Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694874010119.pdf (Gambia)
REPUBLIC OF THE GAMBIA National Assembly, New Assembly Building, Rev.
Pye Lane Banjul, The Gambia NATIONAL ASSEMBLY OF THE GAMBIA REPORT OF THE NATIONAL ASSEMBLY SELECT COMMITTEE ON HEALTH, WOMEN, CHILDREN, DISASTER, HUMANITARIAN RELIEF AND REFUGEES ON INSPECTION VISITS TO OFFICIAL INTERNATIONAL ENTRY POINTS, HOLDING AND ISOLATION CENTRES ON THE STATE OF PREPAREDNESS FOR THE (COVID 19) FROM 3 – 4 MARCH 2020 March 2020 1 Table of Contents Introduction ........................................................................................................................... 3 Members of the Touring Team ......................................................................................................... 5 Objectives .................................................................................................................................................... 7 Conclusions and Recommendations .............................................................................................. 5 Partners .....................................................................................................................................................25 ADDRESSEES…………………………………………………………………………………………………………………………………27 PICTURES………………………………………………………………………………………………………………………………………28 2 Introduction The National Assembly Select Committee on Health, Women, Children, Disaster, Humanitarian Relief and Refugees concluded a two-day visit to selected international entry points, holding and isolation centres to assess the state of preparedness of the Gambia to respond to the Covid 19 outbreak in the world.
This mission, however, is in fulfillment of the Committee’s statutory mandate, in accordance with Section 109 (2) (b) of the Constitution of the Republic and Clauses 97 paragraphs (1) and (2) (b) of the Standing Orders (Revised Edition 2019) of the National Assembly, to perform oversight on the health sector which is under its purview and any health related issue concerning the country such as this public health emergency.
The inspection visits from 3 – 4 March, 2020, are a follow up on the 7 February, 2020, meeting convened by the Select Committee for the officials of the Ministry of Health, under the leadership of the Honourable Minister, Dr. Ahmadou Lamin Samateh, to provide an update to the oversight body and, through it, to the population, on the country’s level of preparedness in terms of measures put in place for screening, prevention, control and containment of the outbreak.
At its planning meeting before embarking on the tour, the Committee concluded that in the face of the looming threat posed by this public health emergency, the state needs to immediately commence the process of national consultation and preparation for a timely and effective response to this Covid 19 outbreak in order to protect the health and save the lives of people residing in the Gambia from this highly contagious and deadly disease.
There is need to “put all hands-on deck” as the saying goes, and this requires involvement and vigilance from all and sundry.

Timely and coordinated collaborative actions involving all the stakeholders, including the public, and under the coordination and leadership of the Health Ministry is what is needed now.
Considering the nature of Gambia’s porous land borders and the fact that our immediate neighbor, Senegal, has confirmed cases of disease infections, the collaboration should even go beyond our borders to include the countries in the sub-region.
It is in this regard that a formal communication, albeit at short notice concerning the urgency, was sent to all the concerned institutions regarding this inspection visit to their facilities to assess the state of preparedness and which was addressed to the Minister of Health and copied to the Director of Health Services (DHS), Chief Medical Director of Edward Francis Small Teaching Hospital (EFSTH), Managing Director of Gambia Ports Authority (GPA), Director General of Gambia Civil Aviation Authority (GCAA) and Director General of Gambia Immigration Department (GID).
3 The tour party, which comprised of the Honourable Members of the Committee, support staff, subject matter specialists (SMS), the public, print and electronic media, visited and held discussions with the management and senior officials at the Banjul Seaport, Banjul International Airport and the land border post at Giboro, on the first day, and the Amdalai border post, Edward Francis Small Teaching Hospital (EFSTH) and the identified isolation treatment centre at the Sanatorium in the outskirts of Banjul on the second day.
Considering the nature of the outbreak and the need for swift, comprehensive, collaborative and effective responses to this public health emergency, the Committee is submitting this report to the Ministry of Health and all the key partners on its findings during the inspection and assessment visits as well as recommendations for urgent action by the concerned partners in response to the outbreak.

2.
2.

Members of the Touring Team 4 The visiting team comprised the following Honourable Members of the Committee 1.

Hon.

Ousman Sillah Chairperson, - 2.

Hon.

Musa Amul Nyassi - Member 3.

Hon.

Saikou Marong Member - 4.

Hon.

