Brussels/Bujumbura –Since February 2002, nearly five million Burundians out of a total population of 6.9 million have had to cover the costs of their medical care.
The government, which devotes the great majority of its budget to its war effort, intervenes only for salaries of medical personnel and financing of infrastructures.
The consequences of this cost recovery system, supported not only by the World Bank and the International Monetary Fund but also by certain donor countries, are deeply worrying: one million Burundians unable to get even the most basic healthcare due to lack of money with a further three million forced to resort to extreme means - such as going into debt - to have access.
This type of practise leads to the lives of the already poverty-stricken becoming even more precarious.
As the MSF survey shows, 99% of the Burundian population live under the threshold of absolute poverty of 1 USD per day and more than 85% survive with less than 1USD per week.
"Given the level of extreme poverty in which Burundians live, asking the population to finance their own healthcare system is tantamount to totally denying them healthcare," explains Luc Nicolas, MSF operational co-ordinator for Burundi.
The results of the survey equally show that the mortality rate, already beyond the emergency level across the entire country, is particularly alarming in the areas covered by the cost recovery system.
Furthermore, in the areas subject to this system a simple consultation in a basic health centre is equivalent to, on average, the wages earned in 12 days of agricultural labour.
"Asking somebody suffering from an everyday - but potentially fatal - disease to spend this amount of money for just a consultation is simply indecent," explains Nicolas.
In five regions in the country, NGOs such as MSF, with support for the Ministry of Health, have developed parallel systems aiming at alleviating the cost of primary health care.
"It is imperative to subsidise the health services to avoid the current exclusion. MSF is calling on all development and health actors involved to guarantee essential care for this impoverished and vulnerable population," concludes Nicolas.