Plans afoot to fully implement gov’t policy to tackle trauma in Gambia

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By Momodou Jarju

Plans are underway to fully implement The Gambia Government’s new policy that aims to prevent and manage traumatic cases in the country. Trauma is a serious injury—possibly life-threatening—that requires immediate medical attention.

Christened the Gambia National Trauma and Injury Plan (GNTIP) and launched last December, its implementation—which was anticipated to kick-off January this year—is hoped to curb morbidity and mortality from trauma.

The Gambia’s first trauma orthopedic surgeon Dr. Kebba S Marenah said in an interview recently that they have started getting people who will serve as coordinators in various hospitals across the country.  

Dr. Marenah, who is also the CEO of the Westfield Clinic and a senior consultant at the Edward Francis Small Teaching Hospital (EFSTH), was among the experts who contributed in the development of the GNTIP.

The orthopedic surgeon revealed that they have a trauma registry beforehand which will now be used to evaluate what they are doing. However, he said they are waiting for an office space and the hiring of other staff for the programme to fully kick-on.

“We plan to have a trauma coordinator at Ndemban EFSTH and then the general hospitals will all have a trauma coordinator. So that will be the start of the plan. When we get the program manager in place, and the deputy and other staff [we will] then start looking at the future,” he explained.

Speaking further, he said they’ve collected 18 months of data and they know how long it takes a person who has an accident in Basse to get to Banjul.

“It takes almost 36 to 39 hours sometimes. So, we will be able to evaluate over the next six to 12 months what has changed? I would have hoped it would be a bit further, but I’m still hopeful. I don’t feel that this is going to die. There’s too much work that has gone into this to just let go. We will make sure that at least it starts then it’s up to others to continue,” he said.  

Reducing Deaths from Serious Injury

Dr. Marenah said there is no country that has zero injury and zero death from injuries, but there will always be a need for how to treat them, adding that one of the most important aspects of dealing with trauma is prevention.

“We’d rather not have injuries. But even high-income countries will show you no amount of safety features and other policies you can bring in will stop injuries,” he said.

According to him, they hope to reduce deaths from serious injury, as well as reduce morbidity and disability, indicating that for every one death, 20 people are left disabled or unable to do what they could do before—an aspect that doesn’t catch the attention as much.

“So, when I say there were 120 injuries and 20 deaths, what everybody hears is 20 deaths. But they don’t realize that 120 injuries, most of them will not walk for six months at least, sometimes longer. Some will never go back to walking again and some will never be the same again,” he said.

Based on statistics, Dr. Marenah said it’s the younger people of the country—people in the age group 10 to 30—that are getting 60 or 70% of these injuries. For that number of people getting injured and not being able to work, it’s going to damage the economy, he said.

The orthopedic surgeon said trauma treatment can be expensive, saying a fracture can cost 10 to 20 thousand dalasis just for the implants that they use to fix. At the moment, he said patients pay to get the implants.

“But you cannot quantify that in terms of what it’s doing for the economy. It sounds like a lot. But imagine the difference; 20,000 or not being able to walk for five or 10 years,” he said.

More About the GNTIP:

GNTIP has been nested under the National Cancer Control Programme headed by Dr. Kebba Bojang. According to the plan, it describes a strategy to optimize and further develop care of the injured in terms of staff, equipment, facilities and systems which is outlined in the immediate application and a five-year and 10-year development.

Dr. Marenah said the plan has been funded majority by the AO Alliance—one of the partners. He said the AO Alliance met the health ministry and shared the idea of the plan which the aforesaid ministry backed.

“But going forward, when it comes to implementation, it will not be sponsored by the AO Alliance. There will be some input from AO Alliance and I also have to mention WHO have also put some input in terms of getting the document through,” he said.

He said the government has budgeted to fund the trauma and prevention program, and the Personnel Management Office (PMO) have also guaranteed salaries for the staff, including the trauma manager, deputy manager and others.