For several weeks, Lamin Ceesay had trouble getting out of bed. He came down with an unexplained illness after coming back from a trip that took him to 5 villages up country. At first, his family thought he was just exhausted from a long journey but when days of resting in bed wouldn’t ease the pain and fatigue, his family decided he should start taking Paracetamol. After several days of pill taking and without improvement, his wife, Amie decided to consult a marabout. She was told Lamin picked up the illness in one of the villages he visited during his trip and one short dark skin frail looking old lady is to blame – she cast a spell on him. Amie was asked to cook 7 meals of beef stew with white rice and distribute it among 11 kids who are not from the same parents. She obliged and carried out the instructions hurriedly.

After several days without feeling any improvement, Lamin decided to try his luck at the Edward Francis Small Teaching Hospital in Banjul with the hope that what home and supernatural readies couldn’t take care of, the main Referral Hospital in the country would easily deal with. So without reservation and with much optimism, he asked the wife to arrange a taxi for him to go to the hospital. We will come back to Lamin’s fate in a little bit.

The Gambia’s Health Infrastructure

The Gambia has 5 major hospitals namely: Edward Francis Small Teaching Hospital AKA RVTH, Sulayman Junkung in Bwiam, AFPRC Hospital in Fara Fenni, Bansang Hospital, and Serekunda General Hospital. The Main Referal that handles critical cases is RVTH.

Below the major hospitals are the Major Health Centers (Soma, Faji Kunda, Essau, Basse, Kuntaur, Brikama). The lowest rank are the Minor Health Centers (e.g Kwinella, Bakau, Yoro Baol). Registered Nurses run Minor Health Centers, while Doctors run the Major ones.

Health Care Budget

The budget allocated for health in 2014 for the whole country was D596,000,000 ($14,900,000). This represented 6% of the entire national budget.

Medications for the entire country are procured and delivered to the Central Medical Store in Kotu. Central Medical distributes to regional stores (Brikama, Mansakonko, Bansang, Basse, etc), who inturn allocate to all major hospitals in the region. Some supplies are delivered when requisitions are made from regional stores.

The most needed medications in the country are: adrenaline (for cardiac resuscitation), dopamine (for renal failure patients), dobutamine (for cardiac resuscitation), anti-coagulant/anti-platelets (for people with diabetes, heart attack, and those with other cardiovascular risk factors), thombolitics (needed immediately for patients showing signs of severe heart attack), broad spectrum anti-biotics (eg. vancomicine, ceftrisone) for patients who are resistant to other anti-biotics like peniciline – these are neumonia, gonorhia, syphilis, septic wounds, etc. , statins (for those with high cholesterol level , etc.) anti-hypertensives (for blood pressure lowering), anti-arrhythmic (intravenous amiodarone – for heart rate and rhythm control), anti-diabetic medications like insulin.

Routine machines and procedures most needed at the hospitals

-Machines for blood sugar monitoring

-Urine dip sticks for urine analysis

-Oxygen machines

-Blood Pressure machines and thermometers

-Oxygen Saturation machines in times when patients are gasping for air

-Suction machines for patient resuscitation

-Bandages for wounds and surgeries

-Chemical re-agents to run samples and lab equipments

-Dialysis machines for hepitis B and C patients

-Catheters for patients going for dialysis (for intravenous access)

-Papers for ECG (Electronic Cardio Gram). Monitoring of patients needing reading of their vital signs

-X-Ray films

-Scanning by qualified Doctors

Compensation for Medical Doctors and Nurses

Starting salary for Doctors graduating from The Gambia’s own medical school is pegged at Grade 8.1 which is D3,500 with on-called allowances amounting to D4,500 a month. Everything totals to around D11,000 ($275) when you add car allowances, residential allowances, risk allowances, and transport allowances. Counterparts in Liberia are getting $1000.

Registered Nurses make on average salary of D4000 (including everything) a month, and D8,000 for those working double shift. Their transport allowance is only D500 a month.

