A video memoir: Our gap year experience in the Gambia

By James Frater, Amos Bursary student

As part of my gap year, with the help of the Amos Bursary and Imperial College London, I was given the opportunity to spend 3 months in The Gambia. I assisted the PROLIFICA (Prevention of Liver Fibrosis and Cancer in Africa) project, where I was able to experience various laboratory procedures and resource-poor healthcare services.

I was given a thorough induction on laboratory etiquette and different laboratory practices, as well as training on how to handle laboratory equipment and the various biomedical samples. This meant I was confidently able to work in and navigate my way around the laboratory with a relatively good level of competence.

The majority of my time was spent in the lab collecting, processing and storing blood samples from the clinic into plasma, serum, EDTA and buffy coat. I was also able to learn how to perform other techniques such as HBsAg rapid tests, ELISAs and extracting DNA from serum to use in PCR.

Throughout my time, I actively sought to expose myself to the clinical services in The Gambia. Although I expected them to be resource-poor, I was really intrigued to find out how healthcare professionals overcame this barrier. I did not only observe the procedures, but I was able to get involved, practically. Things like percussing a patient’s abdomen, listening to a patient’s lungs/heartbeat, operating a Fibroscan and learning how to carry out proper observation – these are all things that will benefit me later in my career and have given me a head start in terms of my medical degree.

I spent a week at the Edward Francis Small Teaching Hospital (EFSTH) in the capital, Banjul. This was very different to the healthcare setting in the UK, but I found it was very similar to the healthcare setting that I had experienced in another developing country, Jamaica. The hospital had limited resources to provide for the patients, but it was encouraging to see that the healthcare professionals were still willing to work relentlessly to diagnose and treat these patients, while also being very accommodating and helpful to my colleagues and I.

I was given the chance to travel upcountry to another MRC unit in Keneba, a more rural part of The Gambia. Clinics here were even more poorly resourced and even more overcrowded, but again the healthcare professional maintained their effective system, which enabled everyone to be seen and treated accordingly. This was my favourite clinical experience because it had a GP feel to it, even though it provided clinical services to a lot of The Gambia, the healthcare professionals were very familiar with a lot of the people and the problems they encountered.

Aside from all the work, I was given the time to engage in other things in the community. My main commitments were the orphanages located in and around Fajara. I visited three orphanages regularly with another student, to play and interact with the children, who were so visibly appreciative. We also taught Mathematics and English at two of the orphanages because they did were not able to go to school. It was very rewarding and I felt intrinsic pleasure seeing these children learning and absorbing all the information they were being taught. It was also very saddening for me because you could see that a lot of these children were very bright and with the right resources they could excel.

There were a lot of sporting activities for me to get involved with throughout the week because there were a lot of club in and around the MRC, which was always brilliant fun and it was a great way to meet new people. I was also chosen to represent the MRC at the May Day Sports competition, which was thoroughly enjoyable and rewarding.

In retrospect, I am even more humbled and fortunate that I was given the opportunity to spend 3 months in the Gambia. Going to The Gambia, took me out of my comfort zone and forced me to broaden my cultural and social awareness. I was a bit apprehensive at the idea of going to such a wholly different environment but as soon as I began working and interacting with the local Gambians, my apprehension disappeared completely.

I feel that throughout my gap year I have gained invaluable life skills and I have matured far beyond anything I could have perceived beforehand. I learnt invaluable practical skills in the laboratory and in the clinics that, as I mentioned before, will help to give me a head start in my peers at medical school.

The one thing I will never forget about The Gambia and I am most grateful for, is that, they showed me it really is nice to be nice.

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