Health in Senegal

The established budget with the expenditure of health in Senegal has triplet between 1980 and 2000. The Senegal board go better and live longer - the Life expectancy with the birth is 55,34 years for the men, 58,09 years for the women and 56,69 years for the global population - and the rate of Prévalence of the AIDS is one of weakest of Africa (0,9%). However of great disparities remain in the country, if one thinks for example that 70% of the doctors and 80% of the pharmacists and the dentists are installed in the capital, Dakar.

History

As in the remainder of the African continent, the population sénégalaise a long time had recourse - and always recourse has - to the traditional medicines, with the healers. Thus with Yoff for example, the mental diseases are treated during a traditional ceremony, the ndeup .

However these sometimes spectacular methods could not stop the great epidemics and the famines which on several occasions decimated the region in the past.

As of the 19th century France provides the foundations of a medical policy there, would be this only to protect its own nationals. The stress is particularly laid on the Hygiène. The advent of AOF is accompanied soon by the structuring of an health system.

In 1905 an Indigenous service of Medical help (AMI) is created. It is charged to take free to the populations the medical care and the councils of hygiene, to promote vaccination and the Maternal protection and infantile.

The decree of January 14th 1918 creates the Medical school of the AOF, thus melting the first establishment of higher education in Africa. It will train until in 1953 581 doctors, 56 pharmacists, but also of the male nurses and the midwives who will work within the framework of the FRIEND.

Between the two wars appears a new concept, that of Preventive medicine and social.

In 1942 the departments of health of the AOF are reorganized and centralized in Dakar. The medical Inspection of the schools is created.

After the Second world war, the international public opinion is shown more critical with regard to the colonial policy, and the priorities are centred on infantile health. Total programs are set up to fight against large the Endémie S.

The University Sheik Anta Diop having been created in 1957, the Medical school is transformed into Medical college in 1962.

Since independence Senegal is implied in the great international programs in favor of the development and health.

Today one does not die any more hunger in Senegal, but the access to the care remains very unequal according to the areas and the incomes.

Organization of the health system

It should be noted that the complete heading of the ministry concerned is " Ministry for health and the médicale" prevention; - a name which proposes the prophylactic actions.

Current Ministre for Health is Abdou Fall, also spokesperson of the Senegalese Democratic party. Pyramidal, the health system of Senegal comprises three levels.

the central level includes the cabinet of the minister, the Directorates and the Departments attached.

the regional level is that of the medical area, which corresponds to an administrative area.
the peripheral level corresponds to the medical district. One currently counts in the medical country 50 districts. Each one has at least of an health center and a network of stations of health, which are established in the communes, the chief towns of rural communities or the relatively populated villages. The district can correspond to whole or part of a department.

This system is the subject nevertheless of many criticisms, in particular because of the increasing requirements for profitability, but also of the corruption which one observes here as in other fields of the public life.

Specific pathologies

Paludism

True public health problems, the Paludisme (also called malaria) are a parasitic disease transmitted by the punctures of mosquitos. It is the first cause of Mortalité and Morbidité in Senegal which is classified in zone 3. It makes devastations, in particular in the children of less than five years and the expectant mothers.

A National program of fight against Paludism (PNLP) was set up and a quarterly magazine, Palu Infos on the matter gives a progress report on the topicality.

The travellers generally have recourse to protection measures (electric sprays, diffusers, mosquito nets) and to drugs antipaludéens adapted to each case.

New generic products represent a hope for the local populations which cannot have access to these often expensive treatments.

AIDS

According to ONUSIDA, a ONG of the United Nations, the proportion of adults (between 15 and 49 years) touched by the virus of the AIDS would be of 0,9%, one of the lowest rates of the continent.

According to these same sources, the number of people touched by the HIV in 2005 is estimated at 61.000 (between 29.000 and 100.000).

5.200 deaths (between 1.700 and 12.000) would be ascribable with the AIDS during the year under review.

Syphilis

The endemic Syphilis is directly related on social environment, the bad hygiene and housing conditions. As for the others Infections sexually transmissible (STI), the risk increases with the Prostitution and the Sex tourism.

Tuberculosis

With regard to the Tuberculosis, the situation has been stabilized for a few years.

One counts 9.500 cases of infection per annum, with 2 to 4% of mortality. The rate of cure passed from 64% in 2002 to 72% in 2005. According to the same sources, the disease is especially localized with Dakar and Thiès and touches the men more the women.

