Djibouti

THE SMALL EAST African nation of Djibouti, which borders the Gulf of Aden and the Red Sea, was formed in 1977 from the French territory of the Afars and the Issas. Djibouti continues to maintain close ties with France. In the 1990s, the Afars minority instigated a civil war, which ended in 2001. Djibouti is home to the [Page 270]only American military base in sub-Saharan Africa and is integral to the war on global terrorism. Half of Dji-bouti's adult population is unemployed, and almost three-fourths of the 476,703 people live in relative poverty on less than $3 per day. Because of prolonged droughts, the World Health Organization estimates that 28,650 Djiboutians are suffering from severe food and water shortages.

As a significant transshipment area for the African highlands, Djibouti's economy is heavily tied to shipping and trading, and two-thirds of the population lives in the capital city of Djibouti. A small number of Djiboutians are nomadic herders. Agriculture is limited because of frequent droughts and the lack of arable land, and most food is imported. The poorest people are dependent on food aid from the government. Many resources of this lower-middle-income nation go toward paying foreign debts.

Djiboutians have a life expectancy of 43.1 years, and the median age are 18.23 years. Approximately 43.3 percent of the population is under the age of 14, and percent are over the age of 65. Djiboutians face a percent probability of not living to the age of 40.

Health problems in Djibouti include an HIV/AIDS prevalence rate of 2.9 percent. By 2003 estimates, some 9,100 Djiboutians have the disease, and approximately 690 have died from the disease and its complications. Djiboutians suffer from a high risk of food-and waterborne diseases such as bacterial and protozoan diarrhea, hepatitis A and E, and typhoid. Common health hazards have been exacerbated in Djibouti because of prolonged droughts that led to outbreaks of cholera, dysentery, malaria, and respiratory conditions. Some Djiboutians, particularly those in rural areas, lack access to proper medical attention and lifesaving drugs. As a result of the droughts, thousands of Djiboutians also lack access to potable water.

The high infant mortality rate of 104.13 deaths for every 1,000 live births is indicative of the problems facing Djiboutian officials. Estimates for 2003 place the under-5 mortality rate at 138 per 1,000. About 18 percent of Djibouti's children under the age of 5 are malnourished, and six percent are severely underweight. Approximately 13 percent suffer from moderate to severe wasting, and 26 percent suffer from moderate to severe stunting. In 2003, 66 and 68 percent of children aged 12 to 23 months received measles and DPT3 immunizations, respectively. Infant immunization rates are now rising again after a drop between 1990 and 2002, during which time both DPT and measles immunizations dropped from 85 to 62 percent.

Women are more likely to suffer from extreme poverty than are men, making females more vulnerable to health risks. In 2005, the fertility rate of Djiboutian women was estimated at 5.4 children per female, and the adolescent fertility rate was estimated at 32 per 1,000 women aged 15 to 19. Statistics on the use of contraceptives are unavailable. Estimates for 2000 place maternal mortality at 730 per 100,000 live births, and poor women are more likely to die in childbirth than are the more affluent. The high maternal mortality rate is due to a number of factors, which include a lack of obstetrical care and cultural traditions such as excision and infibulation. Trained medical staff now attend over 60 percent of births.

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