MCAI Charity Trip To Gambia

October 29, 2015  •  Leave a Comment



In August I embarked on a pretty epic adventure to West Africa. I would like to thank Douglas and Caron Park, from Parks Motor Group, Hamilton for their very generous sponsorship of this adventure. I really couldn't have done it without their help, and I am sure like myself, the charity is very grateful to them also.

This is just a short account of my time there. Very difficult to put it all down in words, but I want to share some of my experiences. There will be much more to come at a later date.


Firstly, a montage of the staff at Brikama Health Centre, what an amazing group of people, who made me very welcome during my time there.


The North West of Scotland is maybe not the obvious place you’d find the headquarters of a charity which spends it’s time saving lives in Africa and other parts of the world, however that is exactly what you will find in the village of Poolewe in Wester Ross.

Maternal and Childhealth Advocacy international, or MCAI for short is run by Prof David Southall and Rhona MacDonald, ably assisted by their small team in the office. Their website shouts out their mission statement of "To save and improve the lives of babies, children and pregnant women in areas of extreme poverty. By empowering and enabling our in-country partners to strengthen emergency health care". Looking beneath the surface there is a much bigger and more impressive story though, and I travelled to Gambia to document their work and find out more about what they do.

The MCAI charity has been around for twenty years, and was started by Dr Southall following the war in Bosnia Herzegovina, during which time he had worked over there with UNICEF. Currently they have people in Gambia, Liberia, Afghanistan and Cameroon. As well as this they have textbooks currently sent out to 32 different countries which will help with medical practices and training there. Generally the work being carried out includes training local midwives and staff on dealing with emergencies and providing a better service, supply of medical equipment, expert obstetric support, as well as helping with the facilities. There are staff working as volunteers in these countries, doing what they can to save lives on a daily basis, backed up by a great team in the Poolewe office.

I had talked to someone from the charity a while back, and took some interest, but never followed it up, until eventually a couple of years later, I put forward the proposal that I should go out there and do some work for them. What followed was a very interesting, inspirational, and exhausting trip to The Gambia, which left me going through every emotion possible, from sadness to huge frustration. It took a long time to get this trip to come to fruition. Lots of hoops to jump through, both at this end and in Gambia, before I could be allowed access to hospitals and patients. Once all the paperwork was in place, security training and briefings completed, I was good to go. I had no idea what I was actually going to get once I got there, which added to the excitement.

After a day of airport delays, no phone chargers and various other first world problems, I arrived in a very hot and humid Banjul. The heat and humid air hit me as soon as I stepped off the plane. It was totally dark, and all I could hear when I arrived at my accommodation was the sound of bats. Lots and lots of bats. I would have to await morning to see the place. My biggest fear, being a midge magnet here, was being savaged by mosquitoes and getting malaria, so my first task was to get a net in place for sleeping, as well as turning the air conditioning to the dial marked "Scotland", which would also help kill off the insects.

I awoke early, uncomfortable from lying on my back under a pop up mosquito net. It was warm. Very warm. The first morning was not just me awakening to the start of this adventure, I was awakening to the fact that I no longer had my home comforts. Although I am sure the house is relatively high standard locally, it took me out of my comfort zone. I had expected this though, so it wasn't a big deal. I certainly didn't travel over to this situation expecting a four star hotel. It was, however, going to take some getting used to having a cold shower in the morning, and sharing a kitchen with some mice and cockroaches. Welcome to Africa.

My first visit to Brikama Health Centre was another eye opener. I had seen photos, and heard about it, but seeing something in person is a different thing altogether. It most certainly wasn't like any hospital or health facility I had seen before. Curtains, designed to give privacy to patients, hung from the walls and ceilings like rags, flapping in the breeze from the open doors and the small amount of air being circulated by the overhead fans. There were flies everywhere. Buzzing around my face and legs. People randomly wandering in and out of the area, some awaiting attention, others just visiting. A random cat wandered in the door and took a left turn into the ward. Nobody batted an eyelid, apart from me. Outside, bins with a mixture of medical waste and general rubbish, overflowed onto the pavement, causing a focal point for the local cats and the masses of flies. The lack of hygiene hit me in the face, and became my most powerful memory of that first day. Cats rummaging through food and human waste, whilst two metres away people queued to see a doctor. Women wandered in and out, with bowls, pans and other household items, containing home cooked meals, teas and coffees and various other nutritional items, as this hospital had no canteen or vending machine.