Yellow fever

The Yellow fever is a serious viral disease, due to a Arbovirus, the virus Amaril, which was isolated in 1927 at the same time with the Ghana and Senegal, at the Pasteur Institute of Dakar. The virus is transmitted to the man by mosquitos of the kind Aedes .

This virus is the subject of research within the Global area network of the Pasteur Institutes, in particular with the Institut Pasteur of Dakar whose laboratory is also approved by the the World Health Organization (WHO) to provide the vaccine to the widened programs of vaccination in Africa.

Vaccination against the yellow fever is recommended, but nonobligatory, for the entry in Senegal.

Chikungunya

The Chikungunya is a tropical infectious illness, also due to a Arbovirus ( Alphavirus of the family of the Togaviridae), transmitted by Moustique S of the Aedes . The risk of infection by this virus in Senegal exists.

Bilharziose and filariose

The Bilharziose (Schistosomiasis) is a rather common Parasitose in the tropical areas and in particular in Senegal. One contracts it while bathing in infested fresh water of worms, this is why it touches in particular the farmers and the fishermen, but also the young children.

In Senegal one observes two forms of the disease: the urogenital form due to Schistosoma haematobium and the intestinal form due to Schistosoma mansoni . The urogenital bilharziose was discovered in the country at the beginning of the 20th century. One finds it today in the majority of the areas. From its frequency, it constitutes second parasitic endémie after paludism. As for the intestinal bilharziose, the first cases were announced to Senegal in 1951. Today this form appears only occasionally and punctually.

Dependant on the presence of stagnant fresh water, the bilharzioses prevail in the delta of the Senegal river, in particular close to Richard-Toll, but the many hydro-agricultural projects of installation constitute additional risk factors in all the country.

A National program of fight against Bilharziose (PNLB) was set up.

The Filariose is a parasitic disease due to telegraphic called parasitic Nématodes. Like the bilharziose, it is related to the presence of fresh water (rivers, lakes).

Trypanosomiasis

The human Trypanosomiase (or Disease of the sleep) is a parasitic disease which a long time touched the valleys of the East of the territory (Ferlo).

Cholera

Cases of Choléra are declared from time to time in Senegal and an epidemic prevailed in the area of Touba in 2005. The disease being transmitted by oral way, in particular by soiled water, its development can be explained by the floods which touched the center of the country at this period. The country knew a new alarm starting from August 3rd, 2007. 1.274 cases whose 4 deaths were recorded, mainly in the Région of Diourbel.

Meningitis

Thanks to the vaccination campaigns, the Méningite is in regression, but one observes nevertheless seasonal pushes from February-March until spring, particularly in Eastern Senegal, and occasionally in the center of the country (Kaolack, Fatick) and in Dakar.

Measles

Generally benign in the Western countries, the Rougeole however caused on average 1.000 deaths of children per annum until in 2002. This is why a Widened Program of Vaccination (PEV) was set up, including measles, with the project to reduce by 95% mortality due to this infantile affection.

Birth control and abortion

Female genital mutilations

The prevalence of the female genital mutilations (MGF) in Senegal would be from 18 to 20%. According to this same study of 1990, the mutilations would be not very widespread at the Wolofs and the Sérères, but more frequent at the Peuls, the Diolas, the Toucouleurs and the Mandingues.

The quoted figures probably moved back in the interval, because of many actions were carried out, like this demonstration with Niodior in 2000, when representatives of 26 villages of the Sine-Saloum wrote a Joint Declaration to fight against these practices.

To note that the Excision is the central theme of the last feature film of the Senegalese scenario writer Sembène Ousmane, Moolaadé (2003).

Handicap

According to the census of 1988, the population counted 2% of Handicap are, but in the interval the criteria changed and the figures of 2002 are not available.

The handicap is the leading cause of social exclusion. It marginalizes the people victims and very often exposes them to the begging. However progress was already accomplished in the integration of the handicapped people, an international festival was organized and of new measurements are being studied. The use of mines during the Conflit in Casamance has made several hundreds of victims, killed or mutilated. Accidents still occur, even if their number strongly decreased (10 in 2005). According to the Observatory of the Mines, 93 of the 3.446 villages of Casamance would have been undermined. In 1997 Senegal ratified the Convention on the prohibition of the anti-personnel mines. Today the work of mine clearance continues.

Handicap International carries out in the country of the activities of socio-economic insertion of the handicapped people and prevention of the Handicap.

Traditional medicine

Tradipraticien

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