Sanitary Action for Young Unimédicos

Colombia has recently become a host country for migratory flows that shape a humanitarian crisis in the transit corridor between South America and North America. Venezuela's sociopolitical situation has turned Colombia into a host society for migrants. Although Colombia is advancing social policies in favor of protecting the human rights of migrants, actions are insufficient, and the rigidity of institutional processes is perceived as a barrier to access, especially to education and training in health, sexual, and reproductive rights (SRR). Often, neighborhoods in cities that have taken on the role of hosting places become unsafe spaces for Venezuelan child and adolescent migrants without access to education or work. Research studying young migrants indicates that migration leads to a deculturation of children and adolescents since native conditions are left behind, and the new context subjects them to subordinate forms of access or exclusion; studies identify that host countries enhance the risks or vulnerabilities of migrants. Societies with educational life teams become a relevant element for the process of building personal identity in children and adolescents. The absence of real family and neighborhood networks determines the importance of providing a trustworthy support that allows autonomy. In this regard, the Unimédicos Foundation has the Titanium Youth program, which will advance this Sanitary Action initiative from reflective spaces of experienced experiences to contribute to the adaptation process to the host society; this intervention is carried out by peers and will identify the socio-educational needs of migrant children and adolescents to build comprehensive support strategies. Research on migrant youths guides to motivate the participation of young women in popular feminist movements as a participatory action that can contribute to self-management and autonomy processes, crucial for accessing rights they lack in their country of origin; when venturing into these activities in the host country, they engage in discourses against the inequality that afflicts them, raising awareness of real needs and giving new meaning to the movements they join. Contact with abortion rights, the fight against gender violence, and sexual education allows them to transform their understanding and that of the communities they are part of. The aim of this initiative is to transform beliefs related to sexuality and gender roles that affect a person's perception of their SRR and, therefore, their decision-making ability and behavior in daily life: in the family, school, work, and society.

The Sanitary Action for Young Unimédicos initiative is carried out in popular neighborhoods of some cities (Barranquilla, Bogotá, Bucaramanga, Cali, Cúcuta, Ocaña, Turbo and Medellín), where the Unimédicos Foundation has branches of the Migrant Women Care Center - CAMMI -. The intervention is carried out through structured reflection workshops in objectives, methodologies, and results, but they adapt to the needs and choices of the participants; playful-pedagogical approaches are used, focusing on play and interaction to structure equal participation dynamics for children, adolescents, and youths in the meetings. Techniques such as educational board games, film forums, dramatizations, and staged performances are used, where participants take the lead. These techniques, combined with introductions and dialogues guided by Young Unimédicos, create training sessions on health care, rights recognition, and the protection of sexual and reproductive rights as individual and collective actions in each meeting. Active search for groups of migrants and local populations with ample free time and fragile social conditions is carried out through flyers and posters in community spaces, informing about the Unimédicos Foundation and its programs. The first meeting takes place in parks, libraries, sports fields, or green areas. Interested adults, children, and adolescents can call others for the initial meeting where they register and can directly inform if they require basic attention in sexual and reproductive health, which is addressed or scheduled immediately and at no cost. During the first meeting, children and adolescents receive information about the purposes and services of the Unimédicos Foundation, its programs. From presentation dynamics, a space of trust and camaraderie is created to agree on future meetings for a series of reflective dialogues close to their homes. Interaction allows the assignment of roles among participants to expand the call, search for meeting places, co-management for workshop organization, and co-construction of workshop content. Workshops are essentially planned reflection scenarios to promote key skills that allow understanding personal values, questioning their foundations, and prioritizing each value. Enhancing this skill that builds autonomy results in questioning beliefs, practices, rights, and needs. Reflection allows constructing alternatives more in line with human rights protection, reducing psychological barriers to accessing these alternatives, achieving new behaviors, and thus expanding one's capabilities. Workshops address experiences on autonomy, prevention of gender-based violence, sexual and reproductive rights, sexual health, and STIs. The content and pedagogical techniques are defined by participants. The Unimédicos Foundation approaches migrant children and youth groups with interdisciplinary teams that integrate biomedical knowledge of health and a psychosocial approach. Each workshop lasts 90 minutes, and materials for its realization are provided.

