Equatorial Guinea

Equatorial Guinea, on the western coast of Africa, is smaller than the State of Maryland, has the smallest population of any country on the continent, and is the smallest Spanish-speaking nation in the world. Significant oil reserves were discovered in 1996, producing 420,000 barrels a day by 2005. On paper, Equatoguineans have the third highest per capita income in the world, just behind Luxembourg and Bermuda. In reality, the people see little evidence of these huge oil revenues, most of which goes directly into the pockets of the leadership.

President Teodoro Obiang Nguema has ruled the country as a semidictatorship since seizing power in a military coup in 1979. In recent years, Equatorial Guinea has become “one of the most paranoid, suspicious and xenophobic countries in Africa,” according to John Vidal, a Western journalist who made a rare trip inside the country in 2004. This apparently stems from Obiang's fear that outside forces are plotting to steal the country's oil reserves. This institutional paranoia makes assessing the health of Equatoguineans difficult.

The population is estimated at approximately 540,000, with a annual growth rate of 2.05 percent. The birth rate stands at 35.59 births per 1,000 people and the death rate is believed to be 15.06 per 1,000. There is little migration. Fifty percent of the population live in urban areas.

Life expectancy at birth is 48 years for males and 51 years for females, with healthy life expectancy at 45 years for men and 46 years for women.

The fertility rate is 5.9 births per woman; maternal mortality rates stand at 880 deaths per 100,000 live births. Infant mortality is 103 deaths per 1,000, and 205 deaths per 1,000 for children aged 1–5. Both infant and child mortality rates have actually risen since 1990.

Malaria, cholera, and yellow fever remain serious problems in Equatorial Guinea. (The regional strain of malaria has reportedly grown resistant to chloroquine, usually the most effective form of treatment.) With little potable water available to Equatoguineans, gastroenteritis and parasitic diseases are endemic.

AIDS statistics are hampered by what the Joint United Nations Programme on HIV/AIDS (UNAIDS) calls “irregular” surveillance. It estimates the adult prevalence rate at 3.2 percent, with 8,900 adults currently infected. There are little data on treatment rates or attempts by the government to quell the spread of the virus.

Increased government revenues have not gone into medical care; per capita spending on healthcare is estimated at $65. There are still limited hospital facilities throughout the small country. The U.S. Department of State notes that payment is usually required up front for any medical services, and that patients are often required to provide their own bed linens and, frequently, their own bandages and dressings. In 2004, there were 153 physicians, 228 nurses, and 43 midwives working in the country.