After months of organisation, the Trustees agreed that their Chairman should travel to Gambia in May 2014 to meet their Health Department staff and hospital surgeons in order to assess what assistance Medi Tech Trust may be able to offer.
They discussed a proposal to supply equipment and training. In return he asked for a person to be nominated who would have the responsibility of maintaining and storing the equipment, and for a prospective future Urology consultant to be identified so that we could train him or her for this future role.
While there, he performed several operations, eagerly observed by the local theatre staff, as it became apparent that prostate cancer and associated problems were rife.
Medi Tech Trust has decided to actively support a Project Gambia group by match funding some of their donations.
Gill Miller and Abdoulai Samateh, Project Gambia organisers, holding their first match funded cheque from Medi Tech Trust.
- The Trustees also agreed that Graham Watson should make a second visit at the end of August 2014. This visit was made with an accompanying Urology trainee, Dr Alexandra Zachou, and a work experience student, Phoebe Crane. His Report on this visit can be summarised as:
- Gambian health care is not free but the cost of a consultation plus a prescription, an operation and hospital stay are purely nominal. (40p, £1 and £2 respectively would cover a TURP).
- The main hospital in Gambia is the Edward Francis Small Teaching Hospital, which has an annual budget of around £500,000 that is spent on salaries and maintenance.
- There is a central pharmacy supply for the whole country (about 1.5 million people) and hospitals request their supply of scalpel blades, gloves, catheters and irrigation fluid (in addition to drugs) from this agency.
- It is usual to only receive a proportion of the budget and the disposable items applied for.
- They performed an open prostatectomy; a complex substitution urethroplasty using buccal mucosa; and two bilateral orchidectomies for prostate cancer.
- More operations could have been performed, but there were too few beds.
- It was apparent that cystoscopies are not currently performed.
- He was able to prepare a list of equipment needed.
In Urology the most common diseases are prostatic outflow obstruction and urethral stricture disease. There should be a dedicated Urology Theatre in which equipment used only by urologists should be stored. It is not feasible to be sharing a stack with the gynaecologists and to have urology equipment locked in their theatre.
Meeting with the Minister of Health
They had the honour of meeting with the Minister of State for Health on 24 August. He asked for a list of equipment and has given his word that the equipment will be purchased. The Minister suggested that there should be a Urology unit at the Serrekunda Hospital because there was more operating space and beds available.
Gambia has the advantage of being small and therefore a single Urology department could be designed so that Gambian Urology could catch up with its neighbour Senegal. As an outsider Graham Watson has been able to appreciate how far Gambia is behind its neighbour. However, the advantage of being a small nation is that a period of intensive training and investment could result in a very rapid period of modernisation. Gambia could just possibly end up with a department that is the jewel in the crown of West African healthcare.