Burundi

Burundi is a landlocked country in central Africa surrounded by Rwanda, Tanzania, and the Democratic Republic of the Congo. Ethnic war broke out between the Hutu and Tutsi in 1993 and lasted until a ceasefire in 2003; the conflict killed 200,000 Burundians and displaced hundreds of thousands more. Two years after the end of the fighting, there were 117,000 internally displaced persons and 485,000 refugees in nearby Tanzania awaiting resettlement. Ongoing in-ter-ethnic tension and occasional violence has hampered the work of international aid workers and restricted the flow of humanitarian aid in recent years.

About the size of Maryland, the population of Burundi is 8,391,000 and growing at 3.6 percent annually. The birth rate is 41.97 per 1,000 and the death rate is 13.17 per 1,000; the migration rate is 7.13 per 1,000, as refugees make their way home. Median age is just 16.7 years. Life expectancy is 68.91 years for males and 54.75 years for females. Burundi is resource poor and has no industrial base. Only 11 percent live in urban areas. Ninety percent of Burundians rely on subsistence agriculture to get by. Gross national income is U.S. $100 a year.

Less than 50 percent of the population has clean drinking water and only 36 percent have sanitary waste disposal. Along with the climate, poverty, and general overcrowding, this creates a breeding ground for epidemic levels of acute respiratory disease and diarrhea. Malaria cases account for 40 percent of health-center patients. Cholera is endemic, as is meningitis.

AIDS has struck Burundi hard, with an adult prevalence rate of 3.3 percent. About 150,000 Burundians are estimated to be infected, including 79,000 women and 20,000 children. There have been an estimated 13,000 AIDS-related deaths. Despite a strategic plan by the government, lack of funding and infrastructure has hampered treatment and prevention efforts. Only 14 percent of patients are receiving antiretroviral treatment. Just 2.4 percent of pregnant woman are being treated to prevent mother-to-child transmission. A 2006 survey found just 3.6 percent of men and women could identify ways to prevent HIV infection. AIDS is still highly stigmatized in Burundi, making life difficult for patients and for the estimated 120,000 children orphaned by the virus.

Women's health has suffered greatly, both during and after the war. Not only do they suffer from the threat of disease, poverty, and malnutrition, they also face widespread sexual abuse and violence. In one recent survey, 42 percent of women said they had been the victims of domestic violence. In another study, 19 [Page 327]percent of women had suffered sexual violence. Rape is stigmatized, and few cases are ever brought to trial.

Only 16 percent of Burundian women use contraceptives. The fertility rate is 6.48 children per woman. About 78 percent receive some prenatal care, but only 25 percent have a trained attendant during childbirth. The maternal mortality rate is among the world's highest, with 1,000 deaths per 100,000 live births. Burundian women thus have a 1 in 12 lifetime risk of dying in childbirth.

Children's health has also suffered. Mortality estimates show that 114 children out of every 1,000 die before their first birthday, with 190 children of every 1,000 dying before the age of 5. Children are much more likely to die from diarrhea and respiratory infections, and 50 percent of all malaria deaths in Burundian hospitals are under age 5. Children also face violence, displacement, death, and injury from land-mines, trafficking into prostitution, or militias.

...