Amadou Camara Member - 5.

Hon.

Omar Darboe - Member 6.

Hon.

Sulayman Saho Member - 7.

Hon.

Ndey Yassin Secka - Member 8.

Hon.

Bakary Camara Member - 9.

Hon.

Dawda Kawsu Jawara - Member Secretaries and other support Staff to the Committee 1.

Mrs. Sarata Bojang 2.


Ms. Isatou Sonko 3.

Mr. Omar Camara 4.

Mr. Matarr Sallah 5.

Mr. Kebba Nying - - - - - Secretary Secretary Research Officer Aide Driver Subject Matter Specialists to the Committee 1.

Mr. Sekou Omar Dibba - 2.

Mrs. Aminata L.R.

Ngum- SMS SMS Media Personnel - - 1.

Mr. Ebrima Jallow 2.

Mr. Musa Sanneh 3.

Mr. Ansumana S.O.

Nyassi - QTV 4.

Mr. Saihou Manga QTV 5.

Mr. Nelson Manneh Foroyaa Newspaper 6.

Mr. Ismaila Sonko Point Newspaper GRTS GRTS - - - 3.
Acknowledgements 5 The Honourable Members of the Select Committee on Health, Women, Children, Disaster, Humanitarian Relief and Refugees, Secretaries and Subject Matter Specialists wish to express their profound appreciation of the warm reception accorded to the team by all the officials who have been met during the oversight visit to the points of entries, the holding and isolation facilities.
Their cooperation in taking the team round on conducted tours of the installations and in responding to the questions and concerns raised by the honourable members and SMSs is highly commendable.

The explanations and responses they have given are invaluable and quite helpful in enabling the honourable members to fully understand or appreciate the realities on the ground in terms of the level of preparedness.
The Committee is able to compile and present this report thanks to the information and support given by the management and officials of the institutions and places visited.

We sincerely thank the Minister of Health, Director of Health Services and all the other directors and senior officials at the ministry for the update given to Select Committee at the engagement meeting held on 7 February 2020, which set the tone for these follow-up inspection and assessment visits.
The Committee also wishes to express its sincere thanks to all those who have met and provided the honourable members with very useful information regarding the operations and measures on the ground at the different places that were visited namely the Deputy Managing Director of the Gambia Ports Authority (GPA), Public Health Officer and the senior port officials, Director General, Deputy DG, Public Health Officer at the airport and the other directors and senior officials of the Gambia Civil Aviation Authority (GCAA), the Public Health Officer, OC Immigration, OC Police, Senior GRA official and the senior officers at Giboro Border Post, the Public Health Officer, Senior GRA officer, OC Immigration, SO Police and other senior officers at the Amdalai Border Post, the Acting Chief Medical Director (CMD), Deputy CMD, Coordinator of the Response Team, the Matron and other senior officials at the Edward Francis Small Teaching Hospital (EFSTH) and Sanatorium.
We sincerely acknowledge and thank the management and reporters/crews from the Gambia Radio and Television Services (GRTS), QTV, Foroyaa Newspaper and Point Newspaper for the media coverage and presentation of the visits in their widely followed media outlets.

The timely support of the Office of the Clerk and staff of the National Assembly in facilitating these urgent engagements is noteworthy.

4.

Objectives 6 4.1.


General Objectives The general objectives of this statutory oversight engagement by the Select Committee on Health, as a follow-up to the update meeting with the ministry of health officials, is to assess the level of preparedness, identify challenges, make recommendations for interventions and provide support.

4.2.

Specific Objectives The specific objectives are: 1.
To pay a visit to key international entry points or border posts to assess the state of preparedness and the measures in place for the screening of travelers entering the country.

2.

To visit and assess the measures in place at key holding places for suspected cases of infections.

3.

To visit and assess the measures in place at the apex isolation and treatment facility for confirmed cases of infections.

4.
4.

To assess measures put in place for the protection of the officials in the frontline of duty at these points of entry.

5.

To be informed of the needs on the ground for a strengthened and robust national system for prevention, management and containment of the outbreak and other public health emergencies.

6.
6.

To have informed knowledge of the current situation on the ground to be able to make recommendations or task the ministry and other relevant partners to implement or undertake actions towards addressing or in response to this disease outbreak.

7.

To have informed knowledge to be able to give support through legislative, budgetary, policy and advocacy processes to issues of public health emergencies in general.

