Public Health in The Gambia: Understanding what many do not know

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By Batou Saidy

For the sake of this article, I’ve created a character I named Bodofel. I’d wanted to make it so personal in first person, but because I put Bodofel on pedestal, I’ve decided to resort to third person. So if you understand that, then you’re welcome to my show.

Brutal honesty. Rugged sincerity. Rough reality. Hodgepodge. However. Whatever. Whatnot. The reality is that – not many people have an idea of what Public Health is about – nor do they have a clue of what it typically entails, particularly students that come freshly from high school.

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Maybe this is due to the subtle fact that: there’s technically no avenue for career coaching in Jollof. Maybe it’s simply because the field is like how Jollof stands in Africa amongst other fields of profession. Maybe it’s what you think.

When Bodofel graduated high school some eleven-and-a-half years ago, he had no idea what to study. Choice, availability, barriers, were all there to inhibit him. He had Engineering in mind, but availability said no. Then he was ready to consider Medicine, but inadequate family support said no to that too. He even wanted to try Law, but family said he must continue in the Sciences. That was the time he resorted to studying Public Health. So he had to go to Gambia College. The rest is history.

But at the Gambia College School of Public Health, Bodofel was apparently un-Bodofel-y when he was a freshman. He was still harboring the rancor he had for choice, availability and barriers. He was still very passionate about sparkling the blue blazes until Classical Conditioning set in. What the Sam Hill was that even supposed to mean?

When I was a stubborn boy at my native village in Eastern Jarra, I was forced to believe that Bodofel was a bad guy. This was simply because any time he came to our village, he’d confiscate a lot of commodities from the shopkeepers and throw them away. Sorry, I mean he’d discard them. I later came to understand that those were expired commodities.

But ironically, when that same Bodofel comes back to our village for RCH (for the sake of those that aren’t Public Health Officers, I simply mean – the routine immunization clinics that we have at communities within our catchment areas), they wouldn’t tell us it’s the Bodofel. Instead, they’d say it’s the Nurse. So this bias, inconsistency, or anything towards or against him, made it all f-ed up.

Whether these stemmed from their limited knowledge on Public Health functions, I don’t know. Whether confiscation seemed evil to them whereas RCH was somewhat godly to them, I still don’t know. But what I know is that – most of them didn’t know what the job was, if they in fact know what it still is, given the purported somewhat little distraction or malaise the field had with FSQA as they miss seeing confiscations now. 

So who told you what Public Health is about before you enrolled with them? Was it what you initially had in mind? Is it because you had a brother or a sister who walked on the Public Health boulevard that you also decided to follow suit? Or is it simply because you think that the field is a lucrative trade?

What may be true for you may not be true for Bodofel, but let’s say these things happen. Yeah, they happen but not desirable if they happen to become ‘nyelenkung bankuma’. If you struggle with that Mandinka word of subtlety, then you may need to ask a ‘tiya seneh Mandinko’ about that.

So what truly convinced you into Bodofel-dom? Was it that-y? Who inspired you, if anyone did? So what do you tell people, particularly lay people and students that want to ply the trade when they ask you? What do you tell your community? How will you convince your kids to study what you’ve studied? Is it what you even want for them?

Look, whatever it is, no one actually cares if you don’t give it an f. Even if you do, no one in fact bats an eyelid over it – because generally, people don’t even care – about you or about anything else that doesn’t directly benefit or affect them. If they’re not directly affected or benefitted, they rather fancy dancing to their comfortable tangos of no effect. This is largely true for a typical man, except very few from the lot, which even makes it somewhat statistically insignificant and professionally negligible.

But hey, Bodofel can be very greedy. Oh, yes! Maybe you needed to see a Public Health campaign like Polio Vaccination to relate what I’m saying. Maybe you needed to be made a Team Supervisor when you qualify for a District Supervisor or so. Maybe you needed to be aware of funny siphoning dramas concerning fuel coupons allotted for Team Supervisors. If you’re aware that mere Independent Monitors that only randomly monitor what field workers do, and Drivers that only take the teams to the communities, are paid more than the field workers, essentially PHOs themselves; including Vaccinators and Recorders, without whom the campaign wouldn’t even be successful,  you’d be convinced that injustice is also a loved child. Designing such programmes of disparity automatically attracts free tickets to hell. What do you need to fill? Look, that ODK can go to hell!

Come to CRVS. Jeh, kori kaira? Kori nsi naa haa nyi? Whatever it is at that office in that island, we know it. Whether it’s about the Jalian too, we know it. But it must all peter out. At least all the Bodofels are in harmony regarding this one. Maybe almost all of them are affected too. Sarcastically ridiculous! Yeah, at least, this time around, no one is callous. Does it qualify a nuisance of Public Health interest?

I don’t like digression. I don’t like nuisances. I don’t like shifting from my created Bodofel. He’d go on to grab an undergraduate degree in Public and Environmental Health in subsequent years. Nko, in fact, he’s now a top Bodofel at the top. Is that okay? Haha, that should be okay.

But honestly, despite his ascendance to the top, not necessarily the very top echelons of the trade, Bodofel understands that most Gambians don’t know what Public Health is, and he thinks that’s why people in the communities refer to him as Doctor or Nurse. Maybe he should succumb to simply accepting the reality that curative health has overshadowed preventive health in The Gambia recognition-wise – even though it hasn’t outperformed it pragmatism-wise one bit.

So Bodofel, for this, for that, you should tell them what they don’t know. And maybe also make them understand what they don’t understand – because after all, Public Health is a noble profession of sacrifice, compassion and reward.

Batou Saidy holds a degree in Public and Environmental Health. He’s a Public Health Officer and a writer. He’s also a football fanatic and a Manchester United aficionado.