A medical professional in scrubs performs surgery on a patient's leg, using a headlamp for lighting.

What We Do

The Gambia lies on the coast of West Africa. It is the smallest country in mainland Africa and has a population of 2.4million.

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It ranks among the poorest countries in the world with a Gross National Income per capita of less than $1,500. Less than half of The Gambia's population has access to electricity, and over a third of the country's urban population lives in slums.

3% of GDP is spent on healthcare compared to approximately 10% in Western Countries. There is a shortage of healthcare professionals. The Gambia has 0.1 physicians per 1000 people compared to approx. 3 per 1000 for western countries, one of the worst rates in the world. Because of the limitation of physicians people often seek treatment from Traditional Healers. This often leads to poor outcomes for patients.

A group of medical staff in scrubs gather around a table in a hospital room.
Four men standing together, one holding a red phone, discussing something intently.

In the summer of 2018 Dr. Kebba Marenah was employed as the Country’s first Gambian Orthopaedic Consultant. Kebba completed all of his medical training in the UK including his Orthopaedic Registrar training in Brighton and Sussex University Hospitals NHS Trust.

In February 2018 Kebba lead the Orthopaedic arm of the West African College of Surgeons Outreach Programme to the Gambia. He, and two Orthopaedic Consultants from Brighton (Mr James Gibbs & Mrs Lisa Leonard) performed surgery and taught in EFSTH for a week.

Out of that trip, Gam Med was formed. The idea being that UK healthcare professionals would continue to give long-term help and support to Kebba in his ambition to raise the standards of hospital treatment in The Gambia.

One way is to continue outreach trips. We send regular teams of healthcare professionals unpaid and in their own time. This includes Anaesthetists, Orthopaedic Surgeons, Radiologists, Plastic Surgeons, Physiotherapists and representatives from the medical devices industry. Surgical cases are performed and teaching & training provided.

We also source & ship medical equipment. Most of this is donated by UK hospitals.

Two medical professionals help a child with a breathing mask in a hospital room.
In the UK, we spend $5,493 per person, per year on Healthcare and in The Gambia, they spend $29 per person, per year.
What We Do
Surgery

We perform challenging cases during the outreach trips. As well as helping many patients, we are also able to provide teaching and training to Gambian Healthcare professionals.

In the Gambia many patients with injuries use traditional medicine and Healers. Fractures are often bound with sticks and then do not heal in the correct position resulting in significant permanent deformity. The resulting deformities would pose a significant orthopaedic challenge to reconstruct the limb in the Western World, let alone in The Gambia.

A man lies on a hospital bed with his leg supported, while another person stands nearby.
Man smiling while sitting on a hospital bed with a bandaged knee.

This man was involved in a car crash some years ago. He sustained a fracture at the level of the knee. Because of a lack of adequate initial care the knee joint fused and the limb healed with a significant deformity. Surgery was performed by the Gam Med team to correct the deformity. The limb had to be immobilised in an external fixation device whilst it healed. This form of treatment is not normally available in The Gambia.

Person lying on a bed, wearing a gray shirt and shorts, stretching one leg upward.
A person in a red tank top lies in a hospital bed with a leg brace on.
A person in a surgical outfit examines another person's leg in a hallway.
Four people standing together, three in green scrubs and one in a yellow traditional outfit.

Open fractures (where the skin is lacerated exposing the fractured bone to the outside world and bacteria) are an Orthopaedic & Plastic surgical emergency. Without aggressive early treatment chronic bone infection will ensue. The fractures need to be surgically stabilised and wounds methodically cleaned, freshened and closed. Often patients with open fractures in The Gambia use traditional medicine and the wounds largely go untreated. Many people therefore have chronic bone infection (Osteomyelitis) that will not resolve without surgical treatment.

This six year old girl had broken her ankle one year ago. This was an open fracture and the bone had been poking out through the skin for a year. As a result the majority of her fibula bone was chronically infected. Her Father had heard that we were working in the hospital and brought her in for us to see her. We were able to operate on her that day. Unfortunately because of the chronic infection the majority of her fibula bone had to be removed.

Man's injured leg with external fixator, removed bone pieces on white cloth, and leg X-ray image.

Whilst performing surgery, teaching and training in surgical techniques is provided to Doctors, Nurses and Theatre staff.

Three surgeons perform surgery in an operating room, wearing protective clothing and masks.
Doctors and nurses perform surgery in an operating room, wearing scrubs, masks, and gloves.

We also run lecture based courses and practical workshops

A group of people gathered around a table with skeletal models and medical tools, smiling at the camera.
A group of people works together on a project using a drill and model bones.
What We Do
Plastic Surgery

Our plastic surgeons are extremely busy in The Gambia. They manage a variety of soft tissue problems including burns, open fractures, tumours and chronic ulcers.

Burns are all too common in The Gambia as people cook on open fires. If not managed correctly the burns can cause scarring and contractures that can impair peoples function.

At present there are no consultant plastic surgeons working in The Gambia yet the need is enormous. Gam Med is partnering with other medical charities (BFIRST and Interburns) to continue to support and develop plastic surgery training. Working with the Gambian Ministry of health, there is also now a roadmap place to set up a plastic surgery department once the surgeons have been trained to become Consultants.

