A walk through a Hospital in Rural Gambia
As part of Hand in Health and Books for Africa’s project to expand ICT in The Gambia, I had the chance to tour the Sulayman Junkung General Hospital (SJGH) located in Bwiam, The Gambia. A government hospital built in 2003, SJGH has undergone a radical transformation over the past decade, and is now an exemplary institution not just within Gambia, but for the entire West African region and beyond. Our project, being implemented in partnership with the Ministry of Education in Gambia, seeks to computerize the hospital’s services, introduce telemedicine capabilities and provide an internet-enabled learning center for the medical school housed in the hospital. As ambitious as it sounds for a rural hospital in West Africa, I was truly in awe of the amazing work that the hospital is doing, and the great strides it has already taken towards modernization. In short, the Sulayman Junkung General Hospital is probably one of the best hospitals in Africa, and can serve as a model for others to replicate. This photo-journal will attempt to run you through some of the facilities at this hospital, and identify potential areas of development as part of the HIH/BFA project.
The Sulayman Junkung General Hospital (SJGH) is one of just five tertiary care hospitals in the country of The Gambia. Located in the township of Bwiam, the hospitals provides medical services to over 20,000 patients every year, and serves over 100,000 people in the surrounding areas. Within the span of just 11 years, the hospital has expanded from two rooms, to the premier healthcare institution in the country. Today, 60% of its electricity is generated by solar panels, there is sufficient clean water throughout the year, WiFi in all the facilities, the only medical library in the country, and a medical school. Let’s take a walk through the hospital… The first thing that you notice when you step in, is the cleanliness of the hospital, and staff presence, guiding patients through the entire process. This is a government-owned and run hospital, and patients are charged a very nominal fee for services. The cost of care at this hospital is so low that it also attracts patients from other regions of The Gambia and also the neighboring country of Senegal.
If the patient is there to collect medication, he/she is referred to the dispensary. The major diseases treated at SJGH are Malaria, TB, HIV/AIDS, Pneumonia, Hypertension, Congestive Heart Failure. Maternal health is also a large part of the care delivered at SJGH. The most common ailments are basic viral illnesses that are treated in the outpatient department.
If however the patient needs a medical consultation, or is being seen for the first time, he/she is ushered into the chambers of a general doctor. The vast majority of the doctors at this hospital hail from The Gambia. There is a medical school established within SJGH and there’s one in Banjul, the country’s capital city too. However, these institutions struggle to graduate high quality specialists due to a lack of teaching staff and resources. There is a cohort of Cuban doctors at the hospital, who have been training the local staff for over three years.
This hospital has pioneered the use of technology in many of its provided services. It now boasts Gambia’s only fully computerized record keeping system. Every patient has a record in their database, which records their biographical information, medical history, as well as recent records of diagnosis and treatment. This database is then used to generate detailed statistics that are then presented to the Ministry of Health and Medical Research Council, the local medical research institute. The Gambia lacks a national medical record system, so the records of each patient stay within a particular hospital or clinic. Part of this issue lies with the lack of unique identifiers, like the social security number in the United States. Gambians are required by law to get a state ID, however these expire every five years, and a new one is issued carrying a different ID number. Hand in Health hopes to work with the hospitals in Bwiam and Farafenni in order to introduce a unified record keeping system.
This hospital offers a range of specialized medical services, including pediatrics, orthopedics, dentistry, surgery, physiotherapy and optometry.
This hospital also focuses on preventative care and has several outreach programs in the surrounding communities. They organize frequent treks to rural communities in the region where they provide vaccinations, pertinent health education and medical consultations. Each week, doctors and nurses from SJBH hold free informational sessions at the hospital for people in these communities.
Aside from medical services, this hospital also houses a medical school. The experienced doctors and nurses of the hospital along with several Cuban doctors have been spearheading the training of the next generation of caregivers at this facility. The hospital also plans to train village doctors and traditional healthcare providers in the future. In 2012, Hand in Health established the first medical library in The Gambia at this hospital. Medical books covering a wide array of topics are accessible to the medical students at SJBH and elsewhere in the country. Now the hospital hopes to partner with Hand in Health to implement a e-library and use technology for doctor/nurse training. The hospital staff has already reached out to medical schools in the US to facilitate such virtual training for practitioners at SJBH.
The CEO of the hospital, Mr. Kebba Badgie, recognizes that there will probably be a dearth of quality specialists in The Gambia for years to come. The hospital, and the government, simply don’t have enough funds in order to pay medical experts. Currently the hospital receives volunteer doctors from a number of countries, however this is not a sustainable approach. Until The Gambia develops the capacity for medical specialists, Mr. Badgie plans to offer telemedicine services to his patients. This will require infrastructure such as high speed internet connectivity, computers, cameras, conferencing and medical imaging equipment, etc. which Hand in Health hopes to implement over the coming years.
Perhaps the most amazing thing about the hospital is how it gets its electricity. An array of 90 solar panels of 60 Watts each, generate enough electricity for 60% of the hospitals needs, including all critical operations. These panels are controlled by six hydraulic solar trackers that change the alignment of the panels depending on the location of the sun. The panels first charge a bank of batteries through inveters and charge controllers, and depending on the need, provides power to the hospital. In a country with very frequent power outages (up to six hours a day), this system makes the hospital self-sufficient. This technology was implemented by the organization, Power Up Gambia. In the future, Mr. Badgie has plans to expand this system and sell the generated electricity to the government as a source of revenue for the hospital. Moreover, the entire SJGH campus is connected by WiFi, allowing access to the staff and the students.
The success of the Sulayman Junkung General Hospital is due to the hard work of many individuals, organizations such as Hand in Health and Power Up Gambia, and the Gambian government. However, the real hero behind this story, is Mr. Kebba Badgie, CEO of the Hospital. When he assumed this role back in 2003, he had two rooms for a hospital, no water or electricity, not even a desk for himself. The culmination of his hard work and dedication can be seen in the success of the hospital. I had a chance to meet with him several times during my stay in The Gambia in the summer of 2014. Mr. Badgie, a long supporter of Hand in Health, is a very inspirational man, with a passion for human development.
We want to make health a universal suffrage. It is a basic human right.
Mr. Kebba Badgie