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“ EXTERNAL CAUSES MORTALITY SURVEILLANCE SYSTEM IN COLOMBIA: A Successful Model ”

“ EXTERNAL CAUSES MORTALITY SURVEILLANCE SYSTEM IN COLOMBIA: A Successful Model ”. Maria Isabel Gutiérrez. M. MD., MSc., PhD Rafael Espinosa del Vallin. MD., MSc. Andrés Fandiño L. MD. Edgar Muñoz St. HOMICIDES BY CITY. 2004. Total number of homicides: 20,167. 3.000. 2.402. 2.500.

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“ EXTERNAL CAUSES MORTALITY SURVEILLANCE SYSTEM IN COLOMBIA: A Successful Model ”

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  1. “EXTERNAL CAUSES MORTALITY SURVEILLANCE SYSTEM IN COLOMBIA: ASuccessful Model” Maria Isabel Gutiérrez. M. MD., MSc., PhD Rafael Espinosa del Vallin. MD., MSc. Andrés Fandiño L. MD. Edgar Muñoz St.

  2. HOMICIDES BY CITY 2004 Total number of homicides: 20,167 3.000 2.402 2.500 1.846 2.000 1.571 1.517 1.500 1.049 900 842 1.000 768 730 672 623 581 541 535 491 462 466 443 436 416 380 373 315 289 500 249 232 230 142 0 Source: Central Judicial Police Directive Office Criminology Research Center 1 Violence is the leading cause of death in Colombia

  3. 2 Inadequate data for defining interventions Standardization and Validation of Primary Information Sources External Causes of Deaths Surveillance System Committee in Cali Number of cases 2500 2000 1500 1000 500 Forensic Medicine Police Public Prosecution office Health Secretariat 0 . 1990 1991 1992 1993 1994 .

  4. HOMICIDE TREND PER MONTH OF OCCURRENCE ACCORDING TO SOURCE 2000 -2003 Ibagué Casos 50 40 30 20 10 0 Jul-01 Jul-02 Jul-00 Jul-03 Dic-02 Dic-01 Dic-00 Dic-03 Abr-02 Abr-01 Oct-01 Oct-02 Abr-00 Oct-00 Jun-01 Jun-02 Abr-03 Jun-00 Feb-02 Oct-03 Mar-02 Feb-03 Mar-01 Mar-03 Jun-03 Feb-01 Ago-01 Sep-01 Ene-02 Ago-02 Feb-00 Mar-00 Nov-01 Sep-02 Nov-02 Ene-03 Ago-00 Sep-00 Nov-00 Ene-01 Ene-00 May-01 May-02 Ago-03 Sep-03 May-00 May-03 Nov -03 Forensic Medicine Police SurveillanceSystem Source: Forensic Medicine and Police 2 Inadequate data for defining interventions

  5. Motorcyclist deaths by traffic injuries in Cali 1993 - 2004 Cases Reduction on Repeal of day time 200 enforcement reflective vests personnel Motorcycle driver 179 helmet law Mandatory 163 driving school National transit 145 after infraction 150 142 code 135 112 110 107 100 90 71 71 68 Motorcycle drivers and passengers helmet law 50 Reflective vest law Weekend motorcycle ban 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Years Source: Fatal injury surveillance system, Cali Prepared by Alvaro Sanchez O. CISALVA Institute- Universidad del Valle, Colombia. 3 Public Policies to Injury Prevention

  6. Objective To develop an instrument that enables local and state governments to deal with causes of urban violence and criminality, as well as with intentional and unintentional injuries, making possible the design and implementation of effective public policies and programs aimed to contribute to safety and citizen coexistence.

  7. Assumptions Political will from governments and local authorities for using information about violence in decision making. Coordination of information source institutions (Police, Forensic Medicine, Public Prosecution Offfice, Public Health, others) contributing with data and integrating in inter-institutional operative and analysis committees Capacity Building and Follow-up with Local Developments (Software, information analysis, intervention strategies, strategy evaluations, Technological transfer, etc.).

