a living example of an internally displaced community forced to live in a makeshift settlement, bringing creativity, diligence, and intelligence to their fight to transform their reality. Crowning the mountainsides that overlook the urban meccas of Medellin and Bello, Altos de Oriente stands as testimony to the power of the human spirit.

Colombia's internally displaced population is the largest in the world, second to Syria. Globally, armed conflict has forcibly displaced more than 65 million people--one in every 113 individuals is a refugee, an asylum-seeker, or internally displaced. It is our hope that the experience of the community of Altos de Oriente provides valuable lessons for integrating and supporting displaced populations worldwide.

ABOUT GRANIZAL

Granizal is the second largest informal settlement of internally displaced persons (IDPs) located within the department of Antioquia, in the municipality of Bello, in northwestern Colombia. Granizal was founded in 1995 and is home to more than 22,000 IDPs, of which 2,300 live in Altos de Oriente.

Granizal is considered one of the poorest settlements in Colombia with 80% of the population living in poverty or extreme poverty. The needs assessment commonly used in Latin America is called "Necesidades Básicas Insatisfechas". It assesses need based on five criteria: geography, basic public services, domestic space, school attendance, and economic dependence.

The community lacks access to electricity, a sewage system, and potable water. The majority of the homes are singled roomed with dirt floors and a makeshift toilet.

There are few public spaces, save for a single primary school and a single community center. The school operates in shifts to accommodate the more than 200 students of various grades. The community center serves as meeting hall, health clinic, and learning center.

Nearly 50% of the community has been displaced for more than 3-5 years. Another 17% has been displaced for 6-8 years. Community members largely hail from Antioquia, with less than 10% coming from outside the department. Altos de Oriente is a relatively young community with about half of the population under the age of 19.

Despite the difficulties endured, the community is determined to build a brighter future for themselves and their country. Members have formed leadership committees to address challenges to infrastructure, land rights, education, healthcare, food security, and employment. Where there was once just empty lots and rule by guerilla forces, there is now an organized settlement moving towards greater integration and a commitment to peace, rule of law, and prosperity for all.

POST-CONFLICT COLOMBIA & PUBLIC HEALTH PROJECT

Open Hands Initiative, in partnership with Harvard Humanitarian Initiative and the University of Antioquia Faculty of Medicine, conducted a three-week academic and health diplomacy exchange in January 2016. The Project investigated and developed practical solutions to public health issues affecting displaced populations. Faculty and students worked in partnership with Altos de Oriente leadership to host a health fair benefiting the community and develop public health interventions on issues identified and prioritized by the community. A subsequent briefing report was shared with members of the Colombian and U.S. governments, the private sector, and civil society, bringing these issues to the forefront and shedding light on ways to aid the community's development and progress.

ABOUT THE PHOTOGRAPHER

Kelly Fitzsimmons is a U.S.-based photographer, specializing in fine art and documentary photography. A visual storyteller with a compassion for perspective, Kelly's work spans the globe. Her work has been published in Forbes and is currently on display in Boston.

"For more than 25 years, my art has explored themes of innocence, hope, family relationships, curiosity, coming of age, friendship, and the joys and challenges of the pursuit of independence. Most of that time has been spent making heirloom portraits of children and families, striving to capture timeless images that transcend trends and fads.

"In photographing the community of Granizal, I was keenly aware of the universality of the themes outlined above. Despite the dramatically different living conditions and the tragic history of violence and displacement, commonalities persisted. Through the lens, I saw unwavering hope and resilience in both the children and adults. From the innocence of toddlers - faces smeared with chocolate - to the aloof, often haunting look of the adolescent teens establishing their identities within a community riddled with poverty and scarce resources.

"By combining both portraiture and documentary photography, I hope to share a glimpse into the heart of the Granizal community and honor its people. I want to highlight the incredible humanitarian efforts of the Open Hands Initiative, Harvard Humanitarian Initiative, and University of Antioquia teams. Through these images, I hope the viewer can engage in the struggle and challenge, to see the hope and opportunity to work with equal determination to find solutions to improve health and offer the options to lead productive lives and build a thriving community."

ABOUT THE PHOTOGRAPHS

The photographs were taken using a Nikon D810 camera and 20-70 mm and 70-200 lenses. They feature various landscapes of Granizal, the community members of Altos de Oriente, and the faculty and students who participated in the Post-Conflict and Public Health Project. All photographs were taken in January 2016.

SPECIAL THANKS

This exhibit is made possible by the Open Hands Initiative, the University of Antioquia School of Medicine, the Harvard Humanitarian Initiative and the David Rockefeller Center for Latin American Studies at Harvard University. We are thankful for the generosity of Eric Luden and Digital Silver Imaging, and for the expertise of Kelly Fitzsimmons, Sybylla Smith, and Gary Knight. Special thanks to Dr. Jaime Gomez, Diana Alvarez, and all the faculty and students who participated in the Post-Conflict Colombia and Public Health Project. We express our deepest gratitude to the Altos de Oriente community, whom the exhibit honors.