Since 2020 WGSP have been developing a new partnership with Edward Francis Small Teaching Hospital (EFSTH) in Banjul, The Gambia.
Lucy, Claire FS and Amelia were excited to be finally going on the first ever WGSP visit to meet our colleagues at EFSTH! After months of virtual discussions and COVID restrictions, we were met by a warm welcome from the team. The whole hospital was buzzing with activity as they were preparing for a visit from the West African College of Physicians: this occurred about halfway through our visit and resulted in EFSTH being given accreditation for resident doctor training. A big achievement.
The 4 focus points for our 3-week visit were: to engage with senior stakeholders; to increase knowledge and awareness of stroke at EFSTH; to begin training in the first 2 cores skills of swallow and positioning; and to establish multidisciplinary (MDT) data collection.
During the visit we met many members of the EFSTH team from the high-ups (CEO, Deputy Chief Medical Officer, and the Chief Nurse) all the way through to the Chief Orderly, as well as nursing, physiotherapy, and medical staff of all grades. The concept of MDT care was embraced and a multiprofessional stroke lead team was identified, including staff from both the main EFSTH site and the Ndemban clinic 7 miles up the road. Ndemban is where the Emergency Department (ED) is currently operating from while the EFSTH ED is being rebuilt.
The hospital itself is much smaller than KBTH, which comes with pros and cons. All staff know each other well and there is already a sense of working together for the patients. A big challenge for EFSTH is the small number of local Gambian consultant doctors: many of the senior physician team are from other countries and some of them are only working at EFSTH for relatively short periods. This can present difficulties for continuity of service development, but the team are working hard to make the most of the resources and opportunities that they have available.
The initial skills training went well. Overall, we trained well over 100 members of staff in swallow and positioning during our visit. Materials were provided for the team to continue to cascade training after we left. Due to a lack of resources such as thickening powder for water, improvisations had to be made: powdered mashed potato was the best solution we could find for this! As well as small group sessions we also delivered more formal Grand Round teaching to the medical staff which prompted good discussion and engagement.
Amelia spent time specifically with the physiotherapists, while Claire and Lucy focussed their time with the ward nursing staff. Three slide sheets were provided to assist with patient moving and positioning.
It wasn’t all work and no play. We were lucky enough to have time to go on some interesting visits to the surrounding country including learning about the historical slave trade from Gambia, and a wonderful trip upriver to see hippos!