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File:U.S. and Djibouti healthcare workers deliver care DVIDS82578.jpgDjibouti suffers from a deadly combination of limited healthcare facilities and extensive health problems. With the help of foreign assistance from nations such as the United States, healthcare in Djibouti may be able to overcome these challenges.

Where is Djibouti?

Djibouti, officially named the “Republic of Djibouti,” is an African country located in the Northeastern quadrant of the continent. It is a part of the “Horn of Africa,” along with Eritrea to the North, Somalia to the Southeast and Ethiopia to the Southwest. Djibouti stands out as a significantly smaller nation than the other countries. Ethiopia, for instance, is 48 times larger than Djibouti.

Even more of a standout than its physical size is Djibouti’s population. Djibouti has less than one million citizens, at 973,560 as of 2019. In comparison, Ethiopia has more than 100 times as many citizens, with a population of 112 million people. Despite Djibouti’s small population size, the nation has historically struggled with poverty, a similarity shared with other countries in the Horn of Africa. As of 2017, 17.1% of Djibouti’s citizens lived on less than $1.90 a day—the very definition of extreme poverty.

Healthcare in Djibouti

One of the largest consequences of this national poverty is extremely limited healthcare in Djibouti. There are many crippling health problems in the nation, but thanks to global efforts, these problems are being addressed. However, there is still much to be done to provide communities in Djibouti with accessible and affordable health care. By furthering global efforts, Djibouti will be able to provide proper medical treatment to its citizens in the future.

Limited Facilities

Djibouti has a severe lack of healthcare facilities. The country’s capital has the nation’s highest concentration of medical facilities, and even still there are very few. Moreover, the facilities can only fulfill limited emergency operations. For instance, trauma services are “only for stabilization and air ambulance transfer.”

Outside of Djibouti’s capital, the problem is astronomically worse. In many remote places, there is so easy access to health care facilities. The few health facilities in the country are limited to certain medical emergencies.

Djibouti’s healthcare workers often recommend visitors to evacuate the nation when significant medical treatment is necessary. This is naturally not possible for Djibouti’s citizens, who are for the most part out of luck when requiring hospitalization.

Organizations around the world are working to increase the capacity and concentration of healthcare facilities in the country. The United States Agency for International Development (USAID), for instance, has helped fund the cause for many years to date. USAID provides much-needed assistance to “support health facilities in order to increase service uptake.”

Foreign assistance has not only been critical toward expanding healthcare facilities in the nation, it has also been crucial in addressing the country’s biggest health issues.

Health Problems in Djibouti

Djibouti has a variety of deadly health issues that threaten the lives of the nation’s citizens on a daily basis. One of the most prevalent is HIV/AIDS, which greatly impacts the Horn of Africa. USAID focuses on supporting the government of Djibouti’s national strategy to fight HIV/AIDS.

Together, the organizations plan to create accessible prevention programs, improve the outcome for PLHIV (People Living with HIV) and bolster the evaluation of the “national response, coordination, management and monitoring” of anti-HIV/AIDS measures.

The cooperation between the United States and Djibouti is not only effective in addressing existing health problems but is also successful in preventing new ones. One such potential threat to the nation is polio.

Djibouti itself has been free of polio since 1999, but there have been a plethora of outbreaks in its surrounding countries in the Horn of Africa, such as Ethiopia and Somalia. As a result, USAID has increased polio awareness and surveillance. They also ensured that every child in Djibouti has been given the polio vaccine. Thanks to these efforts, polio still remains undetected in Djibouti.

Djibouti Amid COVID-19

Amid the COVID-19 pandemic, Djibouti will not only face COVID-19 but and other serious health problems such as malaria, dengue fever and tuberculosis. It will take multiple nations fighting for better healthcare in Djibouti for the nation’s healthcare facilities to adequately handle these threats.

The people of Djibouti are living in extreme poverty. Their limited healthcare facilities alone are not enough to address the massive health problems in the nation. Foreign aid from countries such as the United States has been crucial to combat these health issues and develop medical facilities, giving individuals in Djibouti the opportunity to live longer and healthier lives.

– Asa Scott
Photo: Wikimedia Commons

Tuberculosis in DjiboutiTuberculosis (TB) is an infection caused by Mycobacterium tuberculosis. In addition to airborne spread, TB can be transmitted through unpasteurized milk contaminated with Mycobacterium bovis. This infection attacks the respiratory system, but in extreme cases, it can impact the central nervous system, bones, joints, lymphatic system and urogenital area. It’s a disease that is endemic in Djibouti, a country in eastern Africa. 

Infection Rates and Spending Levels

From 2000 to 2018, there were two peak levels of tuberculosis in Djibouti — one in 2001, and the other in 2010. In these years, Djibouti hit 716 cases of TB per 100,000 people and 621 cases per 100,000 people, respectively. As of 2018, TB rates were the lowest they had been in since 2000, at only 260 cases per 100,000 people. That being said, TB has remained the number four cause of death in Djibouti since 2007.

Despite the fact that deaths have increased, health data analyzers seem optimistic that the incidence of TB will decline as more funding goes toward health in Djibouti. In 2016, only $66 was spent per person on health. By 2050, experts predict that spending will rise to $87 per person. This increase will largely come from expanded development assistance and a rise in government spending on health — predicted to jump from $35 per person in 2016 to $48 in 2050. With more money being put into the health of citizens, it will be easier to get and keep people healthy. If someone does contract TB, there will be more money allotted for their treatment. Increased health funding will also allow for more community outreach and education around the spread and treatment of TB. If someone contracts TB and cannot get to a medical facility, they will at least have tools to keep themselves healthy and ensure that their case doesn’t spread. 

Refugees and Tuberculosis in Djibouti

Refugees account for nearly 3% of Djibouti’s population. Most refugees come from neighboring countries raging with war. Djibouti’s refugee camps are small, cramped and perfect breeding grounds for TB. While things may seem bleak, there is hope. The government in Djibouti is working with multiple NGOs to bring awareness and treatment to TB in refugee camps. UNDP has partnered with UNHCR and the Global Fund to address tuberculosis in Djibouti. So far, they have provided treatment for 850,000 TB patients, as well as 19,139 patients with drug-resistant TB. The work of NGOs has allowed families to stay with the sick during treatment, without fear of contracting the infection.

The goal of this partnership is to end TB in Djibouti by 2030 — an ambitious goal, but one that is potentially attainable as support and funding help to educate, treat and provide support for the people who need it. While treatment is important, however, these NGOs have also shown that community outreach programs aimed at teaching people how to avoid TB are just as vital in stopping the spread of the disease.

The tuberculosis crisis in Djibouti has been a lasting one. Thanks to recent investments by the government, new technologies to combat TB and organizations helping contain the refugee TB crisis, there is hope for the future of this country and its citizens.

Maya Buebel
Photo: Flickr