Mali

Mali, in Western Africa, was once the center of African civilization and home to the legendary city of Timbuktu. Today, it is one of the world's poorest nations, struggling with persistent droughts, troubled neighbors, and deepening food insecurity.

The total population is 11.7 million, growing at 2.63 percent annually. Most Malians are subsistence farmers, surviving on millet, rice, wheat, corn, fish, and livestock production.

Like much of western Africa, the country has suffered from drought and poor crop yields in recent years. The United Nations estimates that 2.2 million (20 percent of the population) were at risk for malnutrition in Mali in 2005. The Malian government has instituted a monitoring program to identify areas where food supplementation is most critical.

Poverty is endemic, with an estimated 72 percent of the population living on less than $1 a day. Life expectancy is presently estimated at 47 years for males and 51 years for females. Child mortality is 120 deaths per 1,000 for children under age 1, and 218 deaths per 1,000 for children aged 1–5. Maternal mortality is high among Malian women, standing at 630 maternal deaths per 100,000 live births in 2000. The fertility rate is 7.5 birth per woman. Few births occur in hospitals, and only 40 percent are monitored by a trained attendant. Child marriage is common, with 74 percent of rural children and 46 percent of urban children marrying before age 16.

Female genital mutilation (FMG) is widely practiced, with more than 90 percent of Malian women aged 15 to 49 having undergone some form of FGM or cutting. Only 6 percent of women have access to modern birth control. Only 38 percent of women are literate. Mali is squarely located in the African Meningitis Belt and suffers frequent, widespread outbreaks. The country has also suffered through several large outbreaks of yellow fever and cholera since 2005. Gastrointestinal diseases are common (because less than 50 percent of the population have access to clean water or sanitation), as are hepatitis A, typhoid fever, and schistosomiasis. Malaria is still the coun-try's leading cause of death, with insufficient supplies of antimalaria drugs to reach those most vulnerable.

The adult prevalence rate for human immunodeficiency virus (HIV)/AIDS is 1.7 percent, low for the region. An estimated 140,000 Malians are currently infected, and 12,000 have died from the virus since record keeping began in the 1990s. Forty-seven percent of those infected are women, and 11 percent are children younger than 14.

Medical facilities are difficult to find outside the capital city of Bamako. It is estimated that 85 percent of the rural population live more than 30 kilometers from the nearest hospital. Annual government expenditures on healthcare are $9 per capita. The assistance of nongovernmental organizations has been crucial in providing care for the 68 percent of Malians living outside the cities. Medicins Sans Frontières/Doctors Without Borders has been active within the country since at least 1992, with an international staff of 15 and a local staff of 87.