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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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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.

upps… We are sorry, but this blog post is not available in English yet.Mai2016_Jahaly-Dorf-2