The state of healthcare in The Gambia

Recently, 18 children died in the Maternity Wing of the RVTH because, according to reliable sources, there were no qualified medical staff to attend to them. They all succumbed to preventable situations. The question that begs to be answered is: how could the death of 18 innocent children under such callous circumstances not have generated the kind of firestorm we see in other nations? The virtual dictatorship in that country has not just been a case of physical tortures, disappearances, killings, illegal arrests and firings being meted out against an innocent citizenry, it has also severely affected the economy, agriculture, healthcare, education, and all other essentials for a viable nation. The case of these children, as catastrophic as it is, is just a symptom of a problem of biblical proportions – 1,000 other faceless victims lost their lives on the same day this tragedy unfolded due to preventable illnesses, malnutrition, poverty, and lack of basic education – all thanks to policies of the current regime.

So what’s wrong with the healthcare system?

For starters, when procurement for medication is made, the supply just simply doesn’t meet the demand. The yearly supply doesn’t last past the first three months. This is happening when the budget allocated to the President’s Office (almost 7% excluding other Departments brought under this office to snatch more funds for the President) is more than what is allocated to entire healthcare needs of the country.

According to our sources, the other problem aggravating the medication problem is that those procuring don’t have a clue what kind of medications are needed, especially the essential ones. This, in addition to the fact that wrong medications are ordered routinely. We already listed for you the essential machines and medications badly needed in The Gambia because of the prevalence of the ailments those facilities are needed for, here is what obtains with regards to that situation: machines for blood sugar monitoring are not available – sometimes only one for the entire hospital. Urine dip sticks for urine analysis are not available. Oxygen machines not available. Blood Pressure machines not available. Nurses are supposed to take the vital signs all the time, this is routine in any hospital around the world. Even thermometers are lacking. Oxygen Saturation machines in times when patients are gasping for air are not available. Suction machines for patient resuscitation are not available. The only one available is a manual, not useful in times of emergencies which is when this is usually needed in the first place. Sometimes bandages for wounds and surgeries are not available. Operation after operation is cancelled because of this. Routine analysis cannot be run in the labs because of lack of chemical re-agents to run samples, and lack of maintenance of lab equipments. No Dialysis machines allocated to hepitis B and C patients. Under normal circumstances, HIV patients should not share the same machine with hepatitis B and C patients but unfortunately this general precaution is not adhered to in The Gambia because of this problem. The only machine working is being used for healthy patients. No Catheters for patients going for dialysis (for intravenous access). The kits needed for dialysis are not available when people with kidney failure have to be on dialysis. Many die because of this. As if these preventable issues are not outrageous enough, we were baffled to discover that even ECG (Electronic Cardio Gram) machines have no papers available to do the reading of cardiac activity. This is now discontinued. So monitoring of patients needing reading of their vital signs has been stopped. We are talking about paper here! X-Ray films are also not available. So X-Rays have been discontinued. Scanning has also been discontinued because only the Cuban Doctors can do that and they are currently on vacation and haven’t returned. They were supposed to return on October 9 but due to unavailability of flights, they are stuck in Cuba. No Blood Bank In the entire hospital system, so when patients need blood transfusion, the hospitals generally make appeals to soldiers and private citizens to help out. Patients in the meantime have to wait until donated blood is available, if they are lucky to be alive till then.

Doctors and Nurses go all around the hospital looking for just one of these items in emergencies without success. Hundreds of patients die weekly due to these problems. Staff morale is at an all-time low due to the stress associated with this.

There is currently one urologist and one neurologist in the whole country. No dermatologist in the entire country. No oncologists (for treatment of cancers, etc).

To control the consumption of essential drugs, due to the shortage, the government came up with a lame attempt – a memo has recently been issued instructing Doctors not to prescribe anti-biotics. That roll has now been assigned to Consultants (Specialists in each department).

