A highlight of our first trip to the Trust’s projects in February 2014 was visiting the Jappineh Health Centre and meeting the delightful staff. Nearby, there is a health facility of a different kind and Kira, aware of my interest in mental health, has arranged a visit there too. It is owned by the Njie family.
The Njie brothers, Karamo and Mdemba, are marabouts - also known as ‘traditional’ doctors. Njie men have treated mentally-ill patients for 350 years. Their healing powers are inherited, and herbs grown on their extensive land are used as remedies for patients. When these are ineffective, the brothers resort to a rigorous, physical approach.
Alhaji Karamo, the most renowned brother, greets us enthusiastically. Tall and flamboyant, he sweeps ahead to show us around. Alas, we are permitted to see few patients. Rumours about Njie patients being shackled and whipped are uppermost in my mind and, I’m sure, in Kira’s too.
We are then ushered into Karamo’s office. Through the interpreter we brought with us, Kira stresses the efficiency of Western medicine for psychiatric disorders. She has addressed this matter with the brothers many times. Amazingly, Karamo is now accepting that his herbs can’t cure every condition. He is asking for help. As we walk back to the Health Centre, we marvel at this breakthrough.
A few days later we visit the only psychiatric hospital in Gambia. Opened in 2009, Tanka Tanka is named after the Dutch Foundation that largely funded it. Anna Bouman, Founder & Vice President, is a friend of Kira’s.
There are no psychiatrists in Gambia, but the secondment of a Cuban psychiatrist has been a bonus for Tanka, albeit brief. The buildings encircle a large outside area, where patients are mingling with others or sitting quietly alone. As we amble across to the male wards, a girl slips in beside me and links her fingers through mine. We continue this way until she loses interest and veers off elsewhere. Another patient howls her misery, eventually collapsing into the arms of a kitchen lady.
Back in England, we soon receive Kira’s ‘Preliminary Ideas’ document for the Trust’s psychiatric programme and we pore over it avidly. It is a thesis! Every possible factor has been thought through. For example, a Jappineh Health Centre nurse will be trained by the Tanka Community Mental Health Team; that team will also visit the Njie facility on a monthly basis, and their transport costs and other allowances will be covered. Kira senses that the Tanka team will relish the opportunity to make an impact at the Njie establishment.
We are very happy to fund the beginnings of this pioneering initiative for Gambia’s mental health, including the cost of psychiatric medicine.
A month later we hear that Karamo Njie is in prison, having allegedly murdered a patient by caning him to death. If ever there is a time to redress the treatment of mental illness in Gambia, this is it.
Kira succeeds in securing the counsel and ongoing guidance of the World Health Organisation (WHO). Their Country Facilitator for the Mental Health Leadership and Advocacy Programme (mhLAP), Dawda Samba, is a huge asset. We are sent the 1st issue of Dawda’s newsletter Drop the Chain and Cane. The title alone is spine-tingling in its intent.
This excerpt shows Dawda’s 4 phases.
Minutes of the Gambian Management Team meetings include updates on the psychiatric programme and for the most part they convey steady progress. The Tanka Tanka outreach team run ongoing and successful joint training sessions with Health Centre staff and the Njie family. A sticking point, however, is the family’s reluctance to contribute towards the purchase of psychiatric drugs, and to contribute towards the services offered to them by Modou Jobe, the nurse assigned to administer the injections. These entirely reasonable expectations are at last (albeit reluctantly) accepted. The Njie family has seen the effectiveness of the drugs on their patients and has at last consented to contributing their quota, thus securing sustainability.
Shortly before my visit to the projects in January this year, Dawda Samba went to the Njie hospital to ascertain the prevailing situation. His report ends: “Patients are no longer put in chains, caned, or locked in. Their rooms look reasonably neat and clean. There was evidence that a closer collaboration between the HC and the marabouts is being fostered, based on mutual understanding.”
African Oyster Trust’s work for the treatment of mental illness in Gambia remains the only collaboration between Western nursing and medicine, and the traditional methods of marabouts. Medical history is being made by a small charity that dares to innovate.
African Oyster Trust director Lady Kira Dalton reports on the latest eye Jappineh Eye Clinic, which helped more than 90 patients in a single day at a cost of £2.50 per eye-test.
