Archive for the ‘Politics’ Category

GAMBIA MEDICAL TOURISM: A BLESSING IN DISGUISE

September 17, 2017

Ousainou Darboe, President Barrow and Chinese diplomat. Photo credit: Mantankara Konko

Gambian President Adama Barrow announced earlier this week that his government has entered into an agreement with Israeli company International Medical Services to build a €220 Million state of the art hospital in The Gambia. At this stage little is known about the agreement, however, it appears as though this is the type of investment that the country needs. Currently, many Gambians travel abroad for health services. According to IMS President Ovadia Yardena, her group is committed to promoting health tourism in The Gambia and will build a modern 350-bed hospital. Ms. Yardena has a good relationship with the Government of Equatorial Guinea.

On the IMS official website, it highlights their “long-standing activity” with the people of Equatorial Guinea. This led to the appointment of Ms. Yardena as an Honorary Consul of Equatorial Guinea for Israel. Equatorial Guinea is currently the country of refuge for former Dictator Yahya Jammeh and their President is one of the longest-serving Dictators in West Africa having taken power since 1979. This may be irrelevant to the subject matter but the involvement of an Israeli medical company IMS in The Gambia requires significant attention, especially from Gambian health professionals.

Medical tourism is when foreign nationals travel to other countries for cheaper, quality health services. These services range from cosmetic surgeries, low-cost dental services, and organ transplantation. These services are primarily provided by the private sector and payments are mostly out of pocket. Private healthcare providers have little incentive to consider population-wide based services, however, the general public must be served through public health interventions focused on the health needs of the entire population or population groups. Individual healthcare, population health, and public policy decisions must, therefore, be premised on best available evidence to avoid poor and inappropriate interventions. This article aims to highlight the pros and cons of health tourism and the involvement of Israel in this booming industry.

Pros of Medical Tourism
There are significant benefits in favor of medical tourism in The Gambia. Patients traveling to Gambia for treatment helps to clear backlogs in sending countries and eases pressure on the demand for health services in sending countries. New health services will now be available to Gambians that can afford it. Previously such services would have to be accessed abroad.

For receiving countries, it will create a new stream of revenue via private-public partnerships and helps to stimulate trickle-down economics by increasing the inward flow of foreign currency. The delivery of construction services for the €220 Million hospital will have a positive impact on the local economy especially if Gambian businesses can feature prominently in construction projects. Revenue generated can be used to improve public health services for the greater population.

Another advantage of health tourism is the importation of new medical technology. The presence of a state of the art hospital can help to provide best practice benchmarking for local health services. A state of the art medical facility will also attract the latest medical technology to The Gambia which could benefit the University and public health delivery.

A thriving health tourism industry will require experts to manage and run daily operations of the hospital. Although this is a private venture Gambian medical experts working abroad could be lured back home, thereby reversing the brain drain of the country’s medical professionals.

Cons of Medical Tourism
In receiving countries, medical tourism contributes to the creation of dual health delivery system, one for rich foreigners and one for poor locals. It leads also to draining of public sector funds and implementation of policies biased to commercial medicine. There are many risks around health tourism such as no congruent treatment and continuity and patient follow-ups. It opens up the possibility of illicit medical practices like illegal organ trade. There are many advantages and disadvantages but the most serious concern is that medical tourism encourages illicit organ trade in poor countries.

According to the WHO’s Veronica Riemer, “while most countries in the developed world have a legal system of oversight for organ transplantation, the fact remains that demand far outstrips supply. As a result, a black market has arisen in many poorer countries enabling those who can afford to buy organs to exploit those who are desperate enough to sell them. Sometimes, people travel to other countries specifically to buy organs they can’t find at home.”

The Royal Society of Medicine highlights the “many risks accompany the inclusion of organ transplant packages among the medical procedures sold to international patients. These dangers are magnified in countries where kidneys are purchased in underground economies or black markets. In these settings, promoting organ transplant packages to international patients’ risks escalating the number of kidneys purchased from poor citizens. Growing demand for transplants prompts organ brokers to increase the number of kidneys bought from impoverished individuals and sold to international patients.”
According to the Royal Society of Medicine study, in the Philippines, poor organ donors sell their kidneys for as little as $2,000. Proponents of commercial organ transplantation argue that poor individuals should be allowed to profit from selling a kidney. However, several studies indicate that the money poor individuals expect to obtain from selling a kidney goes to debt collectors.

