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Short abstract:

While drug use has been addressed as a public health issue through a harm reduction approach, this is far from the case for drug producers. We explore this contrast and discuss the implications of interpreting the experiences of coca workers through the lenses of 'community' and 'harm'.

Long abstract:

While some of the problems associated with drug use have been addressed as a public health issue for more than two decades — giving rise to an influential movement focused on a comprehensive harm reduction approach to drugs — this is far from the case for those who grow and harvest coca leaves (cocaleros). This group continues to face stigmatization, criminalization, and marginalization by the Colombian state, exacerbated by support and political pressure from the US. The multiple forms of bodily deterioration linked to the labor of cocaleros are overlooked amidst the portrayal of cocaine production as a ‘security’ or ‘rural development’ problem. We advocate for and grapple with the need to recognize coca farmers not only as a social movement legitimately struggling for their rights, but as a community deserving care for their experiences of harm and illness shaped by the dynamics of the War on Drugs and the armed conflict in Colombia. We discuss the implications, in terms of public health and peacebuilding, of interpreting the cocaleros experience through the lenses of ‘community’ and ‘harm’. Adopting a narcofeminist perspective, we explore three viewpoints: (1) advocating for an oblique approach to healthcare in rural Colombia, which avoids strict adherence to either vertical or horizontal models; (2) recognizing the pivotal role of community health workers as mediators between the healthcare system and local communities; and (3) recognizing that, notwithstanding historical marginalization, numerous communities possess a longstanding tradition of social organization crucial for enhancing health outcomes in rural regions of Colombia.