It must be noted that contrary to popular belief, most Doctors in the Gambia did not specialize. They all just happen to attach themselves to a particular field and end up being known for practicing in that field but they don’t have the certificates to practice in those areas. The Medical Board unfortunately is dominated by these Doctors and they are just self-policing. Dr. Mbowe, for example, is a General Physician, not a gynecologist. He did no post graduate training in that field even though that is the practice he is known for. Most of the Doctors working in the hospitals also have their own private clinics where they perform the same services. Those who can afford it, therefore seek help from those clinics. The care is still below standard but it is an improvement over what one gets in the public hospitals since you get more attention from the Doctors.

So it is no accident that the disaster unfolding in The Gambia’s healthcare system is a boon for Senegalese private hospitals – most Gambians who can afford it, prefer to go to Senegal instead of going to hospitals in The gambia. Each year, this medical travels inject millions of dollars into the Senegalese economy and healthcare business since these trips are mostly financed by The Gambian Diaspora who have completely lost faith in the system.

Back to Lamin Ceesay. Lamin died at the hospital because he was discovered to have a kidney failure and needed Dialysis. The Dialysis procedure could not be done because there was no Catheter (sells for less than $3) avaible. In the meantime time the President, Yahya Jammeh is spending D80,000,000 ($2,000,000) on birthday celebrations while his wife spends more than D8,000,000 ($200,000) on each shopping trip (about 5 a year) she takes to the United States. Their daughter Mariam’s tuition at the private High School she is attending in Manhattan, New York City is D2,880,000 ($72,000) a year. None of the members of the First Family seek medical help from hospitals in that country, Jammeh’s own mother goes to see her Doctor in Belgium each time she needs to consult regarding her diabetes. Government Ministers make every effort to send their wives to the United States to deliver their babies. Who is left in that God forsaken healthcare system? Go figure.

The Judiciary of The Gambia is reported to have been hit by lack of Judges and Magistrates, a problem that caused the continuous adjournment of several cases including those of people who are still kept in remand at the country’s notorious and ill-maintained Mile 2 Prison. A source indicated that for almost four months, the superior courts have not been sitting regularly and the reasons advance was because the judiciary was in summer vacation. However, since the vacation officially ended at the end of September, there has not been much cases heard at the high court as there are currently only two Judges at the criminal division of the high court, Justice Martin U Okoi and Muhammed Dan Azumi Balarabe.

The problem is aggravated by the decision of two prominent Nigerian Judges not to renew their contracts with government at the end of their terms. Justice Emmanuel Amadi and Justice Joseph Ikpala had since left the country after a farewell ceremony was organized for them on the 6^th of October, 2015. The current Chief Justice of The Gambia Emmanuel Fagbenle, again another Nigerian national was quoted to have said in his farewell speech to the former judges that “they would have loved to keep both Amadi and Ikpala, as they upheld the law and were also competent”.

One unhidden fact is that the Gambia judiciary is a typical mockery of principles of justice including fairness and independence. Since the advent of dictator Yaya Jammeh’s government, Gambian judiciary have seen a serious interference by the Executive in the business of the dispensation of justice. The President has enormous unchecked powers to unceremoniously sack even the Chief Justice.

An action seen by many as a means to wield power and ensure every judge or chief justice dances to the tune of the President instead of dispensing justice. The last Chief Justice to serve The Gambia, Pakistani born Ali Chowan in an interview after his return to Pakistan following his disagreement with Gambia government confirmed huge interference of the tyrannical President in the dispensation of Justice, which resulted to him quitting as he “could not work in such an environment”.

FatuRadio has confirmed that many qualified Gambians have refused to take up appointment as Judges due to the lack of job security and the huge interference of the President and his executive in the cases considered “political”.

A similar situation is reported in the Lower Courts which are also currently experiencing lack of Magistrates as many young magistrates have resigned and taken up appointments with private sectors such as Banks and other corporate institutions.

