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Health & Insurance. 27

Published in Health & Insurance. Written by July 28 2020 0

Antioquia Acting Governor Fernando Suarez announced August 4 via his Twitter account that he has now recovered from Covid-19 infection and released from hospital.

Last week, the governor had suffered a "decrease in respiratory capacity as a result of the contagion with Covid and was preventively admitted to general hospitalization,” according to a press bulletin from the Antioquia departmental government.

However, more than 14 days have passed since the initial infection, and having overcome all prior symptoms, doctors have now declared Suarez "Covid-free," he said.

Earlier, Medellin Mayor Daniel Quintero had announced July 28 that following a July 24 initial test, a follow-up test confirmed that he likewise has been infected by Covid-19 – just one week after Antioquia Governor Luis Fernando Suarez also was hit by the virus. Quintero remains in protective isolation but continues working, he said.

Medellin Gets Extra Covid-19 Physician Support

On a related front, Mayor Quintero announced July 27 that Medellin just won extra physician support to confront a continuing surge of Covid-19 cases, following a special reunion with officials of Colombia’s principal medical trade associations.

The Colombian Society and the Antioquia Society of Anesthesiology and Reanimation, the Colombian Association of Critical Medicine and Intensive Care, the Colombian Society of Emergency and Emergency Specialists, and the Colombian Association of Internal Medicine all made “commitments that will allow providing complete health care to patients who require it in the following stages of the pandemic,” according to the Mayor.

Under the new arrangement, local hospitals just committed to adapting an additional 95 ICU beds, in addition to recent capacity expansions.

What’s more, each ICU physician that previously was responsible for overseeing 12 to 13 patients “will have a support team of anesthesiologists, respiratory therapists, chief nurses, general surgeons, among others, to achieve care of between 20 and 40 patients” per ICU specialist.

The new agreement heads-off a political gaffe by the Mayor when last week he proposed inviting hundreds of Cuban doctors to come to Medellin to help address the Covid-19 surge – a proposal publicly backed by left-wing demagogue Senator Gustavo Petro, a former M-19 guerrilla trained by the Cuban Communist government.

Problem: Colombia hasn’t verified the qualifications of any Cuban “doctors” for expertise in treating Covid-19 patients, Health Minister Fernando Ruiz announced.

What’s more, previous investigations have revealed that the Cuban government takes 60% of the salaries paid to its “volunteer” doctors sent overseas -- principally to prop up the near-bankrupt Communist dictatorship. In addition, at least one Cuban "doctor" posted overseas has been discovered spying on military installations.

Colombian medical associations had criticized the Mayor’s proposal because the Mayor hadn’t first consulted with Colombian medical associations on alternative ways to boost Covid-19 response capacity -- using existing Colombian physicians and support personnel.

Published in Health & Insurance. Written by July 12 2020 0

The Medellin-based “InnspiraMED” consortium producing relatively low-cost ventilators for critical Covid-19 victims got a big boost July 11 when Colombia President Ivan Duque came to Medellin to see for himself these in-development technologies.

According to “InnspiraMed” project coordinator Ruta N, “President Duque received information on the equipment delivery process -- taking place in the coming days -- according to the distribution schedule developed by the InnspiraMED initiative, with the support of the national government.

“The delivery of the first InnspiraMED ventilators began some days ago in different clinics and hospitals in the country, so that the institutions that have received them can use the equipment -- if required -- under the [legal cover] of ‘compassionate use,’” according to Ruta N.

The “compassionate use” exception follows “guidelines of the External Circular 031 of May 27, 2020 issued by the Ministry of Health and Social Protection, which indicates that this type of equipment can be used in particular conditions within the [Covid-19] emergency in the country as long as the patient or their responsible relative gives authorization,” according to Ruta N, Medellin’s high-technology incubator organization.

InnspiraMED is an “interdisciplinary and collaborative exercise” coordinated by Ruta N and funded by Medellin-born, bottled-beverages manufacturing giant Postobón.

The collaboration includes University of Antioquia, Sampedro Medical Industries and EIA University, featuring “engineers, intensive-care specialists and pulmonologists,” as well as manufacturing specialist Haceb (appliance maker) and motorcycle assembler Auteco Mobility, Ruta N added.

