'This is the most violent country in the world,' says Antonio da Silva, Médecins Sans Frontières co-ordinator in Cali, Colombia's third-largest city. A Brazilian, he has worked in many parts of the world and chooses to be part of MSF partly because of the freedom it gives him.
'In Colombia, people talk about political violence, not about urban violence, but only 13 per cent of the deaths are to do with the political struggle and the other 87 per cent are gang-related or drug-related or domestic.'
In Cali, a city of three million, there were more than 2,000 murders last year. One of the main areas of the violence is Aguablanca, a barrio where children in tattered T-shirts pick through a vast rubbish dump and horses and carts clip through dirt roads past breeze-block homes. It is hard to comprehend that many of the gang deaths take place in the name of protecting territory here.
It is in the heart of Aguablanca that MSF has its clinic, treating victims of that violence, whether young gang members paralysed by a shot through the spine or a middle-aged taxi driver shot by an anonymous gunman.
Elkin Yepes is one of the young men being treated both by the MSF physio, Roger Micolta, and a young psychologist, Juan Carlos Torres. Both doctors are Colombians who could earn more in the private sector but find the project a more satisfying use of their skills.
Yepes says: 'How many of my friends were shot, too? I couldn't count. Most of them are dead.' He never thought that he would be end up being treated by a psychologist. 'I thought they were for mad people, I didn't like the idea,' he smiles. 'But [Juan Carlos] is like my brother, my friend.'
Occasionally at the clinic he will literally bump into members of rival gangs, also in wheelchairs. There are no old antagonisms. 'We are all equal here,' he says. 'The fights over territory are over.'
Another young man being treated is the angelic-looking Querubin Perdomo. Micolta, the physio, asks when it hurts. 'When I talk,' says the 25-year-old in a whisper as the nurse, Madalena Hernandez, dresses his bullet wound and dabs at the fresh blood. His two doting sisters who have brought him to the clinic say that he was shot by his wife's family who disapproved of the relationship. His hands are already deformed by wounds from a machete attack four years earlier, one of many 'mistaken identity' cases that arrive in the clinic.
Querubin's sisters say that their little brother is now studying theology, and show a textbook on Genesis as evidence. They seem to feel the pain as much as Querubin as Micolta lays him down on a table and sees where it hurts: almost everywhere because the four bullets have taken different trajectories through his whippet-thin body.
'One of the first questions they ask is, "Will I walk again?"' says Torres, the psychologist.
His response is not to give a definitive 'no' at the first meeting because to do so, he says, could mean that the patient gives up on his body and does not take part in all the necessary physical therapy needed to live the fullest life he can.
A few months later, he says, there are questions about sex. The clinic arranges group therapy sessions with the wives or girlfriends in which each expresses what desires they have and what they think their partner's desires are.
'One time a young man said he thought she would want penetrative sex and she said, "That's the last thing I want!" So we discuss the different options open to them.'
Part of the project's work is taking the wheelchair patients into the centre of the city to get them used to making their own way on the streets, says Torres.
Another job is taking them back to their barrio; one recent event was a wheelchair race in the streets so that family and neighbours could get used to them being around that way.
Roger Micolta says he worked in the private sector before but prefers to be with MSF. 'It is much more satisfying than money ... If it wasn't for MSF many more of them would die.'