Israeli Connection
In 2014 the New York Times published a report headlined “Transplant Brokers in Israel Lure Desperate Kidney Patients to Costa Rica”. The demand for organ transplants is on the rise and this demand will follow hospitals that offer cheap organ transplantation. Many organ transplant experts and journalists highlight that Israel contributes significantly towards the highest receivers of organ transplants. They also have a thriving organ brokerage business with networks across the globe.
According to “a Times analysis of major trafficking cases since 2000 suggests that Israelis have played a disproportionate role. That is in part because of religious strictures regarding death and desecration that have kept deceased donation rates so low that some patients feel they must turn elsewhere. “When someone needs an organ transplant, they’ll do everything in their power,” said Meir Broder, a top legal adviser to Israel’s Ministry of Health.”

In South Africa, the Guardian reports that “Netcare, which also runs hospitals in Britain, took part in an international scam that allegedly saw poor Brazilians and Romanians paid $6,000 (£3,840) for their kidneys to be transplanted to wealthy Israelis.” It’s reported that kidneys “were initially sourced from Israeli citizens, but later Romanian and Brazilian citizens were recruited as their kidneys were obtainable at much lower cost than those of the Israeli suppliers.” This took place in “South Africa’s biggest private hospital group” which admitted to “receiving R3.8m (£342,000) from an illegal organ trafficking scam that included the removal of kidneys from five children.”

Conclusion
Although there is no reason to assume that IMS has or will conduct organ transplantation in The Gambia, significant evidence indicates a heavy Israeli presence in the illegal organ trade. The Gambia has a youthful population and an unemployment problem. This makes them an easy target for organ hunters who usually target young healthy people. It’s not uncommon to read of migrants exploited for their organs. According to the Journal of the Royal Society of Medicine, “selling purchased organs to medical tourists, organ transplant facilities and transplant procedures should be excluded from medical tourism initiatives. Including organ transplants among the procedures marketed to international patients risks undermining health equity and reducing the number of citizens who have access to organ transplantation.” Countries like Israel that conduct organ transplant have strict rules incorporated in their Organ Transplant Act. This helps to regularise the activities of organ transplant and deters illegal black market activities.

Could it be that the Government, Health and Tourism Ministry, in particular, are not aware of the pros and cons of health tourism? A thorough review of the impact could help the executive make an informed decision for The Gambian people. Health tourism should not be promoted to the disadvantage of public health services. It is possible to strike a balance, however, the dangers of exploitation and the health impact it can have on poor people who donate their organs due to financial constraints can be significant and poses a moral and ethical problem.

Most countries that practice organ transplantation only permit altruistic organ donations and ban commercial donations. This often leads to a black market prompting experts to recommend legislating and regulating commercial organ donations to eliminate the black market. What is certain is that the Gambia will need the right legislation and vigilant monitoring if organ transplantation will be permitted. For The Gambia to make this public-private venture a success, commercial organ transplantation should be excluded from health tourism packages. The government will also need to designate revenue generated from this venture toward improving the delivery of public health services.

Even with rigorous monitoring and the right legislation, there are concerns raised by the Guardian that Israeli pathologists harvested organs without consent. This does not give confidence that Israeli Investors will play by the rules. After all, a €220 Million investment will be expected to generate significant profit.

By Yusef  Taylor, @FlexDan-YT

COMMONWEALTH ASSESSMENT TEAM MEETS PRESIDENT BARROW

September 8, 2017

REPUBLIC OF THE GAMBIA
PRIVATE Office of The President
State House
Banjul
THE GAMBIA _____________________________________________________________________________

PR/C/220/(ABS)

Media Advisory

Commonwealth assessment team meets President Barrow

Fajara, 8 September 2017 – President Adama Barrow today received a team of officials from the Commonwealth Secretariat in London. The officials had been in The Gambia for a week-long assessment mission, which could soon lead to the country’s full return to the Commonwealth.