President Duque’s July 11 visit to Medellín not only included educational presentations on the InnspiraMED ventilators, but also included delivery of the first 50 of 187 fully commercial, Invima-certified ventilators that the national government procured from international suppliers for Medellin and Antioquia.

Crucial Situation for Banana, Coffee Harvests

During the visit, Antioquia Governor Luis Fernando Suárez urged the President to provide special support “to address the critical situation of the Urabá banana region and the upcoming coffee harvest in the Southwest” of the department.

The Governor added that his government -- together with the mayors of the banana-growing municipalities of Chigorodó, Carepa, Apartadó and Turbo -- filed a letter with the Ministry of the Interior asking for a special quarantine.

“We do not want to get to the stage where we have to stop, for example, the banana industry, due to the effects of the pandemic,” Governor Suárez said.

In addition, “we are going to have between 40,000 and 50,000 people who are going to arrive [in Antioquia] in the next 15 or 20 days” to work in the semi-annual coffee harvest. “If at the time of the coffee harvest Antioquia faces a collapse [in capacity] in ICUs, we do not want to look at that scenario,” he added.

“That is why it is very important at this time that [the national government] help us with the necessary ventilators to install in the next few days in Antioquia. We have the goal of having, in August,  909 ICU beds, to avoid having people die waiting for an ICU bed,” he said.

As of July 11, Colombia’s Health Ministry had recorded a cumulative national  total of 145,362 Covid-19 cases since monitoring began five months ago. Over that period, Colombia has recorded 5,119 deaths and 61,186 recoveries.

Bogota leads with 47,524 cases, followed by Atlantico (32,635); Cali/Valle del Cauca (14,207); Bolivar (11,913); Antioquia (8,744); Nariño (4,457); Cundinamarca (4,052); Sucre (2,419); Amazonas (2,411); Magdalena (2,785); Choco (2,177); Meta (1,548); Tolima (1,435); and Santander (1,261), according to the Ministry.

Published in Health & Insurance. Written by July 10 2020 0

Acting Antioquia Governor Luis Fernando Suárez Vélez on July 9 issued an “orange alert” as growing Covid-19 cases have now grabbed 50% of intensive care unit (ICU) capacity in Antioquia.

Following the alert, Antioquia Health Secretary Lina María Bustamante Sánchez ordered a department-wide restriction on non-emergency surgeries or dental work in order to ensure more spare ICU capacity.

“Non-urgent surgeries and outpatient procedures will be canceled in order to free more beds of intensive care units,” Bustamante said.

“Obviously, there will be [ICU bed] occupation due to trauma or due to the complication of other pathologies. For this reason, we want to reduce surgeries that are not necessary. We need to free health services, avoid cross-contamination and start to free-up human resources to attend patients diagnosed with Covid-19,” she added.

As a result, as of July 9, new restrictions on health services include “services related to oral health care; outpatient surgeries and non-urgent procedures; [and] external consultations in promotion and prevention procedures and other outpatient services,” according to the order.

“To reduce the risk of contagion in the Department, these measures must be accompanied by actions of individual social responsibility such as reducing levels of mobility, avoiding family gatherings, promoting telework, permanent use of masks, frequent hand washing and social distancing,” the order adds.

“We are going to have more cases -- and the system may collapse, so we are taking action today,” Bustamante said. While spare ICU bed capacity still exists here, “occupancy is going to double,” she warned.

“We are having a high number of infections. With the pilot program [of independent workers traveling on the Medellin Metro system now getting Covid-19 tests] we have realized that there is free circulation in the Department and we cannot lose control if health services were to collapse,” Bustamente concluded.

To date, Antioquia accounts for 11% of the total tests for Covid-19 infections in Colombia, according to the national Health Ministry.

On July 9, the Ministry reported 578 new cases of Covid-19 in Antioquia. Since tracking began five months ago, Antioquia cumulatively accounts for 7,825 cases, of which 4,802 are active and 2,954 recovered.

Published in Health & Insurance. Written by July 01 2020 0

Antioquia Acting Governor Luis Fernando Suárez announced June 30 that another 130 intensive care unit (ICU) beds will debut in Antioquia by July 11 to handle a potential future surge of critical Covid-19 victims.

The latest expansion is part of a plan to have at least 909 ICU beds available over the coming weeks, with a peak demand seen possibly emerging at end-July or early-August, he said.

