Cali, Colombia – At the University Hospital of the Valle Evaristo Garcia, health workers in blue scrubs moved briskly through the courtyard on Wednesday, working beneath a white facade split by deep fissures. The rear of this major public medical centre had partially collapsed on Monday, following a magnitude 7.4 earthquake that struck the west of the country, killing at least 273 people and injuring at least 3,800 others. The National Unit for Disaster Risk Management reports that 377 people remain missing as the crucial three-day rescue window passes.
Carlos Naranjo, a general practitioner at the hospital, estimated that 50 percent of the facility sustained damage. “There is extensive structural damage; some walls are no longer stable, some ceilings have collapsed, and it is still dangerous to walk through,” he told Al Jazeera. With most of the hospital off-limits, medical staff now have to turn away the vast majority of patients. They are able to treat only those who require immediate resuscitation.
The facility is one of four major hospitals damaged and forced out of operation on Monday, alongside six clinics. Amid an influx of injured people, city authorities initially warned that public hospitals in Cali, home to two million people, were at 100 percent capacity and declared a “red alert for hospitals.” At least 96 people died in the city, while 1,224 others were injured and 111 remain officially missing. Authorities report that 45 buildings collapsed, while 832 others suffered significant structural damage.
But on Wednesday – less than 72 hours into the crisis – a combination of effective organisation, plentiful volunteers, and support from the national government has led local health officials to describe the situation as stable. The United Nations’ Office for the Coordination of Humanitarian Affairs (OCHA) confirmed on Wednesday that the “hospital system has stabilised as patients have been discharged and the number of new admissions has decreased.” However, it noted that “a red alert remains declared for hospitals in the city.”
The city averted total collapse of its health infrastructure by enacting a strategy to boost the capacity of institutions less affected by the earthquake. German Escobar, Cali’s public health secretary, explained that the city implemented a plan to create “expansion zones,” largely in and around existing facilities. These include utilizing operating rooms that were previously not in use and recovery areas that were partially spared from the seismic impact.
In other hospitals, such as the private Clinica Nuestra, the expansion zones take the form of temporary field clinics. The hospital was forced to relocate patients after a partial collapse. Here, an ambulance lies crushed by fallen debris, with a buckled “Emergency Room” sign hanging loosely above it, serving as a stark reminder of the destruction that medical teams are working to overcome.
“The situation is now stable,” Escobar said. He noted that while there is still stress on the healthcare system, particularly for patients with chronic illnesses struggling to access care, the immediate danger has subsided. “Unless another major mass event occurs that overwhelms emergency and inpatient services, the system should be fully stabilised,” he added. The health secretary credited the recovery to successful coordination between government officials, relief agencies, and the community.
Relief efforts also depended on vast resources and manpower from civil society organisations. Enrique Zapata, head of logistics at the Cali-based health NGO SARES, stood in front of a crowded medical tent at the foot of the Vanessa apartment complex. As rescuers hurried past carrying buckets and shovels, he described the first chaotic moments after the earthquake, noting that everyone immediately began checking for survivors.
The regional crisis has also sparked international debate regarding institutional responses. Health experts contrasted the situation in Colombia with the response in neighbouring Venezuela. “In one country, there is clearly a much more coordinated and coherent response, while in the other – which is, of course, Venezuela – the response is much more fragmented from an institutional standpoint,” said one expert. While noting solidarity from the Venezuelan population, critics blamed inadequate coordination within the country’s health system for a comparatively poor response to the tragedy.
“The lack of organisation and leadership in the Venezuelan healthcare system exacerbates a situation that calls for a well-coordinated and robust healthcare system,” the expert added. Venezuelan authorities have rejected these criticisms, labeling them the product of “media laboratories.” Meanwhile, in Cali, the focus remains on the ongoing recovery efforts.
With dozens still missing in the city and more than 500 officially recorded as missing nationwide, health workers acknowledge that the emergency is unlikely to ease anytime soon. Despite the stabilization of hospital services, the psychological and physical toll on the population remains immense. Volunteers continue to play a vital role in the recovery process, with many echoing the sentiment that “every little helps” as they distribute supplies.
As the city transitions from the immediate rescue phase to long-term recovery, the resilience of the local medical system remains a focal point. The ability to pivot and expand capacity under extreme duress has prevented a secondary humanitarian catastrophe, though the path to full restoration of services will be long. For now, the medical staff at the University Hospital of the Valle Evaristo Garcia and other facilities continue their work, balancing the need for structural safety with the urgent demands of a city in mourning.
Enrique Zapata, head of logistics at Cali-based health NGO SARES, stood in front of a crowded medical tent at the foot of the Vanessa apartment – a six-storey building that collapsed on August 10.
“Even though your body often tells you, ‘I want to rest’, the adrenaline and the desire to help keep you from doing so,” explained Zapata.
“The work of the people in charge of all this has been spectacular,” he said.
Cali, Colombia’s third-largest city and the capital of the Valle del Cauca province in the Pacific region, is one of the worst-affected areas.
“Everyone first checked on their family, and after that, all of us who are first responders, we immediately got in touch with the organisations we belong to,” said the medic.
Beyond protocol, rescue workers were spurred to work through the night by a sense of duty.
Ricardo Castillo, an army veteran volunteering as a nurse at another collapse site in Cali, described a similar mobilisation.
Behind him, volunteers worked alongside firefighters, police and military personnel among the shattered concrete and metal rebar, removing debris in buckets by passing them hand to hand along chains of rescuers.
The quake’s timing and location – just weeks after magnitude 7.2 and 7.5 earthquakes struck neighbouring Venezuela on June 24 – has prompted comparisons between the two countries’ responses.
The scale of the disaster in Venezuela was far greater than in Colombia, with more than 6,000 killed.
Venezuela’s government has faced sharp criticism over its response, with survivors saying help never arrived in the crucial first hours and days.
Civilians led much of the relief effort, especially in the first two days, while delayed orders from senior military commanders and widespread confusion hampered the deployment of troops, according to media reports.
“It is inevitable to compare the responses of both countries,” said Marianella Herrera, Director of the Caracas-based Venezuelan Health Observatory.
Emergency workers are still calling for all the help they can get.