Meanwhile, sources have informed FatuRadio that Chief Justice Fagbenle has travelled out of Gambia in search of Judges and Magistrates. The fear is however, most of the people he will be bringing will be machinery dispenser of justice who are only interested in what they pocket and how long they stay in those positions as a result of satisfying the wishes of Jammeh’s government to use the courts to punish Gambians who are perceived as enemies or threat to the government

Security sources have confirmed to Faturadio that the Imam of Kanifing South Mosque, Imam Alhagi Ousman Sawaneh has been transferred to the Janjanbureh Prison in The Central River Region. Held for our over a week now, Imam Sawaneh was picked up by operatives of The National Intelligence Agency on the pretext that he was urgently needed in Banjul. At the time of his arrest according to Foroyaa Newspaper, he was leading a team of volunteers that was clearing the grass in the Kanifing South Cemetery.

Security sources have also hinted that the Imam is being investigated on allegations that he does not support the ruling APRC and that he was among those who undermined the APRC candidate during a by-election in the Central River region (CRR) of the Gambia. Different people who spoke to Faturadio believe that the allegations do not make sense as the Imam is not involved in politics or any political activity.

Now that Imam Sawaneh is moved to Janjanbureh, his situation is being closely monitored before another disappearance without trace story is reported. Some other prominent people in his capacity who were arrested in the Gambia in similar circumstances are still unaccounted for. The government has repeated denied that it is holding them eventhough every evidence showed that they were arrested by state security agents. Imam Sawaneh’s case has now been officially reported to all international organizations to ensure that they continue to monitor his situation and to press for his release from illegal state custody.

“Hi fatu Dictator Jammeh will soon arrest muss savage.do you know he has been moved to kanilai now as kanilai camp commander.the reason the Dictator did this because he doesn’t trust him so he has to move him.i can tell you one thing it’s almost impossible to escape mile 2 .kanilai is a way to mile 2 or you get fired from the army.the history is there for everyone to see.will give you a list of former camp commanders.2006 LT Ebou lo .Kawsu camara bomba jailed.solo bojang jailed.bajinka on the run in the U.S. Lagos fired the list goes on.just wait and see muss savage will soon be killed or jailed i can tell you this for free.”

As part of our investigations as to how the criminal den of Gambian President Yahya Jammeh is mismanaging our tax funds, Fatu Radio today focuses on awarding of infrastructure projects to the President’s special friends and business fronts where large chunk of Gambia’s expenditure funds are spent. In 2013/14 fiscal year, the Gambia government claimed to have spent D1882.55 billion on infrastructure projects. This is one big area where the dictatorship in the Gambia has absolute control over and where it continues to commit fraud against the Gambian people.

Many of the infrastructure projects that the government include in the recurrent budgets have in fact been already funded years back. Such projects include construction of feeder roads, refurbishment of police and military barracks, refurbishment of public schools, hospitals, etc.

Investigations by Fatu radio showed that one of the reasons why the dictator has been engaged in spiral spending on infrastructure projects is basically to tighten his grip on the economy and on the unsuspecting populace.

Our investigations have established that Gambian President in particular uses as an opportunity the execution of high flying but hardly sustainable projects to award contracts to special friends and business fronts that engage in callous and sinister manipulation of the entire government procurement process through over pricing of materials and services charges, undercutting and devaluing quality standards.

Many of the so called companies will cease to exist immediately after executing a shady project and all the paper trace and transactions also disappear with them.

Last year, the auditor general in a rather scathing report on the expenditure culture largely criticized the government on chaotic manner in which contracts are awarded and how difficult it takes to trace some of the paperwork.

But what the auditor general failed to document is that many of the quarries should in fact lie at the door step of the Presidency and President Jammeh in particular.