While Medellin specifically and Antioquia generally currently have spare ICU capacity for critical Covid-19 cases, “we must say that the days to come are very difficult because the pandemic is in full swing and every day we have a greater number of infected people, and every day human lives are lost,” Suárez warned.

Today, about half of the Covid-19 patients in Medellin ICU’s aren’t from Antioquia, but rather from neighboring Choco department, Medellin Mayor Daniel Quintero noted. Likewise, available ICU’s throughout Antioquia “are for Colombians” and not just for local people, Suárez added.

While 42% of ICU beds are now occupied in Antioquia, “with the opening of these new ICUs that percentage will drop,” Suárez explained.

“Our initial inventory of ICU beds was 480, of which 240 were left exclusively for Covid patients, and this morning [June 30], 64 of them were in use,” he added.

While Antioquia has suffered 25 fatalities from Covid-19 so far this year, “the numbers will continue to increase,” Suárez warned. As a result, aside from boosting ICU capacity, “everyone should take the best decision to protect oneself adequately, by washing hands, wearing face masks, and maintaining social distance,” he said.

Meanwhile, as of June 30, Colombia’s Health Ministry had recorded a nationwide cumulative total of 97,946 cases of Covid-19 since tracking started five months ago.

Bogota continues to have the most cases at 30,017, followed by Atlantico (23,360); Cali/Valle del Cauca (9,974 ); Bolivar (9,116); Antioquia (4,442); Nariño (3,443); Cundinamarca (2,709); Amazonas (2,299); Choco (1,544); Sucre (1,255); and Meta (1,250), according to the Health Ministry.

While Bogota Mayor Claudia Lopez has continued to criticize Colombia President Ivan Duque for allegedly insufficient deliveries of more ventilators for future Covid-19 critical cases, ironically it's Mayor Lopez that has been the slowest among all big-city Colombian mayors to seek out and buy ventilators on their own account -- beyond what the national government is already providing.

For example: Colombia Health Minister Fernando Ruiz pointed out in a nationally televised broadcast on June 29 that Cali/Valle del Cauca mayors and health officials have recently purchased 300 ventilators in addition to the ventilators provided by the federal government. Cundinamarca mayors likewise bought another 152 ventilators, while Medellin and Antioquia bought 130 and Córdoba 107. Yet over the same time, Bogotá bought only 73 ventilators on its own account.

What’s more -- contradicting the constant complaints from Bogota Mayor Lopez -- the Colombian government on June 30 just delivered another 305 ventilators to Bogota -- a month ahead of schedule. So, as a result, Bogota now has 430 of the 722 ventilators that the national government has committed to giving to Bogotá between now and August, Health Minister Ruiz pointed out. What's more, Bogota is getting far more ventilators from the federal government than any other city in Colombia.

In addition, if Bogota suffers an exceptionally big surge in critical Covid-19 cases in the coming weeks, then the Health Ministry will accelerate delivery of even more ventilators to Bogota, Ministry Ruiz added.

Thanks to this new surge of ventilator deliveries -- and promises of more to come -- Mayor Lopez announced July 1 that she has decided to withdraw her previous demand that President Duque should authorize Bogota to reimpose in July the extreme quarantine measures earlier imposed nationwide in March and April.

Published in Health & Insurance. Written by June 12 2020 0

The Medellin Mayor’s Office announced June 11 that 350 health professionals are now being trained on how to use new, relatively low-cost respirators developed by the ‘InnspiraMED” initiative for Covid-19 victims.

“This training takes place prior to the delivery of low-cost mechanical respirators developed by the InnspiraMED initiative, which is articulated by [Medellin technology incubator] Ruta N and financed by [bottled beverages giant] Postobón,” according to the Mayor’s Office.

“About 350 health professionals in Colombia including general practitioners, internists, anesthesiologists, emergency physicians and respiratory therapists participate in this course.

“The Faculty of Medicine of the University of Antioquia, in coordination with the Universidad Pontificia Bolivariana, the Universidad Cooperativa de Colombia and SENA through their simulation laboratories are part of this training process,” according to the Mayor's press bulletin.

The training includes “correct use of personal protection elements, technical skills for advanced airway management and use of ventilators, as well as the development of clinical cases for problem-solving and decision-making in patient management,” according to the bulletin.