President Barrow expressed his pleasure at receiving the Commonwealth assessment team, and thanked them for their mission. He said it was easy for The Gambia to re-apply for membership of The Commonwealth because of the deep-seated feeling by Gambians that they had never really left the Commonwealth family. He described the unilateral decision to withdraw the country from the organisation in 2013 as unfortunate and uncalled for, stressing that The Gambia never wanted to leave. He said: “Nobody wants to be isolated. We want to be part of all international bodies. This was one man’s decision, and not something that was put to all Gambians. If it had been a referendum, the decision would never have been taken.”

The President stressed that The Gambia wished to be fast-tracked to full membership of the Commonwealth once again. He said it was inconceivable for Gambians to remain outside the Commonwealth when other nations wanted to join. The people of The Gambia, he emphasized, had taken a decision in December 2016 about the direction of their future as a new democracy and a new Gambia.

“We are careful and are calculating our steps so that we do not make mistakes,” President Barrow explained. “We believe in the principle of democracy and are positive about our future. Gambians are looking forward to our return to the Commonwealth. So the message is full membership as soon as possible. We are confident that your fact-finding mission will have provided you with all the information that you need, and we hope that the report will be positive, because The Gambia is back.”

Head of Human Rights at the Commonwealth Secretariat, Karen McKenzie thanked President Barrow for the team’s warm welcome in The Gambia, and for the government’s logistical support for a week of very productive meetings with stakeholders.

Ms McKenzie said The Gambia’s membership in the Commonwealth over the years had been beneficial, and provided technical assistance to the country. She explained that the Commonwealth Secretariat would now make an assessment of how well The Gambia met membership prerequisites, and this would form part of the Commonwealth Secretary General’s consultation with member states.

The formal process, thereafter, will entail the Government of The Gambia being invited to submit a formal request to rejoin the Commonwealth. That formal expression of interest would then be considered by the members.

Other members of the Commonwealth Secretariat team with Ms McKenzie were: Dr Roger Koranteng, Head of Public Sector Governance; Ms Marie-Pierre Olivier, Legal Policy Advisor, Rule of Law; and Ms Lindiwe Maleleka, Political Officer, Africa in the Secretariat’s Political Division. The team was accompanied by Ms Saffie Sankareh, Permanent Secretary from the Ministry of Foreign Affairs, International Cooperation and Gambians Abroad.

End

Contact:

Amie Bojang-Sissoho
Director of Press & Public Relations
Office of the President, State House, Banjul
Email:absissoho@op.gov.gm
dpprop2017@gmail.com

GAMBIA: ON LOANS, DEBTS, PUBLIC ENTERPRISES & GOVERNANCE HALIFA SALLAH’S CONTRIBUTION AT THE ADJOURNMENT DEBATE

August 27, 2017

Halifa Sallah National Assembly Member for Serekunda Constituency

Honourable Speaker, we have finally gathered here to give solemn expression to the constitutional provision which asserts that sovereignty resides in the people. And, when governments derive their authority from the people, they must utilise it only, to promote their general welfare and prosperity.

We are here to promote the general welfare and the prosperity of The Gambian people and that’s the spirit we should direct every word and action in this National Assembly.

This is a transitional government, inherited an order with the mandate to build another order. A new Gambia that the President said the people want and deserved.
Conscience must guide us, truth must guide us, good faith must guide us and the national interest must guide us.

It is important to bear in mind that unless you understand the challenges of a country, you cannot actually provide the policies, the plans, the programs, the projects to address them.
Right here, we’ve been given an emergency development policy funding showing that we are in an emergency situation. And, what we were told is that public enterprises that should provide dividends to government non-taxable revenue like NAWEC owes nine billion. They are in crisis and we are told that part of the money been taken as loan would have to be utilise to try to change those institutions and make them viable.

And, I heard the Minister when questioned by one of the members, would you privatise or invite private investment into this public enterprise? He (Minister) said not now, because they are not viable. But we must take tax payers money to make them viable. And, then do what? Afterwards privatise them, so that the people will continue to pay the loans and others will benefit. Is that the direction?
If that’s the direction, then that is not the direction that I stand for and if they’ve failures, is not my failure. It’s the failure of those who have failed to learn from history. 1988/89 we know what happened here GPMB was collapsing, first 83 million, 30.7 million injected into GPMB, by 1992 prospectors to privatise it to 20 million dalasis CCDB because of the bad debt of 72 million put in 1987/89 126 million.

