New York/Bujumbura, May 6, 2004 - One million people in Burundi are excluded from even the most basic healthcare and two-thirds of the population have to resort to extreme measures like forced labor or selling their meager belongings for treatment, according to a new report from Doctors Without Borders/Médecins Sans Frontières (MSF). This situation is not linked to Burundi's ongoing war, but rather is a direct consequence of a new healthcare financing system.
New York/Bujumbura May 6, 2004 - One million people in Burundi are excluded from even the most basic healthcare and two-thirds of the population have to resort to extreme measures like forced labor or selling their meager belongings for treatment, according to a new report from Doctors Without Borders/Médecins Sans Frontières (MSF). This situation is not linked to Burundi's ongoing war, but rather is a direct consequence of a new healthcare financing system.
Since February 2002, nearly five million of Burundi's 6.9 million people have had to cover the costs of their medical care. The government, which devotes the great majority of its budget to its war effort, intervenes only for medical personnel salaries and infrastructure financing.
Such a cost recovery system, supported by the World Bank, the International Monetary Fund, and several international donor countries, has deeply worrying consequences: one million Burundians are unable to get even the most basic healthcare and three million more are forced to resort to extreme means to have access to any treatment.
An already poverty-stricken population becomes even more precarious because of this system. According to MSF's survey, 99% of rural Burundians live under the threshold of absolute poverty of $1 USD per day and more than 85% survive on less than $1 USD per week. In the areas subject to this system, a simple consultation at a basic health center is equivalent to the wages earned in 12 days of agricultural labor.
"Given the level of extreme poverty in which Burundians live, asking people to finance their own healthcare system is tantamount to totally denying them healthcare," said Luc Nicolas, coordinator of MSF's programs in Burundi. "Asking somebody suffering from a common but potentially fatal disease to spend such money just for a consultation is simply indecent."
The mortality rate, already beyond the emergency threshold of 1.0 deaths/10,000 people/day across the entire country, is particularly alarming in areas covered by the cost recovery system, rising to 1.6 deaths/10,000 people/day. The mortality rate for children under five years of age has risen as high as 4.9/10,000/day in some areas, significantly exceeding the emergency threshold of 2.0/10,000/day.
In five regions in the country, NGOs such as MSF, with support from the Ministry of Health, have developed parallel systems aimed at alleviating the cost of primary health care.
"It is imperative to subsidize the health services to avoid the current exclusion," Nicolas said. "MSF is calling on all development and health groups involved to guarantee essential care for this impoverished and vulnerable population."