On Saturday 16th March the African Oyster Trust (AOT) helped to organise the Jappineh Eye Clinic which 91 patients attended.
It took place at the Jappineh Health Centre, run by the Trust. We provide all the medicines for the clinic and pay a small allowance to the local sight team from Soma Hospital, comprising an Optometrist, Surgeon and two students, for working at the weekend.
We test using an ‘illiterate eye chart’ (they have to say which way the legs are pointing on the letter E). Anyone who cannot see the middle line is referred to the sight team, who then check for refractions and issue them with trial frames. They choose the nearest available from a large collection of donated second-hand spectacles. Some also get reading glasses, as the chance of finding bifocals to suit is very unlikely.
Others are referred to the eye surgeon at Soma, about half an hour away. There they diagnose more serious problems and prescribe medicines for glaucoma, and schedule cataract or other surgery. The Soma Hospital team are happy to work with the Trust as we were able to donate a slit lamp and other equipment to their unit a few years ago.
Usually, we have a small budget to fund a few operations for those who can’t afford to travel to Soma. This includes the elderly, as this is a country where no pensions are paid.
Of the patients who attended this year, 5 needed cataract surgery, and 3 have dates arranged. 25 will need future surgery for cataracts and 22 others for pterygiums. Both these conditions are related to lots of sun exposure, which is why we give our staff sunglasses. 9 patients received glasses, including 2 children, and many were given eye drops.
The total cost of this the Jappineh Eye Clinic was 15,000 dalasis, which is about £230 - roughly £2.50 per patient - which I’m sure you will agree is money well spent. And there are enough eye drops and spectacles left to last the whole year. This means that Jappineh Health Centre can now organise days like this maybe twice a year for a few pounds (to pay for transportation costs and providing lunch and rewarding the Soma people for working over the weekend).
A visit to the optician is something we take for granted in the UK and the rest of the developed world, but in The Gambia it simply doesn’t happen. The impact of this one day will have lasting benefits for the people who attended and help them to see a brighter, more in-focus future.
This is the final of four articles from Trust director Dee Bixley, reflecting on her recent visit to our projects in The Gambia.
Pursuing a longstanding land dispute case on behalf of donors to the Trust, Kira has received notification to attend court at 10am on Wednesday. I must attend too, she says, because it will be an excellent addition to my ‘Gambia Experience’.
General Manager Fanding has driven us here and he will help with translation. We arrive spot on time.
Naively, I’d assumed there would be some sort of Court building but as we walk into the Chief’s compound, I see rows of plastic chairs under the mango trees and realise this is Court. The chairs are empty and yet their presence does suggest that something will happen, sometime.
Gradually people do arrive, greet friends, sit down, have a chat or a nap. There’s an overwhelming air of resignation.
Meanwhile, all around and seemingly oblivious of our presence, the women of the compound go about their unceasing work, collecting water, pounding grain, hanging out washing - whilst tiny tots play in the sand, and goats, hens and chicks weave in and out of the chairs.
I find myself thinking about an old Fry’s chocolate advertisement for Five Boys: “Desperation. Pacification. Expectation. Acclamation. Realisation. It’s Fry’s”.
Three hours later, when the Court Clerk arrives, I have my Fry’s moment, entering what I can only describe as a state of ecstasy. OK it isn’t the Chief himself, but something is happening! I watch as the Clerk carefully dusts the table and then - is it him or the Court Usher - who wheels in the special Chief’s chair? And where did the Call to Prayer fit in? When you’re ecstatic you tend to lose track of the order of things. Meanwhile, Kira continues with her crosswords.
Fifteen minutes later the Chief himself arrives and tackles the first case of the day; witnesses bob up and down stating their evidence, and documents are scrutinised. Then, four hours and twenty minutes after we arrived, the morning session is over. Amazingly, Kira is beckoned forward and given a future date for her diary. She seems quite pleased. This Gambia Experience, it’s exhausting!
This is the third of four articles by Trust director Dee Bixley, reflecting on her recent visit to our projects in The Gambia.
One of the heart-warming aspects of Kira’s largesse is that everyone in her neighbourhood know that she’s there when they need help. If a family can’t afford to pay for a prescription or they can’t get to a medical centre, Kira or her watchmen - all experienced first aiders - step in. They have dealt skilfully with all manner of emergencies over the years.
