The Gambia

Rafik HannaSt. Luke’s Roosevelt Hospital Center

Global Health DivisionMay 16, 2012

Goals of the Trip, March 2012

• To gain more exposure to tropical medicine, particularly TB.

• To help provide medical care at the Medical Research Council Unit (MRC).

• To provide some teaching and oversight in the emergency department at Royal Victoria Teaching Hospital.

• To consider fostering a longer term relationship with Royal Victoria Teaching Hospital (RVTH).

Where in the world is Gambia?

Map of Gambia

Gambia Data

• Population: 1.729 million

• Size: 4,008 sq. miles (smaller than Connecticut)

• Total GDP 2010: $807 million ($430 per capita)

• Ranked 160/179 in poverty (HDI)

• Literacy: 46.5% (Age 15 and above)

Health Statistics

• Life expectancy is 57.8 years.

• Infant Mortality (57/1000)

• Under-5 Mortality (98/1000)

• HIV prevalence (2% of those age 15-49)

• TB Prevalence is 460/100,000 (about 100 times that of the U.S.)

• Physicians per 1000 people (0.0 – 0.1)

HIV in Gambia

• 2% of the population age 15-49.

• Adds to the TB Burden.

• President first denied that there was HIV in Gambia.

• HIV is called “LVD.”• The president claims

he can cure HIV.

MRC Gambia

• It is the UK’s single largest investment in medical research in a developing country.

• The MRC Unit is primarily involved in lab research, clinical research, epidemiology studies, and clinical services.

• Youtube: “MRC Gambia”• Participated in patient care in the clinical

services and took an observatory/educational role in the clinical research aspects.

MRC Gambia

Tuberculosis in the Gambia

TB Field Work in the Gambia

Royal Victoria Teaching Hospital

Royal Victoria Teaching Hospital

Royal Victoria Teaching Hospital

Emergency Medicine in New York and Banjul

• Recognition of need for emergency services as essential to health of population.

• Education of public to recognize symptoms of fatal common illnesses.

• Training of first-level health workers in basic triage and assessment.• Implementation of ETAT at all levels, including the outpatient clinics.• Establish communication on a community level for volunteer

cooperation for transport.• Extra nursing at receiving hospitals.• Establishment of strong team work at receiving hospitals to quickly

be involved in resuscitation.• Supervising physician needs to be physically present in emergency

department at all times.• Cooperation with well-resourced countries and other African nations

in greater establishment of emergency medicine training.

Summary

• Very good experience

• Tale of Two Cities

• Goals of TB, Clinical Work, Lecturing Accomplished

• Further Work with RVTH to be determined

• Join the Global Health Team!

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