Colombia earthquake: Cali hospitals adapt to save lives amid widespread damage

Cali, Colombia – At the University Hospital of Valle Evaristo Garcia, medical staff in green scrubs moved quickly through the hospital grounds on Wednesday, beneath a white facade cracked into deep fissures. The rear of the building – a major public health center in Cali – partially collapsed on Monday, following a powerful 7.4-magnitude earthquake that struck the country's west, killing at least 273 people and injuring about 3,800. The National Disaster Risk Management Agency said 377 people remain missing as the critical three-day rescue window passed.

General practitioner Carlos Naranjo at the hospital said about 50% of the facility was damaged. "The structural damage is significant; some walls are no longer stable, ceilings collapsed, and it is still dangerous to walk around," he told Al Jazeera. With much of the hospital cordoned off, medical staff were forced to turn away most patients; only those needing urgent resuscitation could be treated.

This was one of four major hospitals damaged and shut down since Monday, along with six clinics. Amid the influx of injured, city authorities warned Monday that public hospitals in Cali, home to two million people, had reached 100% capacity and declared a "red alert for hospitals."

Cali, Colombia's third-largest city and capital of the Pacific-facing Valle del Cauca province, is one of the hardest-hit areas. At least 96 people were killed, 1,224 injured, and 111 officially missing. Authorities said about 45 buildings collapsed and 832 structures were damaged.

How Cali's hospitals adapted

By Wednesday – less than 72 hours after the crisis – a combination of effective organization, a surplus of volunteers, and support from the national government had led local health officials to describe the situation as stable. The UN Office for the Coordination of Humanitarian Affairs (OCHA) said the "hospital system has stabilized as patients are discharged and new admissions decline," but "the red alert remains for hospitals in the city."

The city avoided disaster despite the collapse of key medical facilities, thanks to a strategy of bolstering capacity at less affected sites, according to officials. German Escobar, Cali's Secretary of Public Health, said the city implemented a plan to create "expansion zones," primarily in and around existing health facilities, to handle the surge in patients. These areas include previously unused operating rooms and recovery areas – where patients rest after surgery – which were partially or fully closed before the earthquake.

At other hospitals, such as the private clinic Clinica Nuestra, expansion zones took the form of temporary field clinics. The hospital was forced to relocate patients after a partial collapse. An ambulance lay crushed under rubble, with a bent "Emergency Room" sign dangling above.

"The situation is now stable," Escobar said. He noted the health system remains under strain, especially with chronic patients struggling to access medication, but the risk of hospitals being overwhelmed and unable to handle necessary cases has been averted. "Unless there is another major event that overwhelms emergency and inpatient services, the system will be completely stabilized," he added. The health secretary attributed the recovery of the hospital system to effective coordination among government officials, aid organizations, and volunteers.

Volunteers ease pressure

Relief efforts also relied on vast resources and manpower from civil society organizations. Enrique Zapata, logistics chief for the medical NGO SARES in Cali, stood before a crowded medical tent at the foot of the Vanessa apartment complex – a six-story building that collapsed on August 10. The tent primarily served volunteers, treating them as they carried out rescue operations. As rescue crews hurried past with buckets and shovels, he described the first moments after the earthquake.

"People first checked on their families, then all of us first responders immediately contacted our organizations," the health worker said. He explained that response teams followed a plan called the Incident Command System, established beforehand to coordinate how government agencies and civil society groups work together in disasters. "Personally, I think the city was well prepared," Zapata told Al Jazeera.

Beyond procedures, rescue crews were driven to work through the night by a sense of duty. "Even though the body often says 'I want to rest,' adrenaline and the desire to help keep you going," Zapata explained. Ricardo Castillo, a former soldier volunteering as a nurse at another collapse site in Cali, described a similar mobilization. "The work of those in charge of all this is spectacular," he said. Behind him, volunteers worked alongside firefighters, police, and the military amid broken concrete and rebar, passing buckets of dirt in a human chain of rescuers. "The support is endless. These people are amazing," Castillo added.

Comparing earthquake responses: Colombia vs. Venezuela

The timing and location of the earthquake – just weeks after powerful 7.2 and 7.5 earthquakes struck neighboring Venezuela on June 24 – have prompted comparisons between the two countries' responses. The scale of the disaster in Venezuela was much larger than in Colombia, with over 6,000 deaths. Venezuela's government faced sharp criticism over its response, with survivors saying help never arrived in the critical early hours and days. Civilians largely led relief efforts, especially in the first two days, while delayed orders from senior military commanders and widespread chaos hampered troop deployment, according to media reports.

"It's inevitable to compare the two countries' responses," said Marianella Herrera, director of the Caracas-based Venezuelan Health Observatory. "In one country, there is clearly a more coordinated and coherent response, while in the other – Venezuela, of course – the response is much more fragmented institutionally." Though Herrera acknowledged the great solidarity and support from Venezuelan citizens, she blamed inadequate coordination within the country's health system for a less effective response to the tragedy. "The lack of organization and leadership in Venezuela's healthcare system exacerbated a situation that demanded a well-coordinated and robust health system," the health expert said. Venezuelan authorities dismissed criticism of their response as a product of "media laboratories."

In Cali, rescue workers said the crisis is not over. With dozens still missing in the city and more than 500 officially missing nationwide, medical personnel said the emergency is unlikely to subside soon. Rescue teams continue to appeal for all possible help. "In these situations, it's never enough. Every bit of help matters," Castillo said.