The MRC Unit The Gambia at LSHTM operates a small hospital in Fajara as part of their Clinical Services Department. This hospital has a reputation for high quality healthcare which is hard to access in The Gambia, and provides general adult and paediatric medical services to members of the Gambian public as part of our corporate social responsibility and close relationship with the community. It also provides care to Unit staff, their family members and participants in research studies.

Each year, 60 -75,000 consultations are undertaken in The Gate and outpatient clinics, and there are 1000 to 1500 admissions on the 40-bed ward. Between a third and a half of these patients are children aged 14 years or under.

The hospital has access to a wider range of diagnostics than many other facilities in The Gambia, with an internationally accredited clinical laboratory service, providing haematology, biochemistry, and microbiology tests, a medical imaging service providing plain X-rays and ultrasound, endoscopy, and access to tuberculosis, serology and molecular diagnostics through the research laboratories.

However, access to more complex imaging services, such as CT and MRI scans, and our access to echocardiography is not consistent.

These diagnostics, along with hands-on specialist input, allow the hospital to diagnose complex conditions that cannot always be diagnosed and managed at other centres in The Gambia. The service is highly subsidised and funded by MRC(UK), making it affordable for patients who cannot access private services elsewhere.

The hospital finds itself managing complicated tuberculosis, HIV, cardiac, respiratory, gastrointestinal and neurological problems in adults, as well as malnutrition, congenital conditions, rheumatic heart disease and common childhood infections in children.

Patients who are admitted to the hospital are typically acutely unwell, and urgent access to diagnostics can be an essential part of helping them. Tests at the MRC are provided for free to admitted patients, but tests that are not available on site have to be done at other centres, and the members of the Gambia public who are admitted need to find the money to cover these fees at short notice.

This can be difficult, with fees for CT and MRI imaging representing as much as one or two month’s wages for an unskilled worker.

Recognising that patients often struggle to cover these fees in good time and that they often deteriorate during the time they take to raise the money, some of our visiting doctors from overseas, proposed that we should set up a fund to support their needs. This is The Gambia Patient Access Fund.

Donating to this fund allows us to treat more people and provide the best quality of care possible in our setting, and can help save our patients’ lives.

£10 could pay for an echocardiogram

£50 could pay for a CT head scan

£100 could pay for an MRI scan

£150 could pay for a more complex CT scan with contrast