Guinea-Bissau

Guinea-Bissau is a small country on the Atlantic coast of Africa, between Senegal and Guinea. Formerly called Portuguese Guinea, it won independence in 1974 and took its name to differentiate itself from its southern neighbor, itself a former French colony. Guinea-Bissau is one of the world's 10 poorest countries. Political turmoil in the late 1990s sparked a brief civil war that in turn caused severe disruptions in the country's agricultural and fishing industries.

The population is 1,473,000 and growing at 2.05 percent annually. The birth rate is 36.81 per 1,000 population, and the death rate is 16.29 per 1,000. Median age is 19 years. Life expectancy is 45.37 years for males and 49.04 years for females. Gross national income is $180 per capita. Only 36 percent of the population lives in urban areas; 62 percent of Guineans work in agriculture.

Vectorborne and waterborne diseases are common through Guinea-Bissau. Malaria is likely the chief killer. There is also a high risk of yellow fever, cholera, meningococcal meningitis, schistosomiasis, typhoid, hepatitis A, and diarrhea. Less than 60 percent of the population have access to clean water, and only 35 percent have sanitary waste disposal. Little is known about the dimension of the AIDS epidemic in Guinea-Bissau. In 2003, the adult prevalence rate was estimated at 10 percent, with 17,000 people believed to be infected as of 2001.

Guinea-Bissau has abysmal rates for infant and child mortality, with 124 of every 1,000 infants dying between birth and age 1, and 200 deaths per 1,000 for children aged 1–5. In 2005, the United Nations Chil-dren's Fund (UNICEF) estimated the total number of deaths at 16,000 children 5 and younger. A quarter of Guinean children are underweight, 30 percent show signs of stunting, and 10 percent are defined as wasting. Immunization rates run at around 80 percent. Fifty-five percent of children go to work during the school-age years.

The health profile for women is similarly grim. The total fertility rate is 4.79 children per women. Only 8 percent of women use birth control. Just 62 percent have prenatal care, and 35 percent have a trained attendant during childbirth. Consequently, Guinea-Bissau has one of the highest maternal mortality rates in the world, with 1,100 women per 100,000 dying in childbirth.

The medical system in Guinea-Bissau barely functions. Facilities are understaffed, and staff often goes for long periods without pay. There are 188 physicians, 912 nurses, and 160 midwives working within the country; per capita expenditures on healthcare by the government amounts to $8.70. Hospitals often lack electricity and running water. What equipment [Page 761]exists is often antiquated, and most facilities lack the most basic drugs and medical supplies. The necessity for up-front payment for care puts it out of the reach of many Guineans.