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Ever since Equatorial Guinea's independence from Spain and the reign of Francisco Macias Nguema, the overall health of the population has been inconsistent and generally poor. Before independence, Equatorial Guinea was considered a flourishing, prosperous nation, with a very capable medical infrastructure and a healthy population. Malaria, trypanosomiasis (African sleeping sickness), tuberculosis and leprosy had all been somewhat contained through treatment programs and vaccinations. Drugs were in constant supply from Spain and the thirteen hospitals throughout the country were efficient and provided adequate care (2). Since then however, the government's neglect of the health concerns and needs of the population has led to an increase in easily preventable diseases and deaths: diseases which seemed under control as early as the 1950s while Equatorial Guinea was still in the clutches of colonialism.

Why is health important?

The health of the population of any country is extremely important. It seems tragically unfair that people in Equatorial Guinea or any other developing nation should be forced to suffer and die from curable diseases and illnesses. Everyone should have the right to a long and healthy life, and it is unfair for a government to neglect its populous. Not only is the health of a population a moral issue but sick citizens can negatively affect a country in several ways. In general, tired, sick and certainly dead workers are far less productive and as a result business and the economy seriously suffers. When children are sick and bear the pain of poor health, an education is often passed over and the very tools and knowledge which may help the next generation in its quest to improve their lot will be missed. Although in the western world we often take our health and ability to seek treatment and medicine for granted, the health of a population should be the first priority of any government. Today in Equatorial Guinea it is extremely apparent that the health of the population is a serious problem. Average life expectancies are low, child and infant mortality rates are high, and diseases which used to be under control have been affecting large portions of the Equatoguinean population.

How does poor health manifest itself among Equatoguineans?

A good statistic to measure the health of a population is the life expectancy. The average life expectancy at birth of a person born in Equatorial Guinea according to the 2001 World Health Report, by the World Health Organization, is just over 53 years. This stands in stark contrast to life expectancies for Americans at 77 years or Norwegians at 80. There are a number of reasons for why this number is so low. Newborn and child deaths are also a serious health problem. Infant and child mortality rates are also frequently used in order to site poor health in a country. Equatorial Guinea's mortality rates for infants and children are very high. Although the numbers have slowly dropped from 1988 when infant mortality rates stood at 144 deaths per 1,000 births, today, 91 babies die for every 1,000 born (3). Child mortality rates, (the probability of children under the age of 5 dying) are still very high at 150 deaths per 1,000 children (World Health Organisation).
Part of the reason that these numbers remain so high and life expectancies so low is the devastating effects of the tsetse fly; the vector of malaria and sleeping sickness. While malaria is particularly dangerous at birth, the disease continues to affect people of all age groups and demographics in Equatorial Guinea. Although under Spanish rule a large majority of the population was vaccinated, under the Marcias and Obiang governments people have only been sporadically vaccinated against viruses and infectious disease and usually at the insistence of UNICEF or other outside groups (15). Another problem is that new chloroquine-resistant (chloroquine is the medicine used to prevent or cure malaria) strains of malaria and sleeping sickness have appeared and the government has done little to prevent their attack (3).
In rural areas, young children are also dying from yaws, a syphilis like infection, measles, tetanus (tetanus infections in newborns accounts for about half of tetanus-related deaths in developing countries) and low birth weights, while all over Equatorial Guinea, during the rainy season, typhoid, spread through unclean and contaminated water, and hepatic amebiasis also become more prevalent (24).
While there are no exact figures as to how many people have it, AIDS is also beginning to seriously affect the country. Although in the late 1980s and early 1990s Equatorial Guinea remained unaffected by the HIV/AIDS virus, the disease is becoming more and more of an issue and affecting previously healthy members of the working population. As the labor force continues to suffer because of unemployment and low wages, slums continue to grow and prostitution has become more widespread, bringing the disease in from Cameroon, Nigeria and Gabon (3).

What are the underlying causes of poor health?

There are a number of reasons for why the health of the population has stagnated and even digressed in some instances. With respect to the growing AIDS crisis; the rise in prostitution coupled with the fact that Equatorial Guinea is a very religious country where 90% of the population is catholic and the church does not support the use of contraceptives has lead to the easy spread of the disease. It does not help that the majority Fang population is also traditionally a polygamous group and is also strongly against condoms and other forms of contraceptives.

