The State of Public Health in The Gambia

Jawneh Mboge/Facebook

By Jawneh Mboge

What makes some people healthy and others unhealthy?

How can we create a society in which everyone has a chance to live a long, healthy life? The answer to these questions lies in the social, cultural, environmental and economic determinants of health. These factors determine health outcomes for people all over the world and Bakoteh is no exception to that.

The current public health situation in the Gambia is a cause of great concern for many people. Over the last few days, we saw public anger and frustration about the current situation. We also witnessed the exercise of constitutional and democratic rights of the people of Bakoteh about their right to a CLEAN and LIVABLE COMMUNITY. The people came out and engaged their government, public health and environmental officers on a very critical issue. Whether it is the issue of Bakoteh dumping or the environmental disaster in the fishing communities of Kombo, this is a clear manifestation of bad governance from the local municipality and the past central governments. In 2006, dumping was not allowed at the Bakoteh site. Why did they allow dumping to resume? The high cost of transportation? Political power? What about the health of the local people? Where lies the priority?

The theme, “health is wealth,” is the philosophy of the national health system in the Gambia. A healthy population is, therefore, a requirement for sustained economic development. However, we had a government where institutions, policies, and planning don’t matter. The president was expected to provide expertise on literally everything. Furthermore, the rapid population growth with high population density in Greater Banjul Area created so much pressure on an urban infrastructure that was already decaying or non-existence. Fear, poverty and other forms of deprivation including ignorance also contributed to the problem.

The Gambia like most developing countries does not have the capacity to address all her health needs at once due to severe budgetary constraints. However, we have the institutional framework that could support this in the long term. The Primary Health Care System represents an approach that could assist in resolving our health needs. The health service delivery will require a shift from the therapeutic or medical approach of “big hospitals” to a public health intervention with stronger partnership and coordination with the people, NGOs, the private sector and other bilateral and multilateral partners. The Gambia embraced this strategy since 1979, weakened by the ERP, but now it only exists on paper. We can still implement PHC with others forms of financing instead of relying solely on the central government.

In his interview, the Director of NEA reported that the people of Bakoteh and KMC administration are apparently on a different page on the issue. Therefore, the government will need the cooperation of her population in the implementation of National Environment Management Act (1994), the Food Act (2005), and the Public Health Act (1990). These legislations are important, but the population should know its provisions in other to support its implementation. Also, some of the colonial public health laws do not reflect current realities. Therefore, it is necessary to review and update these legislations and instruct the public health inspectors to enforce them. The era of selective enforcement is gone!

The current situation is also an issue of uncoordinated approach among different actors (NEA, KMC, and the people). I hope this will lead to a review by Public Health Council and Board of Health about the current public health situation in the Gambia.

In conclusion, I STAND WITH THE PEOPLE of BAKOTEH that dumping should stop in their community. How that should be carried out, I will leave that to the politicians and the technocrats. There have been multiple suggestions in turning this into an employment opportunity for the youths while promoting the greater good of environmental health. #better Kambia

Culled from Facebook


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