  8. Methodology !!!

  9. *Immediate Reaction Unit (URI) & the Technical Investigation Body (CTI) Monthly meeting with primary information sources to validate and complete data

  10. CRIME SURVEILLANCE SYSTEM DEPARTAMENT OF NARIÑO – MUNICIPALITY OF IPIALES GEORGETOWN UNIVERSITY – CISALVA INSTITUTE - UNIVERSIDAD DEL VALLE HOMICIDIES FORM 1. MUNICIPALITY OF THE EVENT: 4. TIME OF EVENT 2. CODE: MILITARY TIME 3. DATE OF EVENTS DAY MONTH YEAR 5. PLACE OF OCURRANCE 5.1. ADDRESS 5.2. NEIGHBORHOOD – SMALL VILLAGE – SMALL TOWN 7. TYPE OF PLACE OF THE EVENTS 6. AREA OF EVENT 1 Urban zone 2 Rural zone 3 Rural town 2. PUBLIC ROAD OR SPACE 1. HOME 3. FARM OR COUNTRYSIDE 4. BAR O RELATED FACILITY 8 DAY OF THE MONTH (Monday, Tuesday, etc.) 5. RIVER / LAGOON 6. PRISON 7. PLACE OF WORK 9. NUMBER OF FATAL VICTIMS IN THE SAME EVENT( ) 8. OTHER PLACE 9. UNKNOWN 99. NO DATA 10. NAME OF THE VICTIM 11. LAST NAMES OF THE VICTIM 1. Male 12. SEX 2. Female 3.Unspecified 13. AGE MEASURED IN : 14. AGE 1. Years 2. Months 3. Days 15. OCCUPATION 4. Unspecified 16. MUNICIPALITY OF RESIDENCE 19. ID # 17. NEIGHBORHOOD OF RESIDENCE 21. CONTEXT OF ASSAULT 20. TYPE OF WEAPON 18. TIPO DE DOCUMENTO DE IDENTIDAD 1. Firearm 2. Sharp object 1. Unknown or to be established(the context is unknown) 5. Id card 6.Adult without Id 7.Minor without id 8.No data 1. Cedula de Ciudadanía 2. Cedula de Extranjería 3. Passport 4. Birth certificate 2. War conflict(conflict with military forces and illegal armed groups) 3. Firearm/sharp object 3. Interpersonal violence(dispute) 4. Blunt object 4. Domestic violence(dispute between relatives; against women, minors, elderly; due to passion issues) 5. Strangling/Suffocating 6. Explosives 5. Organized crime(drug trafficking; by assassins; kidnapping; collection of debts, car jacking, motorcycle jacking, bank robberies; common robbery, social intolerance) 7. Other arm 8. Under study 6. Confrontation with law enforcement (by official authorities) 7. Other type of violence(eg. a lost bullet) 22. SHORT NARRATION OF EVENTS (write down whether if it is a special day in the Municipality, the sector, or the neighborhood where the event occurred; if the victim presents involvement of alcohol use) Elaborated by the “Crime Surveillance” Project Technical Group

  11. Systematization of information Statistical Analysis Geo-reference Bulletin production Homicides Suicides Traffic deaths Non-intentional deaths

  12. Decision making and strategy definitions for Violence and Non-intentional Deaths Prevention and Control

  13. Results !!!

  14. Homicides according to day of the week January - October 2004 Crime Surveillance of Apartadó - Antioquia Cases 25 N = 62 20 34% 15 10 15% 13% 13% 11% 5 8% 6% 0 MON TUE WED THU FRI SAT SUN Day of occurrence Source: Crime Surveillance, Police, Technical Investigation Body (CTI), Forensic Medicine, Judicial Police and Investigation Section (SIJIN)

  15. Homicides according to time of occurrence January - October 2004 Crime Surveillance in Apartadó - Antioquia Casos 16 N = 62 24% 14 23% 12 19% 10 8 6 10% 8% 8% 4 5% 2 3 % 0 06:00-08:59 09:00-11:59 12:00-14:59 15:00-17:59 18:00-20:59 21:00-23:59 00:00-02:59 03:00-05:59 Time of occurrence Source: Crime Surveillance, Police, Technical Investigation Body (CTI), Forensic Medicine, Judicial Police and Investigation Section (SIJIN)

  16. Homicide according to day and time January - October 2.004 Apartadó - Antioquia Cases 25 N = 62 18:00-23:59 21 12:00-17:59 20 06:00-11:59 00:00-05:59 15 Hora 9 10 8 8 7 5 4 5 0 MON TUE WED THU FRI SAT SUN Source: Crime Surveillance, Police, Technical Investigation Body (CTI), Forensic Medicine, Judicial Police and Investigation Section (SIJIN)

  17. HOMICIDE DEATHS IN APARTADOJANUARY – OCTOBER 2004 URBAN ZONE MAP

  18. Homicides according to sex and age groups Social Surveillance for Citizen Coexistence Ibagué Tolima 2003 Number of cases 25 Women=7.4% N= 121 21 Men=92.6% 20 17 15 11 10 5 3 0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 >65 Age groups Source: Inter-institutional Committee (Police, SIJIN, CTI, Forensic Medicine, Health, Government, Traffic) 41% of the cases represents youth between 15 – 29 years (50 cases) and an important percentage (39%) represents adults between 35 – 49 years (47 cases). under 14 years 3 cases were registered.

