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It is a milestone in the history of Jahaly Health Centre: since February 15th, 2019, almost 28 years after the opening, the project compound has been connected to the public electricity grid. Even though the clinic has had its own solar power system since 1991 and for decades was the only place in the entire area with its own uninterruptible power supply, the connection to the public power grid is important as a reserve in case of technical problems with solar system or storage batteries. This was the case for several months at the end of 2018: the storage batteries had reached the end of their lifespan and had to be renewed. It took several months for the fault to be localized and for new batteries to be ordered, delivered and installed. Now, in case of technical problems with the solar system, it is easy to switch to the public electricity grid.

As early as the end of 2017, the overland power lines along the South Bank Road had arrived from the coastal region in Jahaly. During 2018, some families in Jahaly who could afford it were connected to the grid. It was not until the middle of January 2019 that we noticed that the electricity subdistribution of the village ended at a power pole directly opposite the Jahaly Health Centre. In an absolute record time of only two weeks, the power line was extended in cooperation with the Gambian electricity supplier Nawec over the highway to the project site and connected to the island network of the clinic and kindergarten. To do this, a large power pole had to be delivered by tractor-trailer to cross the highway and set up with a crane truck, the cables had to be laid and an electricity meter had to be installed. Without the many years of good contacts in The Gambia and without the active support of the  electric company “General Engeneering” run by Charles M’bye, who is the chairman of Project Aid The Gambia, it would never have been that easy. Nocturnal births in the light of flashlights or cell phone lights are now a thing of the past. We are very happy.

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On 24.01.2019 Project Aid The Gambia, Projekthilfe Gambia e.V. (Germany)  and Dr. Isatou Touray, Minister of Health *, signed a Memorandum of Understanding to improve health care in the rural Gambia.

1. Initial situation
The state health service in The Gambia is disastrous. The larger state run hospitals lack medicines and medical devices. The same applies to rural health centers spread across the country.

The rural health centers  are structurally and hygienically in a desolate condition. Very few have a supply of electricity and running water. Health centers connected to the electricity grid have a monthly budget for electricity (“cash power”) that is too small and often used up in the middle of the month. Nocturnal births take place in the light of flashlights or cell phones.

The lack of medicines means that patients need to buy their medicines for treatment in nearby private pharmacies at overpriced prices. These private pharmacies are operated by well-trained nurses who were formerly employed in the state health care system and are now lacking the state system.

Specialist doctors are missing throughout the country. For example, in Gambia there is only one diabetologist who can treat only a very small number of diabetics – and that only in the capital  area of Banjul and only with the help of an association in Germany.

Many rural nurses have left the civil service because the ministry can not provide them and their families with housing in or near the health centers.

Medical equipment donated from Germany and other European countries often does not last long, as there are no training ocapacities for technical personnel and / or lack of money for maintenance and repairs.

In 2011/2012, Project Aid The Gambia e.V., with funding from the German BMZ (Federal Ministry for Cooperation and Development), rebuilt the state run health centre in the village of Njaba Kunda as a model clinic and handed it over to the Gambian Ministry of Health.

In 2009/2010 Project Aid The Gambia e.V. carried out a structural survey of all 33 then existing rural health centers. Floor plan drawings and photos are available from that survey.

Through the project described below The Gambia could become a model region in Africa.

2. Project description

Buildings / Equipment

  • The health centers shall be renovated / renovated.
  • The hygienic conditions shall be improved: creation of a water supply, tiling of all premises etc.
  • In each chealth centre a small laboratory shall be set up
  • Housing for staff, not from the surrounding villages, should be created (new building)
  • Establishment of a central “Facility Management” team of local craftsmen who are responsible for maintenance / repairs of the buildings (planned: over a period of 10 years after initial   renovation or new construction

Energy and water supply

  • If possible, all rural health centers shall be equipped with an uninterruptible 24/7 (solar) power and water supply – by installing small PV systems including storage batteries.

Medical Equipment

  • Medical equipment (second-hand) for state hospitals shall be get hold of in Germany (donation or purchase) and be shipped to The Gambia
  • Training for technical personnel
  • Creating a facility for maintenance / repair of medical equipment locally in The Gambia

Drug supply

  • The existing system of free delivery of – non-existing medicines  – to patients shall be abolished. Patients shall in the future purchase prescribed drugs at the purchase price (wholesale prices) plus 10% surcharge. This has already been agreed in the present MOU.
  • From drug sales and patient treatment fees, new medicines can be purchased
  • The procurement of medicines incl. Logistics (delivery / storage) should be outsourced to local private wholesale pharmacies.
  • This would cut off the business basis of the small private pharmacies in the neighborhoods of the health centers. The owners  (nurses) would return to the state health service.

