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Saturday, September 23, 2023

Public health in The Gambia

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By Yahya Barrow & Lamin NS Fofana

Despite its centrality in the health system, Public Health remains poorly understood by its primary beneficiary – the public. An average Gambian would confuse a Public Health Officer for a nurse or doctor. More often than not, they would even call them a nurse or doctor. Why is this the case? Were we complex and incomprehensible in our explanation to the masses what Public Health is, and what it’s not?

This article seeks to communicate Public Health to you in simpler terms for a better understanding and appreciation for this noble cadre within the health domain.

Public Health raises different images for different people as it can mean different things in different contexts. However, several classical definitions have been a consensus among scholars in the said field. Winslow defined it as “the science and art of preventing diseases, prolonging life and promoting health and efficiency through organized community effort.” Yet, the prestigious Institute of Medicine (IOM) in 1988 defined it as “fulfilling society’s interest in assuring conditions in which people can be healthy.” And also, a prominent British industrialist Geoffrey Vickers, define Public Health as “successive re-defining of the unacceptable.”

From the cloud of definitions above, we can conclude and summarize that Public Health is an effort to prevent and protect human population from all negative health outcomes and modify environmental factors that may impair health. Therefore, healthy people in a healthy environment are the primary goals of Public Health. Call it a social enterprise akin to a movement if you may wish. But certainly, as Public Health practitioners, if we are confronted with a situation to describe Public Health in one word, it would be “Prevention.”

It is a fundamental principle in Epidemiology that diseases don’t occur at random but has causative agents or factors. Until this breakthrough in science, causes of diseases were embedded in superstition, hence the belief that little or no collective actions could be taken as epidemics were prevalent. And by the way, Epidemiology is no stranger to us anymore. We have top-notch Gambian Epidemiologists. One of them is my “Karamo” SG Sillah; better known as Public Health commentator.

In The Gambia, our first attempt to respond to epidemics collectively was in the first republic when the “Board of Health” was instituted. If you ever wonder why Public Health Officers in The Gambia are called “Bodofello”, it’s a distorted version of the phrase “Board of Health.” It is narrated that the common Gambian, especially the elders, couldn’t pronounce the phrase and, in their effort to do so, led to the distortion of the phrase as we know it today “Bodofello.”

Today we have the Directorate of Public Health Services within the Ministry of Health as the main custodian for the implementation of Public Health activities in the country. Just as the Board of Health used to be. If you are not without a Birth Certificate and you are immune or protected against any vaccine-preventable diseases, you owe the Public Health cadre a huge gratitude. And so do you if you have been sensitized against any bad health behaviors that you quit accordingly and follow those health guidelines which inevitably impact your health positively thank to PHOs. The works of this cadre are numerous and population centered. Thus, the populace is the primary client of a Public Health practitioners.

Current issues affecting Public Health in the country are Covid-19 and its aftermath effect; inadequate specialized trainings, social media misinformation and disinformation campaigns. However, defying the odds, a lot is improved, too. First of its kind the history of our country, two low-cost air quality monitoring devices piloted in greater Banjul area to monitor air quality in order to prevent the population from the effect of air pollution as globally 7 million people are dying as a result of air pollution. Everyone needs air without exception and the air we breathe has an impact on our health, so its quality is of concern to us, and this is the essential. Everyone’s health is Public Health Officers’ concern.

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