How did it end up? AMRC. When they check over it was 110 million bad debts, only 20 million could be recovered and Meridian Bank took the 20 million and the rest to AMRC.
Is that where we are moving? Because the Minister told me here right on my face that the ERP was successful, were GPMB could only purchase 2200 of groundnuts in 1991. And, some members here are saying a ‘successful agricultural programme, when in 1994 the cooperative union collapsed owing millions from Gambia Commercial Development Bank. And, they had to establish the Macaulay Commission, commission of enquiry and the coup d’état came.

Is that were we are heading to? So, it is important for us to know that this is not the time to romanticize; it is a time to be calculative. We need to find out how are we going to ensure that food sufficiency is guarantee, to remove the farmers from poverty.
What I hear people saying ‘well why don’t we get investors to take over the land? Where will people work when they’re removed from the land? Is that the development policy that will save our people from poverty?

What we are saying is that their family farms require fertiliser, seed, farming implements so that they produce and remove themselves from poverty. If that fails to happen, if you fail, that is not my failure, because that’s not my direction. My direction is to create a cooperative bank that will help those farmers, family farms to own their land, not to become like the Kafuta one, working for somebody else from the cattle to the giraffe.

I see those women who come to my street, coming from the Kombos every single day at 05:00 am in the morning and then go back by 02:00pm selling on the ground their vegetables with prizes, which cannot be bought. How do you save those women? By empowering them, by creating the market opportunity so that they will not have to come to that street and disrupt the traffic. They are not the problem; we have not been providing solutions for them such as a marketing strategy, where you go to their farms and buy their produces, process them or market them that are the challenges.

We do not have the solutions yet, I said here there’s no development blue-print. And, the majority leader copiously quoting from a national development plan the very president of the republic said it is yet to come to fruition, maybe this coming month before the end or two weeks after that. There is still need for a national development plan encompassing all the sectors, indicating the direction of the government so that ultimately, you have the strategic plans of the ministries, which becomes more concrete to the programmes and projects, which are time bound to be able to address the aspirations of the youths. That’s how a government works and it should be a consultative exercise, which ever consultant prepare all this, should call all of us, we validate it, have an input to. It should have started six months ago, but now that it had not this is the time to move on and to move on with sincerity and modesty.

ON GOVERNMENT PAYSCALE
Honourable Speaker, it is very clear, if we look at the grades, one less than 1000, two to four less than 2000, 5 to 6 less than 3000 a month, 7 to 9 less than 5000 a month, the highest grades are between 5000 and 8000 a month, that is the salary scale of the country and when the president spoke to us they talking about staff audit. And, from the staff audit, maybe they will have to increase salaries. The very people who will be pushed out are Gambians who need to survive. What are you going to do? Package them and throw them into the Ocean? Whose responsibility it is to provide for every Gambian? That’s not the way to think.

There’s no excess baggage. Anywhere, government`s responsibility is to provide for everyone. And, if the trend continues, the trends I see, then we are yet to talk about moving towards a New Gambia, which is inclusive, the New Gambia cannot isolate anyone, and the New Gambia must be inclusive.

It must provide for everyone and we have seen the industrial sector contributes just 13% to GDP and that is the basis of employment. What are we going to do with the GGC? What is its capacity? Who told us what is it producing? How much oil? If we imports over 600,000,000 million worth of oil, if GGC can produce that, we are putting 600,000,000 in to our national economy.

If we produce 200,000 tons of rice, we are putting into our economy 1.9 billion. So, we need to see all these sectors, where we importing and look at the distortion in terms of import-export. We have come to a point where in terms of import in 2014 the deposit was 11.7 billion, and 2015, 12 billion. How do we deal with the deposit? We must enhance production that is what a plan is all about. That’s what we need to think about, what we do to expand import substitution so that we provide for ourselves that is the task.

ICT, we are told that in all the five regions, there are seven centres that were meant to connect schools and connect communities to ICT programmes. Have we been told anything about that? Nothing. And, people claim that there’s a development plan. Where is it? not yet, that’s why we are saying it is not yet, because you need to plan for that.

