Dear Editor,

President Adama Barrow’s recent announcement of over two hundred (200) Doctors from Cuba to arrive in The Gambia as part of the administration efforts to boost our deplorable healthcare system should be a concern for all citizens regardless of political affiliation. The Gambia cannot continue to be used as a clinical practice site for Cuba’s medical students who are falsely classified as specialist Doctors.

The Gambia government should stop bringing so called Doctors from other world countries to serve our citizens.The Gambia’s healthcare system cannot entirely depend on foreign Doctors  because it is not sustainable endeavor gear toward healthy and prosperous nation building. Cuba’s remarkable healthcare outcomes among developing countries was direct result of government investment in health education, training of medical professionals and expansion of rural hospitals across the country but not through importation of foreign Doctors in their country.

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The negative implications of having these foreign Doctors far outweigh the benefits the citizens gain from the care they are expected to deliver. One of the most important competencies required for quality healthcare delivery is cultural competence care. Example, the United States healthcare system recognize that healthcare delivery should always be based on cultural competence care which entails not only  recognizing and understanding one’s own culture but also understand another culture with appreciation and positive attitude. The use of culturally appropriate language will promote trust and understanding which could lead to acceptance of viewpoints in the cultural competence care. Cultural competence care is essential to recognize and eliminate bias in healthcare delivery. It is this reason that universities and colleges which offer medical, nursing and other health specialties programs conduct classes related to cultural competence care. The healthcare practitioners ( Doctors, Nurses and others) are supposed to be patients advocate but The Cuban Doctors’ language and cultural barriers would make it highly impossible to deliver quality care and at the same time advocate for best healthcare outcomes the Gambian people deserve. Thus, lack of understanding of Gambian native languages or cultures could effectively impact their ability to deliver quality and satisfactory healthcare outcome. Many Gambians may also be reluctant or hesitant to seek care from these Doctors especially in the rural areas where literacy rates are extremely low. In the last few years there has been widespread dissatisfaction about Cuban Doctors across the country because of poor performance due to various factors such as language and cultural barriers as well as questionable qualifications of these foreign Doctors as suggested above.

Apart from linguistics and cultural barriers, The Gambia did not have independent credential evaluation and verification agency which could be used as a safety mechanism to protect patients and general population from harmful medical practice. In many advanced countries, there are non-governmental and government agencies  which are responsible for credential evaluation before any medical or healthcare license is issued for practice. In the case of the Cuban Doctors , their medical credentials should have been evaluated and verified by independent and internationally recognized credential evaluation agency before arrival in the country but this has never been the case since the bilateral relationship was established between The Gambia and Cuba some years ago. Therefore , people without required qualifications and skill sets could be practicing medicine in the country. Medical malpractice, negligence, abuse and other violations would be common practice as a result of lack of safety mechanism to protect patients and general population.

The Gambia’s healthcare facilities especially the hospitals where health services are provided also did not have video or voice interpreter services which could facilitate communication between the Doctors and patients in various communities across the country. This implies that Cuban Doctors would have difficulty to understand medical problems of patients as a result of lack of  necessary technology such as interpreter services which could  be helpful in assessment and other therapeutic interventions.

The bilateral agreement between Cuba and The Gambia benefits Resident Doctors because they would gain clinical practice experience but patients would have poor healthcare outcomes . This was evidenced by high maternal and infant mortality rates during the last assignment of these Doctors in The Gambia.

The way forward for sustainable,  affordable and accessible  healthcare system in the country is the need for significant monetary investment in healthcare system. The education and training of  more Gambians in various medical specialties should be the highest priority for transformation of our deplorable healthcare system. Special attention should be placed on  Primary care service which would help in health promotion and disease prevention strategies. This would also increase access to healthcare delivery and ensure cultural competence care that promote trust and understanding between patients and their Doctors. The provision of better benefits packages to Gambian medical professionals working in the United States and Europe as a motivation factor to come and practice in the country is far more beneficial than bringing Cuba Doctors who have no cultural, traditional and language connections to the Gambian people . The health of any nation is key to achieving its development aspirations and The Gambia is not an exception to this universal agreement. The government must educate citizens to take care of our people. Using foreign Doctors in every political season as a political campaign tool is not going to improve our healthcare system. President Adama Barrow needs to get rid of ignorance advisers and hire people who are highly educated, compassionate and honest to transform our healthcare system in The Gambia.

Thank you
Maxs Jarju

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