Evaluating emergency physicians' knowledge, attitudes, and experiences of FARC ex-combatants: A pilot study of Colombia's emergency medicine teaching hospitals.

• Authors: Christopher W. Reynolds, University of Michigan; Leonar G. Aguiar, Pontificia Universidad Javeriana Hospital Universitario San Ignacio; Katelyn Moretti, Brown Emergency Medicine; Andres Duarte, Pontificia Universidad Javeriana Hospital Universitario San Ignacio; Fabian Andres Rosas Romero, Fundación Santa Fe de Bogotá; Andres Patino, Emory University; Adrienne Fricke, Harvard Humanitarian Initiative; Virginia Zarama, Fundación Valle de Lili; Atilio Moreno, Pontificia Universidad Javeriana Hospital Universitario San Ignacio; Heidy Carranza, Pontificia Universidad Javeriana Hospital Universitario San Ignacio; Christian Arbelaez, Pontificia Universidad Javeriana Hospital Universitario San Ignacio
• Journal Title: J Am Coll Emerg Physicians Open
• Volume: Volume 1, Number 5
• Publisher: JACEP | 2020-10, Pages 757-765
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1002/emp2.12066
• Subjects: Health Sciences, Public Health; Psychology, Behavioral
• Keywords: FARC ex‐combatant, armed conflict; attitudes and practices; bias; global health; health knowledge; public health

Abstract

OBJECTIVES: In the 2016 Peace Accord with the Fuerzas Armadas Revolucionarias de Colombia (FARC), Colombia promised to reincorporate 14,000 ex-combatants into the healthcare system. However, FARC ex-combatants have faced significant challenges in receiving healthcare, and little is known about physicians' abilities to address this population's healthcare needs. METHODS: An electronic questionnaire sent to the Colombian Emergency Medicine professional society and teaching hospitals assessed physicians' knowledge, attitudes, and experiences with the FARC ex-combatant reincorporation process. RESULTS: Among 53 participants, most were male (60.4%), and ∼25% were affected by the FARC conflict (22.6%). Overall knowledge of FARC reincorporation was low, with nearly two-thirds of participants (61.6%) scoring in the lowest category. Attitudes around ex-combatants showed low bias. Few physicians received training about reincorporation (7.5%), but 83% indicated they would like such training. Twenty-two participants (41.5%) had identified a patient as an ex-combatant in the healthcare setting. Higher knowledge scores were significantly correlated with training about reincorporation (r = 0.354, n = 53, P = 0.015), and experience identifying patients as ex-combatants (r = 0.356, n = 47, P = 0.014). CONCLUSION: Findings suggested high interest in training and low knowledge of the reincorporation process. Most physicians had low bias, frequent experiences with ex-combatants, and cared for these patients when they self-identify. The emergency department (ED) serves as an entrance into healthcare for this population and a potential setting for interventions to improve care delivery, especially those related to mental healthcare. Future studies could evaluate effects of care delivery following training on ex-combatant healthcare reintegration.