Paraguay

Paraguay is a landlocked republic located in South America, bordered by Brazil, Argentina and Bolivia. Its name means “from a great river,” meaning the Rio Paraná, which forms the border with Brazil. All of the country's power comes from the hydroelectric plants along the Paraná, and it is also the world's largest exporter of hydroelectric power. Paraguay became a Spanish colony in 1537 and declared independence in 1811. The country has a long history of political instability and fractious relations with neighbors and has struggled to find a firm economic foundation for its citizens.

Paraguay has a current population of approximately 6,669,000 and is growing at a rate of 2.416 percent annually. The birth rate is 28.77 per 1,000 population and the death rate is 4.54 per 1,000 population. It is a young society, with the median age at 21.6 years. Life expectancy at birth is 72.78 years for males and 78.02 years for females. Infant mortality is 26.45 deaths per 1,000 births. The total fertility rate is 3.84 births per woman. Paraguay is highly urbanized, with 58 percent of the population living in the cities. Gross national income is $1280 per capita, and 16 percent of the population is estimated to live on $1 a day.

Paraguay has to contend with a few serious communicable diseases. Chagas’ disease is among the most widespread problems, although control programs and careful survaillence seems to be reducing the number of infections. Cutaneous leishmaniasis is prevalent in agricultural areas. Cholera is not as much of a problem in Paraguay as in other parts of Latin America, but there are at least 40,000 cases of diarrhea each year, mostly in children under 5. Hantavirus emerged in the 1990s.

There have also been considerable gains in disease control. Malaria has not been eradicated, but it is no longer epidemic. After a serious outbreak of dengue fever in 1988–89, it has been seen infrequently, although the vector is still present throughout the country. Measles, which once reached epidemic status once every three years or so, has been brought under control. The country has been polio free since 1985.

The prevalence rate for HIV/AIDS is 0.4 percent, with an estimated 13,000 cases and slightly over 500 deaths so far. Good epidemiological information is scarce, so it is difficult to assess the spread of the virus. Most cases seem to involve heterosexual contact [Page 1333]in people between the ages of 15–24, and is concentrated in the capital city of Asunción and the border regions.

Aside from cardiovascular disease and cancers, accidents and violence are leading causes hospitalization and death in Paraguay. One survey in the 1990s found that accidents and violence were most common in the young, with 58 percent of victims between the ages of 15–24 and 80 percent of them male. In Alto Paraná, the region along the Brazilian border, accidents and homicides were the second and third-leading cause of death in the late 1990s. One in every five homicides occurred in this district. Paraguay has both a public and private healthcare sector, and there has been significant growth in private healthcare since the mid1990s. Coordination of health policy is the responsibility of the Ministry of Public Health and Social Welfare. Government expenditures on healthcare constitute 7.7 percent of the annual gross domestic product. Paraguay spends $88 per capita.

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