“Under a clinical simulation model, 150 health professionals from the Aburrá Valley [metro Medellin] are trained in-person, while another 200 professionals from 25 municipalities and capitals of the country such as Leticia (Amazonas), Tumaco (Nariño), Plato (Magdalena), Chiriguaná ( Cesar) and Lérida (Tolima), among others, will do so virtually.

“By means of an anatomical model that behaves in the same way that a patient would under certain circumstances, the training will allow medical simulations to be carried out in which the assistants will delve into the management of patients with respiratory distress caused by Covid-19."

“The production of low-cost mechanical ventilators is one of the main tools that the country has to face the crisis caused by Covid-19,” added Gabriel Sánchez, manager of the InnspiraMED initiative.

Invima in ‘Extraordinary Session’ for Ventilator Approvals

Meanwhile, Invima -- Colombia’s national medical-device approval agency – announced June 11 that a special commission in charge of Covid-19 ventilator evaluations is now in “permanent extraordinary session until the initiatives of prototype respirators meet all requirements.”

“After evaluating development of novel Covid-19 respiratory devices from June 4 to June 9, 2020, the specialized commission on medical devices and in-vitro diagnostic reagents of the Review Committee declares itself in a permanent, virtual extraordinary session until the requirements on the research protocols of the ‘InnspiraMED’ and ‘Unisabana Herons’ projects are rectified,” according to Invima.

The decision is based upon the "importance of these medical devices in the current health emergency and the need to supply their evaluation with rigorous technical-scientific protocols,” according to Invima.

“The approval of research protocols of the projects by the specialized review commission is necessary to start the clinical research phase with human beings. Herein lies the importance of making this evaluation quickly, but with all the sanitary rigor, so as to mitigate any risk in their use.

“Thanks to the permanent monitoring by the specialized commission, it has been verified that the projects present significant progress, within the framework established by international norms for manufacturing these medical devices.”

However, the novel ventilators still must go through further evaluations -- in part to ensure that Colombia’s “EPS” health insurance networks indeed will approve their use and then reimburse the clinics and hospitals that would employ such technologies, Invima added.

Published in Health & Insurance. Written by May 21 2020 0

Medellin-based insurance and health-network provider Seguros Sura announced May 21 that it’s expanding a novel home-care testing-and-recovery program for Covid-19 patients.

“The company is a pioneer in this model that already operates in Antioquia, and from next week in Barranquilla, Cali and Bogotá, and then in other cities in the country,” according to Sura.

The scheme “will operate through the ‘Salud en Casa’ Sura home care program and also with other allied medical services of this type,” according to the company.

“The model has a great educational, self-management and interdisciplinary accompaniment component including [services from] professionals in general medicine, nursing, internal medicine, pediatrics, gynecology, infectology, nutrition, respiratory therapy and psychology.

“It includes periodic measurements of blood oxygen saturation levels, postural correction and respiratory therapy. With this, Sura wants to intervene directly in the reduction of two fundamental indicators for the control of the pandemic: mortality and hospital stays, especially in intensive care units (ICU),” according to the company.

“Educating people will allow us to empower them and make them participate in the management of their health and that of their family group,” added Sura EPS general manager Gabriel Mesa Nicholls. “For this we rely on technological advances to intervene early in populations that are symptomatic and require attention. Germany, for example, with a similar model, has achieved mortality levels 50% below the world average,” Mesa explained.

Home-care implementation of the scheme “begins with the delivery of a kit for positive or suspected patients with risk factors for Covid-19, consisting of a pulse oximeter, thermometer and an education plan with very precise and simple instructions for constant monitoring of [blood oxygen] saturation levels and temperature; as well as a guide to postures that patients with symptoms should adopt,” according to the company.

“Based on the data that users will permanently provide from the measurements,via WhatsApp, face-to-face or virtual accompaniments by general medicine doctors and specialists in internal medicine, [subsequent treatment schedules] will be programmed for pediatrics, gynecology, infectology, nutrition or psychology, according to the particular needs of each patient,” according to the company.

“This model benefits the affiliates and policyholders of EPS Sura, Complementary Plan, ARL Sura and Health Policies, and began in Antioquia on May 18.

“It will gradually be extended to the other cities where Seguros Sura Colombia has a presence, through the ‘Salud en Casa’ home-care model or through agreements with other home health service providers.”

Seguros Sura Colombia also processes 600 samples daily (25,000 tests to date) to detect possible Covid-19 infections -- either from patients driving to Sura locations or else at home. The company also is racking-up 9,000 related home-health services daily through virtual care and telecare services, according to the company.

