Gambia Healthcare Advisory
Banjul photo courtesy of William Adams at billtrips.com
85% of children are vaccinated for measles
72% of deaths due to communicable diseases. To fight communicable diseases:
To fight non-communicable diseases:
Measures that will improve public health, in general:
Increased access to doctors
57% of Gambians aged 15+ are illiterate
Sources: World Health Organization and World Bank, 2000-2009
In the public health arena, The Gambia has many of strengths. Gambia only has a 0.7% human immunodeficiency virus (HIV) / acquired immune deficiency syndrome (AIDS) prevalence rate among its adult (15+) population compared to the much higher rate of 5% in the rest of sub-Saharan Africa. Gambia has taken laudable and effective actions to improve drinking water and sanitation facilities. As a result, 85% of the Gambian population enjoys safe water and sanitation facilities. Children under 5 are probably the most vulnerable population, but in Gambia, 85% of children are vaccinated for measles within their first year of life resulting in a childhood mortality rate of only 0.7% due to measles.
Despite these strengths, Gambia is still faced with several public health challenges. Unfortunately, communicable diseases like malaria, tuberculosis and HIV/AIDS account for 72% of deaths in Gambia, but fortunately, communicable diseases are relatively easy to curb with the right cultural and financial attention.
Malaria, one of Gambia’s biggest killers, is both preventable and treatable. To prevent malarial infection, Gambians can take anti-malarial medications, avoid mosquito bites by using repellents and nets, and visit a doctor immediately if symptoms of malaria occur. Most forms of malaria are curable with chloroquine, a medication that kills the malarial parasite in the blood.
Tuberculosis, pneumonia, and several other communicable diseases are spread by bodily fluids. The number one way to curtail infection in Gambia is to recognize and institutionalize a rigorous hand-washing campaign. Washing one’s hands with soap and water or with an alcohol-based waterless sanitizing gel is the number one way to prevent the spread of communicable diseases worldwide. The second way to avoid transmission of communicable disease is to avoid unnecessary contact with people who are sick or to stay home if you are the one that is sick.
HIV/AIDS is spread by exchange of blood or bodily fluids as a result of unprotected sex with an infected partner, sharing of needles with infected parties, or receipt of a blood transfusion from an infected donor. There are three ways to reduce HIV/AIDS in Gambia:
♦ EDUCATE the entire population about how HIV/AIDS is spread, why it is dangerous, and what they can do to prevent contracting it. Talking openly about sex must become an accepted social custom as well as encouraging abstinence, condom use, and monogamy/marital fidelity.
♦ USE CONDOMS - Condoms are relatively inexpensive and for less than one dollar and one minute of one's time, the transmission of one of the world’s deadliest diseases can be prevented. Condoms have multiple benefits: they prevent the spread of HIV/AIDS and they prevent unwanted pregnancies. Currently, only approximately 10% of the Gambian population use contraceptives. There is a huge margin for improvementin this area and it can be achieved at a relatively small cost.
♦ PROSECUTE rapists.
Gambia must also take steps in the face of the threat of non-communicable diseases – diseases that are not “caught” from another human being but are developed internally.
Hypertension, also known as high blood pressure, affects almost 10% of the Gambian population. Two powerful remedies for hypertension are both inexpensive and uncomplicated to implement. First, promote high protein, low-salt, and low-fat diets. Second, promote ample exercise, especially cardiovascular. Exercise can be as simple as going for a walk or a run. Exercise can also be incorporated into community life by offering things like group dance classes, for example.
Cardiovascular disease and diabetes can also be addressed with proper diets and exercise regimens.
Malnutrition affects 20% of the vulnerable 5 and under population. It is less expensive to purchase and prepare healthy food in mass quantities, such as in schools. With the promotion of schools, not only would children have increased access to an education, but to a healthy diet, as well.
In addition, there are several important measures that Gambia can take to improve public health overall.
Access to healthcare professionals – Only 1 out of every 10,000 people in Gambia are physicians, or medical doctors. While there are several things that Gambians can do on an individual-level to prevent disease, the lack of access to qualified medical professionals in the event of an illness is a huge problem, and probably one of the most expensive problems. Recruiting external and training internal medical professionals is going to be a very expensive, time-consuming venture, but it will be worth it.
Literacy rate – While this report is primarily about the public heath sector, not the education sector, in Gambia, it is important to recognize that Gambia only has an adult (15+) literacy rate of 43%. The need for an increased literacy rate is several-fold: Literacy rate is proportional to educational level. The more educated a population is, the more informed they will be about the public health issues that affect them everyday. People will be able to read educational materials, understand the biological causes of disease, and discuss these issues with fellow citizens. Achieving higher levels of education will encourage the pursuit of medical education, which will increase the number of available medical professionals thus increase the average citizen’s access to medical care.