Ebola, And Gambia’s Alarming Death Rate: A Recipe For Disaster

The frequency with which adult Gambians die from preventable diseases, such as 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. 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 visit 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. And, something must be done at the levels of government, and personal responsibility, to reverse the numbers.

Granted, Gambia is a resource-poor country, yet, this is no reason for the alarmingly high rate of preventable deaths. Factor into this deaths from cancer, and renal failure, for instance, and the death-rate would be simply outrageous. To these number 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 death rates from preventable diseases would have declined. And, most Gambians would have a 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.

These celebrations are all the more worrisome when you consider that 90 percent of Gambians are food insecure, and famine an ever present threat. 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- in the end it becomes a vicious cycle.

Ironically, Jammeh, and his family do not use Gambia’s healthcare services- for obvious reasons. Instead, they travel to the U.S., or Europe for 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 are today mired in darkness, emaciated by hunger, and poor health, and visible shadows of death- literally sick, and dead people walking the streets.

If Gambians die routinely from preventable diseases, how could Gambia’s poor medical infrastructure adequately respond, and possibly contain an Ebola outbreak?

I do not believe for a moment the APRC-government is ready for such an eventuality? Are there equipped isolation wards in hospitals ready to receive, and treat the first cases of Ebola? Are there adequate medical, and other supplies to protect medical personnel? Is the population schooled on safety measures to stem the spread of this deadly virus?

Consider also for a moment valued communal cultural practices of eating, drinking water, and attaya 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 Serrekunda, crowded ferries, and busses are all potential sites for transmission of the 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, provides just the right mix of forces for a national disaster of epic proportions.

Adequate preparation 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. This is misleading, and dangerous, and potentially breeds 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 be faced with a national health crisis that the country’s own healthcare apparatus cannot handle. With thousands already dead, and the death toll mounting in Guinea, Liberia, and Sierra Leone, and Mali identifying its first case- Gambia’s health, and political authorities must work doubly hard to avert a health 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 rather 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 national disaster. Thinking about these issues keep me awake many a night.

Abdoulaye Saine

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