ThinkTank ideas-Country planning health


By Momodou Lamin Jammeh

The national health services of the Gambia could have been the paragon of West Africa if the Medicare and primary delivery system were properly managed. It undisputable fact that a sick nation cannot be productive neither toil for the nation’s wealth to grow. For this reason, a new limelight for a paradigm shall be focused on mistakes on failures and not mistake for wrong doing. The Gambia has a population of two million inhabitants. After fifty years of independence, there are only five major hospitals, 45 health facilities (outreach secondary services of 233 villages). Among the lot there are 433 primary health care villages, organized in 69 circuits at village based care and outpatient clinics with physicians in 38 primary health care satellite villages. There are 42 private and non-governmental clinics to implement government’s primary health care system. According to an conservative estimate the public sector has 1700 beds, 256 doctors and dentists, 25 pharmacists, 402 registered nurses and 152 public health officials.



For a simple understanding of an equation on doctor population ratio, the forecast is calculated as given below:
2000.000/256=78.125>doctor representation. There is five more districts duel short of referral hospitals considering their geographical location: Wulli/Sandu, Basse, Janjanbureh, Mansa Konko, Kaur, Kuntaur and Kuntair.


It is not even enough to build one hospital per region due to area population square miles. Despite the five (5) hospitals built, there is scarcity of medical drugs, lack of specialist medical staff, diagnose-surgery equipment facilities and logistic mobilization. In this de facto situational background, the challenges ahead will require, to upgrade the existing to referral hospital status, improve minor to major health centers and to re-examine the control of disease outbreak, drug life span, sources and usage of imported drugs, regular inspection on inbound and outbound consumable goods in their distribution and display.


Most importantly, to formulate a policy suitable for affordability, accessibility and availability for a sustainable health care delivery system. It will be useful idea to introduce conventional electronic network system bearing rural and urban health statistics data banking, call centers, health insurance ID certificate for Gambians and a emergency air and mobile ambulance service.


The medical certificate number is to authenticate medical history of a patient seeking treatment in any part of the country.


Bearing in mind that the Gambia is endowed with pedigree of herbal treatment, a solution can be found to cut cost of importing medical drugs. Our research scientists can produce a formula to blend the chemistry for production and even export in demand pending the manufacturing machinery and practice is being certified by WHO.


According to records, there is low infant mortality rate in the urban areas but high in the rural areas. This is mainly due to low nutritional diets and insecure maternal delivery which seems to have no sign of unending ox drawn carts and wheel barrows as a means of transportation. In space of time, consideration should be given to procurement of advanced medical equipment to epitomize treatment for cancer, neurology and thyroid, eczema, epilepsy, cancer, optical, Alzheimer’s disease, dentistry, and oncology.


There are only two infirmaries located at Bond road and Salaji layout in the whole country. The Social Welfare department of health ministry bears the onus of building more in every region so that marginalization in country development programs will be history of the past. Similarly, there should be a follow up realization of President’s vision to establish correction centers for inmates released from convicted sentences.


Author was Ex-CEO of Brikama Area Council with higher Diploma in Architecture and Master in Project management, specializing in construction engineering and infrastructure management and country planning.