Stay of Mireille in The Gambia from November 15 to December 7, 2019.


I have been home for almost a month and after all the hustle and bustle around the holidays I now have time to write a report about my stay in Gambia and my work in Tanka Tanka. A lot has happened and done during my stay, both good and less good developments, but that is really no different than usual.


In Tanka Tanka it was quite busy with patients, there were more than a hundred patients and also during my stay serious, psychiatric patients were admitted. As soon as I was among the patients, I was surrounded by patients who all wanted something from me, a Dalasi (money), a cigarette, a hand and sometimes a request to get married, because Europe is still luring! I usually started the day by turning off medication and then distributing the medication to patients. All the medicine boxes contain a piece of paper on which the name of a patient is written, one by one I had to call the names aloud. Usually I didn't bother with this, it was hard to read and then I often misread it. Funnily enough, I always received help from a few patients and of course from a nurse. Quite a job to get rid of all the pills, once in a while even under heavy pressure, and if that really caused major problems, an injection was ultimately chosen.


Most patients have since suffered considerable psychological damage from drug use, according to the psychiatrist that is now the most common cause of admission. A lot of cannabis is smoked, but even cocaine is abundant here. For many here, this is increasingly seen as a way out of all misery. I usually have no idea what the diagnosis is, but it is often clear enough when someone is very angry or aggressive, during my stay I was unexpectedly surprised while taking care of wounds. A patient kicked the sink out of my hands and wished me a lot of trouble, only with the help of another nurse was the patient calmed down. Concerning wound care, luckily that is still going well, except for the example just described. I am very happy with Fatou, a sweet hardworking nurse who takes her responsibility.

Every time I am surprised by events that go well, but unfortunately also often disappointed by what is not going well. During my stay I had 15 new mattresses, which were still in stock in the hospital, exchanged for broken and very dirty mattresses, Rob Geus would love that. The nurse who is responsible for this (from the infection control department) indicates that his new job is very difficult and that he cannot take care of everything alone, with the result that very little to nothing happens. Cleaning the solar panels remains a difficult problem. The importance of doing this is not seen at all, despite all the explanation, no one feels responsible for it.


But as I said happily, I have also been made happy by positive events. Thanks to a donation from "Gambia for You", we were able to have 30 fabric mattresses covered with waterproof mattress protectors during the last week of my stay. Intended for better hygiene and a better resting and lying comfort for the patients staying in Tanka Tanka. Great such a success.


Both Jan and I have given training. Jan has given training in dealing with patient aggression, how to humiliate a patient to the ground during a violent situation. Almost all staff members and guards have followed the training and 1 employee is now going to continue this and has been trained for this. The employees were enthusiastic and the training courses were well received. Also positive is that group therapy is given at least once a week. In a small group, patients get the opportunity to tell something one by one. This can be anything, about their home, about being sick, fears and sadness, or what to do if they can go home again, what will they do or not do. It is so nice to see what personal attention and support of fellow patients does with these people. Sometimes shy and sometimes with a big smile they receive the applause when the turn goes to another patient.



Two new basketball boards are placed on posts, with enough balls in stock, a game can finally be played again.


The fences at the men's department are ready, it looks good and very strong. It is really very important that the gates are locked at night, it happens regularly now that patients try to flee and climb over the walls with all the consequences that that entails. At night there is 1 nurse and 1 guard, that's nothing for 110 patients.


The developments in Gambia, since the installation of the new president, seem to be slow. New water pipes are being laid and the roads are being improved here and there, not to mention the rise of the Chinese. But unfortunately it also takes crime, drug use and a complete madhouse on the road with traffic accidents as a result.


I experienced all of this myself. On the way to Tanka Tanka we were hit from behind, apart from some headaches and a stiff neck, we were particularly shocked, the driver behind us had fallen asleep, but was actually even more shocked than we were and after several excuses we could drive on, Car damage is part of this. A car also drove a calf to death for us, also not nice to see.


Well you experience something again, it is never boring in The Gambia! With sufficient satisfaction I look back on my 3 week stay in The Gambia. The Amsterdam Dakar Challenge is coming in November 2020. Then I go with a few friends to Gambia by car, and then auction it in Banjul, the proceeds go to our foundation. More information about this will follow on our website and facebook (