Political Difficulties in The Gambia

In The Gambia, I worked with the MRC, the Medical Research Council which is affiliated with the UK government and has been working in Gambia for over 50 years. It's now the 2nd largest employer in the country after the Gambian government. Their role is to provide clinical care and clinical research relevant to the local population. For example, the new meningitis vaccine funded and championed by the Gates Foundation as the first vaccine developed to treat a disease that affects the developing world rather than the developed world, underwent clinical trials at MRC.

As you saw from my West Africa Profile post, the country is extremely poor and health and development needs are great. However, the political situation in The Gambia is making it increasingly difficult for NGOs and other nonprofit organizations like the MRC to continue functioning. The President, Yahya Jammeh, who per his official website carries an astounding 6 titles: "His Excellency Chief Sheikh Professor Alhaji Dr," has been in power since a coup in 1994. Despite being democratically elected 3 times since then, he has been increasingly consolidating power and censoring the media and all opposition.

Apparently, anything the President decides to do can have no competition. And he decides to do a lot. He has been entering into every realm of business in the country and pushing out all competitors. He has a bakery. An NGO that grew mangoes as part of its work to sustainably support local communities had to leave when the President decided to start mango farming. Even more difficult for health-related NGOs, the President offers his own cure for HIV/AIDS. Yes, all people with HIV/AIDS can leave their cumbersome antiretroviral medications behind and go to the President's house, where he will lay his hands on them a-la Jesus and thus cure them. His "cures" are performed and presented on national television on a weekly basis. Of course, anyone with basic knowledge or education should know that if someone infected with HIV does not take their medications to keep their viral levels low and their immune system strong, they unfortunately will not have long to live (as those who were alive in the early 80s before the ARV medicines were developed will remember).

Even more difficult than trying to keep your organization's goals and activities from offending the President's next investment whim is attempting to partner with the existing political system in order to create sustainable aid projects. The hospital directors, in addition to the government Ministers, are politically appointed positions. The newest Minister of Health is a young woman in her 20s with absolutely no health-related experience. Hospital administrators are often equally inexperienced. Even so, they could be trained on the job, but political favour shifts quickly and most Ministers and Directors are fired, or sometimes jailed, within a year of their appointments, just as they begin to figure out how the systems they've been "running" were supposed to work, and just as NGOs have finally negotiated agreements for partnership and buy-in on their projects.