 

Health Centre App

Project Aid Thee Gambia is currently developing an App for smartphones, with which the operation of a health centers can be completed, including

  • Registration of patients
  • Revenue fees for medical treatment and laboratory services
  • Diagnosis / treatment inclunding medical guidelines for the treatment / medication of the most common diseases
  • Laboratory results
  • Issue / prescription of medication
  • Possibility of data transfer from  of symptoms / diseases to UN / WHO or other international organizations.

The app sends all data daily and automatically for evaluation to a central server (via Internet or SMS)

Information on the number of patients treated and diseases are available on the same day.
The accumulation of diseases in specific places / regions and possible incipient epidemics can be detected and combated at an early stage.
Information about the number of medicines issued is available on the same day and can be used for reordering / logistics.
In larger health stations, a small network (“intranet”) with server (PC, laptop) for data storage / forwarding must be set up. Prerequisite for this is an uninterruptible 24/7 power supply. This is guaranteed by the installed PV system(s) and storage batteries.

 

3. Status of the Project 

At the moment Project Aid The Gambia is awaiting information from the Gambian Ministry of Health about

  • Number / designation of the rural health centers to be renovated / renovated
  • structural condition of each health centre
  • Connection to the mains
  • staffing
  • Number of patients / year
  • Existing medical equipment in state hospitals
  • lack of medical equipment in state hospitals

Subsequently, the financing requirement can be determined, a cost calculation and a scheduling can be worked out. At present, partners are being sought for the implementation of the Memorandum of Understanding (MOU).

* Update: On March 15th, 2019, the Minister of Health, Dr. Isatou Touray, was appointed as the Vice President. On March 27th, 2019, Dr. Ahmadou Lamin Samateh was appointed as the new Minister of Health.

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20180516_Projekthilfe-Matthias-Ketteler-bei-Präsident-Adama-Barrow

It was a long journey for Project Aid The Gambia`s chairman Matthias Ketteler, Charles Mbye, the Local Chairman of Project Aid The Gambia and Christian Goeken of Riverboat Doctors International, to meet the Gambian President Adama Barrow. 370 kilometers from the coast to the very east of the country, where the president spent some days in his hometown Mansajang Kunda

President Barrow took 45 minutes on 16/05/2018, to discuss with the delegation of Project Aid the challenging situation of the rural centers in particular. After 22 years of dictatorship of the former ruler Yaya Jammeh, the state treasuries were looted, the president said. The smallest country in Africa relies on international aid.

Charles M’bye emphasized the many years of help provided by Project Aid The Gambia in various areas. President Barrow praised the work of Jahaly Health Centre, which has had an excellent reputation for over 27 years and is known in the Ministry of Health as THE role model for rural health services.

Matthias Ketteler explained some ideas for improving the supply of medicines and the provision of used medical devices. In the past ten months, various devices have already been made available through Project Aid The Gambia. However, for the collection of donations in kind, for maintenance measures and for training of Gambian technicians, tProject Aid needs appropriate agreements with the government, he said. Charles M’bye made it clear that such a cooperation would require a direct and competent government contact person to speed up communication and decision-making.

These proposals were approved by President Barrow. While still in the talk, he ordered a meeting over the phone for the next day with the Minister of Health, the Permanent Secretary, the Health Director  of The Gambia and the head of the largest Gambian Hospital (RVTH) with the representatives of Project Aid The Gambia

The following topics should be discussed:

– Provision of medicines in rural health stations

– Assistance in the maintenance / repair of health centers

– technical possibilities of collecting treatment statistics, drug use, early detection of epidemics

– Support of hospitals with medical equipment

– Training measures for the qualification of Gambian technicians regarding the maintenance and repair of medical devices

An employee of the President’s Office was designated as a direct contact person for Project Aid.

Towards the end of the very productive conversation, the work of the Health Centre Buniadu of Riverboat Doctors International was also addressed. The president was also well informed on this issue. He thanked the delegation for the help of the past years and for the reopening of the health centre.

