Brunei

Brunei, also called Brunei Darussalam, is a small country on the northwest coast of the island of Borneo in [Page 317]the South China Sea; it shares that island with Malaysia. Brunei is a sultanate ruled by the same family since the 15th century. It derives enormous wealth from rich petroleum and natural gas fields, as well as from strong foreign investment, and has one of the highest per capita Gross Domestic Products in Asia. However, leaders worry that outside influences on this strictly Islamic country might soon undermine social cohesion.

The population is estimated at 374,500, growing at 1.81 percent annually. Life expectancy is about 75 years for males and 77 years for females. Infant mortality is 8.80 deaths per 1,000 live births; under-5 mortality is 9.80 deaths per 1,000. With government-subsidized housing, food, education, and medical care, there is no real problem of poverty in Brunei. All but 0.9 percent of the workforce are in the industrial or services sectors.

While communicable diseases were once major causes of poor heath and death within the sultanate, they are now practically nonexistent. The country has a robust surveillance system to spot emerging health threats, including new diseases like severe acute respiratory syndrome (SARS) and avian flu. There is almost universal immunization for the chief diseases of childhood, and Brunei is polio-free.

Both morbidity and mortality in Brunei are driven primarily by noncommunicable diseases and disorders. Leading causes of inpatient morbidity are pregnancy, asthma, gastrointestinal disorders, acute respiratory infections, heart and circulatory diseases, and diabetes. The leading causes of morbidity in Brunei are cancers, heart disease, diabetes, cerebrovascular diseases, respiratory diseases, hypertensive diseases, traffic accidents, influenza and pneumonia, and congenital disorders.

Brunei has a well-integrated network of health-care facilities under a centralized Ministry of Health. There are four public hospitals and one private facility; five medical centers; 15 regional health centers; 10 health clinics; 15 mother-and-child wellness clinics; 13 “traveling” health clinics; and five “flying” health clinics that reach the most isolated communities on a regular basis. There are 463 physicians, 1,925 nurses, and 68 dentists working within the country. Health-care is free to all residents.