SEATTLE — Guyana, a small country in northern South America formerly known as British Guiana, drafted its initial constitution in 1961. A modified version of that document would later take effect on May 26, 1966, as the small, agricultural river colony gained its independence from the United Kingdom.
The agrarian region, layered with a complex network of rivers which originate at its large Atlantic coastline, has a history of poor health and living conditions. Originally settled by the Dutch and used as a northern docking point for sugar plantations, workers’ rights, safety and health were originally of little concern in the country.
Early in its development, Guyana had very low life expectancy and a high rate of infant mortality. Vectorborne diseases like dengue fever and malaria are among the top diseases in Guyana. Last year, the country ranked 64th in infant mortality, and that is with a comparatively impressive historical improvement. On average, in 2016, 31.5 infants died per 1,000 live births. There are only 0.21 physicians and two hospital beds per 1,000 residents. Guyana spends 5.3 percent of its gross domestic product on health. In comparison, the United States spends nearly 18 percent of its GDP on health.
A 2009 estimate placed the average age of a mother at first birth at less than 21 years old, and just 42.5 percent of the population use contraceptives. This low contraceptive prevalence has contributed to a staggering percentage of the population living with HIV/AIDS: 7,800 of its 735,909 people or 1.5 percent. In 2015, the number of orphans due to AIDS was estimated at more than 1,000.
A large percentage of that population included Guyanese sex workers, who contracted the virus at a rate 15 times the national average. Another group disproportionately affected was loggers, who live largely secluded and without access to contraception and sex education.
This situation has improved drastically over the last decade. In 2009, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) cited 11,000 HIV-infected in the country. In the early 2000s, the U.S. responded to the AIDS epidemic by strengthening its surveillance system to produce information to inform the design of interventions for HIV/AIDS reduction and plan care for those affected. PEPFAR funded a network of community and faith-based organizations in strategic locations to provide prevention, care and support services.
At that time, Guyana was one of 15 focus countries which collectively represented at least 50 percent of HIV infections worldwide, receiving $12.2 million in 2004 and $19.7 million in 2005. AIDS was the second-leading cause of death among Guyanese in 2002 when nearly 35 percent of the population lived below the poverty line.
A 2009 PEPFAR report states that 221,800 individuals were reached by programs that promoted abstinence and faithfulness, 5,700 pregnant women received prevention of mother-to-child HIV transmission services, 67 women received antiretroviral prophylaxis, 8,900 individuals received counseling and testing, 300 received palliative or basic healthcare and support and 800 orphans or vulnerable children were served.
While the situation in Guyana remains serious, this aid has made significant strides toward reducing the incidence of new infections. With continued international support, one of the top diseases in Guyana can be pushed back even further, allowing the nation’s people to pursue their own prosperity.
– Shaun Savarese