Panama

Panama is located on a narrow strip of land that forms the geopolitical boundary between North and South America. The Panama Canal, bisecting the isthmus for 64 kilometers (40 miles)brought little prosperity to [Page 1325]Panamanians as the canal was built on land that had been leased to the United States. Panama regained control of the canal zone at the end of 1999.

The population is approximately 3,242,000, growing at 1.564 percent annually. The birth rate is 21.45 per 1,000, the death rate is 5.44 per 1,000, and the migration rate is slightly in deficit at minus 0.37 per 1,000. Median age is 26.4. Life expectancy at birth is now 72.69 years for males and 77.8 years for females. Gross national income is estimated at $4,630, with about 7 percent of the population living on less than $1 a day.

With a tropical climate and poor sanitation in large parts of the country, Panama is a perfect breeding ground for a variety of water-borne and vector-borne diseases and malaria is prevalent. While the last case of cholera was documented in 1993, diarrhea and other gastrointestinal complaints remain common. Acute respiratory infections are a leading killer among children, although immunization rates for vaccine-preventable diseases are good, and the country has been free from polio since 1972 and diptheria-free since 1981.

HIV/AIDS first emerged in 1984 and now affects 0.9 percent of the adult population. There are an estimated 17,000 people living with the disease today. The Ministry of Health runs a national AIDS program but lacks the resources to fully exploit its strategic plan. Because Panama is somewhat erroneously designated as a up-per-middle income nation, it has difficulty finding international donors to support their programs.

Among the non-communicable diseases, cardiovascular disorders and cancers are the leading killers. Malnutrition is a continuing problem for children, particular in rural areas, where almost one-half of all children are underweight. About 18 percent of children under 5 show signs of stunting, the hallmark of chronic undernourishment. The country has made gains in infant and child mortality, with 19 deaths per 1,000 in those under 1 year and 24 deaths per 1,000 for those between the ages of 1 to 5. About 72 percent of pregnant women receive prenatal care, and 93 percent are assisted in childbirth by trained attendants. The maternal mortality rate is 160 deaths per 100,000 live births. The country devotes 7.7 percent of its gross domestic product to health care, and spends about $229 per capita. It has 4,400 doctors, 8,200 nurses, and around 5,000 health-care workers. Panama boasts 19 major hospitals and a very high quality of in Panama City. Outside the city, medical centers are more widespread and limited.