In Gambia, Hospitals Cesspools for Disease, Infection, Premature Death

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By Professor Abdoulaye S. Saine, Miami University

The frequency with which adult Gambians die from preventable disease- malaria, diabetes, or hypertension, is simply alarming. Hardly a week goes by without another obituary- reports of sudden death or collapse of citizens from all walks-of-life. Gambia’s “Teaching Hospital,” as well as other “hospitals” strewn around the country, remain death-traps from which few patients escape alive.

What passes for hospitals are dilapidated, virtually empty structures without adequately trained medical personnel, equipment, and medications. Cuban “doctors,” rather than helping the situation, more often administer untimely death to their unsuspecting, and desperate patients. They are, for the most part, undertrained, do not speak local languages, and are pawns in a deadly political dance from the cold-war (I wrote an academic paper on this subject in 2004 after a research trip to Cuba, and Gambia).

While it is difficult to know how many Gambians die from these preventable diseases, (a major problem in itself because of poor record-keeping, if records are kept at all), anecdotal evidence strongly suggests that it is extremely high.

Granted, Gambia is a resource-poor country, yet, this is no reason for the alarming rate of preventable deaths. Factor into this, deaths from cancer, and renal failure, and the death-rate becomes simply outrageous. To these deaths must be added women who die routinely from complications arising from childbirth, and children who die from childhood diseases before the age of five years. Combined, the death-rate goes through the roof.

One would have expected that after twenty years of A (F) PRC rule that deaths from preventable diseases would have declined. And, that most Gambians would have a better chance combating, and possibly overcoming, more life-threatening ailments.

Regrettably, this does not appear to be the case. This is not because resources are necessarily lacking. They are available but are, instead, squandered on feel-good projects, expensive overseas trips, and celebrations, when, in fact, there is little to celebrate.

Celebrations of the, “July 22 Revolution” are all the more worrisome when you consider that 90 percent of Gambians are, food insecure, and at the brink of famine. Compromised immune systems due to poor nutrition, low caloric intake, and poor healthcare further expose Gambians to untimely death.

And, as Gambians die in such large numbers from preventable diseases, so does the country itself, because a generally unhealthy population is unlikely to produce at capacity to sustain the economy. This, in turn adversely affects the healthcare delivery system- it is a vicious cycle.

Ironically, Jammeh (the President), and his family, do not use Gambia’s healthcare services- for obvious reasons. Instead, they travel to the U.S., or Europe for annual checkups, and urgent medical care, while the average Gambian contends with sub-standard care.

This raises the obvious question: Is Gambia ready to handle an Ebola outbreak? This is not a futile question, because following twenty years of promises to provide countrywide electricity, adequate water, food, health, and sanitation, a vast number of Gambians go without these essential services. Many live in darkness without electricity, and water, turned into skeletons by hunger, and poor health. Literally, visible shadows of death walking the streets.

If Gambians die routinely from preventable diseases, can its poor medical infrastructure adequately respond, and possibly contain an Ebola outbreak?

Is the APRC-government ready for such an eventuality? Are there equipped isolation wards in hospitals ready to receive, quarantine, and treat the first cases of Ebola? Are there adequate medical, and other supplies to protect medical personnel? Is the population informed enough about safety measures to stem the spread of this deadly virus?

Consider also for a moment cherished communal cultural practices of eating, drinking water, and attaya (green tea) from the same vessels without proper washing, or praying in close proximity to one another, and hand-shaking- these are means of exposing, and transmitting bodily fluids of the infected. Crowded markets in Banjul, and Serekunda, crowded ferries, and busses are all potential sites to transmit this deadly virus.

At another level, Gambia’s porous borders coupled with growing cross-border trade, and immigration- both legal, and illicit in one of Africa’s most densely populated countries, provide just the right mix of forces to set ablaze a national Ebola crisis.

Adequately preparing for a potential Ebola outbreak is, therefore, a must, and a national security priority that Jammeh, and the nation must take seriously. Jammeh must also resist the temptation of politicizing Ebola, as he has done in the past with other deadly diseases. And, must likewise, stop making unverifiable claims for various cures. These are misleading, and dangerous, and potentially breed complacency- resulting in widespread infections, and death.

This may sound alarmist, I admit, but I believe, it is more prudent to prepare now, and err on the side of caution, than to face a national health crisis that the country’s healthcare system is ill-equipped to handle. With thousands already dead, and the death tolls mounting in Guinea, Liberia, and Sierra Leone, and Mali identifying its first reported case of Ebola- Gambia’s health, and political authorities must work doubly hard to avert an Ebola crisis in the country.

We must stop blaming God for Gambia’s rising premature death crisis, and deaths likely to result from an Ebola outbreak, and other calamities- this is blasphemy. Blame it instead on poor government preparation, and policy, or the lack of it.

Twenty years into Jammeh’s rule, many hospitals in Gambia are cesspools for disease, infection, and premature death. Add Ebola to the mix, and you have a national health disaster of epic proportions. Government, and personal responsibility are key to reversing Gambia’s high premature death numbers, and keep Ebola at bay.

Abdoulaye S. Saine, Professor and Former Chair

Miami University Distinguished Scholar

Department of Political Science

Harrison Hall # 224-225

Oxford, OH 45056

(513) 529-2000 (O)

(513) 529-2489 (Direct)

(513) 529-1709 (Fax)





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