The first visit in 1992:

With all the progress of recent years, it is always sobering for me to look back upon my first visit to Bansang. I hope this article from many years ago gives an impression of just how depressing and horrific the hospital was all those years ago.

Having despatched my first container to the hospital some weeks before, I decided that I must now pluck up the courage to visit the hospital. If I had any intentions of continuing with this work it was essential that I knew, first hand, exactly what the conditions were really like. Clearly for my fund raising activities to achieve the desired effect I needed to know exactly where I should focus my efforts and to establish what were the hospital's most pressing and urgent needs.

The hospital, back in 1992, did not have a direct phone line so the planning for my visit was very much a journey into the unknown. The best plan that I could come up with was to fly to The Gambia, catch a bus to the hospital and then introduce myself and hope that I would be welcome. The fear and apprehension that built up during the flight were quickly dispelled on arrival in Banjul where I was made so welcome by everyone and this friendliness was to be totally eclipsed by the welcome that I would receive at the hospital.

However before arriving at Bansang I had to endure one of the most excruciating uncomfortable bus journeys that I would ever experience. The 200 mile journey from the coast to the hospital was negotiated over roads that had been badly damaged during the recent rainy season. Some of the pot holes, the bus had to negotiate, were like craters and together with the heat and constant dust the journey proved to be long and extremely tiring. Fortunately in recent years the roads to Bansang have been significantly improved.

Some ten hours after leaving the coast I eventually arrived in Bansang during the early evening, just as the light was fading. I could not believe the reception that I received from the hospital staff. The display of friendship towards me from everyone that I met was overwhelming. However this exhilaration was to be very short lived, soon to be replaced by total anguish and despair at the sights that would confront me as I entered the hospital wards for the first time.

Never had I felt so totally helpless and so completely overwhelmed by the devastating sights that I witnessed in the dimly lit surroundings of the children's ward.

It took a while for my eyes to adjust to the poor light within the ward. The noise, the heat and the smells were almost unbearable. Children were laying four to a bed, the look of fear and confusion filling their eyes, drips were kept in place around their little wrists using old pieces of rag.

Serious burns victims lay motionless, just like corpses, hardly breathing, close to death. They remained silent, they did not stir, just staring blankly into space. How could they suffer so much obvious pain without shedding a tear, was there fight for life nearly over. I cried openly as I saw bed after bed covered with these motionless, tiny little children.

One by one a steady stream of desperate mothers approached me, they beckoned me to go with them to look at their child, they begged me to help them. I could offer nothing.

Over the next few days I visited every ward in the hospital and was continually shocked by the appalling conditions. I cried frequently and was often in total despair at what I was witnessing. These sights coupled with the exhausting, sap draining heat mixed with the overpowering smells regularly overwhelmed me and I frequently had to go outside, into the hospital grounds, to recover my composure.

The following are just some of the sights that so shocked me during that first visit.

All wards were so overcrowded with patients and visitors that the corridors and landings were used as make shift wards. To cope with this vast number of patients, multiple occupancy of beds occurred in the children's ward.

The beds were rusty and broken with only bare mattresses for the patients to lie on. These mattresses were contaminated with every imaginable body fluid. The mosquito nets, essential in the fight against malaria, were full of holes. There was a complete lack of basic medical equipment throughout the hospital.

Every single ward that I entered displayed that totally worn out look, window glass missing, doors missing, broken lighting, exposed wiring, pitiful lighting, damaged sinks, faulty toilets the list was endless.

The operating theatre was desperate. The operating table was worn out and the limited surgical equipment was rudimentary. There was no emergency patient resuscitation equipment in the theatre. I later learned that such equipment did not exist anywhere in the hospital. The very poor lighting frequently failed during operations due to power supply problems and this caused severe complications when operations were in progress. Many operations were completed using torch or even candle light!

There was only one suction machine available for use on all wards and this was situated in the operating theatre.

The maternity ward / labour ward was like a hell hole. It was a 12ft x 12ft room with four worn out delivery beds. I could not imagine how a mother to be could endure a birthing procedure in this dreadful environment.

The pathology laboratory resembled a scene from the Victorian era.

The combined sluice and sterilisation department was indescribable. The autoclave sterlisation unit was so old and ineffective and only functioned on one element. Such a machine would have been condemned years ago in the UK.

The x-ray department produced such poor quality results that the resulting x-rays could not be relied upon. There were no x-ray viewing boxes on the wards the only available viewing box was situated in the x-ray room.

The pharmacy was desperately short of drugs, even stocks of basic antibiotics and pain relief tablets were dangerously low.

There was no working blood bank and so emergency transfusion procedures were impossible to perform. Many malaria patients suffer severe anaemia with haemaglobin levels as low as 3 and life saving blood transfusions are essential in the treatment of such cases. The operating theatre's effectiveness was also seriously impaired by the lack of immediately available blood to transfuse patients.

Telephone communications internally and externally did not exist. The mail was only delivered once a week by express bus taking passengers from the coast to Basse further up river. The very first telephone system, in the area, was installed by Gamtel in 1994.

The main power supply frequently failed plunging the hospital into darkness.

The hospital had only one working ambulance. Even with this limited service, the lack of telecommunications services ultimately resulted in seriously injured or sick patients travelling for days by horse and cart.

However the nursing staff never ceased to amaze me, their extraordinary dedication to the patients was quite bewildering. Here they were surrounded by confusion, despair, anguish and a total lack of vital equipment and yet they were still able to dispense quality life saving health care.

They were extremely committed, caring professionals and were more than capable of performing procedures that only doctors would be allowed to in the UK. Even though their undoubted skills were tested to the limit they never ever complained, they just got on with their job and did the very best they could do.

Having witnessed pain, suffering and anguish on a scale that was far beyond my comprehension I now knew I had to respond, I had to continue to help. Being a mother of three children I fully realised, 'there but for the grace of God go I'. To walk away and do nothing now was not an option.

I left the hospital knowing that I would return, I was going to make a difference to the lives of those desperate people, especially the poor unfortunate little children.

Footnote:

I could not physically or mentally have coped with the duration of that first visit without the extraordinary friendship, support and complete understanding that I received from everyone that I came into contact with. The compassion and concern that the Gambian people, especially the hospital staff, showed toward me was quite unnerving and yet so genuine ~ these were very, very special people indeed.

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