Dramatic Drop in Maternal Mortality in Gambia

Medical Xpress.com

Long-term research collaboration has helped reduce maternal mortality in the Gambia to less than half its previous level over 14 years. However, the country is still facing numerous challenges in terms of health.

In a small, dusty village some miles away from the pulsating capital city of Banjul a woman is lying in bed, whimpering in pain. It is quiet at the health centre, with few patients. However, there are no doctors or midwives present. In maternity wards in the rural areas of the Gambia, assistant nurses most often help in the delivery of babies. Only a small minority of Gambian doctors are trained and work in the country. Most of the hospital doctors are Cuban doctors on short-term engagements and speak only Spanish or English, while the majority of the Gambians speak local languages such as Mandinka or Wolof.

Johanne Sundby, gynaecologist and professor of social medicine, is on field work in the area and is asked to examine the pregnant woman. The woman is suffering from delayed progress in her delivery – the baby's head has not entered the birth canal, in spite of the contractions – and if the baby is to survive she must be sent to hospital. An ambulance is called, but the road to the nearest hospital is long and arduous. The woman must cross the river on an overloaded ferry. If she is lucky, she will catch the fastest ferry and arrive at the hospital in time. If only the slow ferry is available, the outcome may be fatal. The latter is often the case. Poor infrastructure, lack of doctors and adequate health facilities are only some of the causes of the country's high infant and maternal mortality rates, which have long remained among the highest in the world.