I was there when the little girls, pictured here, came to support their friend, while her wound is checked, and bandage replaced. A minor matter, perhaps, but their big smiles tell the story.
Urgent knocking at the gate can occur at any time of day or night. Late one afternoon, I happen to be nearest the gate - what calamity will I face?
Three attractive young girls stand before me, looking robustly healthy to my untrained eye. They seem disappointed at the sight of me but then Celberr appears and it’s fascinating to watch the fluttering of their extension eyelashes. One girl makes a show of putting a hand protectively over her arm, but we hear later that there was nothing to be seen on her arm.
My theory is that they came to admire Celberr and, well, who can blame them?!
This is the second of four articles, as Trust director Dee Bixley reflects on her recent visit to our projects.
We have booked a two-night stay at a modest guest house in Soma near Jappineh. On arrival, we find the staff dazzled by the upcoming opening of the nearby Senegambia Bridge. A momentous achievement, it promises to end centuries of trade chaos, and has taken 7 years to build. Not surprisingly, journalists and photographers have been jostling for rooms, which is why (we discover later) our rooms for tomorrow have been double-booked.
Meanwhile, we surrender to our parts in a situation comedy. My role has three room changes because the keys don’t fit or don’t lock or there’s no lighting. So, I flit about unpacking, packing, unpacking and although it’s a non-speaking part I do indulge in some fruity ad-libs.
Kemo’s role is that of a gentleman, which requires no acting skill because he’s like that anyway. As for Kira, she merely gives one of her famous shrugs and remains sanguine throughout.
Strangely, my third room is behind fretwork bars, with a door that also has keys. Kemo wants to make quite sure that my door key will work this time, so I proudly demonstrate my ability to double-lock. We both jump in horror when the door swings open anyway! Still, I’ll be safely behind bars.
As we eat our evening meal, huddled on a tiny balcony, we receive light entertainment from the electricians alongside.
“Did you know that roosters can crow all night?” is our question to each other over breakfast. And who would want a second night being kept awake by them? We’ll squeeze in more meetings today and drive back to Kombo later.
As we get ready to depart, it is Kira’s turn to lose track of keys: her car keys. Without them we are stuck! Happily, she finds them in her handbag, and we drive away from the place. Kemo shakes his head in bewilderment. “Did that madness really happen?” he asks, as he forages for his phone - whoops! He’s left it in his room.
African Oyster Trust director Dee Bixley shares some reflections on her recent visit to the African Oyster Trust projects. This is the first of four updates, the rest of which will follow over the coming days...
Kira, Kemo, Fanding and I head up country to the Jarra Region, where the Trust supports the Jappineh Health Centre, a psychiatric service, and a school.
The many boxes of medication with us must be kept cool, so we’re in a hire car with air-conditioned luxury.
Kira’s own car has no air-con. As she says, it’s reliable and very economical to run, so why change? And she is not impressed with charities who waste money on costly cars for their staff.
During a community meeting in the Centre’s grounds, Kira and the team report on a very busy 2018. The need for a further nurse is underlined, to help with the increasing flow of patients. This is being addressed by Officer in Charge, Ansu Manjang.
It’s a lively meeting with many points of view, proving the community’s passion for its clinic. The Bank Book is passed around, and there are updates on significant progress towards long-term sustainability.
Another development is that under the auspices of The Global Fund - an organisation designed to accelerate the end of AIDS, tuberculosis and malaria - Gambia’s Ministry of Health & Social Welfare has built a brand-new laboratory alongside the Centre. Kira has since been advised by the Ministry that they will donate a fair few items for the lab.
The Trust continues to fundraise for more equipment, and to maintain supplies of all the consumable items needed to run a laboratory successfully.
There is 1 doctor for every 15,000 patients in Gambia. If that isn’t a statistic that underlines the importance of the Jappineh Health Centre, I don’t know what is. Our experienced nurses and technicians serve a catchment area of 30,000, with up to 1,000 patients a month.
During a visit to the Trust’s projects in January 2019, Dee Bixley grabbed the opportunity to ask Ansumana Manjang, Clinical Director, Gambian Management Team & Officer in Charge, Jappineh Health Centre, about his work.