Surgeons in blue scrubs perform surgery under bright lights, with a nurse observing nearby.

This poor boy sustained severe burns from a fire. He had severe contractures to the face, neck, arms and hands from the resultant scar tissue.

A person with visible skin condition sits on a green chair wearing beige pants.
Person in a red shirt looks up, displaying visible facial scarring, sitting indoors.
A person with vitiligo on their arm is seated, scratching their elbow.
A person with severely bent arm and dry skin sits in a chair wearing a red shirt.
Young boy with a serious expression and facial burns, wearing a red shirt, seated indoors.
A child with facial scarring sits on a green chair, looking to the side.
A child with a skin condition sits on a green chair, displaying an affected arm and shoulder.

The scar tissue and contracture meant he was unable to move his elbow and so unable to feed himself.

An arm wrapped in blue cloth, showing healing scars and stitches on the forearm.
A hand with vitiligo patches is pulling the skin on an arm with similar patches.

Gam Med plastic surgeons performed surgery to his elbow which has restored his function and he can now feed himself.

Surgeons in blue scrubs perform surgery under bright lights, with a nurse observing nearby.
A young person with a bandaged arm stands next to a hospital bed.
A person with a bandaged arm sits on a red chair, showing injury or treatment.

In November 2023 further surgery was undertaken to his face and chin area.

Doctors and nurses perform surgery in a hospital operating room with medical equipment.
Three surgeons wearing masks and surgical attire perform a procedure on a patient in an operating room.

Skin grafts beneath the right eye and under the mouth have enabled him to close his eye and mouth.

A person with severe facial burns wearing a gray shirt lies on a hospital bed.
A person with severe facial injuries lies on a hospital bed, receiving medical attention.
What We Do
Anaesthetics

Our Anaesthetists train in regional anaesthetic techniques. This means patients can have surgical procedures without the need for a general anaesthetic.

During our outreach trips our anaesthetists assess patients preoperatively to ensure they are optimised for theatre.

General anaesthesia in Gambia is challenging for a number of reasons. The hospital is prone to power cuts, drugs can be in short or variable supply, the anaesthetic machines are older and less serviced than in the UK to name but a few.

We therefore perform most operations under awake regional anaesthesia (spinal, epidural or nerve blocks), avoiding the need for a general anaesthetic This is safer for the patient and provides better post-operative pain relief.

Medical staff perform a procedure on a child in an operating room, while others observe attentively.
Doctors and nurses focused on performing surgery in a hospital operating room.

Many children however are unable to tolerate the procedures without a general anaesthetic and we have the support of specialist Gam Med paediatric anaesthetists.

Our training focuses on teaching the Gambian anaesthetists regional anaesthetic techniques so they can avoid giving a general anaesthetic where possible. We also focus on the safe provision of general anaesthesia, early detection and management of emergencies and advanced life support in the event of a cardiac arrest.

What We Do
Operating Department Practitioners/ Peri Operative Theatre Nurses

Senior Theatre & Recovery Nurses play a central role in the surgical team, ensuring that patients receive safe and effective care before, during, and after an operation. Their role combines clinical skill, technical knowledge, and patient care.

1. Pre-operative care (Before surgery)

  • Check and prepare all equipment, instruments, and drugs.
  • Ensure the operating theatre environment is safe and sterile.
  • Reassure, support, and monitor patients before anaesthesia.
  • Assist the anaesthetist in preparing for the patient’s care.
Three medical professionals perform surgery on a patient in an operating room.

2. Intra-operative care (During surgery)

  • Act as scrub practitioner: working directly with the surgeon, passing instruments, and maintaining the sterile field.
  • Act as anaesthetic practitioner: supporting the anaesthetist with airway management, monitoring, and patient stability.
  • Act as circulating practitioner: managing equipment, fetching additional items, and ensuring smooth theatre flow.
  • Monitor the patient’s vital signs and respond to changes.

3. Post-operative care (After surgery)

  • Transfer patients safely to the recovery unit.
  • Monitor vital signs as patients recover from anaesthesia.
  • Provide pain relief and psychological support.
  • Ensure accurate handover to ward staff for ongoing care.
What We Do
Post Anaesthetic Care

We provide post anaesthetic care and training for all our surgeries and procedures, ensuring patient comfort is at the forefront of all that we do.

What We Do
Physiotherapy

During the outreach trips, the physiotherapy team are involved assessments and treatments at the clinic, cleaning equipment and delivering teaching sessions to local physiotherapists. Our primary focus is on providing aftercare physiotherapy in the wards, working alongside the local team. We aim to ensure that patients who have undergone surgery are safe and ready to return home.

What We Do
Radiology

Our radiologists provided scanning, reporting, teaching and support to radiologists and radiographers as well as identified ways in which radiology services can be improved in the long-term. Back in the UK they continue to provide support with remote reporting of scans and providing training attachments to Gambian trainees in the UK.

What We Do
Teaching

We provide extensive teaching and training for Gambian Healthcare professionals both in The Gambia and the UK.

What We Do
Hospital Kit

We source medical equipment for multiple Hospitals across The Gambia. We send unused and unwanted consumables. We have donated theatre tables, drills, orthopaedic instruments to name but a few.

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All money donated goes directly to helping raise the standards of healthcare in The Gambia.
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