In 201, there was an agreement between company’s and government so that in terms of the landing, there will be co-operation. We need to look at each sector, the Minister told us that as far as airplanes are concerned, 471 million will be earn from selling them.

Why can we not have a national courier? If we want to go to Senegal, sometimes how many days on road? We are told four airplanes what are we going to do with them? Sell them? At least that seems to be the intention, 471 million. Why can’t we, if they are viable transform them into national careers? If not sell, them and buy what can provide national courier servicer. So essentially, what I am saying Honourable Speaker is we must start to settle down and know that we have a long way ahead.

We are just scrolling, we need to stand and then walk for money and yes many things I could have said but essentially, I don’t have the time, but I want everyone to reflect on what is happening in Venezuela right now, what has happened in Libya, what is happening in South Sudan.

It is not military might that create security in a country, is not what create peace in a country and many of you are praising rightly the President of Senegal, but let me tell you that it was a team work headed by the President of Liberia, President sir-leaf.

Without her, we will not have the peace we have today. Let me tell you that ECOMIG forces can threaten, but if ECOMIG forces brought down their weapons and aeroplanes storming the State House and Kanilai, do you know how many weapons were deposited in those places? Your army would have disintegrated, your security forces would have disintegrated, the whole society disintegrated. Who will control what, so let us all move to One Gambia, One Nation, One People that is our destiny, that’s our liberation.

Source (Kexx Sanneh)

PRESIDENT BARROW SWEARS IN NEW JUDICIAL SERVICE COMMISSIONERS

August 20, 2017

PRESIDENT BARROW

REPUBLIC OF THE GAMBIA
PRIVATE Office of The President
State House
Banjul
THE GAMBIA _____________________________________________________________________________

17th August , 2017

PR/C/213/(ABS)

President Barrow swears in two new Judicial Service commissioners

Fajara 17 August 2017- President Adama Barrow has sworn in two new members of The Gambia’s Judicial Service Commission. Former National Assembly member Lamin Ceesay of Jarumeh Koto and veteran agronomist Bolong L.K. Jatta of Busumbala both took the oath at a swearing-in ceremony in the Office of the President today.

Constituting the membership of the commission and getting it fully operational is part of the institutional reforms underway to improve efficiency in the Gambian Judiciary.

Messrs Jatta and Ceesay told journalists after the ceremony that they would work diligently along with other members to contribute to sound reform of the Gambian Judiciary. They expressed their appreciation for the trust bestowed on them, and optimism that the appointment of qualified Gambian judges would restore confidence in the country’s judicial system.

Chief Justice Hassan Abubacarr Jallow said the new members of the Judicial Service Commission brought a wealth of community experience to the work of the body, and strengthened it immensely. He expressed confidence in their ability to discharge their responsibilities with professionalism and integrity.

The Judiciary Service Commission is responsible for recommending appointments of judges and magistrates. It also advises the President and the government on measures to improve efficiency.

The appointments were based on section 145(1)(e) and section 145(1)(f) of The Gambia’s 1997 Constitution.

The Secretary General and head of the Gambian Civil Service, Mr Dawda Fadera, and senior officials from the Judiciary and the Office of the President witnessed the ceremony.

End

Contact:

Amie Bojang-Sissoho
Director of Press & Public Relations
Office of the President, State House, Banjul
Email:absissoho@op.gov.gm
dpprop2017@gmail.com
Tel: +220 9957592
Twitter: @BarrowPresident
Twitter:@AmieBSissoho
Facebook: Barrow PORG
Website: statehouse.gov.gm

HELLO MR PRESIDENT : OUR NATIONAL DOCUMENTS

August 8, 2017

Author: Tha Scribbler Bah

It’s been months since your government through the minister for the Interior, Mr Mai Ahmad Fatty, announced the discontinuation of the issuance of the national documents, ID Cards and Passports. This has had some serious consequences on many folks in this country. For instance, one goes to a bank and is unable to withdraw any money because the ID card is expired. Or, one goes to a hospital and cannot enjoy the privilege of being a Gambian so one has to pay the fee foreigners are supposed to pay. There are many others to this effect.

