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Strengthening the hospital care systems

Since February 2005, MCAI and ALSG have provided large amounts of essential drugs, medical and surgical supplies and surgical instruments to the 3 hospitals/major health centres in which we have been working. MCAI and ALSG have also provided emergency equipment such as portable ultrasound scanners, oxygen concentrators, pulse oximeters and neonatal platform incubators for resuscitation. We have provided 750 MCAI textbooks for doctors and other front-line health workers in all hospitals and major health centres in The Gambia.


We have renovated and refurbished maternity wards, labour and delivery units, operating theatres, and children’s wards.


Working with traditional birth attendants and ambulance drivers, we have organised emergency transport systems to increase the number of births undertaken in hospitals.


This work has been implemented in Basse, Brikama, and Essau regions, covering a population of > 500,000 people.


Click here to read a published paper on this work.


In addition, international volunteers ( 4 paediatricians, 3 obstetricians, 2 midwives and 2 anaesthetists) have worked alongside Gambian health workers on the frontline in maternity and paediatric wards to enhance care and provide apprenticeship-based training.


Advocacy for the use of misoprostol and magnesium sulphate in managing obstetric emergencies resulted in widespread availability of these drugs in The Gambia.


Short courses on the safe use of morphine for pain control and palliative care were undertaken and systems to distribute this controlled drug were put in place.


Advocacy concerning the identification and management of the abuse of children and of women was undertaken, including a one day course on child protection for senior health workers. 

Refurbishment of Basse MHC maternity unit and operating theatre


Basse is approximately 350 KM from the capital of The Gambia and the most rural major health centre.

Operating theatre renovated in Basse MHC.  Many hundreds of life-saving caesarean sections have been undertaken in this theatre since 2012

Mother and her newborn baby in the Basse maternity unit before renovation.

New labour ward renovated in 2013 at Basse MHC showing 3 of the 5 beds

Refurbishment of Essau MHC maternity unit and operating theatre

Essau is a heavily populated area on the North side of the country seperated from the capital city by an estuary 5KM wide.  Emergencies have to wait for the extremely unreliable ferry to Banjul and at night the ferry does not run.  MCAI provided a temporary emergency boat but it was essential to establish a functioning maternity unit and operating theatre.  With funding from Soroptimists International of Great Britain & Ireland (SIGBI) this was achieved in 2013.


However, it has not been possible to find a Gambian doctor able and willing to provide comprehensive emergency obstetric care to work in Essau and the theatre remains unused.


Slide show revealing the improvements made to the maternity unit (antenatal and postnatal wards) and labour and delivery wards at Essau Major Health Centre

Refurbishment of Brikama MHC maternity unit and operating theatre

Brikama is a semi-rural area based in Western Gambia comprising an expanding population of around 250,000 people. Following the education of traditional birth attendants undertaken during 2006-2008 the number of pregnant women attending for delivery increased from around 2500  per year to now reach over 5000 per year.


Our initial renovations included the operating theatre, children's and maternity wards. A comprehensive set of medical and surgical equipment, including an operating table, anaesthetic machine and neonatal resuscitaire and special equipment for a high dependency area in the children's ward was provided.   


In 2012 we built a new 10 bedded labour ward which was equipped by UNFPA and ourselves. In 2007 and in 2012 MCAI  provided two new portable ultrasound scanners, essential for safely managing pregnancies and deliveries.


A flying squad ambulance was provided by the President's Office manned by senior midwives from Brikama MHC to respond to requests for emergency care made by traditional birth attendants who had undergone 2 day training courses.  

Portable ultrasound scanner donated by SIGBI to Brikama Major Health Centre.

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