  19. Characterization of homicides according to the comuna* of occurrence Social Surveillance for Citizen Coexistence Ibagué 2003 Number of cases 20 (17) N= 121 15 20% (12) 10 14% (8) (8) (7) (7) (5) (4) 5 (4) (4) 9% (3) (3) 8% 9% 8% (3) 6% 5% 4% 5% 4% 5% 4% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 Comuna *comunas are delimited regions in municipalities represented by neighborhoods grouped together. Source: Inter-institutional Committee (Police, SIJIN, CTI, Forensic Medicine, Health, Government, Traffic)

  20. TRAFFIC RELATED DEATHS ACCORDING TO TYPE OF ACCIDENT Social Surveillance for Citizen Coexistence January - December 2003 44% Pedestrian 33 22% Automobile driver 8 11% 16% Motorcyclist driver 12 Automobile passenger 16% 12 5% Motorcycle passenger 4 Cyclist 2 3% n= 75 no data 4 5% 0 5 10 15 20 25 30 35 40 Cases Source: Inter-institutional Committee (Police, SIJIN, CTI, Forensic Medicine, Health, Government, Traffic)

  21. TRAFFIC RELATED DEATHS ACCORDING TO CHARACTERISTICS OF THE VICTIM AND AGE January - December 2003 25 n=75 22 20 7% 15 14 90% 7% 14% 10 8 21% 7 6 25% 5 26% 5 4 4 86% 20% 3 50% 25% 40% 38% 50% 1 21% 33% 40% 25% 25% 14% 100% 5% 0 <14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 60 y más Autom. Driver Autom. passenger Motorcycle driver Mot. passenger Pedestrian Cyclist No Data Source: Inter-institutional Committee (Police, SIJIN, CTI, Forensic Medicine, Health, Government, Traffic)

  22. TRAFFIC DEATHS MUNICIPALITY OF IBAGUE

  23. HOMICIDE DISTRIBUTIONS ACCORDING TO PLACE OF OCCURRENCE Departmental Crime Surveillance in Antioquia - 2004 n= 70 n= 49 n= 24 n= 20 100% 80% N= 157 60% Other 40% Place of work Bar/Related Farm/Countryside 20% House Public road 0% APARTADO TURBO CHIGORODO CAREPA Source: Crime Surveillances of Apartadó, Chigorodó, Carepa, Turbo

  24. HOMICIDE DISTRIBUTIONS ACCORDING TOTYPE OF WEAPON Departmental Crime Surveillance inAntioquia - 2004 n= 70 n= 49 n= 24 n= 20 100% 80% N= 157 60% 40% OTHERS 20% EXPLOSIVES BLUNT SHARP OBJECT 0% FIREARM APARTADO TURBO CHIGORODO CAREPA Source: Crime Surveillances ofApartadó, Chigorodó, Carepa, Turbo

  25. HOMICIDE DISTRIBUTIONS ACCORDING TO TYPE OF CONTEXT Crime Observatory for Departament of Antioquia - 2004 n= 70 n= 49 n= 24 n= 20 100% N= 157 80% 60% 40% Other Legal intervention Interpersonal v. 20% Armed conflict Organized crime Unknown 0% APARTADO TURBO CHIGORODO CAREPA An intra-family violence case in Turbo Source: Crime Surveillances of Apartadó, Chigorodó, Carepa, Turbo

  26. Public Agenda

  27. Other applications, Domestic violence surveillance system

  28. DOMESTIC VIOLENCE SURVEILLANCE IN LIBANO - TOLIMA DISTRIBUTION OF DV CASES PER AGE AND DISTRIBUTION OF DV CASESACCORDING TO TYPE OF MALTREATMENT YEAR 2004 SEX GROUPS YEAR 2004 Number of cases Number of cases 70 200 Women 70.8% N = 298 60 56 56 162 Men 29.2% 150 50 N = 298 40 100 32 75 68 68 28 27 30 61 57 40 50 20 16 18 11 11 9 9 9 10 6 6 0 4 3 3 3 2 2 1 1 1 1 1 0 0 0 0 0 0 Other Physical 0 Verbal Sexual Psychological Alimentary Abandonment 0-4 5-9 S/D >65 Neglect 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 Age groups Sources: FHN, Hospital, Colombian Institute for Family Welfare (ICBF), Legal Medicine, Police Sources: FHN, Hospital, Colombian Institute for Family Welfare (ICBF), Legal Medicine, Police

