Gambia’s health system near collapse amid pandemic

BANJUL, The Gambia

The Gambia has seen over a 70% rise in coronavirus cases last week, and its health sector is crumbling under the weight of the deadly virus.

The total number of confirmed cases in the country as of Aug. 7 stood at 1,235, with 23 deaths and 221 recoveries, according to the latest Health Ministry data released on Sunday. The Gambia’s reporting of cases is two days behind due to lack of capacity to deal with the surge.

The situation is “alarming” in the small West African country of around 2.4 million people, according to Modou Touray, communications director of the Gambia Red Cross Society, as the number of COVID-19 cases continues to rise.

In the past week, Touray said the Red Cross buried 42 people, 17 of which were confirmed COVID-19 deaths, and a large number of “high-probability cases.” The Red Cross helps families ensure the safe burial of those suspected of dying from coronavirus since some families could not wait for their tests to be completed.

On Sunday, The Gambia reported 145 new cases, the highest recorded in a single day.

A leading child and maternal care hospital in Bundung, Bundung Marternity and Child Health Hospital, shut down on Friday to be fumigated. The hospital’s chief executive officer Kebba Manneh told Anadolu Agency they are being forced to scale down operations due to the rising number of infections among their staff.

Around 40 of their staff and patients also tested positive Thursday.

“Most of the people infected are the trained staff and our doctors,” Manneh said.

The infection rate at the hospital increased significantly, according to the Health Ministry report. At least 40 reported in biggest one-day jump were health workers from mainly Bundung Maternity and Child Health Hospital.

“We will not close down, but we will definitely scale down operations … We do not have the manpower to deal with all the numbers that come to the hospital,” he said.

Country’s main hospital feels pinch

At the Bundung hospital, they are “prepared for the worst,” Manneh said. But they are not the only hospital affected.

The Gambia’s Director of Health Services Mustapha Bittaye confirmed to Anadolu Agency that infection among health care workers is increasing.

“About 20 of our members have been affected by the virus. A number of them have recovered and are still in self-isolation,” said Musa Marenah, president of the Gambia Association of Resident Doctors (GARD).

The GARD members account for over 90% of the doctors providing care at COVID-19 treatment centers across the country.

By Aug. 9, the number of infected doctors rose to 32, GARD said on its Facebook handle.

The situation at the country’s only teaching hospital in Banjul is not any better. Kebba Sanneh, spokesperson for Edward Francis Small Teaching Hospital (EFSTH), said they have seen a “steady increase” among their staff infected.

“We are seeing a steady increase in the number of our staff with coronavirus. That is a concern for us, and we believe it should be a national concern. It might limit our ability and capacity to handle the situation,” said Sanneh.

Marenah is also worried.

“If you remove 20 doctors -- and they are those who tested positive and not those in quarantine or self-isolation -- you will know that the health service provision is being affected. If you go to the EFSTH, a number of departments are crippled,” he said.

The Gambia has little more than 200 doctors.

‘Shortage of adequate protective gear’

According to Sanneh, the steady rise in positive cases at the Banjul hospital is not due to lack of personal protective gear. However, frontline workers disagree with him.

On July 21, the Gambia Association of Nurses and Midwives issued a statement saying its members are working without adequate protection.

“The rate at which our nurses are testing positive for COVID-19 at EFSTH is skyrocketing,” they said.

“The National Association of Gambia Nurses and Midwives wants nurses to be supplied with adequate and appropriate PPE,” it added, referring to personal protective equipment.

About two weeks ago, the GARD issued a press release highlighting the risks its members are exposed to as COVID-19 cases in the country rise.

“Resources are never adequate and our members do not have PPE,” said Marenah.

Since March, The Gambia has spent over $12 million on equipment to support the country’s health sector. The equipment, which includes ambulances and ventilators, was purchased from Turkey and flown to the country two weeks ago. The country has also allocated another $10 million to support treatment, quarantine, the purchase of vehicles, and allowances to frontline workers.

Barely three weeks ago, Finance Minister Mambury Njie, now infected with the virus, got approval from lawmakers to spend an additional $5 million on COVID-19-related activities. This is in addition to financial and material support that Turkey, China and the European Union provided for the country’s various institutions. The EU gave the country $ 18.3 million few months ago to support the country's budget.

In late March, a Chinese billionaire Jack Ma donated 10,000 medical masks, 1,000 N95 respiratory masks, 100 protective suits, 100 safety goggles, 79 infrared thermometers, and 15 sewing machines to The Gambia.

Turkey delivered 45 hand washing machines to Vice President Isatou Touray, who has also tested positive for COVID-19, through the Turkish Cooperation and Coordination Agency (TIKA). The Turkish aid agency also paid for the processing of 20,000 locally-made face masks for the population. It has previously donated food aid to almost 2,000 needy families in the country.

On Aug. 5, The Gambia again received a supply of protective equipment from the West African Health Organization. The consignment included 5,800 protective goggles, 21,000 test kits, 24,000 surgical masks, and 6,000 N95 face masks.

The country shut down its borders and airspace Thursday, introducing further stringent measures to curb the spread of the virus.

“For now, our strongest defense is prevention. Our health care system is not adequately equipped for this,” said Touray.