Mr President, the public does not really know the reason[s] behind the discontinuation of the issuance of the national documents. The saying that many non Gambians were given these documents, or that some people have the ability to produce fake ID cards is not reason enough to stop issuing them to genuine Gambians. Why can’t the government find a way to produce ID cards which cannot be forged? Why can’t there be a mark which will differentiate between the fake and genuine one? There has to be way of doing it which doesn’t include denying genuine Gambians their right to obtain the national documents.

It is also said that the previous government signed an agreement with a foreign company for the issuing of biometric ID cards and biometric passports. It is said that in this contract, the government of the Gambia gains only D500 out of the D3000+ that passport applicants pay. I do not know whether this is true or not, but if it is, then it is ridiculous and that the government should terminate it forthwith. Certainly, there are Gambians who have the expertise to produce such documents. There is no reason why we should allow a foreign company to take away our hard earned money when our people can do it and the money remain in our country.

While we are talking about the national identity card, I want to suggest that we combine the ID card, the voter’s card and social security number in one. Let us find a way of making all these into one card. This has a lot of benefits for the country and will solve many problems for us.

Besides, the issue if the ID card expiring after five years should be revisited. Why don’t we have an ID which does not expire, or, at least let it last for a period if ten years. This will reduce the burden on ordinary citizens to be running around looking for ID cards every now and then.

The national documents are too important to be discontinued for this long. Find a way of surmounting this problem as soon as possible.

Tha Scribbler Bah

A Concerned Citizen

THE DOYEN IN GAMBIAN POLITICS HALIFA SALLAH IN OSLO

August 2, 2017

Halifa Sallah at Oslo Airport

The doyen in Gambian politics Halifa Sallah has landed safely at Oslo’s main international airport Gardermoen late yesternight and was warmly welcomed. Mr. Sallah who is the national assembly member for Serekunda constituency and adviser to president Barrow is on an Europe tour to meet Gambians and well-wishers in the diaspora. In Norway he is expected to meet with politicians, technocrats and experts in various fields. His engagement begins today wednesday August 2nd , a day in which he is scheduled to visit a waste management or recycling plant in Oslo  this morning. The Gambia has a huge waste or rubbish disposal problem which has resulted to serious environmental hazards affecting residents close to the main dumpsite at Bakoteh. The lack of proper measures geared towards finding a lasting  solution to the problem created unease between the municipality, central government and residents. Therefore Halifa Sallah’s visit to the rubbish cycling plant in Oslo will avail him the opportunity to have first hand information which he can share with relevant authorities back home as a politician and law maker.

Tomorrow Thursday August 3rd, the veterant politician is scheduled to have a seminar with the diaspora youth  at 1500hr. He would joined two other panelists to have a qualitative dialogue on the theme “Engaging Culture and Identity”. This seminar will take place at the Nordic Black Theatre down town Oslo. Before the seminar on Thursday he would have a meeting with leaders of the Norwegian  Red party in the morning at 9:30, and Oslo City Council at 12:30.

On Friday morning August 4th Mr. Sallah is scheduled to visit the Norwegian parliament  to meet  with the  leader of foreign affairs and defense committee. On Friday evening at 18:00hrs he  will grace another seminar that is going to be also a qualitative dialogue with the Gambian diaspora community in Oslo on the theme ” National Reconciliation, Justice and Democratisation in the New Gambia” – The Gambia is experiencing a new era after 22 years of brutal dictatorship which has seriously weakened the country’s social fabric. This fragile fabric needs to be carefully strengthened in order avoid a civil catastrophy. Those who invited the national assembly member for Serekunda constituency are aware of the crucial role he played as spokesperson of the coalition that outed former president Jammeh, they are aware of the calmness and resolve he displayed during the tense political impasse prior January 19th 20017. This is why they felt it is very pertinent for Mr. Sallah to engage the whole Gambian community in Oslo of different background and different political affiliation in order to clear out assumptions and misconceptions surrounding the current affairs of our beloved country The Gambia. It is through such honest qualitative dialogue that runs across the board we can together help realize the agenda of one Gambia, one nation, one people.

From Oslo Honourable Sallah will travel to Stockholm on Saturday where he is expected to be engaged in a series of meetings with the Gambian community there as well. From Sweden he will travel to Denmark and then to Hamburg Germany which is expected to be the last stop of his Europe tour. Continue to visit this medium for updates on Halifa Sallah’s tour.

