By Nelson Manneh
Halifa Sallah put forth a PDOIS-led government strategy to enhance the current health system that will cover every Gambian in a more comprehensive and integrated manner. He said health has four components; preventive, curative, rehabilitative, and restorative. Sallah said sometimes people suffer skin diseases who need help to restore their skins but that is absent in The Gambia. He said they will ensure that happens.
“You look at rehabilitative, you see people not having wheelchairs, not having mobility aids, completely abandoned, they cannot even do their work. So we will ensure there are public rehabilitation facilities to be able to help those people have access to health.
“You have the curative dimension, we are saying it should be community-centered. There should be a primary stage, secondary stage, and tertiary stage. The primary stage should be at the village level, to make sure villages are trained at their level to be proper birth attendances and certain basic things like diabetes they should be able to test it and save lives very quickly.
“Then from the village, you can move to the District level where you will have a major health center or a District hospital that will be treating other issues with properly trained doctors and nurses in order to render proper services. We also have the regional hospital which will be referral hospitals. That is how we intended to structure the health system. We also want to involve the communities participating in minor health problems by ensuring that the community will be able to identify the illness that appears within a year through a simple means to know which diseases are affecting a particular district or in a region therefore the drugs that will be bought will be prioritized,” he said.
Speaking further, PDIOS leader said health technology is necessary because many people live in Gambia for Senegal to get treatment. He said that comes to an end by identifying what the country needs and prioritizing in accessing them in the country, while indicating that the National Assembly has passed a bill to help build a national insurance scheme.
Sallah pointed out that every service must deliver according to standards and if the country wants quality, there must be a regulatory authority that supervises service delivery. He said they will ensure a regulatory body exists in all sectors of society, all areas of services and public enterprises, that will annually present reports to the executive and to parliament to show whether those institutions are delivering services according to purposes, whether they are accessible, affordable and providing qualities. This, he said, comes through institutions building.
“My executive will look at the existing laws and ensure that the money provided for the rendering of services is delivered according to the purpose. We are saying that a new government should know the characteristics of what it is inheriting. First, we are going to establish a commission that within three months will be able to identify all the gaps and make recommendations of how to address them and the recommendations will be implemented including our own conception of how to address the problem. To me, there is no traditional medicine, the medicine is medicine…
“Health education will be given a priority; we will also need to build up an infrastructure where much investigation, much research can be conducted for us to be able to produce some of the drugs we need to cure our people,” he said.
The Gambian politician also said their-led government will ensure each village has a health centre. He said the clinics they intend to establish at the village level will be first aid clinics, where they will train healthcare workers through in-services.
“If you don’t protect women you are sacrificing the future and with the PDOIS-led government, we are going to protect them. We are saying in our executive we are going to have equal men and women so that the major problems could be solved,” he said on the issue of maternal mortality.
He said they would ensure a pregnant woman is taken care of as there will be three months leave for pregnant women and nine months after delivery. This, he added, is to protect women from the type of illness and death they are going through.
For Essa Faal, the Gambia’s health sector is practically dead or not existing, something he said his-led government intends to remedy.
“What we have of hospitals are in fact hospices where people go to die and this must change. Women died because there are no gloves, women died because there is no blood, women died because power failure, women died because there are no doctors, women died because there are no medicines.
“Growing up the [Senegalese] used to come here for medical help. Now is the reverse. We have to change that. In order to change that we have to have massive investment in the health sector and the investment has to be in the infrastructure, in the personnel and the healthcare givers. All three segments we need massive investment in it,” he said.
The Gambian international lawyer-turned-politician said they will ensure they revamp the health sector in several ways, adding they can get the money if they are serious about it.
“You see there are so much pork that the government is dishing out on a daily basis, 2.5 billion dalasis is going on duty-free. They are not going to the poor person in Dingarai or to the village market in Mansajang, they are going to well able Gambians who are rich. We have to cut that and invest that money into the healthcare sector. The insurance that we have is not an insurance that covers the people, we should have a national health insurance system that covers everybody.
“This is all a function of good leadership, proper management, and resources. The resources are there even if you cut all the waste that is going on in the government you can have a lot of money that can be put on this. In fact, we have 2.2 billion that is going to subsidize institutions that exist only to pay salaries to themselves and if we cut all those things five billion dalasis will be available. You cut the money going to the President’s office by five hundred million dalasis, you will have five point something billion dalasis available that will help to fund some of these programs, including the health sector and with insurance more money will be available. So this is doable,” he said.
Faal reiterated that the country has to be serious about healthcare and bring insurance that will cover everybody, saying if that is not done the country will not have all the resources necessary to pay for its healthcare bill. Otherwise, he went on, it will be the paracetamol hospitals found around the country where they dish out paracetamol for almost every ailment.
The lawyer cum politician said they will invest in the infrastructure, saying there are not enough hospital beds. He said there should be investment in education, in caregivers, and in doctors. There is no reason why all the Gambian doctors working abroad cannot assist us through video conferencing consultations and all that, he added.
