A medical aid agency says Burundi's healthcare reform, launched two years ago has made basic medical services inaccessible to one million of the country's seven million people and very costly for most.
A director with Doctors Without Borders, Meinie Nicolai, told reporters in Nairobi a visit to the doctor is a major investment for the majority of Burundi's people.
"To have just a simple consultation in a health center, an average Burundese would have to work 12 days - 12 days just to go and see the doctor," she said.
Ms. Nicolai says, ever since the Burundian government introduced its cost recovery program in the health care system two years ago, the majority of people in Burundi have either gone without health care or have had to sell their land, homes, livestock, and other possessions to receive treatment.
She says some patients have even been detained at hospitals or clinics, often being forced to work to pay off their bills.
The medical aid agency's survey says 99 percent of Burundi's people live on less than one dollar a day, with some 85 percent of the population surviving on one dollar a week.
Yet, the government's tariff structure, endorsed by the World Bank and the International Monetary Fund, requires five million people to pick up the cost of consultations, drugs, and treatment. The government pays for the salaries of medical personnel and infrastructure.
In some areas of the country, Doctors Without Borders and other non-government organizations are providing subsidized health care.
Ms. Nicolai says, Doctors Without Borders is not opposed to cost sharing in principle, but maintains the poorest and most vulnerable must have access to basic health care even if they can't afford it.
She urges the Burundian government and international donors to make money available for health care for the poor.
"We recommend that their health care system is further subsidized," she said. "They have to see what space they have in their own national budgets and what needs to come from the outside world."
No government official was available for comment.
Doctors Without Borders' report says in 2003, Burundi's health budget was 2.2 percent of the country's total budget.