The Government of the Gambia under the leadership of His Excellency the President identified the sector as one of the priority areas of its intervention since July 1994. The ten year period (1994-2004) could be termed successful years of the management, protection and provision of health care to Gambians.
Government and health development partners’ investments in the sector were on a steady rise and this resulted in many major developments, notable among them are:
- the construction of new hospitals,
- developments in Edward Francis Small Teaching Hospital (formerly Royal Victoria Hospital to a Teaching Hospital) status to support the training of medical doctors, construction of a new paediatric hospital with MRI, CT Scan, new orthopaedic equipment, other diagnostics, construction of new haemodylsis facility and ward, new faculty for School of Medicine and allied Health Sciences; construction and operation of Tanka Tanka (psychiatric wing-Mariama Kunda) and;
- Upgrading and construction of several health centres to improve access to basic health services to the population.
The high level of coverage achieved with the National Immunisation Days for Poliomyelitis eradication, and Vitamin A coverage for the under – five children.
In the area of infrastructural development, Service delivery the following can be mentioned:
– 4 new health centres have been built and commissioned during 22nd July 2005, and 19 of the existing health centres were being upgraded are almost complete. These 4 new facilities constructed include:
Foday Kunda and
The nineteen health centres upgraded and rehabilitated were:
Basse Major Health Centre
Fatoto Minor Health Centre
Kiang Karantaba Minor Health Centre
Brufut Minor Health Centre
Yorobawol Major Health Centre
Kuntaur Major Health Centre
Sukuta Minor Health Centre
Banjulunding Minor Health Centre
Gunjur Minor Health Centre
Medina Bafuloto Minor Health Centre
Kuntair Minor Health Centre
Ngeyen Sanjal Minor Health Centre
Kwinella Minor Health Centre
Brikamaba Minor Health Centre
Dankunku Minor Health Centre
Sami Karantaba Minor Health Centre
Chamen Minor Health Centre
Gambisara Minor Health Centre and
Diabugu, Minor Health Centre
– A Modern Central Medical Stores complex was built in Kotu to take care of the medicines supply of the country.
– A modern Standards laboratory was built for strengthening disease control including diagnosis and surveillance as well as quality control of foods and medicines and to support export of Gambian products.
NORTH BANK REGION
All the health centres in the region were rehabilitated and upgraded through the support of the CISP Italian Project, which was personally, negotiated by His Excellency the President himself. The centres were:
- Kerewan health centre
- Medina Bafuloto
- Ngayen Sanjal
- A new health centre was built in Illiasa
- And ten (10) new community health posts built to support primary health care delivery
- The African Development Bank Project supported the construction of a new ward and medical store for drugs and vaccines in Essau.
UPPER RIVER REGION
With African Development Bank funding the following have been upgraded:
- Basse major health centre to the level of a Regional hospital
- Fatoto and Yorobawol to the level of major health centre.
- Foday Kunda newly built to standard of minor health centre
LOWER RIVER REGION
- Soma Major Health Centre upgraded to a Regional hospital
- Kiang Karantaba health centre similarly upgraded.
CENTRAL RIVER REGION
- Bansang hospital has undergone some rehabilitation
- Kuntaur Health Centre rehabilitated and expanded with the inclusion of a reproductive health (RH) clinic.
- Sulayman Junkung Jammeh Hospital in Bwiam and Serekunda General Hospital newly constructed and operational,
- Jammeh Foundation Hospital in Bundung also newly constructed and operational.
Human Capacity Development
- The first batch of medical students have progressed to the clinical phase under the University Extension Programme;
- There has been major increase in the intake and output of nurses and other health personnel;
- A large number of health staff have been provided opportunities for overseas training in various health disciplines.
The following additional health manpower was provided through technical assistance from the following organisations and countries:
- United Kingdom through the – VSO
- United States of America through the Peace Corps.
