Comoros

Comoros is an island nation located in the northern edge of the Mozambique Channel, midway between Mozambique and Madagascar. It is comprised of four islands: Ngazidja, Mwali, Nzwani, and the disputed island of Mayotte, which is also claimed by the French. The French colonized Comoros in 1841 and maintained control until the country won independence in 1975. Political stability did not follow independence; there have been 19 attempted or successful coups in 30 years. At 2,170 square kilometers (1,348 square miles), it is one of the smallest and most densely populated countries in Africa. Comoros has a growing population, high unemployment, and few natural resources. It is the world's largest exporter of ylangylang, and one of the largest producers of vanilla.

The population of Comoros is 711,400 and growing at 2.84 percent annually. The birth rate stands at 36.35 per 1,000; the death rate is 7.95 per 1,000. Median age is 18.7 years. Life expectancy is 60.37 years for males and 65.15 years for females. Gross national income is $640 a year, with 60 percent living well below the poverty level. It is among the poorest countries in the world, relying heavily on the remittances of 150,000 Comorans who live off the islands.

The islands are prone to tropical storms and cyclones. The volcanic Mount Karthala on Grand Co-more has erupted several times in recent years, once causing the evacuation of 40,000 residents to protect them from the release of toxic gasses. Volcanic ash has contaminated the rainwater cisterns on Grand Comore and other islands.

Malaria, tuberculosis, cholera, and gastrointestinal illnesses are the most common communicable diseases on Comoros. Only 33 percent of the population has sanitary waste facilities, and 86 percent has access to clean water. AIDS is not a major health threat on Comoros. There are believed to be 500 to 1,000 current cases and there have been between 100 and 200 AIDS-related deaths since the virus emerged.

Children are especially prone to diarrheal diseases and malaria. Infant mortality is 53 deaths per 1,000; the mortality rate for children between the ages of 1 and 5 is 71 per 1,000. One-third of children are working and one-third marry in adolescence. Literacy rates are low at 64 percent for males and 49 percent for women. The total fertility rate is 4.97 children per woman. Only 26 percent use contraceptives. Seventy-four percent of women receive prenatal care, with 62 percent having a trained assistant during childbirth. The maternal mortality rate is consequently high, with 480 deaths per 100,000 live births.

Comoros has limited medical facilities; those with means travel to Mozambique, or even to France, for critical care. Islanders without means often rely on traditional healers. Each island has at least one hospital [Page 437], but medical staff is limited and facilities are poorly equipped.