Health, Wealth and Poverty in the Cote d’Ivoire

World Economics
2 March 2020

In stark contrast to the well-heeled expatriates who can often be found complaining about their lot in the handful of international hotels in Abidjan, most families in the Cote d’Ivoire have perilously low incomes and virtually no long-term savings. When I worked there recently, I estimate that I earned in a month what 90% of adults in Abidjan earn in five years.

Most expatriates working in the multinational institutions of the country have earnings equivalent to the super-rich in comparison to Abidjan’s working class, which is stalled in poverty, condemned to live in a different world in the very same cities with only occasional contact with the shatter-proof bubbles of the super-rich.

Despite this, Cote d’Ivoire is, from the statistics, one of the economically stronger countries in Africa, and lies near the top of the African GDP table. Like many African countries, it also has a prominent minority cadre of Ivorians whose income and capital can outpace even those of the foreigners.

This imbalance provides a serious statistical problem for GDP, which does not recognise the degree to which earned income is spread equitably through the population, and which therefore introduces a major fault into the economic index.

The huge contrast between the haves and have-nots is made terrifyingly obvious by the issue of public health and health insurance. Almost everybody in the country, except politicians, expatriates, the very rich, and those working for multinational institutions or companies, has no comprehensive access to health insurance. Sudden healthcare costs, for example for a relative suffering from long-term illness, or treatment for injuries following a car accident, or even just a dental bill for a tooth extraction, can ruin the lives of whole families.

Most families’ first healthcare recourse is to the potions and remedies of healers and others whose home-made products often heal, albeit more slowly, than the manufactured pill or potion of the all-encompassing multinational company.

The average family, including uncles, aunts, cousins, nieces, nephews, step-children and step-parents, normally together discuss and deal with any major costs arising, and seek assistance from those in the family with money, if such exist.

This is why the small proportion of Africans who have money to spend should not always be assumed to have plenty to spare. Their wealthy-healthy status means that they are often the sole providers of funds when anyone in their family needs help.

Africans are natural sharers and givers, and spare money is used first for close relatives in need. But money from traditional, family based benefactors is reducing. It’s a brutal outcome of the deregulation of the economy, sometimes measured as improving ‘the ease of doing business’, and as free market values replace those of religion, morality, family, and community.

This is why poverty is increasing fast amongst the already severely poor as wealthier family scions increasingly decide that they need not be bound by traditional family ties and, encouraged by financial institutions and governments as representing the ‘private sector’, start to invest their capital in opportunities with higher yields than their own families.