Kiribati

The 33 atolls and reef islands of Kiribati stretch 4,000 kilometers from east to west and 2,000 kilometers from north to south. Kiribati is made up of three island groups, the Gilbert Islands, the Line Island, and the Phoenix Islands, but the total landmass is a mere 811 square kilometers, or about four times the size of Washington, D.C. The country straddles both the Equator and the International Date Line, although in 1995, the government unilaterally “moved” the line to assure that all the islands fell under the same day. It was a change that allowed Kiribati to tout itself as the first inhabited place on Earth to see the sun rise on the millennium in 2000. Because its written language lacks a letter “s,” the name is pronounced “Kiribas,” and residents are known as I-Kiribati.

The population is 105,400 and is growing at 2.24 percent annually. Most I-Kiribati live in villages of 50 to 3,000 residents. The capital island of Tarawa is the most heavily populated, with more than 29,000, and many demographers believe this is an unsustainable population size. Kiribati's economy is driven by tourism, fishing exports, and remittances from residents working abroad. The underemployment rate is 70 percent, with an official unemployment rate of two percent.

Life expectancy is low for the Pacific region, probably driven down by high child mortality rates. Life span is now 59 years for males and 65 years for females. Infant mortality (ages 0 to 1) and child mortality (ages 1 to 5) are each 65 death per 1,000 population. Most children die from respiratory infections or diarrheal illnesses. Maternal mortality is 103 deaths per 100,000 live births.

Kiribati is largely free of communicable diseases such as measles, polio, and diphtheria. In 2004, there were 51 new cases of hepatitis and 64 cases of leprosy. Past years have seen sporadic outbreaks of dengue fever and cholera. The government is working to improve drinking water and sanitation, with 65 percent of the population currently able to access potable water and 40 percent using adequate sanitation.

Acute respiratory diseases and gastrointestinal diseases are the greatest sources of morbidity on Kiribati. “Lifestyle” diseases such as diabetes and hypertension are becoming increasingly common. There were 4,000 diabetes patients in 2000, and the figure is expected to grow to 7,000 by 2030. Accidents and suicides are frequent sources of both morbidity and mortality among I-Kiribati, especially the young.

HIV/AIDS has not emerged as a major issue in Kiribati, with only 46 cases reported by the end of 2004. However, the country has all the elements necessary for a serious outbreak: widespread poverty, high unemployment, drug use, and a growing sex industry. Attempts to institute education programs have been hampered by a generally held belief that AIDS is not a problem in the Pacific region.

The geography of Kiribati presents challenges for both the healthcare and social service systems. The population is widely dispersed, and those living on outlying islands are not always able to access (or afford) an airlift or a boat to the nearest medical facilities. The central hospital is located on Tarawa, with an additional 94 district hospitals spread across the more populous islands. The government is working to increase access in remote locations. In 2004, there were 20 doctors, three dentists, 238 nurses, and 32 midwives working in Kiribati.

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