Ailing health care system gets boost for UN agencies

In a bid to encourage refugees and other war victims to repatriate voluntarily and reintegrate into Burundian life, UN agencies are turning their attention to improving the low level of social services, particularly with health care. Three UN agencies and the Burundi government jointly signed a memorandum last week to provide equipment and essential medicine as well as to rehabilitate health centres ruined by 10 years of political crisis and war. The aim is for all Burundians to have an effective minimum care package, they said "Beneficiaries include returnees, IDPs (internally displaced persons) and the local population in Burundi taking into consideration the specific needs of children and women," Cherif Benadouda, the UNICEF officer in charge in Bujumbura, said. The UN Secretary-General's Special Representative to Burundi, Carolyn McAskie endorsed the memorandum. Health care costs increased for many rural Burundians after April 2002 when the government privatised the management on state-owned hospitals and health centres. Initially Burundians were issued a low cost health insurance card, but the system broke down for most poor people and the card is no longer used. High costs have meant that people cannot pay their bills. Some have been detained by health care authorities. Even dead bodies have not been released to relatives until charges are recouped. An estimated 1.5 million people now live without access to health care, said Francoise Ngendahayo, the minister for rehabilitation, reinsertion and reintegration of IDPs and returnees. In 2003, the Ministry of Health was allocated 2.2 percent of the national budget, while around 40 percent went to defence. With the support of UN agencies such problems will end, Ngendahayo said. No one will have to be detained for not paying their bills, she said. The Office of the UN High Commissioner for Refugees, the UN Children’s Fund and the UN World Health Organization are to collaborate with other NGOs and the European Commission Humanitarian Aid Office to rehabilitate 10 hospitals and 200 health centres in 10 provinces. Bujumbura Rural Province is excluded because fighting continues. But the memorandum includes a second phase that would extend to the remaining seven provinces by 2005.   Ngendahayo said 25 percent of the population were war victims. Since the assassination in 1993 of Burundi’s first democratically elected president, Melchior Ndadaye, hundreds of thousands of Burundians have fled their homes either to displaced camps or outside the country, mostly to refugee camps in Tanzania. A voluntary repatriation process started in 2002 as stipulated in the Arusha Peace and Reconciliation Agreement. In the last six months, more than 52,000 refugees have so far repatriated voluntarily, facilitated by UNHCR and 281,000 IDPs have returned home.