Published in Health & Insurance. Written by May 21 2020 0

Antioquia Governor Aníbal Gaviria Correa on May 20 hailed leadership by the “LivingLab-Telemedicina” patient-contact-and-testing center here in the continuing struggle to detect, contain and overcome Coronavirus.

“LivingLab-Telemedicine is developing as one of the greatest successes in Antioquia in confronting the Coronavirus contingency,” Governor Gaviria said following a personal visit to the lab.

“This, in a way, is a hospital not only for the present but also for the future. Here we have the functions of promotion and prevention, but also, especially, everything related to telehealth and telemedicine, which has been absolutely key to containment of Covid-19,” he added.

To date, the lab and its 200 health professionals have dealt with more than 200,000 calls from Antioquian citizens worried about suspected or possible cases of contagion, along with related concerns about mental health problems arising from the pandemic. 

“One of the keys to the [relatively low rates of contagion] that Antioquia has obtained has been telemedicine and, in this initiative, the University of Antioquia, the LivingLab, other universities in the city, the EPS [health-insurance networks] and the government of Antioquia are integrated,” the Governor said.

Antioquia Health Secretary Lina María Bustamante Sánchez added that the LivingLab-Telemedicine center not only screens initial calls from concerned citizens, but also refers patients with likely contagion for follow-up testing, diagnosis and treatment services.

Published in Health & Insurance. Written by May 10 2020 0

The Medellin Mayor’s Office announced May 10 that starting tomorrow (Monday, May 11), 201,461 more people will return to work here at 12,210 companies newly meeting Health Ministry Covid-19 prevention protocols as well as registration in the high-tech “Medellin Me Cuida” program.

Prior to May 11, Medellin and its neighbors in Valle de Aburrá already had 52,852 companies registered in “Medellin Me Cuida” -- and also approved as meeting biosafety protocols.

“Our purpose from the Mayor's Office of Medellín is to guarantee that all these companies can operate without neglecting the health and well-being of all our inhabitants,” said Medellin Secretary of Economic Development Paola Vargas González.

Qualifying companies and their employees “must register their data on the Medellín Me Cuida platform. Employers must attach the biosecurity protocol, which will be reviewed to verify that the requirements that guarantee the health and well-being of workers are met,” according to the Mayor’s Office.

The computerized “Medellin Me Cuida” program feature big-data analysis, including a “technical table for economic impact measurement,” which now indicates an “urgent need to encourage staggered [work-hours] scheduling strategies in companies in order to avoid crowds in public transport and common places,” according to the Mayor’s Office.

“We are going to work hand-in-hand with the public sector but also with companies and transporters to ensure that employers have all the necessary requirements to protect the employee, that they can be transported safely, and that they can travel to their office if it is strictly necessary,” Secretary Vargas added.

Medellin Leads All Colombia in ‘Smart’ Covid-19 Response, Controls

While Bogota, Cali and other cities poorly struggle to cope with Covid-19, Medellin once again leads all Colombia in “smart” technology and “smart” public policy – with exceptionally low rates of Coronavirus infections combined with relatively successful, well-organized, gradual economic reopenings -- without political demagoguery.

As of May 9, Colombia’s Health Ministry had recorded 10,495 Coronavirus cases nationally, with 445 deaths and 2,569 recoveries. Bogota has nearly 40% of all cases (4,028) followed by Cali/Valle del Cauca (1,320) and then Medellin/Antioquia (466 cases, including six deaths, 335 recoveries and a 77% recovery rate so far).

In a May 8 report from Bogota daily newspaper El Tiempo, Medellin Mayor Daniel Quintero and other local experts explain why Medellin has had such unusual success in Covid-19 control.

One key to success is sophisticated “big data” analysis of the 2.2 million individuals and 800,000 families registered in the “Medellin Me Cuida” database, which among things enables tracking of people to-and-from the tens of thousands of workplaces included in the computer program.

The report quoted Dr. Carlos Agudelo – infectious disease specialist at the Clínica Universitaria Pontificia Bolivariana here – as saying that Medellin not only moved relatively quickly to enforce quarantine at an early stage, but also aggressively tracks and studies every outbreak of contagion, especially originating at sites of notable crowding.

