Central African Republic

IN THE LOW-INCOME, SEVERELY indebted Central African Republic, subsistence agriculture and forestry dominate the economy. Poverty is widespread, with 67 percent of the population living below the poverty line and 45 percent living in absolute poverty. Some 84 percent of the population live on less than $2 a day. Almost a quarter of children in the country suffer from a lack of adequate nourishment. Decades of civil unrest and four coups have drained resources and hampered efforts to deal with economic problems, and basic health and education services have often been interrupted by paralyzing strikes.

Over 70 percent of Central Africans live in rural areas where resources are inadequate and healthcare is limited. Inequality is a fact of life, and the lowest 10 percent of the population receive only 0.7 percent of total income, while the richest segment possesses almost half of national income. The fragile economic situation in the Central African Republic has led to a call for international attention and aid.

The Central African Republic suffers from low life expectancy (41.01 years) and a low growth rate (1.49 percent). The median age is 18.12 years, and 42.5 percent of the population are under the age of 14. Only 55.3 percent of Central Africans can expect to see their 40th birthday, and only 3.4 percent of the population have reached 65 years of age.

Central Africans lack adequate access to potable water, basic sanitation, physicians, and lifesaving drugs, and the HIV/AIDS prevalence rate of 13.5 has created a national health crisis. Some 260,000 Central Africans are living with the disease, and 23,000 have died from the disease or its complications. Very high risks of food-and waterborne diseases such as bacterial diarrhea, hepatitis A, and typhoid fever continue to further drain the country's resources, as do malaria, polio, meningococcal meningitis, and the so-called sleeping disease.

Central African children are at significant health risk, and the infant mortality rate of 115 is unacceptably high. Between 1995 and 2000, the mortality rate for children under the age of 5 rose from 158 to 194 per 1,000 live births. Child immunization rates are declining, with only 35 percent of children between birth and 23 months receiving measles vaccinations and only 40 percent receiving DPT3 immunizations. Between 1990 and 2000, immunization rates for measles, DPT, and tuberculosis declined. Only 35 percent of all children receive oral rehydration therapy when necessary. Current estimates place the number of Central African orphans [Page 141]at 110,000, in great part because of the HIV/AIDS epidemic. Children have also frequently been taken hostage during the constant political upheaval that has plagued the country.

Females in many African countries are often victimized by endemic discrimination, a significant lack of resources, and a tacit acceptance of violence. Women are more than twice as likely as men to contract HIV/AIDS.

Females in the Central African Republic are often victimized by endemic discrimination, a significant lack of resources, and a tacit acceptance of violence. Women are more than twice as likely as men to contract HIV/AIDS. Central African women continue to produce children at a rate of 4.5 children per female, and only 28 percent of all women use any form of contraception. The fertility rate of 122 per 1,000 births and the maternal mortality ratio of 1,100 per 100,000 live births are indications that the country needs to pay increased attention to reproduction health and education. Less than half (44 percent) of all Central African births are attended by trained medical staff, and barely one-fourth of rural women receive obstetrical attention.

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