Clean drinking water is often very important in order to maintain a healthy life. In urban areas throughout Equatorial Guinea unsanitary communal taps lead to the spread of diseases including malaria, worms, and gastrointestinal diseases (3). Clean drinking water has also been identified as one of the main factors leading to poor health and a rise in the number of cases of diseases like tetanus, typhoid and hepatic amebiasis. These are all mostly spread through unsanitary living conditions and dirty or contaminated water. According to a study done in 1993 by the United Nations, only 17% of the population, mostly those in urban areas had access to potable drinking water (3).
One of the main reasons though for the overall poor health in Equatorial Guinea is the inadequate facilities and the lack of trained personnel on the island. After the end of the Cold War, Cuba, Russia and China stopped supplying the country with cheap drugs, medical technology for the hospitals and good doctors. As Equatorial Guinea had very few doctors of their own, they relied heavily on trained personnel from other countries. When these doctors were removed, drugs from china stopped being shipped and the Russians refused to send anymore hospital supplies, the result was the complete breakdown of the medical infrastructure (21). In essence, after the cold war, the Obiang government let the medical system rot. Hospitals were deserted and left unattended and the population was essentially forced to fend for itself. This had huge consequences on the health of the people. Deaths from malaria and yaws skyrocketed and infant mortality more than doubled (24).
UNICEF and the United Nations have once again begun to help supply the country with much needed medicine and vaccinations and recently pledged to give $500,000 worth of vaccinations for children against measles, polio, tuberculosis, diphtheria and whopping cough. However, Equatorial Guinea, and Equatoguineans cannot always count on the U.N. to supply them with medicine. Spain, France and the U.S. as well as several other non-governmental organizations have continued to provide assistance programs with technical aid, food aid, drug donations and clinical help but while medicines are beginning to trickle back into the country, doctors and trained physicians are not. In fact, a 1996 study by the World Health Organization showed that for every 100,000 people living in Equatorial Guinea, there are only 24 physicians, an appalling low number. This isn't just a problem in Equatorial Guinea but one that affects many African Countries. The U.N. has even recognized the lack of doctors in Africa as one of the worst problems affecting health issues throughout the continent and gone as far too publicly call the problem a "crisis of health man-power" (28). The World Health Organization has even stated that medical facilities in Africa in general were, "barely able to function for lack of qualified, motivated doctors, nurses and other health workers" (28). Equatorial Guinea can no longer sit back and rely on foreigners unfamiliar with the country and the people to provide medical assistance. This is not enough. The government can take very easy steps to ensuring the healthy future of the people of Equatorial Guinea by building and creating its own doctors.

Solution: Medical school scholarship programs

With all the oil money coming into Equatorial Guinea, the Obiang government is now more then ever capable of solving this doctor shortage crisis and thereby improving the health throughout the country.
There are several reasons for the doctor shortage in Equatorial Guinea. First, the education system in Equatorial Guinea is poor and few students finish school and are prepared enough to enter a medical school. Then, students that are qualified to attend a medical school must leave the country because Equatorial Guinea no longer has a functioning university. Students who do leave tend to stay out of the country because pay is so low for doctors and the political environment is unstable so the incentives for coming back and becoming a practicing doctor in the country are very few. In Europe the U.S. and Canada, countries are suffering from a shortage of doctors and nurses as well (although not even close to the magnitude of the shortage in Equatorial Guinea) and recruit heavily from developing countries. This is extremely unfair to the developing world and the sick and untreated all over Equatorial Guinea.
No solutions have been successful for ending the doctor crisis in Equitorial Guinea (thereby alleviating the tragic health problems of the country) or any other African country and it is a problem that may never end until other political and social issues are worked out. However, some things can be done.

It seems unlikely that President Obiang will ever do anything to dramatically improve the situation in his home country but sadly, the future of the country may depend on him. With the new oil money coming in, the possibilities seem endless, and if this money is eventually diverted to where it is needed, similar to what Chad or Cameroon are doing (see solutions for oil section) then perhaps Equatorial Guinea does have a chance.

There are several solutions that can be achieved with money. Firstly, an increase in doctor's salaries would greatly increase interest in working in Equatorial Guinea. The government could easily do this. Perhaps a better and more feasible solution though would be to provide scholarship money to bright students. Scholarship money would allow students to travel to other countries and receive top notch medical training at the best universities around the world. If the government gave out these scholarships with the stipulation that the students were required to come back and practice medicine inside Equatorial Guinea, it is very possible that the number of doctors able to provide for the population would rise and alleviate some of the health issues in the country. This may seem simple, but at this point the government needs to do anything it can to bring in more doctors and quell the health needs of the small country.

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