"I became interested in nursing and healthcare during my school years, from Primary through to Senior Secondary School. It was largely because I was a very active junior volunteer for the Gambia Red Cross Society. Our motto was:
I promise to serve God, President, and my Country and join with others all over the world to help the sick and suffering.
I was always saying this in my mind, I am Ansumana Manjang and I promise to serve the sick and suffering … I thought about it, talked about it, and I still do! That is why I became a nurse.
Through my Red Cross volunteering I attended numerous incidents. If there was a road traffic accident I would rush to help, or if someone was sick near our compound. If they had diarrhoea, I quickly mixed a drink solution. Whatever it was, I gave primary care and when necessary referred to the nearest facility.
As soon as my academic career finished, and achieving very good grades, I wrote a formal application to the School of Nursing. I was interviewed, shortlisted, then admitted for a 3-year nursing education. I should add that midwives in other parts of the world are mostly female but in Gambia there are male midwives too.
Although I have worked in other areas, I think my decision to return to my village, where I was born and where my whole family and community lives, has made a big difference. Every day I see that people appreciate it. I even thought about going to work abroad - some of my friends have done this and I’ve seen photos of their houses and cars. But why would I do that? What could be better than helping my own people?
Working with the African Oyster Trust is interesting and important. It is helping rural Gambians by bringing more knowledge and medical equipment, which is so needed in our community. We still need the Trust’s financial support, but we are working very hard towards the time when we can sustain our projects completely.
I now have a motor-bike and this means that attending emergencies is much easier. For example, this morning 10 kilometres away a woman delivered a baby but no placenta. They called my cell phone, I put the equipment in my rucksack, climbed on the motorbike, and delivered the placenta. It was fantastic! I was so pleased because without the motorbike she would have bled to death.
I have very little recreational time, I’m constantly on call. I might read a novel, but I’ll also update myself on the latest medical information.
The best aspect of my work is that I enjoy it."
Dee adds: "During our conversation a young man joined us, quietly sitting beside Ansumana, taking it all in. “Is this your successor?” I asked. “We continuously think about that process,” was Ansu’s discreet reply. “And now I must go – a woman is waiting to deliver.”"
Everyone at the African Oyster Trust would like to thank all of those who have helped make the last couple of months so successful for fundraising.
Big Give Christmas Challenge
First of all, we achieved our target of £4k - and then some! In fact we raised an epic total of £4,540 through the Big Give (including Gift Aid).
The funds raised will allow us to purchase all the items on our Wish List, namely a portable ultrasound machine and an X-ray machine, plus we can start to equip the new laboratory and pay for staff training.
This really will make a huge difference to the welfare of the local people in and around Jappineh.
Also last month, successful wine tasting tickled the taste buds and, with your donations, raised over £1,000.
Some fabulous wine descriptions, courtesy of our friend Matt from Majestic Wines who entertained guests: "To bring a pantomime theme to the proceedings, if Burgundy in France was Prince Charming, then Beaujolais would be seen as Widow Twanky."
Only one table managed a full-bodied SWEEP! But everyone had a good time as shown in the photos below.
Auction bids for extra colour and comedy!
The two signed prints by artist Perry Taylor together raised £106.50, while Christmas wreath sales added a further £75 and the meal voucher, kindly donated by The Falcon, Warmington, was sold for £50.
The last item, a book; 'Good Moaning France: Offcer Crabtree's Fronch Phrose Berk' went for £20.
The African Oyster Trust is once again taking part in the Big Give #ChristmasChallenge18. Our aim is to raise funds to equip a lab for Jappineh Village Health Centre which provides care for 30,000 people.
The Big Give, the UK’s biggest online match-funding campaign, starts at noon on 27th November until noon on 4th December. Any donations made during this period through www.theBigGive.org.uk will be DOUBLED. So a gift of £10 will become £20, or £50 will become £100, and so on.
The lab will help diagnose and treat malaria and other tropical illnesses, bringing relief to thousands. We are also looking to raise funds to buy a portable X-Ray machine and an Ultra Sound machine.
Why does the Gambia need our help?
