Eritrea

Eritrea is a small country on the eastern coast of Africa, bordering on the Red Sea. Endlessly at war with its southern neighbor Ethiopia and mired in drought, Eritreans have faced many hardships in recent years, many of them having an impact on the general health and welfare of the people.

The total population is approximately 4,790,000 and growing at a rate of 2.47 percent annually. The birth rate is 34.33 per 1,000 and the death rate is 9.6 per 1,000; there is little or no migration. Life expectancy at birth is 58 years for males and 62 years for females, with healthy life expectancy at 49 years for men and 51 years for women. Eritrea is overwhelmingly rural, with just 21 percent of the population living in urban areas. Most Eritreans are subsistence farmers. Gross national income is $145 annually.

Eritrea has had to cope with back-to-back disasters since the late 1990s. Between 1998 and 2000, more than 1 million Eritreans were displaced by war with Ethiopia, with another 70,000 to 100,000 reportedly killed. (There are an estimated 70,000 still living in refugee camps around the country.) In 2000, a severe drought led to a total crop failure. Recent years have seen crop yields rebound slightly, but not enough to stave off persistent food insecurity. In 2005, the United Nations estimated that 2.2 of 3.8 million Eritreans lacked adequate food supplies.

Access to potable water is limited to about 44 percent of the population and only 9 percent use sanitary facilities—a mere 3 percent in rural areas. Malaria, tuberculosis, human immunodeficiency virus (HIV)/AIDS, and malnutrition account for 60 percent of all outpatient cases and 40 percent of inpatient admittances in 2003. These four conditions were responsible for 56 percent of the deaths among inpatients in [Page 620]2003, a figure which increased in 2004. Acute respiratory infections are also a problem, accounting for more than 17 percent of hospital cases.

Immunization rates among children are good in most areas, although not good enough in some regions to prevent localized measles epidemics. Infant mortality is 50 per 1,000 and child mortality is 78 per 1,000. Under-5 mortality has been cut in half since 1990.

Eritrean women face many challenges. Child marriage is widely practiced, with about 60 percent of rural teens wed before the age of 16 (as are 31 percent of urban children). Female genital mutilation (FGM) is widespread, with a 1997 survey finding 90 percent of women reporting they had undergone some type of FGM in youth. In many areas, the cutting is performed in infancy, and in most of Eritrea, is rarely performed after the age of 7. The most radical form, type III or infibulation (including the removal of the clitoris and labia and sewing shut of the vaginal area) is performed mainly in the northern regions of the country, while type I (clitoridectomy) or type II (removal of the clitoris and labia minora) are spread throughout the country.

Early marriage and childbearing contributes to a high maternal mortality rate of 630 per 100,000 live births. Seventy percent of all births happen at home, with just 28 percent under the supervision of a trained attendant. An uncounted number suffer from obstetric fistula, an injury of childbearing that leaves an open hole in the birth canal which leads to chronic fecal and urinary incontinence. Only 8 percent of Eritrean women have access to birth control. Women account for more than half of all HIV/AIDS cases within the country. The adult prevalence rate for HIV/AIDS is estimated at 2.4 percent. There are 59,000 Eritreans living with HIV/AIDS, 31,000 of them women. Ongoing internal and cross-border instability has made it difficult for the government or international organizations to craft a national plan to combat the spread of the virus or other sexually transmitted diseases.

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