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1403Politics and graft undermine African health care

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  • bobutne
    Jan 2, 2008
      By Daniel Flynn, Reuters

      LIBREVILLE (Reuters) - The crowd of African women are tired and angry
      after hours waiting in the hot sun, but the officials will not
      vaccinate their children until the president inaugurates the campaign
      on state television. When he finally does so, half a day has been
      lost from the five-day vaccination scheme. It is a small reminder
      that, for health care in Africa, politics can be as decisive as

      Grasping her son by the hand, Marie Issa is determined despite the
      long wait to get him a measles vaccination and a free mosquito net
      which could save the two-year-old's life. "Our children often fall
      sick, especially with malaria," Issa said. "Hygiene here is bad. When
      it rains, everything floods and the toilets are outside. We need to
      protect our kids against illness."

      This is no isolated rural African backwater but a poor neighborhood
      in the glossy capital of oil-rich Gabon. Although it ranks as one of
      Africa's few middle-income countries, Gabon's health record is poor.
      Less than half of its 1.6 million people have had any kind of
      vaccination, despite billions of dollars in oil revenues.

      "Many people here are now in ill health," said the local
      representative of the World Health Organization (WHO), Andre
      Ndikuyeze. "It is really a surprise. If they had invested more in
      health and education, it could be much better."

      Gabon's President Omar Bongo, Africa's longest serving leader and
      widely viewed as one of the world's richest rulers, has blamed the
      poor health services on corrupt officials, in what his critics say is
      an attempt to deflect public anger. "I refuse to believe that the
      lack of medicines in our health centers, despite the large budgets
      allocated to them every year, is not due to embezzlement," he said in
      speech in December to commemorate his 40th anniversary in power.

      But foreign aid workers have questioned the government's strategy.
      They say plush hospitals, like the state-of-the-art new military
      clinic in Libreville where Bongo has a private suite, are no
      substitute for local healthcare. "They've neglected the basics, so
      now we are trying to convince the government to invest in health
      posts at a village and community level," said the WHO's Ndikuyeze.


      The five-day inoculation campaign in Gabon, funded by the United
      Nations Foundation, aimed to provide some 300,000 children under five
      with a measles vaccination, vitamin A and de-worming tablets, and a
      mosquito net to prevent malaria.

      Worldwide more than 750,000 children under five die each year from
      malaria, most of them in Africa where it is the main cause of infant
      mortality. Only 3 percent of African infants sleep under long-
      lasting, insecticide-treated nets, the United Nations says.

      The vaccination campaign faced huge challenges: materials were late
      reaching vaccination stations as officials complained they lacked
      vehicles. Some centers were not well signposted, and many staff
      appeared poorly trained. Some aid workers expressed frustration Gabon
      did not provide more support for the program. It relied on a $1
      million donation from the U.N. Foundation, while using a $200 million
      windfall from record oil prices to cancel foreign debt. Government
      officials said the IMF-backed debt repayment should free up future
      budgetary resources for social spending, and would brace Gabon for a
      gradual decline in its oil revenues.

      Despite a slow start, U.N. officials said the campaign had reached
      the vast majority of Gabonese children, particularly in rural areas.
      Some voiced optimism that central Africa could make great inroads
      against disease if the political will was there.

      "We should see a huge reduction soon in the number of children dying
      from malaria in Gabon," said Andrea Gay, U.N. Foundation director of
      child health, adding that more effort would be needed to eliminate
      diseases such as measles. That takes political leadership ... The
      countries here that have the highest income like Gabon and Equatorial
      Guinea ought to be doing more," she said. Demonstrating the
      importance of political leadership, she noted that that a backlash
      against polio immunization by traditional Muslim leaders in northern
      Nigeria in 2003 suspended vaccinations for more than a year and
      allowed the disease to spread to 10 countries across the Sahel.


      The discovery of oil in Gabon in the late 1960s, during the first
      decade of independence from France, brought the country billions of
      dollars in revenue, but it still has one of the most unequal income
      distributions in the world. In Libreville, a flood of migrants from
      the countryside and neighboring countries live in the ramshackle
      slums a stone's throw from the city's glitzy oceanfront hotels and
      offices. It is a familiar story in much of central Africa.......

      In Lybe, a village near Gabon's border with mainland Equatorial
      Guinea, Marie Eyeang says she must travel 25 km (16 miles) to reach a
      clinic if her baby daughter falls ill. "I know if a mosquito bites
      her she can fall sick," she said, cradling her child as she shows off
      her new mosquito net hanging over the bed. "So this is to avoid