The Gambia is a small country, 30 miles wide and 295 miles in length, situated on the West African coast. It stretches inland on both sides of the River Gambia and is totally surrounded by the country of Senegal. Within the borders of The Gambia live over 1,100,000 people and they rely on three government run hospitals to dispense their essential life saving health care.

Successive Gambian Governments have striven relentlessly to offer the health service as much resources as the meager and hard pressed economy will allow. Unfortunately the economy just does not generate enough money to satisfy the enormous demands that these high use hospital facilities require. The consequence of this shortfall in finances is a health service that is constantly functioning close to and at times well below crisis point.

The three main hospitals are:

The Royal Victoria Hospital situated in the capital Banjul.

A recently opened facility in Farafenni situated half way between Banjul and Bansang on the north bank of the River Gambia.

The Bansang Hospital situated in the remote town of Bansang.

There are additional primary health care clinics dotted around The Gambia, however these only provide basic health care facilities and are designed to deal with simple day to day health issues only.

Bansang Hospital stands deep in the African bush, 200 miles east by road from the coast and is responsible for the health care needs of some 600,000 Gambians. Additional strains are placed on its extremely limited resources with the constant arrival of patients from, Senegal, Mali, Guinea Bissau, Guinea Conakry and refugees from Sierra Leone.

The health care for this vast community is dispensed from within the walls of this small 160 bed facility that was originally designed and built by the British back in 1938 when the Gambia was part of the British Empire.

Dispensing health care in the Third World is so different to that of affluent western societies and The Gambia is no exception. Patients do not arrive with minor ailments, the majority are admitted with serious health conditions requiring urgent and at times very lengthy procedures to be performed.

Many of the ailments, viruses and infections are consistent with extremely hot and humid Equatorial zones. Malaria, diarrhoea, malnutrition, tuberculosis, anaemia, snakebite, dysentery, pneumonia, burns and severely broken limbs are just a few of the more common entries on the hospital patient's records.

Once admitted onto the ward the patient has to endure a further complication, cross-infection. The hospital does not have the necessary quarantine facilities to correctly treat the many infections that require patients to be isolated and so cross infection between patients becomes a major hazard on the wards.

Three children, with a variety of infectious conditions, will regularly share a bed and at the height of the rainy season this will increase to four when malaria admissions swell the numbers dramatically. Cross infections wreak havoc with original diagnosis and therefore ongoing treatment becomes very complex and lengthy.

Further critical factors that complicate the treatment and care of the patients are the extremes of weather that the region is subjected to. There are two distinct seasons in the Gambia namely the rainy season and the dry season.

The rainy season temperatures in Bansang, during June - October, hover constantly around 30 degrees celsius together with saturating levels of humidity caused by the torrential rainfall. These rains turn the landscape into a quagmire and frequently villages are cut off and even main road links to the hospital become hazardous and at times impassable.

The dry season in Bansang is a blisteringly hot period where temperatures frequently rise to as high as 50 degrees celsius. Temperatures on the wards become suffocatingly difficult to endure with many patients losing the will to live.

It is so very difficult to fully describe the extremely hostile climatic conditions that this wonderful Gambian nation endures on a daily basis. However I do hope that this page has given you some idea of just how tough the conditions can get and how desperately important the Bansang Hospital is to the 600,000 Gambians who rely on it to being able to deliver effective, life saving health care.

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