The "Acción Sanitaria Jóvenes Unimédicos" initiative focuses on the care of the young migrant and native population located in the marginalized neighborhoods of Barranquilla, Cúcuta, and Medellín. In these contexts, children and young migrants suffer from socio-economic exclusion conditions, and the guarantee of rights is tied to the payment capacity for services such as food, education, health, and entertainment. These populations can be found on streets and public spaces, hanging out to pass the time, and are recruited by illegal groups or organized crime in exchange for food, accommodation, money, or protection, taking advantage of legal loopholes in case they are captured. These contextual threats increase their vulnerability and expose them to greater risks in SRH.

Urban violence contexts can represent intimidation, physical, psychological, and sexual violence for children and young people, behavioral changes due to freedom limitations, and human rights protection threats. These violences significantly impact female adolescents' SRH because they increase pregnancy rates, early marriages, the non-use of contraceptives, and complications during childbirth. For the migrant population, trajectories of inequality and barriers to accessing the healthcare system are evident, which, besides being fragmented and untimely, imposes excessive costs for technologies such as long-term contraceptives and voluntary termination of pregnancy.
Furthermore, migrant populations have their beliefs and practices, which do not facilitate the adoption of alternative perspectives on gender roles, abortion, contraception, and rights. Often, migrant communities are affected by stigmatization and systematic rights violations, restricting their abilities to earn a living and provide greater protection to children, who may also be affected by assuming caregiver roles, especially girls and teenagers, limiting their opportunities and naturalizing pregnancy.
The Unimédicos Foundation has over 20 years of experience in SRH care and more than two years of the CAMMI program operation in the three cities where we offer care to migrant women from a rights perspective and with a gender and inclusion focus. This experience has allowed us to understand the needs faced by young migrant women, child sexual exploitation risks, and teenage pregnancy. As a reflection of the interdisciplinary team, the initiative arises to anticipate harm determinants in violence and exclusion contexts. The accumulated knowledge is the practical foundation of the Reflection Workshops designed to strengthen autonomy that promotes protective environments within communities for children and young groups and implements community pedagogical strategies that favor social cohesion based on affection and respect relationships as a measure for the reduction of gender-based violence, teenage pregnancy, and sexual exploitation.

The "Acción Sanitaria Jóvenes Unimédicos" initiative is immersed in a barrier-free and free access model anchored to each city's CAMMI program, which serves vulnerable families. There, we offer protection of SRH rights to children and young people by applying scientific and technical knowledge within a comprehensive social health intervention approach. SRH care is based on the available WHO evidence for the recommendation of modern contraceptive methods and IVE techniques, complemented by education, information, and communication activities. Consultation, advice, and contraceptive delivery services are free of choice. Care is personalized, humanized, and confidential. The Unimédicos Foundation has over 20 years of experience protecting SRH for women in social and economic vulnerability, starting in Medellín and expanding to seven cities in Colombia. As the team leader, I have a vision: it is necessary to address women's existential needs related to their sexual and reproductive rights so that they can develop skills and abilities for decision-making, promote their self-esteem, improve their sense of self-control, and feel triumphant. In this way, they can believe it's possible to acquire other technical and leadership skills, allowing them to improve their quality of life and transform the reality of their homes and communities. This process involves timely accompanying children and young people, so they trust the society they live in, feeling that they can overcome the anxieties generated by living in scarcity, poverty, hunger, insecurity, and multiple violences that affect them. This initiative's great purpose is to create bonds between young people who have grown with opportunities and those growing amidst adverse circumstances due to forced migration, displacement, or other indignity conditions. We aim to inspire hope and motivation in them for their lives, showing them a path dependent on themselves, where the Unimédicos Foundation, with its various programs, can offer support and accompaniment. We hope that children and young migrants establish a trust relationship with us, allowing them to build a new identity, seeing themselves as managers of their lives.

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