Djibouti

Djibouti is located on the eastern coast of Africa, a small, narrow country between Eritrea to the north, Ethiopia to the west and south, and Somalia to the southeast. Yemen is 12 miles off the coast, across the Gulf of Aden. The country has historical ties to France. Ninety-two percent of Djiboutians are Muslim, with 60 percent belonging to the Issa people, 35 percent to the Afar, and the remainder a mix of Arab, Ethiopian, and European.

The population is 486,500, growing at a rate of 2.2 percent annually. The birth rate is 39.53 per 1,000 and the death rate is 19.31 per 1,000.

With its favorable location at the end of the Red Sea, Djibouti's economy is almost entirely reliant on shipping. Most of the population, 86 percent, lives on the coastline, with just a minority of nomadic peoples subsiding in the hot, dry interior. Unemployment in Djibouti is 50 percent, and per capita income is $1,030 per annum.

Life expectancy at birth is 54 years for males and 57 years for females, with healthy life expectancy at 42.5 years for men and 43 years for women. Infant mortality is 102 deaths per 1,000 live births. The death rate [Page 547]for children aged 1–5 years is 126 per 1,000. Maternal mortality is high at 730 deaths per 100,000 live births. About 60 percent of births are monitored by a trained attendant.

Sanitation within the country is limited, with 80 percent of Djiboutians having access to clean water and 50 percent having sanitary facilities. Hepatitis A and E, typhoid, malaria, and dengue fever are common. Djibouti has a high rate of tuberculosis infections, with 100 cases per 100,000 people. Polio has been identified in all neighboring countries and is suspected to be present in Djibouti as well. Immunization rates for children against polio and other illnesses are about 60 percent. A single case of avian flu was detected in May 2006.

The human immunodeficiency virus (HIV)/AIDS rate is 2.9 percent, with an estimated 9,100 Djiboutians infected with the virus and 690 deaths from this disease. The highways passing through Djibouti from Ethiopia are among the busiest on the Horn of Africa, and an active sex trade exists between truckers and the pover-ty-stricken women who live along the way. A 2005 survey by the United Nations Children's Fund (UNICEF) found that 48 percent of Djiboutians under age 24 did not know that using condoms could help prevent the disease. UNICEF set up an education center in an old shipping container left by the side of a highway; it also hands out an average of 300 condoms a day.

Female genital mutilation (FGM) is widely practiced in Djibouti, with the U.S. State Department estimating that 90 percent to 98 percent of girls under age 10 are undergoing the procedure. Girls from the Issa and Afar tribes are usually given type II FGM, called excision—the removal of the clitoris and the labia minora. Girls from Yemeni tribes are generally given type III, also known as infibulation—the removal of the clitoris, labia minora, and labia majora, with the vagina sewn up with only a tiny hole left open for the passage of urine and menstrual blood.

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