The Project Film...

Swansea-Gambia Link Project 2010 from Jimmy Hay on Vimeo.

The project finishes...

This week has seen the Swansea-Gambia Link Project 2010 come to an end, but has also seen the completion of an 86-page report that we hope will provide a working-practice structure for future multi-disciplinary partnership projects.

The project has been hugely successful, on both a professional and personal level, and has convinced us all that partnership projects are a hugely beneficial way to approach global health care and international development.

This week has been all about finishing the report, and so on both Monday and Tuesday we gathered once again at CIAM’s offices to work with the Gambian students. Having finished the bulk of the report last week, it was largely the small but time-consuming details that needed to be finished; referencing, formatting etc. After two long days, the report was finished, polished and ready-to-distribute by Tuesday evening.

With this major milestone complete, we decided to host a thank you meal on Wednesday evening for all of the people who have helped us during our time in Gambia, from senior health officials to our amazing drivers, Ebrahim and Soreba. We arranged for a local chef to prepare Chicken Yassa and barbequed goat, and decorated Dana Lodge with welsh bunting and flags.

It was a great evening, not only for the chance to see everyone one last time, but to have everyone together in order for ourselves and the Gambian students to offer our thanks and appreciation for the great amount of work and assistance that has helped us succeed for the past four weeks.

We hope that the success of this project will enable the Swansea-Gambia Link to develop further with yearly projects, and so the myriad relationships we have developed during our time in Gambia will be integral to that, and hugely beneficial to future project leaders and participants.

Tuesday 10th August

On Tuesday, the International Relations and Development students were invited by the Governmental Department of Community Development to visit an ongoing, sustainable project in Brufut. The project (funded by the Government) is aimed at local women who as part of the scheme collectively own a vegetable garden with different plots. The project has been successful in presenting a source for a sustainable diet and an additional income for families within the local area. The garden also contains a Day Care Centre for children to attend whilst their mothers work the gardens. The Centre, whilst great in its positioning and availability, is very small and pupils range up to 250 per day. There was also a communal hall for women to develop other skills such as tie-dye, sewing and crafts.

For our understanding of malnutrition, one of the most interesting aspects of visiting this community project was the fact that the women emphasised that they use and eat rather than sell most of their vegetables and only sell what is left over. As one of the major problems identified throughout this research has been the unavailability of fruits and vegetables for children this was a really positive development to see as developing effectively.

Such projects, whether funded by the government or private organisations should be supported wholeheartedly, to further health promotion with local communities.

- Lella Nouri

Sunday 7th August

On Sunday, the International Relations and Political Science students involved in the project, set out on a search to further explore the wider determinants of health within The Gambia. As a small group of students guided by Sait Matty Jaw, Political Science student at the University of The Gambia, we were able to experience public transportation both in Banjul and the North Bank as well as visit a rural village off the coast. We began the day by taking a public bus to Banjul and then made our way through the city to the ferry crossing over to Essau. On the way we chatted with a number of local people who were keen to tell us of the challenges of public transport within the Gambia and crossing the river to and from work on a daily basis.

On arrival in the village, we were invited in to numerous family homes and were able to see and hear for ourselves how healthcare within the rural community is incredibly limited. The villagers were more than welcoming, providing us with a local concoction called ‘Sour Milk’ straight from the cow and mixed with water. A delicious but interestingly textured drink that broke the ice for further interaction with the locals. We then visited the Muslim schools within the village and were able to learn what the pupils were learning and the conditions of the school environment.

After a lengthy and thorough walk around the village; meeting uncles and aunties as we went, we arrived for an unplanned lunch with some members of Sait’s family. We were made to feel incredibly welcome as we shared their communal meal of broken rice and fish. We all dived in, eating with our hands in the traditional manner, and were able to see the importance that is placed on sharing within both Islamic and Gambian culture.

At the end of the day we travelled back to the ferry crossing and decided to cross in the local manner; by small wooden fishing boats which travel at twice the speed of the ferry. After much bartering we all climbed on and were instructed that lifejackets were a necessity. The experience was exhilarating, being so close to the river and travelling with local tradesmen crossing the width of the river sometimes over four times a day.

Overall, the day spent on the North Bank enabled a greater understanding of how policies and health promotion is translated to the rural environment. Furthermore we were able to comprehend the polarisation of conditions between the urban environments already experienced around Banjul and those in the rural villages.

- Lella Nouri

Week Three

This week the Gambian students and ourselves have completed the last of our visits to health organisations and clinics. On Monday morning we met with senior officials at CIAM, a public heath research and development centre that has expanded from merely researching and tracking malaria in Gambia, to monitoring and evaluating HIV and Malaria, capacity building (training individuals on monitoring and evaluation techniques) and public engagement.

The medical students then visited the case study and her mother at their home, as the case study was discharged from the Royal Victoria Teaching Hospital last week. It was incredibly interesting and helpful to visit them at home, as we were able to gather more information on the feeding habits of the mother, details of the case’s siblings and the home environment itself – all vital information for evaluating the broader social, environmental and developmental determinants of malnutrition.

