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Guinea Bissau
  1. Sarah Cooper, Specialist Registrar in Neurology*,
  2. Sam McConkey, Head of Virology Division
  1. *Southern General Hospital, Glasgow,
  2. Medical Research Council Laboratories, Fajara, the Gambia and Medical Research Council, Caio, Guinea Bissau; E-mail: sarah.cooper{at}


Guinea Bissau is a small country on the west coast of Africa, south of Senegal. One of the 10 poorest countries in the world, it depends largely on farming rice, palm oil, cashew, timber and fishing. Since a civil war in 1998 it has maintained a fragile peace, with one coup and rumours of others. The crippled economy and lack of infrastructure mean a high level of illiteracy, little tarmac on the roads and an infant mortality of 108 deaths per 1000 live births. The external debt for Guinea Bissau was estimated in 2000 to be $941 million with approximately 88% of the population living on less than $1 per day. Health facilities for the average Guinean are scarce. The life expectancy reflects this: 45 years for men and 48 years for women. Most doctors are ‘generalists’ because the luxury of working as a specialist is not feasible. Even when

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