More reports are still emerging about how President Jammeh uses and misuse young Gambian girls for sexual exploits. In the past several weeks, Fatu Radio has been documenting the experiences of girls, mainly of them teenagers employed as Protocol Officers attached to the Office of the President who openly accused the President of sexually exploiting them. Most of the girls are housed in a complex a few metres away from the State House where they said they are perpetually trapped and are always on standby to satisfy the President’s unusually high appetite for sex with young girls. A few weeks ago Fatu Radio came up with an in-depth investigative report which documented how virgin girls are lured into sexual relationship with the President where they are dis-virgined and their blood used for rituals.

Two of the girls who were victims of this scary encounter and who were employed as Protocol Officers at the State House, have since escaped to relative safety in a neighboring where they are receiving counselling and being treated with trauma related problems.

And now a former chauffeur attached to the Presidential fleet at the Office of the President has come out in the open to further confirm the President’s exploit of young girls.

The chauffeur who has also escaped to a neighboring country in the region in an interview with Fatu Radio last Thursday 15^th October, said he was part of a special group of drivers whose job include running errands for the President, picking young girls for him late at night. The chauffeur told Fatu Radio how he would hang around waiting until 5 am when the President is done with the girls to drop them back home.

He confirmed that many of the girls that he used to pick late at night are normally light/fair skinned ladies who are mainly young. “But in some cases, we would be assigned to pick up mature ladies, some I guess could be married” he said.

The interview on Fatu Radio which attracted a huge interest from the audience was confirmation of earlier reports detailing President Yahya Jammeh’s lust appetite for sex particularly with under aged virgin girls.

The chauffeur told Fatu Radio that during their typical errands, they do not have a conversation with the girls. “We are always given strict orders to only just pick and drop them off and not engage in any form of conversation with them.”

He also disclosed the President lust for movables such as latest cars. “The President has a long list of latest cars parked at his garage including: two Bently cars, 5 Rolls Royce Phantom, 4 BMW X6s and host of other expensive cars,” he said.

The chauffeur also talked about President Jammeh’s assassin team called the Junglers  which he confirmed is a militia within the regular army who mainly receive instructions and orders from only the President. “They are very powerful set of people….even the head of the army is afraid of them. They normally come out at night when they are to kill or arrest people on the orders of the President,” he said.

The chauffeur is now on the run for his life following involvement in an automobile accident during one of his errands driving a presidential car. One this particular day, he was assigned to pick up popular Senegalese musician Ms Adji Ouza and her father Ouza to perform for the President. After he dropped them off at the hotel, he went back home and had a call later from the guests that they needed him to go run an errand for them.

As he was heading there, a taxi driver hit his car and he had to use part of the D15, 000 per diem given to him to fix the presidential car.

After I was done with that, he told Fatu Radio, I informed General Saul Badjie head of the Presidential Guards about the accident who told me that the President has given directives that anyone who has an accident with his cars, should be arrested and detained or fired from his job. He said he left the President’s Office for home that evening promising to come back to work the following day but instead he decided to flee the country for a safer place. “I know the consequence of returning back to State House the following morning because I was going to be arrested and detained as this was the tip I got from one of my friends within the presidential guards” he said.

He disclosed that the President does not care about what happens to them chauffeurs at the State House but rather cares more about his cars. He said the brother of the Chief of Protocol, Ebrima Jarju was removed from his job after the windscreen of one of the cars got cracked while he was driving it to run errands for the president.

He also said that President’s personal driver is also often treated very badly by the president and that he still lives at the government’s housing quarter in Mile 7 and does not own a compound, stressing that once he is removed he will not have a place to stay.

It is always a joy listening to Gambia’s Finance Minister present the country’s budget. It is one such occasion that the entire country looks forward to hear the health of our economy and what government plans to do in the next 12 months particularly related to development projects and expenditure outlay. However beyond the rhetoric that defines the annual budget presentations lie one of the biggest of scams which President Jammeh and his government engage in to swindle hundreds of millions of Dalasis of tax payers’ money. And it all has to do with what Fatu Radio has discovered to be “a cunning strategy where holes of spending on repeat projects” are deliberately and continually inserted in the budget where spending on such projects are never accounted for.