“There is a regulatory authority. There is a medical and dental association which has the responsibility to ensure quality delivery of medical services in this country. There is a bit of lacuna that is not controlled and that is the traditional practitioners. I have seen a recent document on the issue of treatment for HIV AIDS in which an effort was made to also regulate traditional practitioners who are engaged in HIV AIDS treatment. That is not enough, we need a more robust regime for that. But really for the purposes of medical practices that are already regulated; what we should be talking about is to ensure more robust enforcement of the rules. If you go to the provinces there are lot of charlatans and quacks portraying themselves as doctors and selling medicines and nobody is doing anything about it. That is the bit that needs to be attacked and dealt with.
“Also, the traditional practitioners who think that they have panaceas and can cure all sorts of diseases, maybe including death. These are the people we have to deal with to ensure what happened in The Gambia from State House would not happen again. People being given poison in the name of drugs,” he said.
Speaking further, Faal said he was astonished that Mr. Sallah would suggest that there should be no separation between “traditional medicine and [modern medicine].” He said in medical practices, there are standards and institutions that are responsible for ensuring that all sources of treatments work.
He also said under his-led government, all Gambians will have access to quality medical health services and that every region in this country will have two referral hospitals and clinics established across the regions depending on the population.
“We will ensure that there are adequate medical doctors who will take care of the people. I don’t think it is realistic to establish a health center in all villages in this country. There are hundreds of villages in this country so I don’t think that is achievable. In a government led by me, I will ensure that there are lots of hospitals in the country. We will also ensure that people in the villages have access to these hospitals. But to suggest that one can build medical centres in each village is just a fanciful dream in my view. It cannot happen. We don’t have those resources and it is absolutely unnecessary. What we need is a system of collecting sick people from their residences to the hospital and that we can do with a good network of ambulances. Once that is available the problems will be solved,” he said.
Faal further said in order to address maternal mortality, they have to identify where the problem lies, citing lack of access to health facilities, lack of gloves, among others as problems that ought to be solved.
On the economy
Speaking on the country’s economy, Sallah said the country’s economy has three elements: agriculture contributing just 19% of the GDP, industry 20%, and services 55%. He said on agriculture, the country can produce the rice she needs.
“We are spending twenty-nine million on potatoes and we can produce potatoes here; one hundred and eight million on onions and we can produce onions here; in terms of edible oil we are importing 1.2 billion whilst our groundnut can be transformed into edible oil. Just cereals we are investing two billion, we can produce it here; milk products five hundred million we can produce it here. So, everything we are importing up to 2017 when Barrow’s government came into being is up to twenty-four billion are things we can produce. We are going to focus on that, expanding the productive base and with that, we will reduce the importation and work towards exportation.
“Look at our oceans, we are capable of having fishing trowels to reap our waters. Jawara left a trade deficit of about 1.4 billion, Jammeh left a trade deficit of 11.9 billion, now we are going to thirty billion trade deficits as Barrow’s existing government whose efforts is meant to expand our export which falls below one billion and moves just about 1.3 billion if the re-export trade is facilitated. So we are exporting nothing, we are not a producer country, so that must be eradicated and we aim to eradicate it. That is why we are talking about the two financial institutions that are the cooperative bank and the sovereign wealth investment fund,” he said.
Sallah also said running a government is a budget and the budget allocated to the office of the President depends on the provisions. He said the constitution gives every Gambian the right to be the sovereign authority that determines government, adding when that authority is entrusted, it must be exercised to promote the general welfare of the people
“So women must participate equally, in cabernet there must be an equal representation in the National Assembly. We will make sure there are some legal changes to ensure equal representation and move towards equalization and representation. The equalization even starts at the schools’ level where we will train both boys and girls equally both mentally and on the mindset,” he said.
Sallah said they are going to ensure that everybody occupying a post must have the professional qualification, capacity, and experience to do so.
“We want to ensure that discrimination is in reverse. We have seen that throughout the colonialism period the state has been an instrument of quashing and that machinery has not been nullified, we are going to nullify that. We are going to ensure that there is community security and village institutions will have their securities, then our police force will turn to a mobile force who will be called upon to come and assist this community security to be able to handle any crime.
“But we are also going to ensure that they are well trained and nurtured. We are not going to allow any use of handcuffs in this country, no detentions in horrible cells. We are going to look at all the cells and transform them, because one is presumed innocent until proven guilty. Nobody is going to be treated like a criminal before going to the court and we are going to give community sensitization on that,” he explained.
In terms of the security, Sallah said the Gambia’s navy is capable of having a production base to have fishing trawlers to harness from the fish they country can earn from it and also export it in order to have revenue.
“The Army will be transformed into a disciplined workforce. We are saying that regulatory bodies are going to be built and operated by human beings of integrity and they will do proper monitoring to ensure that policies are implemented. There will be no compromise on that; you either deliver or you go and there will be a performance contract and you will be rewarded for good services. The security apparatus will also be transformed into a workforce so that the building of our school structures and state structures will be done by them,” he said.
