By Yobba Baldeh
Public health is more than just medical care; it reflects society’s values and priorities. In The Gambia, likewise other democracies where politics heavily influences nearly every aspect of public life, the intersection of politics, social justice, and healthcare exposes a complex web of power, privilege, and responsibility. At the heart of this intersection lies a critical question: should public health serve the needs of the entire population, or should it be reserved for the political elite?
The recent decision to build a hospital within the State House has sparked an important debate. Defenders of the move argue that the hospital is there for those who protect and serve the nation and the nation’s leaders. However, many see it as a troubling example of how public resources are used to benefit the few at the expense of the many. This decision underscores the growing concern that public health in The Gambia is increasingly becoming a tool for political exclusivity, where privilege is reinforced rather than challenged. This is socially unjust, as healthcare should be a space where equality and fairness prevail, not where privilege is enshrined.
Public health is meant to be a public good—something that benefits everyone in society, regardless of their social, economic, or political status. In The Gambia, however, the allocation of healthcare resources often reflects the political priorities of those in power rather than the needs of the population as a whole. The decision to construct a hospital within the State House, a location that is inaccessible to ordinary Gambians, raises serious questions about fairness and justice.
Building a hospital at the State House symbolizes the growing divide between the ruling elite and the general population. It suggests that the health of politicians is prioritised over the health of ordinary citizens. This is not only a misuse of public resources but also a violation of the principle of social justice. Public health should be about ensuring that everyone has equal access to the care they need—not about creating special privileges for the few.
In a country where many people struggle to access basic healthcare, building a hospital exclusively for political leaders is a stark reminder of the inequalities that persist in the system. Rural areas, in particular, are often neglected, with underfunded and understaffed health facilities. By directing public resources toward the construction of a hospital that only a small fraction of the population will ever use, the government is sending a clear message: those in power are more deserving of quality healthcare than the rest of society.
Social justice calls for the fair distribution of resources and opportunities, ensuring that all members of society have the ability to live healthy, fulfilling lives. In the context of public health, this means ensuring that everyone—regardless of their income, location, or political connections—has access to quality healthcare. Unfortunately, in The Gambia, this is not the reality.
The Gambian healthcare system is marked by significant disparities, particularly between urban and rural areas. While urban centres like Banjul and Serekunda have relatively few hospital equipped facilities and access to specialized care, rural areas are often left with lack of medical facilities, a shortage of medical professionals, and limited access to essential services. This is a clear violation of the principles of social justice, as the people who are most in need of healthcare are often the least likely to receive it.
The construction of a hospital at the State House only exacerbates these inequalities. Instead of investing in healthcare infrastructure that benefits all Gambians, the government has chosen to build a facility that serves a small, privileged group. This is a direct contradiction of the principles of health equity and social justice, which demand that resources be distributed in a way that prioritises the needs of the most vulnerable.
If the government is truly committed to improving healthcare in The Gambia, it should focus on strengthening the health system for everyone, particularly in underserved communities. This means investing in rural health clinics, improving access to maternal and child healthcare, and ensuring that every Gambian has access to the care they need, regardless of where they live or who they are.
Public health is not just a medical issue; it is also a political one. Decisions about where to build hospitals, how to allocate resources, and which populations to prioritise are all inherently political. In The Gambia, these decisions are often shaped by the interests of those in power, rather than the needs of the general population.
The decision to build a hospital at the State House is a clear example of how political considerations can distort public health priorities. By focusing on the needs of the political elite, the government is neglecting the needs of ordinary Gambians, many of whom lack access to even the most basic healthcare services. This is not just a failure of policy; it is a failure of responsibility. Political leaders have a duty to serve the people, not just themselves.
When public health becomes a tool for political exclusivity, it undermines the very foundations of democracy. In a democratic society, all citizens should have equal access to public services, including healthcare. By creating separate systems for the political elite and the rest of the population, the government is sending a message that some lives are more valuable than others. This is a dangerous precedent that threatens to erode trust in the political system and deepen social divisions.
Leadership comes with responsibility—especially when it comes to matters of public health. Political leaders in The Gambia have a duty to ensure that the healthcare system serves the needs of all citizens, not just the privileged few. This means making decisions that prioritise equity, transparency, and accountability.
Building a hospital at the State House is not just a poor policy choice; it is an abdication of this responsibility. It sends a message that the health of politicians is more important than the health of ordinary Gambians. This is not only socially unjust but also short-sighted. A healthy society is one in which all citizens have access to the care they need to thrive—not just those with political power.
Leaders must be held accountable for how they allocate public resources, especially in a country like The Gambia, where healthcare is already under strain. Instead of investing in facilities that serve only a select few, the government should be working to improve healthcare access and quality for everyone. This is not just a matter of fairness; it is also a matter of national development. A healthy population is essential for economic growth, social stability, and political progress.
For The Gambia to move forward, public health must be reimagined as a space for social justice, not political exclusivity. This means addressing the structural inequalities that exist within the healthcare system and ensuring that resources are distributed in a way that benefits everyone, not just the elite.
Healthcare is a fundamental human right, and it should not be contingent on one’s social or political status. The government must prioritise investments in healthcare infrastructure that serve the needs of all Gambians, particularly those in underserved areas. This includes building and upgrading hospitals in rural regions, expanding access to essential services, and ensuring that all citizens have the opportunity to live healthy lives.
Moreover, public health policy must be driven by the principles of equity and fairness. Decisions about healthcare should be made with the goal of improving the well-being of the entire population, not just a select few. This requires a commitment to transparency and accountability, as well as a recognition that the health of a nation depends on the health of all its citizens—not just its leaders.
The intersection of politics, social justice, and public health in The Gambia reveals a complex web of power, privilege, and responsibility. While public health should be a space where social justice is realised, it is increasingly becoming a tool for political exclusivity in the Gambia, where the elites prioritise their needs over the general population. The decision to build a hospital at the State House is a clear example of this trend, and it raises serious concerns about the direction of healthcare policy in The Gambia.
For the country to move toward a more just and equitable healthcare system, public health must be reframed as a space for advancing social justice. This means ensuring that all Gambians, regardless of their social or political status, have access to quality healthcare. It also means holding political leaders accountable for how they use public resources and making sure that healthcare decisions are made with the goal of benefiting everyone, not just a privileged few.
Public health should be a unifying force in society—a space where the values of fairness, equity, and justice are realized. It is time for The Gambia to embrace this vision and build a healthcare system that serves the needs of all its people.
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