Written by Landing Nyassi , Oslo 02-08-2017

EXAMINING BARROW’S PLANS FOR GAMBIA’S HEALTH SECTOR

August 2, 2017

 

Author: Dr Muhammed Teks Tekanyi, USA

Dr Muhammed Teks Tekanyi, USA

 

“Alongside providing people with safe drinking water and sanitation, my government, through the Ministry of Health, is scaling up its efforts to improve our health delivery systems, especially for women and children.

As a first step, we have obtained additional assets to support primary health care provision in the country. This includes 800 pedal bicycles and 29 motorbikes for Village Health Workers and Community Health Nurses across the country’s seven health regions.

I am pleased to report that the World Bank has approved US$7 million in additional funding for the Maternal and Child Health as well as the Nutrition Result Project. My government has also submitted a proposal to the EU to enhance food security.  We would welcome their support to help us treat acute malnutrition and prevent all forms of under-nutrition.

With more than 95 percent coverage, we are also getting support from the Global Alliance for Vaccine Initiative (GAVI) to help us consolidate our strong track record on child immunizations. This project, estimated at US$4.6 million will help strengthen and enhance our immunization systems.” President Barrow, July 24, 2017.

A review of the president’s deliberation on health would conclude that it was entirely based on primary healthcare which fortunately has been the most active component of the Gambian health delivery systems since the first republic with both the secondary and tertiary remaining as strugglers.

How do we then as a nation improve the functions of the two other important components of the health system?

At a personal level and in consideration of the small size of our population, I will suggest an emulation of the National health Service (NHS) UK and in this, primary health care should be made free or next to free in order to make it readily available as a measure of preventing disease burden while maintaining it completely at Health Centre level.

Furthermore, all the regional hospitals including Bundung Maternal and child (formerly Jammeh Foundation) hospital be upgraded into proper general hospitals to provide affordable secondary care for each administrative region with Polyclinic serving as a secondary care service centre for Banjul.

And the Edward Francis Small Teaching Hospital and Serrekunda General Hospital can then be given full autonomy to be managed by their own independent administrations and as well upgraded as proper and well equipped tertiary hospitals for Medical & Surgical and Maternal & Child Care respectively.

However, the care at the tertiary level should be purely advanced specialist paid for services in order to meet their maintenance cost and most be made adequate and readily available by the respective hospitals.

This will help decongest both hospitals in terms of capacity needs and as well reduce the burden related to demand overriding supply which has always been the cause of deficit in services rendered at the tertiary level.

Moreover, to prevent the stagnation of the health personal (doctors and nurses) particularly doctors, the Medical and Dental council can restructure the internship program for graduates of the medical school into two phases; a one year 3 monthly rotation at the teaching hospitals and a year rotation at the regional hospitals.

This can come with three benefiting results;

1 – it will reduce the expenditure relating to increased staff capacity of the teaching hospitals thus creating funds for the improvement of other areas of the hospitals.

2 – it will improve performance by creating competition for those doctors/nurses that may want to return to the tertiary hospitals at the end of their regional hospital rotations.

3 – it will broaden and enrich the experience of those posted doctors and nurses.

How can we improve the human resource  capacity to maintain the functionality of these systems?

It is commendable to say that the country has trained many doctors, nurses, public health officers and other cadres. However, in health, training without specialisation is synonymous to building a multipurpose house without furniture.

Hence the need to graduate the government’s concentration from undergraduate to postgraduate training with diversification of specialty for both doctors and nurses while creating attractive incentives for those abroad to return and contribute in the strengthening of the existing systems.

And to avoid brain drain, flexible bonds with as well incentives should be attached to postgraduate training grants which can be gained through bilateral and multilateral cooperations with countries like Nigeria, Turkey, India, Senegal, China etc thus instead of building a $50M conference centre or a $48M forensic lab for example, these funds can be used to train 10 -15 specialists whom in 5years upon their return can save the government more than the amount spent on their training.

It is therefore paramount for the government to work on redirecting its foreign aid policy from monetary to human resource development which will thus prevent the drainage of funds into unknown wells and as well reduce corruption.

Dr Muhammed Teks Tekanyi, USA