children generally acquire Tunisian Arabic at home, when they enter school at age six, they are taught to read and write in Standard Arabic. From the age of 8, they are taught French while English is introduced at the age of 12. The four years of secondary education are open to all holders of where the students focus on entering university level or join the workforce after completion. The Enseignement secondaire is divided into two stages: general academic and specialized. The higher education system in Tunisia has experienced a rapid expansion and the number of students has more than tripled over the past 10 years from approximately 102,000 in 1995 to 365,000 in 2005. The gross enrollment rate at the tertiary level in 2007 was 31 percent, with gender parity index of GER of 1.5. Health In 2010, spending on healthcare accounted for 3.37% of the country's GDP. In 2009, there were 12.02 physicians and 33.12 nurses per 10,000 inhabitants. The life expectancy at birth was 75.73 years in 2016, or 73.72 years for males and 77.78 years for females. Infant mortality in 2016 was 11.7 per 1,000. Culture The culture of Tunisia is mixed due to its long established history of outside influence from people – such as Phoenicians, Romans, Vandals, Byzantines, Arabs, Siculo-Normans, Turks, Italians, Maltese and the French – who all left their mark on the country. Painting The birth of Tunisian contemporary painting is strongly linked to the School of Tunis, established by a group of artists from Tunisia united by the desire to incorporate native themes and rejecting the influence of Orientalist colonial painting. It was founded in 1949 and brings together French and Tunisian Muslims, Christians and Jews. Pierre Boucherle was its main instigator, along with Yahia Turki, Abdelaziz Gorgi, Moses Levy, Ammar Farhat, and Jules Lellouche. Given its doctrine, some members have therefore turned to the sources of aesthetic Arab-Muslim art: such as miniature Islamic architecture, etc. Expressionist paintings by Amara Debbache, Jellal Ben Abdallah, and Ali Ben Salem are recognized while abstract art captures the imagination of painters like Edgar Naccache, Nello Levy, and Hedi Turki. After independence in 1956, the art movement in Tunisia was propelled by the dynamics of nation building and by artists serving the state. A Ministry of Culture was established, under the leadership of ministers such as Habib Boularès who oversaw art and education and power. Artists