Mali

Mali is a landlocked northwestern African country with 80 percent of its population dependent on subsistence agriculture. The desert is encroaching, and the infrastructure is inadequate. Half the population has no access to safe water. Mali ranks 173 of 177 countries on the Human Development Index, with a life expectancy of 53.4 years, adult literacy of 24 percent, per capita Gross Domestic Product (GDP) of $1,033 (the European Union average is over $34,000, and the United States is $49,500), and school enrollment at all levels of 36.3 percent. The literacy rate, the percentage aged 15 and older who can read and write, is 46.4 percent overall, but 39.6 percent for females.

Sub-Saharan Africa is particularly plagued by high child mortality rates due to poor prenatal care, human immunodeficiency virus (HIV), and preventable diseases. One in 12 children worldwide dies before age 5, and half of them die in sub-Saharan Africa. The poorest countries had an average childhood death rate of 158 per 1,000 while the industrialized world averages 7 per 1,000. Mali is in the top 10 countries with highest child mortality rate, and its rate has shown no improvement since 2002. Mali is among the 98 countries not expected to reach the Millennium Development Goal of reducing child deaths by two-thirds by 2015. HIV/acquired [Page 681]immunodeficiency syndrome (AIDS) is an underlying cause, but poor prenatal care and health services are the greater proximate causes. Malnutrition and poor water and sanitation also promote infectious and parasitic diseases.

Forty percent of pregnant Malian women receive prenatal care or assistance with delivery. The maternal mortality rate is 73 times that of the United States. In the late 1980s, the rate was significantly higher in urban than in rural areas: 69 to 14 percent, respectively. Assistance is available to 74 percent of urban but only 12 percent of rural women. Twelve percent of babies die at birth and 20 percent before their 5th birthday.

Ninety percent of Malians are Muslim, mostly Sunni and Wahhabis. The Muslim population opposes birth control because the imams oppose it, and the men of Mali follow anti-birth control fatwas. Family planning is rejected, and the birth rate rises.

Ninety-six percent of Malians practice excision, an extreme form of female genital mutilation that causes hemorrhaging and intense pain during childbirth. Mali allows polygamy and easy divorce for a man, with divorce more difficult for a woman. Abortion is illegal and 1 in 20 maternal deaths is due to an unsafe abortion.

The total fertility rate is the average number of children a woman would bear if she lived to the end of her childbearing years and had children at the average rate along the way. Two children are the replacement rate. Above this, the population is growing and growing younger, making it more difficult to feed and educate children. Mali had a total fertility rate in 2003 of 6.7. By 2008, the rate had risen to 7.3.