Given the extreme poverty in The Gambia it is not uncommon for a small illness, even a splinter, to become infected and if not treated it can worsen and lead to an amputation. The situation with serious illnesses is much worse with patients facing long and expensive journeys to other towns for treatment.
Jappineh is in Jarra, Matsakonko region of Central Gambia. This is a heavily indebted, remote and poor area which relies mainly on subsistance farming. Gambia itself is an extremely poor country, rated 10th from the bottom in the human development index. Average incomes in this region are under £1 per day. Even the cost of travel to the nearest town's clinic is beyond the means of most of the local population.
The nearest large hospital from Jappineh was a good two hours away. The journey involved pot holed dirt tracks and a ferry crossing. There is only one major teaching hospital in the whole country which is approximately 5 hours away.
What impact is the charity having on health issues?
To address these needs the African Oyster Trust opened the Jappineh Health Centre, also known as the ‘Sir Howard Dalton Clinic’, in 2009. The medical centre is the only one serving a population of around 30,000 people from Jappineh and surrounding 20 smaller villages.
It now employs seven full-time members of medical staff, supported by the Trust, and treats about 700 patients every month. Having a health centre means ailments can be treated immediately, people do not need to decide between feeding their families or paying to travel to distant towns for healthcare.
Following the opening of the medical centre there has been a general improvement to Jappineh community health. There has been a measurable reduction in maternal and infant mortality, better survival and cure rates for malaria and other infectious tropical diseases, “the African Oyster Trust's work has transformed the welfare of people in the district and beyond,” says Chief Alhagie Dampha.
Having a well-stocked dispensary saves people buying costly drugs from a retail pharmacy.
It is often difficult securing skilled expertise to service the technical equipment and to find replacement parts for complex equipment such as centrifuge and solar fridge.
We routinely purchase lab equipment through the Department of State for Health Central Laboratory stores so that we can call upon their expertise and store of spare parts whenever required. We want to build on this healthcare success story.
Help us equip our new laboratory
One of the aims of this year’s Big Give campaign is to equip our newly built laboratory as well as providing ongoing consumables, parts and maintenance for equipment, and training for the lab staff. These facilities will ensure quick, cheap and accurate diagnosis - accessible to all the community.
By having a fully equipped laboratory on site, staffed by a trained lab technician, patients will no longer have to travel in order to have routine blood tests.
The onsite facilities will allow fast and accurate diagnosis of common tropical diseases leading to appropriate treatment and better survival rates.
Before, problems in childbirth often had fatal consequences, exacerbated by lengthy journeys in private vehicles or on donkey carts to get to the nearest medical help. We are delighted to report that the Jappineh Medical Centre is now delivering 20-30 babies every month, and as a result of the anti-natal care being offered, birth weights are above the Gambian average.
With the additional funds raised through the Big Give we plan to add a portable X-Ray machine and an Ultra Sound machine to the equipment already in the Health Centre so we can improve our medical care even further.
Please help us achieve our fundraising targets!
Make one donation with TWICE the impact!
Simply log on to the BIG GIVE website www.theBigGive.org.uk (or click the button below) between noon on 27th November and noon on 4th December. and look up the African Oyster Trust – Project ‘Equip a lab.’
You can raise funds for the African Oyster Trust at a fun evening of wine tasting with genuine and dubious wine connoisseurship!
Whose Wine Is It Anyway? takes place in Oxhill, Warwickshire on Friday 30th November 2018
Each table will present a wine by sharing prepared scripts with the whole room - one true and 2 false. Everyone votes to decide the most convincing description. Adjudicated by an expert from Majestic Wines.
The evening offers:
Plus other special lots to bid for – details to follow.
Tickets for the event are £15 each, or you can buy a table for 8 guests and bring your friends. Starting at 19:15 for 19:30 and running through to approx. 21:30, this special event will raise funds for the African Oyster Trust to equip a lab for Jappineh Village Health Centre in The Gambia
To book, contact Shirley Cherry on 01295 680793 or firstname.lastname@example.org
The News Diary is a regular account of all that is happening at The African Oyster Trust. Please pop back for regular updates, follow us on Twitter or sign up for our RSS feed to have the latest news sent straight to your computer!
The news diary is written by a number of people close to the work of the African Oyster Trust, including founder James Holden, his co-directors, trustees and volunteers.