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Strengthening Anaesthesia Care in The Gambia


Access to safe, affordable anaesthesia and surgery should be a universal right, but in countries like The Gambia, there is a significant shortage of health personnel, which leads to a major obstacle in the provision of surgical and anaesthesia services. With less than one physician per 20,000 inhabitants, The Gambia falls well below the WHO African Region average of nearly five physicians per 20,000 inhabitants. Most notably, 80% of practicing physicians within the country are not Gambian nationals.

Anaesthesia in The Gambia, is primarily delivered by nurses and clinical officers, it is therefore important to ensure appropriate training is delivered in country. Recognising the need to build the capacity of health care providers within the country, WFSA in partnership with THET, visited The Gambia to support activities in November 2019.

Over the two day visit a taster Essential Pain Management (EPM) course was delivered to 39 nurse providers and 4 residents. EPM is a cost-effective, multi-disciplinary programme brings together local health workers to improve pain knowledge. Participants learn how to implement a simple framework for managing pain and address pain management barriers. The course has been designed for any health worker who comes into contact with patients who are experiencing pain.

Dr Omar Cham, Secretary General of Anesthetists’ Society of The Gambia (ASOGAM) said, “The training really lived up to its name, ESSENTIAL, because it covers an area that is somewhat a blind spot for anaesthetists in The Gambia. The blind-spot is created partly due to socio-cultural influences.”

Touching upon the cultural context surrounding pain Omar further added, “In certain cultures in The Gambia, people are expected to bear their pain, sometimes health workers also expect patients to live through some degree of pain. With this course, we are armed with the slogan pain is what the patient says, so we should try to control their pain and alleviate their suffering as much as possible.”

In conjunction with the EPM course, the WFSA also supported ASOGAM to hold their first inaugural congress. The aim of the congress was to provide ASOGAM members with up to date information on relevant scientific issues including anaesthetic management of eclampsia/pre-eclampsia and general anaesthesia for neurosurgery, as well as to discuss ways to increase and upskill the current anaesthesia workforce in The Gambia.

Dr. George Njie, President of ASOGAM said, “The timing couldn’t have been more perfect, due to our patients rising concern about pain management in hospitals. This training gives our members the knowledge to tackle these concerns head on and to at least ease the pain of our patients.”

In low-and middle income countries the rate of death and disability occurring from treatable surgical conditions remains unreasonably high with the delivery of timely and effective medical care hindered by the lack of infrastructure and a shortage of human and physical resources. We hope for the opportunity to conduct further training sessions in The Gambia and work alongside ASOGAM to improve anaesthesia care to patients.

Further resources 

WFSA in the media