 

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DSC_0447-klein Upps – we are sorry. This post is only available in German ;-(

Video: Ankunft Schulmöbel in Jahaly (2018)

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20170730_MK-Mass-Haddy-mit-Kinderakten-01The cooperation between Project Aid The Gambia (International NGO A57)  and the Friedensdorf International (Peace Village) in Oberhausen/Germany will be continued. The two organizations recently confirmed this after a discussion. In October the next mission of Peace Village in The Gambia will take place. Sick and injured children, who can not be helped medically in The Gambia, are presented to the members of the team of Peace Village. The team then decides on the spot, which children  can be treated overseas in Germany. At the moment the management team at our project office in Manjai Kunda saves the medical reports and documents of the children who are on the waiting list for overseas treatment by Peace Village. In order to improve the medical preparations for overseas treatments in Germany and to ensure professional preliminary examinations, Project Aid plans to expand the management team by a trained nurse and to work with the MRC (Medical Research Council) in The Gambia. After the return of the children to the Gambia, the nurse will also look for their aftertreatment.

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Mass-Suso-u-Matthias-Ketteler-4-Ausschnitt
Dear members, sponsors and friends of Project Aid The Gambia!

On 1 June 2017, our new project manager in Gambia, Mass Suso, started his work.

Mr. Mass Suso, aged 39, possesses widely ranged capabilities of management skills. He holds a Diploma in Management Studies and a Postgraduate Diploma in Public Administration. He attended professional training for Leadership and Project Management. In his last position he worked as the Human Resources Manager as a member of the senior management team of Radville Farms Ltd. in The Gambia.

The Board of Project id The Gambia is looking forward to working together. In the first months, Mass Suso is supported by Biba Mousa, who was a project manager in 2011/2012.

The background of changing the management can be summarized as follows:

After an astonishing joint resignation of the four-strong management team as well as the joint resignation of all the project employees of Jahaly Health Centre and Kindergarten in Jahaly all projects in the Gambia were steetering on the brink of collapse, after 25 years.

Jahaly Health Centre was closed for 17 days. The clinic staff did not resume their work until June 6, 2017.

The former management team submitted incomplete, late or not at all the necessary information from the projects needed for the decisions of the Management Board. Information from the Management Board to the employees in Jahaly were not disclosed.

The former management team replaced a letter from the clinic staff in which salary increases were demanded by its own completely different version, titled “Letter of Resignation” and sent it to the board in Germany.

After further investigations, the Management Board will decide whether the former management in the Gambia will be charged with criminal charges for falsification of documents.

The Kindergarten remains closed and will open again in September after the summer holidays. Project Aid The Gambia is currently under negotiation with the Gambian government, which is set to provide the teachers for the kindergarten from the new academic year. The Gambian Ministry of Education has already announced the willingness to do so. Project Aid The Gambia remains responsible for the buildings, for renovations and teaching materials.

This cooperation with the Gambian government is initially planned as a pilot project for a period of two years. In so far as the quality of education and care of children is maintained, the Board of Management of Project Aid The Gambia considers such a cooperation to be forward-looking in development cooperation: non-profit organizations such as Project Aid are responsible for building and maintenance and overseeing the organization and structure of the projects. The government provides the staff.

If this cooperation does not develop to the satisfaction of Project Aid The Gambia, the employees would return to the Project Aid after the pilot phase.

By saving the staff costs for the teachers of the kindergarden, funding is available to Project Aid, which the Manament Board would like to use in the long term to support further state Health Centers and schools.

The first such project where Project Aid The Gambia is going to take over the responsibility for buildings and technical installations (water / solar) and for the supply of drugs is the state run Njaba Kunda Health Centre.

In this context, the Board of Management of Project Aid The Gambia has decided on a strategic reorientation of the project work in The Gambia:

  1. As a model clinic, Jahaly Health Centre remains completely in the hands of Project Aid The Gambia
  2. The Moringa plantation is still operated by Project Aid The Gambia
  3. The kindergarten is run in a two-year pilot phase in cooperation with the Gambian government
  4. Njaba Kunda Health Centre as a joint pilot project of Project Aid The Gambia and the Gambian government leads to a new organization of rural health care in The Gambia

A detailed report is available on request. This report will be presented at the next regular annual meeting of Project Aid The Gambia in Germany.

 

Sincerely, Your Board of Management

Project Aid The Gambia / Projekthilfe Gambia e.V.

Matthias Ketteler, Frank Heuer, Dieter Lieken, Ulfert Engelkes, Thomas Wiegeman

Hattingen/Germany, June 12th, 2017

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mariama-dobasin-swWe mourn for Mariama Dobasin, who died yesterday evening (27.11.2016) completely unexpectedly at the age of 24 years in Jahaly. Mariama has been an untrained nurse in the Buschklinik since 24.10.2014. In our ambulance car she is transferred to Brikama, where she today is buried with her family. She leaves behind her husband.

Board Projekthilfe Gambia e.V.

Management Project Aid The Gambia with the entire staff

entire staff, Jahaly Health Centre

entire staff, Jahaly/Madina Kindergarten