I spent my first day sitting in on some exams. A doctor from a teaching college in Banjul was putting two of the locals through their paces. Dr Kanteh and midwife Arfange have been undergoing training with MCAI and were being tested on their skills. No fancy devices here for demonstrating techniques. A pillow took on the role of a female abdomen, whilst some pieces of foam, possibly from a sofa, were shaped into other parts of the female anatomy. It was hard to take in, but it actually worked. Both guys showed just how well they had been trained and how enthusiastic they were about their work, and passed with flying colours. It was a quiet, uneventful start to my time in Brikama, but it was about to become much busier.

The next nine days saw me having to deal with babies being resuscitated, a mother dying on the table in front of me, several cases of eclampsia, caesarean section operations, and much more. I'm not the best at dealing with surgery and such like, so I did have some tough moments whilst in theatres, trying my utmost not to faint and cause another emergency in the room. It was, however, interesting watching the newly trained staff, performing these operations, under the watchful eye of Dr Johan Creemers. I was totally impressed by the dedication of him, as well as the other MCAI people, who are working in these tough conditions, as volunteers, with the added frustration of seeing the lack of support from the government. He seemed to be on call pretty much 24/7 during the time I was there. I would hear his phone ring at 3 or 4 in the morning, and him talking through patients with the night staff, then at 8.30 he'd be back in the hospital for the shift handover, as fresh as a daisy and ready for another day. Selfless dedication to saving lives.

The staff in the hospital were friendly, and made me feel so welcome. They possibly had a slightly relaxed approach to timekeeping and turning up at work at times, but they seemed to be very focused and career minded. One of the midwives has combined his knowledge of the job he works in, with a brilliant engineering mind, and has created two devices which have been incorporated into the hospital equipment used on a daily basis. One of them, a vacuum delivery device, has been invented using various other pieces of generic medical equipment, to create a very low cost equivalent of the vacuum machines normally used. And more importantly it works. He has been invited to speak about it at medical conferences, and his enthusiasm is infectious.


The local children never stopped smiling. Local men, hanging around in the shade near the house, never failed to shout over with greetings every time I passed. The locals just seemed to accept what they had, and I suppose if it is all you have known, you would just get on with it. The local market was like no market I have seen. There was nothing there I’d want to buy, but it was buzzing every time you walked through it. Women selling bananas, bags of water, corn on the cobs, and mango on every corner, alongside stalls selling bit of old bikes. Half worn mountain bike tyres hung from the roofs and rows of second hand trainers and flip-flops were laid out underneath. Second hand bikes in various conditions were on sale at one stall, some of them covered in rust. One day I went past and saw a Cannondale road bike for sale. I have no idea what price was on it, or if they even realised the value of it, but it caught my eye. It was gone by the time I went back past.  I had four different requests from people to have my converse trainers. It was just a totally different world. People making do, just surviving and making the best of what they had. Very humbling.


The most frustrating part of this trip was seeing the way the country is run. To see people go through hell due to lack of the most basic equipment, whilst a few miles along the road the government buildings are modern, with stunning and certainly expensive architecture. It seems like a country which has its priorities very wrong. We hear a lot of people complaining in the UK about injustice but in Africa it seems to be on a whole different level. Here there seems to be a small number of people with wealth, and everybody else is in poverty. It is quite sad that the locals rely on outsiders such as this charity, to come over and save their lives, when their own government could do so much more to help.


Overall this was an incredible experience. Despite the 28 hour journey to get home whilst suffering from severe food poisoning, and the difficult conditions, it was worthwhile. I feel another week would have been good as I struggled to get everything I wanted, but I did get a good selection of images to document the work there. The enduring feeling from the trip was one of respect for the people working there, both the locals, with their constant smiles and great attitudes, and the volunteers, working so hard under such difficult circumstances, just because they want to help.


Ultimately, like all charities, their existence depends upon donations and fundraising, and the continuing fight to save mothers and babies depends on a constant revenue. If you can help in any way, or know anyone who is interested in helping, please get in touch and try to make a small difference. More information is available on their website


Here's a tiny selection of the images I have from the trip, with much more to follow.




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