Gambia’s main hospital deals with internal corruption, gross under-funding

Gambia’s main hospital deals with internal corruption, gross under-funding

The new management of Gambia’s main referral hospital in Banjul has dealt with a number of management irregularities often leading to loss of revenue since taking over in 2017.

The management of the Edward Francis Small Teaching Hospital was forced to suspend some of its staff after suspicions that their various unit are underperforming in the area of revenue generation, the chief medical director, Ahmed Lamin Samateh, has said.

Samateh said the suspension appeared to have confirmed their fears that some people were stealing money from the hospital that he said is struggling with “gross under-funding” inherited from the past.

“Some people were suspended and we realized that the income generated from one particular unit quadrupled… For example, in a particular unit at the hospital, the income they generated in July was D58 000 and we knew it could have been a lot more based on the number of the people we sent there,” he said.

“So we got furious and suspended some people in early August and the revenue we generated after that suspension was D156 000. And in September, we generated D256, 000 and in October 278, 000 and in November close to 290, 000.”

EFSTH is the country’s most advanced hospital but the institution has been grappling with serious under-funding from the central government that is supposed to subvent its activities.

With a capacity of 510 beds and over 1000 staff which increases yearly as students graduate from the Gambia university, the EFSTH struggles with a monthly funding of 8 million on personal emoluments and 1.2 million on other charges.

But this has not been sufficiently addressing the problems of the hospital that currently struggles to fund one of its most critical units, Haemodialysis.

Haemodialysis, the unit that is responsible for treating people with kidney problems and it is taken 3 times for each patient in a week, consume at least D1.2 million monthly.

There are 49 patients in this unit and Samateh said sometimes they do run out of medicine until patients would intervene to buy it for themselves.

“Haemodialysis poses the biggest funding challenges to this hospital. It cost us about D1.5 million to buy consumables for that place alone. Sometimes we don’t get the resources and the patients couldn’t get their dialysis… And there are no special funds for this unit,” Samateh said.

“Sometimes we do have to wait for consumables. And in some cases, patients will have to buy for themselves,” according to Mamina Sambou, a nurse at the Haemodialysis unit.

Despite their past under-funding which still haunts them, the new administration by President Adama Barrow has made some commitments that could change their situation for the better.

The government has committed 100 million for medicine for all the hospitals and also 35 million to buy equipment.

“I think what the government did so far is commitment. I have personally seen the president and we have discussed our problems. The finance minister was also here and the first lady has been here and she has been going in and out to help us with funding,” said Samateh.

“This government has given us 100 million dalasi already…That is why I am saying we are hopeful. It is still grossly not enough but at least something is being done. Discussions are well advanced to give us another D35 million dalasi to buy equipment. They are not here yet but we are hopeful we will have them by February or March. Gambians deserve better than what this hospital is giving them now.”

According to the medical director, the situation they have met was a very serious one.

“The situation we met was a disastrous one. There was no functional ventilator in the intensive care unit or a monitor. What happened if you have accident victims who can’t breathe? We have some old ones but they are bad,” he said.

“Plaster, POP, syringe, cotton wool and a lot of other things that the government used to supply, we were buying them ourselves.”

But he also added that despite the commitment of the government, country’s main referral hospital still struggles with a huge funding gap given the responsibility it has.

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