Central African Republic

The United Nations recently described the Central African Republic as “the world's most silent crisis.” A landlocked country bordered to the east by Sudan, Chad, and the Democratic Republic of the Congo, the Central African Republic has had to cope with the spillover of neighboring conflicts while dealing with a low-level internal conflict that has led to the displacement of 1 million citizens by 2006. Even before the increase in hostilities, the Central African Republic was one of the 10 poorest nations in Africa, with 66 percent of the population living on less than $1 a day.

The population is 4.3 million, with an average annual growth rate of 1.53 percent. The birth rate is 33.81 births per 1,000 people, and the death rate is 18.65 per 1,000 people. The migration rate is zero. About 45 percent of Central Africans live in urban areas. Life expectancy is low, averaging less than 44 years, with healthy life expectancy estimated at 37 for men and 38 for women.

The formal economy is based on agriculture, particularly the cultivation of staple crops such as cassava, peanuts, maize, and cotton. The Central African Republic is known to have a widespread informal economy based on the illegal export of diamonds, ivory, bushmeat, and other banned items. Poaching has led to a serious loss of biodiversity in one of the world's last great wildlife refuges.

Access to clean water is 75 percent nationwide, and only 27 percent of citizens have access to sanitary facilities. Gastrointestinal diseases are common. Malaria and tuberculosis are the most serious infectious diseases in the Central African Republic; the country also lies squarely in the African meningitis belt. Recent years have seen outbreaks of polio and shigellosis. Only about one-third of epidemiological reporting sites are operating, making it difficult to track or handle emerging outbreaks.

Infant mortality is 115 per 1,000 births, with another 193 deaths per 1,000 for children between the ages of 1 to 5. The immunization rate is around 30 percent for the most common childhood diseases. Malnutrition is widespread, with 3 percent of children under 5 classified as severely malnourished. Almost 60 percent of Central African children are in the workforce before the age of 14, and 57 percent are married by the age of 16. Civil unrest, low adult life expectancy, and the expanding AIDS crisis has left a large orphan population, estimated at 330,000 in 2005. Literacy rates are low, especially among females.

Female genital mutilation is widely practiced in the Central African Republic, with about 36 percent of girls having undergone the procedure, either type I (circumcision, or the removal of the clitoral hood) or type II (excision, the removal of the clitoris and labia). Access to contraception is low, with only 28 percent of women using birth control. The fertility rate is 4.8 births per women. There is a shortage of trained birth attendants, with 44 percent of births occurring under supervision, and only 62 percent of women receiving prenatal care. Maternal mortality is high, with 1,100 maternal deaths per 100,000 live births.

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