Gambia

Gambia is located in western Africa, completely surrounded by Senegal except for a 80 kilometers (50 miles) long coast on the Atlantic Ocean. Only 48 kilometers (30 miles) across at its widest point, Gambia follows the track of the River Gambia for 740 kilometers (460 miles). The country is overwhelmingly rural, with only 20 percent of Gambians living in urban areas. Poverty is widespread, with much of the population working as subsistence farmers; the chief export crop is the groundnut (or peanut).

The population is 1,688,000, growing at 2.78 percent annually. The birth rate is 38.86 per 1,000 population and the death rate is 11.99 per 1,000 population. Median age is just 17.8 years, with 49 percent of Gambians under the age of 18. Life expectancy is 52.68 years for males and 56.46 years for females. Only a quarter of the population lives in urban areas, and 75 percent are involved in agriculture, either for subsistence or trade. Gross national income is just $290 a year, with 59 percent of Gambians getting by on $1 a day or less.

Gambians are threatened by any number of communicable diseases, including malaria, dengue, Crimean-Congo hemorrhagic fever, yellow fever, schistosomiasis, trypanosomiasis, meningococcal meningitis, tuberculosis, acute respiratory disease, and others. Sanitation rates are low, with 82 percent of the population able to access clean water and 53 percent using adequate sanitary facilities.

HIV/AIDS certainly exists in The Gambia, but there is little information on its spread or impact. The Joint United Nations Programme on HIV/AIDS (UNAIDS) does not list an adult prevalence rate for the country, although some groups put the rate at 1.2 percent. A national coordinating committee was instituted in 2001.

While communicable diseases are the most urgent threat to the health of Gambians, they are not the only ones. Diabetes is an emergent problem noted by the Secretary of State for Health and Social Welfare in mid-2007. There are an estimated 29,600 Gambians suffering from diabetes today, with about 500 deaths in the first part of 2007. The number of cases are expected to climb to 53,600 by 2025.

Female genital mutilation (FGM) is another issue for Gambians. Gambia has one of the highest rates of FGM in the world, with estimates of between 60 and 90 percent of women in the county having gone through some form of the procedure. Rates seem to vary by ethnic group, with reports that 100 percent of Mandinga and Serehule women (about 50 percent of the total population) undergo FGM, along with 93 percent of Fula women (18 percent of the population). Excision is common, with some cases of infibulation. There is also a regional technique called “sealing,” about which little is known. There is an active campaign both nationally and internationally to end FGM.

The fertility rate for Gambian women is 5.21 children. Only 18 percent use contraceptives. Although 91 percent receive at least some prenatal care, only 55 percent give birth with the help of trained attendants. The maternal mortality rate is 540 deaths per 100,000 births.

Infant and child mortality rates have stayed steady since 1990, with 97 deaths per 1,000 for infants younger than one and 137 deaths per 1,000 for those between the ages of 1 and 5 years. Immunization rates are 88 percent for most vaccine-preventable childhood diseases. Seventeen percent of children under 5 are underweight, and 19 percent show signs of stunting.

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