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Comoros Public Health
After independence in 1975, the French withdrew their
medical
teams, leaving the three islands' already rudimentary
health care
system in a state of severe crisis. French assistance was
eventually resumed, and other nations also contributed
medical
assistance to the young republic. Despite improvements in
life
expectancy and the infant mortality rate, Comoros in 1993
continued to face public health problems characteristic of
developing countries.
Life expectancy at birth was estimated at fifty-six
years in
1990, up from fifty-one years in 1980. The crude birthrate
was
forty-eight per 1,000 and the crude death rate, twelve per
1,000
according to 1989 statistics. All three of these figures
were
close to the averages for sub-Saharan Africa. The rate of
infant
mortality per 1,000 live births was eighty-nine in 1991,
down
from 113 in 1980. The 1990 average rate for sub-Saharan
Africa
was 107.
Malaria was ubiquitous in the islands, with 80 to 90
percent
of the population said to be affected by the disease.
Other
prevalent maladies included tuberculosis, leprosy, and
parasitic
diseases. In 1989 about half of all children one year old
or
younger had been immunized against tuberculosis,
diphtheria,
pertussis, tetanus, polio, and measles, a proportion
roughly
comparable to the rate of immunization among other states
in subSaharan Africa. Per capita daily caloric intake in 1988
was
2,046, about average for sub-Saharan Africa but only a
little
better than 90 percent of daily requirements. Children
were most
often the victims of malnutrition. Their generally poor
diets
were deficient in protein in part because local custom
discouraged the feeding of fish to children. The scarcity
of safe
drinking water--available to about one in three
Comorans--made
intestinal parasites a problem and compounded
malnutrition, with
children again being the main victims.
The World Bank estimated that in 1993 Comoros had one
physician per 6,582 Comorans, a marked improvement over
the ratio
of one to 13,810 reported in 1983. Comparable data for
subSaharan Africa as a whole were not available; however, it
appeared that Comorans enjoyed a more favorable ratio than
many
of their neighbors in East Africa and the Indian Ocean.
Despite improvements in life expectancy, infant
mortality,
and the number of physicians, the overall quality of care
remained poor. About 80 percent of the population lives
within
one hour's walk of a health facility, usually headed by a
trained
nurse, but paramedical staff are in short supply and many
health
facilities are in poor condition. Some international
medical aid
has been provided, mostly by France and the World Health
Organization (WHO).
Although Comoros lacks homegrown narcotics, the islands
are
used as a transit site for drugs coming mainly from
Madagascar.
In view of international concern about drug trafficking,
in 1993
France began providing technical expertise in this field
to
Comoros. In addition, the World Bank in a 1994 report
pointed out
the "high prevalence of sexually transmitted diseases and
the low
use of condoms" as a significant health threat with regard
to the
spread of acquired immune deficiency syndrome (AIDS),
which
already affected the islands. However, in the period prior
to
1990 and extending through 1992, the WHO reported that
Comoros
had a very low incidence of AIDS--a total of three cases
with no
case reported in 1992, or an overall case rate of 0.1 per
100,000
population.
Data as of August 1994
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