Suriname

Suriname is the smallest independent nation in South America, a tiny green wedge of land surrounded by French Guyana, Guyana, and Brazil on the western coastline of the continent. A long-time colonial colony, the official language of Suriname is Dutch, and the majority religion is Hindu. Almost 40 percent of the population is of Hindustani or East Indian descent, with 31 percent Creole, and 15 percent Javanese. Most of the country is covered by dense rainforest, confining more than 70 percent of the population to a mere 0.4 percent of the total area. Population density is 526.5 people per square kilometer.

The population is 439,000, growing at 0.2 percent annually. The economy is based on mining, primarily bauxite and gold. About 70 percent of Surinamers live in poverty. The net migration rate is minus 8.76, as people leave the country in search of better conditions.

Life expectancy is 67 years for males and 71 years for females. Child mortality is 23 deaths per 1,000 for those under age 1, and 39 deaths per 1,000 for those aged 1 to 5. Maternal mortality is 110 deaths per 100,000 live births, and 85 percent of births are monitored by trained attendants. The fertility rate is 2.32 births per woman, with 42 percent using modern birth control methods.

Sanitation varies throughout the country. For the majority living in the cities, 92 percent have improved water and 93 percent use improved sanitary facilities. For those living in the small indigenous communities in the interior rainforest, only 20 percent have clean water and only 30 percent have sanitation.

Malaria is endemic in some regions, with 60 percent of all cases involving children under age 14. Salmonella cases have been on the increase in recent years, and shigella continues to be a problem in areas. Sexually-transmitted diseases have grown dramatically, with gonorrhea almost doubling and syphilis almost tripling in the 1990s.

Accidents and violence are the leading causes of death for both children and adults under age 45. For those over 45, cardiovascular disease, cancer, and diabetes are the main causes of mortality.

The human immunodeficiency virus (HIV)/AIDS prevalence rate among adults is quite low at 1.9 percent. About 5,100 Surinamers are believed to be infected. However small that figure seems, it is still the second leading cause of death for men and the third leading cause of death for women. Monitoring of the epidemic is poor, with limited government resources available to develop surveillance programs. Tuberculosis (TB) rates have also risen, and those with HIV are now routinely tested for TB.

The Ministry of Health monitors three public hospitals, 41 clinics, and 1 psychiatric hospital, with a combined staff of 191 doctors and 688 nurses. The Ministry also runs an epidemiological surveillance program for emerging health threats. More than 40 percent of the population receive free healthcare due to poverty. State-run programs receive assistance from various nongovernmental organizations.