It was with mixed emotions that I went to the Gambia for this visit. I always look forward to meeting all the folk in SZRECC and it was so sad that two key members of the Gambian team (Bakari Cham and Sherif Trawally) had passed away. I had fond memories of travelling with Bakari to the secondary centres, repairing equipment as we went. I was pleased to find out that Bakari’s son, Lamin, was working at the clinic under the wing of the newly promoted Fofana Muchtarr and that I would have the chance to work with him.
Fofana and Lamin
Prior to the visit, I had managed to acquire and ship ten autoclaves. I hoped that we would be able to spend most of our time checking and servicing these prior to them being used in their cataract centres around the country. As usual, quite a large amount of time was spent repairing equipment rather than training preventative maintenance. In fact the autoclaves were not made available until more than half way through the visit. We managed to service four machines but did not reach the stage where they serviced them while I observed. Fofana felt that our visits should be for longer.
Unpacking the autoclaves
We repaired quite a lot of equipment but it was a concern that the equipment that they were obtaining for the centre was not standardised, which makes it harder to maintain. They used to have only the solidly made Haag Streit and Zeiss slit lamps but now there were at least four different models. Also the newer equipment was often less reliable than the equipment that it replaced. For example, they had bought new operating microscopes with LED lights; the lamp no longer needed replacing but the power supplies were failing. There were definitely more power cuts on this visit; perhaps a sign of the country’s worsening economy; presidential elections are next month.
Fofana has done a good job under difficult circumstances; their team is responsible for plumbing, electrical work and anything “technical”. Perhaps it is not surprising that they never have time to do maintenance. As Bakari had died unexpectedly, there was no handover. I think that it was useful that I went through the spares stock with Fofana identifying what spares were for what equipment and deciding those that should be thrown away (including a large number of blown lamps). I hope that communication between us will improve as this is the weak link and will be the key to making sure that equipment is repaired and maintained well.