Health

In terms of key indicators, health in Bolivia ranks nearly last among the Western Hemisphere countries. Only Haiti scores consistently lower. Bolivia’s child mortality rate of 66 per 1,000 live births is the worst in South America. Proper nourishment is a constant struggle for many Bolivians. Experts estimate that 7 percent of Bolivian children under the age of five and 23 percent of the entire population suffer from malnutrition.

Bolivians living in rural areas lack proper sanitation and medical services, rendering many helpless against still potent diseases such as malaria (in tropical areas) and Chagas’ disease. Statistics indicate that only 20 percent of the rural population in Bolivia has access to safe water and sanitation.

The prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in Bolivia appears to be low, around 0.1 percent of the population. Between 1984 and 2002, only 333 cases of AIDS were reported to United Nations officials. CIA World Factbook estimated this number for 2007 as being 8,100, with fewer than 500 deaths.

Major infectious diseases with high degree of risk are:

• food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever
• vectorborne diseases: dengue fever, malaria, and yellow fever
• water contact disease: leptospirosis (2009)

The Bolivia section of country studies published by the Federal Research Division of the Library of Congress of the USA mentions the following: “Bolivia’s booming cocaine industry was also spawning serious health problems for Bolivian youth.

In the 1980s, Bolivia became a drug-consuming country, as well as a principal exporter of cocaine. Addiction to coca paste, a cocaine by-product in the form of a cigarette called ‘pitillo’, was spreading rapidly among city youths. Pitillos were abundantly available in schools and at social gatherings. Other youths who worked as coca-leaf stompers (pisadores), dancing all night on kerosene and acid-soaked leaves, also commonly became addicted.

The pitillo addict suffered from serious physical and psychological side-effects caused by highly toxic impurities contained in the unrefined coca paste. Coca-paste addiction statistics were unavailable, and drug treatment centers were practically nonexistent.”

Bolivia’s health care system is in the midst of reform, funded in part by international organizations such as the World Bank. The number of physicians practicing in Bolivia has doubled in recent years, to about 130 per 100,000 citizens, a comparable ratio for the region.

Current priorities include providing basic health care to more women and children, expanding immunization, and tackling the problems of diarrhea and tuberculosis, which are leading causes of death among children.

As a percentage of its national budget, Bolivia’s health care expenditures are 4.3 percent, also on a par with regional norms. However, its annual per capita spending of US$145 is lower than in most South American countries.

Education

Education in Bolivia, as in many other areas of Bolivian life, has a divide between Bolivia’s rural and urban areas. Rural illiteracy levels remain high, even as the rest of the country becomes increasingly literate.

This disparity stems partly from the fact that many children living in rural areas are forced to contribute economically to their family households and thus are much less likely to attend school. On average, children from rural areas attend school for 4.2 years, while children in urban areas receive an average of 9.4 years of education. A gender divide also exists.

The country’s literacy level as a whole, 86.7%, is comparably lower than in other South American countries.

The problems with Bolivian education are not necessarily attributable to lack of funding. Bolivia devotes 23% of its annual budget to educational expenditures, a higher percentage than in most other South American countries, albeit from a smaller national budget.

A comprehensive, education reform has made some significant changes. Initiated in 1994, the reform decentralized educational funding in order to meet diverse local needs, improved teacher training and curricula, formalized and expanded intercultural bilingual education and changed the school grade system.

Resistance from teachers’ unions, however, has slowed implementation of some of the intended reforms.