  29. Number of cases 50 44 N = 298 43 39 40 28 30 24 21 20 19 18 20 15 14 13 10 0 Jan Feb Mar Apr May Jun Jul Aug Set Oct Nov Dic Sources: FHN, Hospital, Colombian Institute for Family Welfare (ICBF), Legal Medicine, Police DOMESTIC VIOLENCE IN LIBANO - TOLIMA DISTRIBUTION OF DV CASESACCORDING TO MONTH OF OCCURENCE DISTRIBUTION OF DV CASESACCORDING TO TYPE OF PERPETRATOR Number of cases 120 108 N = 298 97 100 80 66 56 60 40 32 20 10 8 7 5 2 0 Other Son Father Mother Brothers Step-mother Step-father No Data Ex-partner Spouse or partner Sources: FHN, Hospital, Colombian Institute for Family Welfare (ICBF), Legal Medicine, Police

  30. a Alto Los Naranjos Cafetal a Vda. San Juan Calle 13 Calle 12 LOS PINOS Manuel Calle 11 Tiberio Gallego Carrera 11 PABLO SEXTO Carrera 10a Lago Carrera 8a Cafetal Calle 10a San Vicente Transversal 9a Escuela Los Blanca Pinos SAN VICENTE Saenz a la Polka Calle 9a Carrera 12 Cra. 10A Calle 8a Caño Calle 8a Carrera 9a Calle 7ª Taller y parqueadero Escuela SAN JOSE Carrera 13 OO.PP Gabriela Calle 7ª Mistral Colegio Claret ICBF Fany Hartman EL ESTADIO Calle 6a Cafetales Casa Episcopal PRIMERO DE MAYO Calle Circunvalar Caño Colegio Cruz Roja Calle 6a Carcel Alicia Velez Estadio Ariel Gonzalez Catedral de Calle 5A Calle 5a Ntra. Señora Parque del Carmen Infantil Piscina Alcaldia Carrera 7a Status Iglesia Jesus Maria Nuestra Villegas LAS FERIAS Señora San Antonio Carrera 16 Carrera 15 de Lourdes Carrera 5a Casa de la Colegio Calle 5a Palacio Comercial Cultura EL CENTRO Parque Justicia Bomberos Isidro Parra COLOYITA Carrera 2a Emser Calle 4a a Villahermosa Escuela Almacafe Juan XXIII Calle 4A Heraclio Lastra C. Calle 3a Carrera 3a Carrera 14 Carrera 1a Granja Monumento Carrera 6a Telecom Alsacia Líbano San Juan Notaria Avenida los Fundadores SAN ANTONIO Instrumentos Calle 3a Instituto Policia Públicos Carrera 13 Ancianato Centro Hotel Los Isidro Parra Plaza de LAS FERIAS Carrera 12 Fundadores Universitario Ferias Carrera 11 Hospital Regional Liceo Calle 3a Quebrada Sede de El Líbano Unisur Diagonal 3a Carrera 10a Instituto SANTA ROSA EL CARMEN Tolima Calle 2a Preescolar Carrera 4a Quebrada San Juan Calle 2A Eugenia Sub-Estación Ravasco ISS Piscina Eléctrica Villa Arango LAS ACASIAS Carrera 7ª A Matorral Carrera 2a Escuela Polideportivo Carrera 14A Cafetal Alfonso Cafetal Calle 2a LAS BRISAS Sta. Ana Jaramillo VILLA EMMA Transversal 11 Cll 1C Tayrona Diagonal 2 Calle 1C Carrera 8a Carrera 9a Instituto Deptal Cafetales Futura Carrera 8A Carrera 6a Diagonal 3 Nuestra Señora Urbanización JARAMILLO del Carmen EL TRIUNFO Instituto Técnico Sede EL CEDRAL Industrial Social Carrera 1A Calle 1B Carrera 5a Hospital 20 DE JULIO Caño Calle 1B Campo de Rosa futbol Calle 1A Calle 1BBis Unidad Carrera 1E Planta de EL PALMAR Deportiva tratamiento de agua Cementerio Carrera 2E Carrera 3 Cafetal Calle 1A Piscina Calle 1A Cra. 3E. Calle 1B Quebrada Santa Carrera 3A Carrera 3B A Sebastopol Plaza Matadero MARSELLA Nuevo Toros Calle 1A2 El Mosquero Calle 1a Types of Maltreatments Calle 1 Carrera 2AE REYES UMAÑA Cra. 2 Santa Helena Calle 1A Bis Calle 1ABis Cra. 1E Diag. 1A Cra. 1C URB. LUIS FLOREZ Cra. 2A A Guayabal LA Carrera 5ª A Cra. 1B Calle 1S LIBERTAD Carrera 7ª A Cra. 1D Quebrada Iglesia Carrera 7ª Calle 1 Calle 1 Sur Physical Cra. 1 Divino Niño Escuela EL PORVENIR Internado Caño Cra. 1A Marsella Manuel Mejía Cra. 2Este Caño PIZARRO L. GOMEZ Quebrada Santa a Tierradentro Granja la Diag. 1 Sur Psychological Unión VILLA ESPERANZA Verbal Planta de gas LAS AMERICAS ISIDRO PARRA Cafetal Rosa a Murillo A Santa Teresa Alimentary LA POLCA RAMON Mº ARANA Sexual Neglect Abandonment Other DV CASES IN LIBANO 2004 URBAN ZONE Norte