Thanks to this program, people infected were interviewed promptly to see what other contacts they had recently, which enabled early testing and isolation of more potential spreaders of disease.

Statistically, Medellin’s “smart” response to these early infections was nearly four times greater than in Bogota and more than three times greater than the national average, Agudelo explained.

Mayor Quintero added in the same report that “through epidemiological fencing exercises, we have managed to keep this [infection growth rate] curve low.”

For example: The “Medellin Me Cuida” database enables local health officials to “pick up the phone and call a person who is over 70 and who has hypertension and lives with someone who is working in a department store. With that information, when there is a [Covid-19] case we can test not only a first circle of related people, but up to five circles around, and even a block, to try to find positive cases,” Quintero was quoted as saying.

“From the first infection [detection], we began to practice examinations at home, instead of telling people to go to clinics. Then we start continuous monitoring, with daily calls.

“This helps us not only to know if the person is well, but if, in fact, he is at home. We call him and ask him to pass the phone to his mother, his brother, and [if] they did not pass [the phone to] someone, we immediately made an inspection visit. This includes in some cases putting plainclothes police outside the houses,” he added.

Published in Health & Insurance. Written by April 18 2020 0

The Mayor’s Office of Medellin announced April 17 that 100 of 183 confirmed cases of Coronavirus here have already fully recovered – a 54% recovery rate to date, with more recoveries expected.

In total, 4,154 persons in Medellin suspected of having Coronavirus-like symptoms have undergone laboratory tests. “Of these, 3,669 have shown no infections, 302 are under study and 183 have been positive,” according to the Mayor’s Office.

What’s more, “100 of the 183 confirmed cases have been recovered -- that is, more than half,” according to the Office.  So far, only one person in Medellin -- a 90-year-old woman suffering several other life-threatening illnesses -- has died of Coronavirus complications.

“Timely decision-making, rigorous monitoring of each case, and other measures implemented by the Medellin city government have been decisive for the containment of the virus one month after the first case of Covid-19 in the city was confirmed,” according to the Mayor's Office.

Beyond the national quarantine that is helping not only Medellin but also all Colombia to stem the spread of Coronavirus infections, Medellin also ordered compulsory use of masks in public transport and all enclosed spaces.

“In addition, the activation of 123 field investigations and isolation [orders] has allowed the epidemiological dynamics to be different compared to the rest of the country,” according to the Office.

“We have had valuable days that have allowed us to prepare for the most important phase of the epidemic: the mitigation phase,” added Medellin Health Secretary Andree Uribe Montoya.

“All the actions we have taken to anticipate the Coronavirus have allowed all cases to be controlled and we have all the measures identified to control the spread of the virus,” Uribe added.

Since January 27, the Health Secretariat of the Mayor's Office of Medellín “began executing an action plan to deal with the Coronavirus, initially focused on preparation and coordination of all the actors that would be key to containing the virus: departmental administration, transport terminals, airports, hospital network, personnel and health professionals,” according to the Mayor's Office.

“From then on, [the city government issued] timely communications about personal hygiene and healthy lifestyle recommendations; the training of more than 4,000 people in topics related to Covid-19 prevention; the allocation of more than COP$3 billion [US$763,000] to strengthen the health system; the activation of the ‘Acute Respiratory Infections’ contingency plan and the start-up of the ‘123’ emergency line for the attention of Covid-19,” according to the Office.

“Thanks to timely diagnoses, it has been possible to identify and treat the 183 local patients, thus avoiding [a greater pandemic]. The good news for the city is that more than half of the cases have already recovered . . . a figure that added to those recovered from the rest of Antioquia reaches 158,” or fully one-quarter of the entire national recoveries, the Office noted.

According to the Colombia Health Ministry, as of April 17 Colombia had 3,439 cases of Coronavirus, led by Bogota (1,396); Cali/Valle del Cauca (605); and Medellin/Antioquia (324). Nationally, 153 persons have died from Coronavirus complications, while 634 have fully recovered as of April 17, according to the Ministry.

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Medellin Herald is a locally produced, English-language news and advisory service uniquely focused upon a more-mature audience of visitors, investors, conference and trade-show attendees, property buyers, expats, retirees, volunteers and nature lovers.

U.S. native Roberto Peckham, who founded Medellin Herald in 2015, has been residing in metro Medellin since 2005 and has traveled regularly and extensively throughout Colombia since 1981.

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