Signing of the peace agreement between the Colombian government with the Revolutionary Armed Forces of Colombia (FARC), on September 26, and endorsement by the people on October 2, 2016, are the starting point for the country’s transition from the old structures going back to the colonial period and the first stages of the fledgling nation to newer structures of the more socially developed countries in the 21st century, built on equality and equity, respect for the environment and for differences, and the fight against corruption. Since we became a nation and up until this second decade of the 21st century, land ownership has been the source of constant strife. The land tenure model was shaped by the Conquest, when the Spanish became the owners, and continued during the colonial period and the dawn of the Republic, when criollos of Spanish descent became their heirs. The indigenous peoples, the original owners, or their descendants, the peasants, became the workers of the land, either as forced labour or driven by their need for sustenance, and were excluded from land ownership (1). Under this model, the "lords" were the owners not only of the land but also of what it produced and even of part of the time of their workers. It was a system tinted with feudalism (2).

This model gave rise to several wars between those who were intent on preserving the status quo and those who wanted to change the state of things. Such was the origin of the war that broke out in the middle of the 19th century and then later in the century the One Thousand Day War that was a determining factor in the loss of Panama in 1903. Then came the years of the Violence between liberals and conservatives in the late 1940s and early 1950s, marked also by the assassination of political leader Jorge Elicer Gaitan. It was during this time that the first paramilitary activity began to break out in Colombia (3). This period came to an end with the Rojas Pinilla dictatorship and then the creation of the National Front. The latter was an agreement characterized by the splitting of power and its benefits between liberals and conservatives during equal time periods. This state of affairs lasted 16 years, to the exclusion of all other political alternatives, situation that led to the emergence of the liberal guerrillas, later transformed into communist guerrillas in the 1960s (4). During that period, corruption, ever present since the birth of the Republic, became finally entrenched in Colombian politics, giving rise to cronyism, social exclusion and repression (5).

When drug trafficking took the stage in the mid 1970s, a new power emerged in Colombia in the form of drug dealers, and the ethical structure of Colombian society was seriously undermined. Easy money became the new paradigm and the resources of this activity gave new muscle to the guerrillas and the paramilitary groups - resulting from alliances between certain sectors of civil society, law enforcement and drug dealers - which emerged later as a force against the guerrillas (6). As a result, poverty increased, corruption was rampant, and a new process of land concentration took hold, bringing additional social exclusion and selective repression (7).

It was against this backdrop that we stepped into the 21st century. However, the effect of certain forces such as the generalized rejection by the people of guerrilla activities consisting of kidnap, extortion and murder, added to the change in the dynamics of war during which the State achieved important military victories that undermined the guerrilla troops and eliminated several members of the command cadres - and because of the possibility of achieving structural changes for the nation, the FARC started a negotiation process (8) that will culminate with the signing of the peace accords and their validation by the Colombian society. But this is not the end of the issues that led to war in the first place, but rather the starting point for the changes required for the transformation of a country that will put to the test its ability to deal with the challenges of the 21st century.

The Colombian society of today must be able to respond to new challenges such as globalization driven by information and communication technologies, recognition of the rights of the minorities and respect for difference, the indiscriminate use of non-renewable resources that has resulted in global warming and threatened ecosystems and, finally, the fight against corruption as a source of poverty and inequalities. Peace is a promising stage for these changes.

The signing and the approval of the peace agreement will be only the first step in a process of transformation required to achieve lasting and stable peace for our Colombian society, based on tolerance and respect for those who think differently, on social punishment against those who steal public funds for their own private benefit or against those in the private sector who, thorough unethical workings, seek to increase their wealth at the expense of the consumers of their goods and services. It is a transformation that includes respect for, and protection of, our most precious natural resources like the highlands and forests, sources of water and oxygen, which, together with our rivers and oceans are the habitat of countless animal species and the source of food safety for our communities; a transformation in which wealth will also reach the indigenous peoples, the farmworkers and the working class in order to secure a more equitable country.

For the health sector, the challenge is even more daunting, in particular as pertains to women's health during childhood, adolescence, pregnancy and menopause. In obstetrics and gynaecology, we need to work hard to overcome, with the support of other sectors, the economic, social and cultural issues that determine concentration of maternal and infant mortality mainly in the poorer areas (9, 10) and among minorities; (11) to ensure that women are aware of their sexual and reproductive rights so that the members of the subsidized health regime may have the same health outcomes as those in the contributive regime; (12) to minimize healthcare quality problems in both public and private institutions; (13) and to ensure that the stakeholders in the sector fulfil their duties within the framework of the Statutory Health Law .

The Colombian Federation of Obstetrics and Gynecology - FECOLSOG - will play its part in helping to consolidate peace in Colombia as part of a nationwide effort of building a better country for our children.

Hernando Gaitán-Duarte, MD MSc