Politics and graft undermine African health care
- 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.
CORRUPTION DRAINS RESOURCES
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