Essa Faal, on the other hand, saidThe Gambia is the most terrible place to do business and direct foreign business is not coming to the country. He said foreign direct business is massively going to Senegal because Gambia is doing badly. The newcomer politician said he intends to change that and ensure that Gambia has a business-friendly environment that will allow people to do business free of the massive corruption that imputes business.
“We will ensure that we look at our tax laws again and simplify them and ensure that there is a greater collection of taxes than what is happening today. There are many loopholes and very lapse enforcement. We will ensure that we digitalize our financial system, insist on greater transparency and that will reduce corruption. We will ensure fiscal discipline takes place; there is a lot of waste going on. We will ensure Diasporas bonds to finance some of the projects that will help spur economic growth. The policies I have just outlined will help create a lot of savings for the government and I have just mentioned two issues, we can save five billion dalasis by just ending the subsidies and ending the unnecessary duty waivers.
“The budget approved for the office of the President for 2022 is six hundred and seventy-seven million dalasis. I have raised this concern, what are they going to do with that money. We could just remove six million dalasis from that and we would still be spending in the office of the President more than what we are spending on sports,” Faal said.
The former lead counsel of the Gambia’s truth commission (TRRC) said his-led government will ensure gender balance in the cabernet, saying 50% will be women and that there will be positions reserved for youth. He said this will be a policy that will be retained by all aspects of government and they will ensure inclusiveness, diversity and regional and gender balance.
“This is a time when the Gambia needs everybody. For me, the only requirements will be qualification, experiences, and integrity of the person once all those three boxes are ticked, we will ensure equality across the board. In a government that I lead, discrimination will end. In a government that I lead, regionality will end. In a government that I lead, favoritism will end. In fact, I have always said, for us, we choose knowledge over ignorance, we choose pragmatism over dogmatism and idealism, we choose experience over neophytes and these are the principles that will govern our government and it will run across the board from top to bottom,” he said.
Faal said reforms are needed in this country and they should start from the fundamental basis of the constitution. He said the 1997 constitution is a dictatorial constitution that has enabled massive abuse of power in the country, and that one hundred and ten million dalasis was just spent to come up with a new constitution that has not metalized.
“We will go through that constitution and that will be the beginning of our government. We will ensure that there is great transparency in government. The first reform we will do is to ensure that a new constitution that is fit for purpose is put in place. We will also ensure that civil services reform is put in place because civil services are the delivery of all government programs. If it does not fit for the purpose, you will have serious problems. We will establish a civil services training academy which will help train individuals in line with the modern era. The performance contracts could come back; they are useless if they are not enforced. We will ensure transparency and that will help to reduce corruption in this country. If that is done, government will be able to function properly,” he said.
“This is not the type of debate I wanted to engage in, it is very combative. I expected something different. But then when personal assault comes, I will hit the person right in the face and people must be careful. There is nothing in a republic that can turn the country into an ideological state.
“So all those people who are saying those things are misleading you. I am a member of ICP-OACP assembly, I sit with European parliaments, they listen to me. People who are hoodwinking you that what they are saying reflect the ideas of Europe are deceiving you. Europe will speak for itself, Africa will speak for itself but not these people who are misleading you to believe that when a particular person is in power…
“Even Jammeh could not be isolated because of international politics. He was getting grants, pretending not to. He was getting loans, pretending not to. How many roads have been built by the European Union? So you must bear in mind when you’re running a government. Now we should not talk about ideology because we have a constitution and the Honourable gentleman knows that. I was appointed as a minister when the coup took place and I rejected it. And when that happened eventually, they closed all chapters of political parties. I struggled against it. Whether briefcase lawyer or whatever, he was there, among those people who were prosecuting me.
“He should know how I value democracy, how I value the republic. I fought for it, I have lived for it and I will die for it. We will build the most democratic country in this continent. That’s what we intend to do. People should love the republic and they should love the people.”
“I am really surprised that Mr Sallah appears very angry. I must apologize if I have said anything that riled you up. That was never my purpose. It was a simple debate where we exchanged ideas and I challenged some of your ideas.
“But let me tell you Mr Sallah, I would not apologise for having views that are different from yours. Gone are those days when we are indoctrinated and caught in awe of some of these statements you have made. We have come of age and we must free ourselves from that shackle of domination. We are now able to think for ourselves and look at things and not awed by the language that we use but rather we scrutinize the content of what is said and I do not apologise for having capitalistic views for I believe it is the system that will make the world run and not archaic and dogmatic and old systems that did not even work where they are created let alone in this country.
“So I am not talking about ideology. I am talking about practical ideas that would work in this country. And Mr Sallah let me tell you: like you, many of us have also made sacrifices for this country. I have left a great deal to come and do this truth commission that is being talked about everywhere in the world and it was a personal sacrifice. So we are all in this together. And I respect you for who you are, I respect you for what you have done for this country. But equally, you must respect other people for what they have done for their country. You do not have a greater love for this country.”