These additional medical officers and other health personnel which include Physicians, Pharmacologists, Surgeons, Nurses, Medical Equipment Engineers, General Practitioners, Administrators, Lecturers were distributed to hospitals, the medical school, Regional Health Teams, health centres, dispensaries and village health posts all over the country. Specifically they were in:
- Edward Francis Small Teaching Hospital (formerly Royal Victoria Teaching Hospital
- Sulayman Junkung Hospital
- Bansang Hospital
- Jammeh Foundation for Peace Hospital
- AFPRC General Hospital in Farafenni
Upper River Region
– Dembakunda Koto
– Dembakunda kuta
– Fodeh Kunda
Central River Division
– Sami Pachonchi
– Nana Fula
Lower River Region
– Kiang Karantaba
North Bank Region
– Ngeyen Sanjal
– Daru Rilwan
– Kerr Cherno
– Medina Sering Mass
– Fass Njagachoi
HEALTH SERVICES DELIVERY
The National Malaria Control Programme (NMCP) is responsible for reducing morbidity and mortality due to malaria. A national control work plan that included the Roll Back Malaria plan have been developed and implemented. In addition The Gambia is co-ordinating the Roll Back Malaria Component of the Health for Pease Initiative. Also the first and last Saturday of every month is set aside as an ‘OPERATION CLEAN THE NATION’ day countrywide.
To protect the pregnant women and children and other vulnerable groups in the major mosquito breeding areas, Government with the support of the development partners distributed free of charge well over hundreds of thousand nets. Accelerated Child Survival and Development Project & IPT interventions supported by UNICEF and MOH&SW contributed to reductions in infant and maternal deaths in CRR and LRR.
A large quantity of insecticide was also provided and a total of 2000 litres of biolarvicide was used, with Cuban technical assistance, in rice fields in Niamina and some areas in the Greater Banjul. With the provision of two aircrafts by His Excellency the President, it is now possible to conduct large scale aerial spraying of the malaria vector by targeting breeding sites.
As part of malaria prevention strategy, the Ministry introduced large scale indoor residual spraying of houses country-wide, with residual insecticides against indoor resting as well as long lasting mosquito nets (LLINs) through Government and the Global Fund.
- Blindness has been reduced from prevalence of 0.7% in 1986 to 0.4% in 1996 and some reports indicate a further decline.
- A cataract surgical rate close to the estimated national target of 2000 has been achieved
- An urban Eye Care program to meet the eye needs of the urban poor has been implemented
- The National Eye Care Program has been rated the leading prevention of Blindness (PBL) Program in the sub-region and is co-ordinating the PBL component of the Health for Peace Initiative
- Construction of the Regional Eye Centre in Kanifing has commenced and work is in progress.
- The National Eye Care Program is now running a regional training program for Community Ophthalmic Nurses, Cataract Surgeons and is providing training for Senegalese, Liberians, Bissau Guineans and there are plans to extend such training to Sierra Leone and Guinea. Hundreds of cataract and trachoma operations were perfumed by our staff in Senegal and Guinea-Bissau under the Health for Peace Initiative.
REPRODUCTIVE AND CHILD HEALTH
Maternal and child health services are now provided throughout the country and as close to the homes as possible.
– New equipment are being purchased to be distributed all over the country
– Integrated Management of Childhood illness will soon be implemented countrywide to strengthen the care of children
The prevalence of HIV I is at 1.2 percent and HIV II at 0.9 percent. The HIV prevalence is currently 1.8 percent from the GBoS recent 2013 GDHS.
The HIV/AIDS Rapid Response (HARRP) Project has picked up in terms of implementation in some of these areas:
- Provision of condoms
- Support to youth and community programs
- Support to health education programs
- Support to those afflicted and affected
- Construction of Reproductive Health (RH) clinics in Faji Kunda, Essau, Kuntaur, Soma, Basse health centres completed and work is in progress since 2005.
To be Continued
by Prof Pierre Gomez
Dean, School of Arts and Sciences
The University of The Gambia