Health Sector Reality Versus President Barrow

President Adama Barrow speaking at a Rally © State House

By Dr. Ousman Gajigo

It is easy to differentiate a serious government from an incompetent one. One way of doing so is to see how they respond to valid criticisms. The response of President Barrow to concerns about the current deplorable state of healthcare in The Gambia leaves no doubt as to which kind of government he is leading. The reality is that everyone in the country knows that the average Gambian does not have access to affordable and quality healthcare.

In response to complaints about healthcare in The Gambia, President Barrow claimed that no country has free healthcare, and he proceeded to give various implausible examples of people leaving the US for treatment in The Gambia. To say his response is out of touch would be a major understatement.

Such a response is a dodge from a leader who does not want to face the failure created by his incompetent government across most sectors. No Gambian expects to get free services. What people expect from their government is access to essential services such as healthcare. Basic healthcare is not a luxury. Basic healthcare is a fundamental right.

What the average Gambian cries about is the unaffordability of healthcare. The absence of affordable healthcare in The Gambia is manifested in several ways. Health centers are still not easily accessible to a large number of Gambians, particularly those in rural areas. There are virtually no medications provided by public health centers. The cost of medicines in private pharmacies is simply beyond the financial means of the average Gambian. Certain kinds of treatment are simply unavailable in The Gambia—hence the need for expensive trips to Dakar.

The physical states of almost all health facilities in the country are unacceptable. It is a frequent occurrence to find patients lying on floors and in hallways simply because there are not enough hospital beds in health centers. How can any patient be expected to receive the minimum acceptable care when a hospital bed cannot be secured?

Even when hospital beds are available, the conditions inside the government-run health facilities are rarely conducive for quality healthcare provision. Basic facilities to accommodate caregivers of patients are lacking even in major hospitals. Essential equipment that healthcare workers need is frequently not available. Hospital beds, electric fans, privacy curtains, and many other facilities are in conditions that are not befitting a health center.

The government allocates millions a year to the purchasing of medication. Yet, from the moment these medications land in the Central Medical Store, the absence of a well-functioning system means that only a fraction reaches the average Gambian patient who visits the government-run health centers. What is happening to these medications that are being bought but are not reaching patients?

The average Gambian is frequently given prescriptions during visits to public facilities for tests and medications at private facilities. The cost of these medicines and services is simply too high given the anemic increase in incomes in the country over the years. Furthermore, there is a poor system in place for the procurement and regulation of drugs entering the country.

The above is a fraction of the problems in the sector. So, the problem in the healthcare sector is not due to Gambians unrealistically expecting free healthcare. The problem is that the Adama Barrow government has failed in providing basic healthcare that is affordable for the average Gambian.

If a fraction of the large amount of the budget that is annually allocated to the State House is given to the health sector, that would make a major difference. If the government had taken major reforms, particularly after the Covid-19 funds scandal, that would have made a major difference. But there has been no interest in doing the necessary reforms. Hence, the poor results. Given the lack of desire to frankly face reality, we cannot expect any change from this regime.

President Barrow receiving Covid 19 vaccination © State House