Yesterday we were able to go on a ward round with the medical team at the MRC (Medical Research Council), which for our medical students in particular, was a great experience. The ward round was extremely beneficial to our project, as almost all of the patients on the ward, though suffering from different conditions such as malaria, pneumonia and diarrheal illness, had a background of malnutrition – highlighting the severity of the problem in Gambia, and the need for alternative approaches in tackling malnutrition, such as ours.

Further visits to the case study and her mother are planned for this week, which we are really looking forward to. The mother has been so incredibly welcoming to us, and to being interviewed for the project. These visits aside, the writing of the project is now our main focus. We were able to start writing this afternoon, which has been a real boost to all of us, as we can now begin to see all of our hard work and research during the past two and a half weeks start to take shape in a written form. Numerous health organisations and international bodies will see the final report, and we’re hopeful it will make a real difference not only in the approach to tacking malnutrition, but to encouraging the formation of multi-disciplinary, partnership projects in the future.

Week Two Recap - Jane Thomas

Week Two - Out and About

Yesterday Team Gambia made the long and occasionally arduous journey across to the North Bank of Gambia, via a ferry from Banjul. Our earliest start of the project so far was compounded by having to wait for almost two hours at the terminus to board a ferry. Once on board, however, we climbed to the top deck to enjoy some well-earned breeze for the fifty-minute crossing.

Just a short drive from the North Bank port is the Esau Major Health Centre. Esau Major serves a large rural catchment area and can cater for all but the most serious of health conditions. The centre boasts a large maternal ward which accounts for the majority of its patients, delivering on average three babies a day.

We then travelled further north to visit the Cherno Baba Traditional Healers Association in Berending. The head of the centre and his two senior practitioners offered us a warm welcome, and were happy to answer all of our questions. It was incredibly interesting to hear about their traditional treatment methods and the large number of the North Bank population who still rely on them.

More interesting, however, was how keen the head of the centre was to stress the “progressive collaboration” that exists between themselves and the Royal Victoria Teaching Hospital, freely stating that many illnesses cannot be cured by traditional methods alone, and instead require modern medical treatments.

This morning our first visit was to the Brikama Health Centre, though it could perhaps be more accurately described as a district general hospital. The centre runs numerous clinics, including a baby clinic at which any child under the age of five can be weighed and immunised for free. It also has several wards, including paediatrics, separate male and female wards, a labour ward and theatre, and a laboratory for testing.

From Brikama we travelled to Gunjur, to meet three traditional birth attendants operating out of Gunjur, but who serve the large number of rural villages in the Kombo South District. Whilst being specifically focused on maternity and birthing, the birth attendants are committed to women’s health in general, and health practices from a specifically female perspective.

Travelling to different health centres, clinics and organisations is proving extremely helpful in developing the focus of the Swansea-Gambia Link project, as we are seeing first-hand the various methods by which health care is being delivered and accessed by people across Gambia, and furthermore how much health education is already a considerable part of health care here, and yet still such an area for improvement.

Week Two - Day One Video Diary

Week Two Begins

This week we are visiting a variety of health organisations throughout Gambia, in order to develop and broaden our knowledge of the health systems ad services already established here.

We had a high-energy presentation first thing this morning, as the Nova Scotia Gambia Association (http://www.novascotiagambia.ca/) treated us to a powerful performance from their peer-to-peer drama troupe. The organisation runs numerous health education programmes in the country, one of which uses the drama troupe to deliver issue-based theatre sketches to villages and towns throughout Gambia, using young people to target and educate fellow young people.

This education programme, and its focus on using drama as a key vehicle to disseminate information, has been incredibly successful in educating young people in Gambia through its ability to tackle sensitive issues such as HIV, domestic violence and sex-education in an engaging and accessible manner.

We then visited Concern Universal (http://www.concernuniversal.org/), a British NGO that specialises in offering education, support and treatment for HIV, Malaria and Tuberculosis. They have a particular focus on capacity building, setting up organisational structures and frameworks for governmental and non-governmental services.

Concern Universal receives financial support from the Global Fund, and has offices in several countries throughout Africa. Their Gambian office also serves large sections of Senegal, particularly in the south of the country, where they have primarily been involved in peace-building operations.

Finally, we met the several members of staff at the Gambian Family Planning Association (GFPA), before having a tour of their clinic, in which they offer family planning advice seven days a week, as well as also carrying out comprehensive medical services, including anti-natal care, vaccinations and infant care.

It was extremely useful to meet with the three organisations and see the work that they do, as all three are relevant to out infant-malnutrition project, in particular through their focus on health education. Seeing first-hand other organisations and the methods by which offer health care, education and treatment is enabling us to better assess and develop our own methodology, and will hopefully help to positively influence the outcomes of our project.