  31. DV SURVEILLANCE INESPINAL - TOLIMA DISTRIBUTION OFDV CASESACCORDING TO TYPE OF PERPETRATOR DISTRIBUTION OF DV CASES PER AGE AND SEX GROUPS 2004 Perpetrator Casos Cases 42% 42% MOTHER 25 25 35% 35% Mujer n=58 Mujer n=58 FATHER 20 20 Hombre n=82 Hombre n=82 4% 4% STEP-FATHER N=140 N=140 SPOUSE OR PARTNER 15 15 SON 10 10 STEP-MOTHER EX PARTNER 5 5 N=179 N=179 BROTHERS 0 0 13% 13% OTHERS 4 4 9 9 - - - - >65 >65 0 0 54 54 59 59 5 5 14 14 19 19 24 24 29 29 34 34 39 39 44 44 49 49 64 64 0 0 20 20 40 40 60 60 80 80 - - - - - - - - - - - - - - - - - - - - - - 50 50 55 55 10 10 15 15 20 20 25 25 30 30 35 35 40 40 45 45 60 60 Cases Casos FUENTE: FAMILY POLICE STATION - ICBF Age range – – Sources: ICBF and Family Police Station . .

  32. SEMINARIO CONCILIAR LINEA FERROCARRIL VIA VARIANTE ESPINAL GIRARDOT VIA A IBAGUE QUEBRADA LA PIOJA Bodega BANCOLOMBIA Carrera 4 Parque Carrera 5 Carrera 6 Calle 8 Carrera 7 2 VIAS Calle 1 Calle 1 Oeste Parque Calle 2 Catedral Calle 5 Calle 3 Calle 4 Carrera 9 Carrera 8 VILLA Calle 7 OLIMPICA Calle 6 Calle 10 Carrera 10 Calle 9 Calle 13 Calle 16 Carrera 9 Calle 17 Calle 15 Calle 12 Types of Maltreatments Carrera 11 Calle 18 Calle 11 Calle 14 Al Espinal Carrera 12 Plaza de Mercado Physical BARRIO NACIONAL Escuela Colegio TECNICO INDUSTRIAL Carrera 13 Psychological Al Guamo URBANIZACION Verbal SANTA MARGARITA BARRIO FATIMA Alimentary Carrera 14 Sexual VIA Y CANAL A CARTAMA Neglect Abandonment QUEBRADA AGUA SUCIA Other DV CASES IN ESPINAL 2004 URBAN ZONE URBANIZACION CARACOLI BARRIO SAN RAFAEL VIA PUERTO PEÑON Carrera 2 BARRIO RONDON Carrera 3 Escuela BARRIO BELEN Calle 12 Parque Carrera 4 Carrera 6 Mitologico Carrera 5 Calle 14 C E N T R O Carrera 7 GRACIAS Colegio Molino Espinal BARRIO LIBERTADOR Fedearroz Colegio Calle 20 Carrera 8 El Rosario Carrera 6 B/IO. ISAIAS Calle 19 GRASCO Libertador OLIVAR Escuela Calle 22 Parque North Carrera 7 Calle 21 B/IO. CABALLERO VIA HATO VIEJO MARIA Calle 8 BARRIO STA. MARGARITA Y GONGORA Colegio Bodega Cocacola Fatima Carrera 9 1o. de MAYO Plaza de Ferias

  33. Web site: www. prevencionviolencia.org.co

  34. Thank you!!!

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