Fatu Radio investigations have revealed that many of such repeat projects have appeared in eight budgets since 2005 eventhough evidence shows that they were already funded years back. This monumental fraud first came to light during Fatu Radio’s weekly Thursday program with journalist Ebrima Sillah who admonished Fatu Radio to develop interest in the way Gambia’s budgets are prepared and spent.

Mr Sillah said for two decades now the APRC government has been using a highly subtle, a highly delicate spending culture where on the surface, it claims to be using people’s tax funds to work for them. But in reality he said, a further investigation reveals one of the biggest scams in the way a country’s tax revenue is managed.

Mr Sillah’s exposé focussed on construction and other infrastructure projects funded by the Gambia government some of which have already been funded and work said to have been validated and verifiably completed. Yet those same completed projects repeatedly appear in subsequent budgets with huge of chunk of tax payers’ money allocated to them.

Fatu Radio investigations discovered that this is one big area where the dictatorship in the Gambia has absolute control over and where it continues to commit fraud against the Gambian people. Many of the repeat projects include construction of feeder roads, refurbishment of police and military barracks, refurbishment of public schools, hospitals, etc.

In 2013 for example, the entire budget of the Gambia was D3, 612.67 billion out of which the government had allocated D1, 693.03 billion for infrastructure projects. However a further investigations showed that the government ended up spending D1, 882.55 billions on infrastructure projects representing almost D200 million as excess expenditure. The justification for excess expenditure came as a form of supplementary budget which was submitted to the National Assembly by the Finance Minister but on the authority of the Office of the President.

Subsequent investigations by Fatu Radio also show that even the contractors of some of these projects, have questionable profiles making it difficult to trace their sources of expenditure as per the work that they say they have done.

Our investigations also show what one of our government sources drew our attention to as “mispricing” where the contractors quote usually higher than normal prices for services but still such services rendered are of substandard quality.

Fatu Radio is also in possession of credible evidence that show corrupt practices in the way Gambia’s tax funds are managed. For example the way funds are allocated to the different ministries where we see the office of the president is allocated the chunk of funds in the budget which are never audited.

Looking at the figures in the 2013 budget, the office of the president was allocated D345 million out of a total budget of D7279.20 billion.  However the Ministry of Defence which also is directly under the Office of the President was allocated D372 million, Fisheries ministry which was also under the Office of the President at the time in 2013, was also allocated D323 million, Agriculture also under the Office of the President was allocated D413 million. And remember Yahya Jammeh was the Minster designate for all these ministries. The ministry of Petroleum and Natural Resources also under the office of the president was allocated over a 100 million.

Our investigations show that in actual fact if you look at what the State House alone controlled in the 2013/2014 budget, stood at 37.8% of the entire budget. This is a big chunk of our nation’s funds in the hands of one person.

The situation is even worse in the 2014/2015 budget because now we have seen that the Office of the President was allocated D556 million, Ministry of Defence D558 million, Ministry of Agriculture D151 million, Petroleum Ministry about D85 million. Now interesting the Ministry of Fisheries which now has a functioning minister, is now allocated only 59 million in the 2015 from D323 million when Yahya Jammeh was handling the position.

Now all throughout particularly from year 2000, we have seen the difficulties our farmers are going through to the point that the government could not buy their nuts. We have seen the difficulties the people engage in the fisheries sector are going through. Now many Gambians have started seriously asking where all these millions accolated to the Office of the President have gone to.

From the foregoing, Fatu Radio investigations have concluded that even if the international donor community tighten their rules as to how their funds are spent in the Gambia, the President Yahya Jammeh still has vast amount of sources that he can lay his hands on. Within our budget alone, one in every three Dalasis that we collect as tax actually goes to the office of the president.

In our next report on this investigation, we will bring to fore how Jammeh uses infrastructure projects to award contracts to special friends and business fronts where the large chunk of our expenditure funds actually go back to Yahya Jammeh.