5.1/First Day – Tuesday, 3 March 2020 7 5.1.1.


Visit to the Banjul Ports The team commenced the tour after departing from the National Assembly complex at 9 am to its first port of call at the Banjul seaport under the management of the Gambia Ports Authority (GPA).

We were met on arrival by Mr. Alhaji Cherno Ceesay, Deputy Managing Director of GPA, in his office where a brief introductory meeting was held.
In attendance were also Mr. Kuleh Manneh, Harbour Master, and Mr. Siaka Touray, the Senior Public Health Officer (PHO) and head of the Public Health Office at the ports.

among others.

The Chair of the committee Hon.

Ousman Sillah, after silent prayers and the introduction of all those who were present, opened the meeting and explained the purpose of the Committee’s visit to the Banjul ports.
He said this is an oversight engagement by the Committee to inspect and assess the measures put in place and the level of preparedness at the seaport in response to the virus outbreak.

In welcoming the visiting lawmakers, Mr. Ceesay, on behalf of the Managing Director who, he said, went for another meeting at the National Assembly, thanked the committee for embarking on this very important tour which is geared towards promoting the welfare of Gambians.
He said GPA accommodates health personnel and various security outfits and that they are ready to provide support that would enable them to effectively carry out their duties.

The Harbour Master, Mr. Manneh, also took the Committee through their work and how they collaborate with the health officials posted at the ports.
For his part, Mr. Touray, Senior Public Health Officer in charge of the Public Health Office at the seaport, said his unit cannot handle the work alone and that they are getting support from the GPA management and other outfits stationed at the ports.
During a guided tour the Public Health Office at the Ports and to a docked container vessel discharging cargoe, Mr. Touray explained the various procedures they follow when a vessel docks at the quay such as the filling of forms which he lists as Maritime Declaration of Health by WHO to be filled by the crew members, Health Clearance Form, Ship Shelter Certificate, which lasts for only six months, Certificate of Medical Compliance for one year, Dangerous Goods Manifest, Ship Store Declaration and Vessels Particulars.
He added that the crew list is also provided for reference purposes as well as the travelling history of the vessel.

On the preparedness and response to the Covid 19, the Senior Public Health Officer said the Ministry has provided his office with sanitary and protective materials as well as temperature machines or thermometers.
8 Honourable Members of the Committee and Subject Matter Specialists also took turns to raise concerns and questions and were given responses by the public health and port officials.

The public health officer also identified some challenges they are contending with and which, he said, need to be brought to the attention of the Select Committee to address.

He listed the following as the challenges: Challenges 1.

The materials are provided but not sufficient.

2.

Insufficient face masks 3.


Small and congested office 4.

Gaps in the Public Health Act 5.

The importation of the second hand goods e.g.

old newspapers poses a public health hazard 6.

Lack of mobility for the public health staff The Committee Members, while standing on the quay near a discharging container vessel, observed that the ports and dock workers on board were not putting on the protective masks.
It was therefore recommended by the Committee that all workers on board vessels, who would obviously come into contact with the crew, should be putting on masks for their own safety and that of their co-workers and larger society, including their families.

On its insistence that the first port of call for visitors should be the health workers for purposes of screening, the members of the Committee were assured by the public health officer that this is exactly the practice on the ground.

5.1.2.
5.1.2.

Visit to Banjul International Airport From the Banjul seaport, the Select Committee on Health proceeded to the Banjul International Airport and arrived there around noon.

In his introduction, the Chairperson of the Committee, Hon.

Sillah, told the senior management members, who were found on a meeting, that the visit of the oversight body is to follow-up on the meeting they earlier had with the MoH to enquire about the state of preparedness of the country in response to the outbreak.
He said the visits are meant to assess the level of preparedness of the country in terms of screening and detection of cases and will take them to selected health facilities and PoEs, including the Banjul International Airport.
He noted that the country’s only airport is identified as a potential source of contact through the inflow of travellers from the Covid 19 affected countries or regions and 9 that as such it requires maximum attention and the putting in place of all the necessary and adequate control and prevention measures.

He also emphasized the Committee’s position that its concern is also the welfare of those at the frontline i.e.
health, aviation and immigration officials, among others, who are the first to come into contact with passengers coming with aircrafts.

Hence the need for adequate protection measures for these officials.

The Chair told the GCAA that there is no Emergency Fund or approved budget for such a situation and that as such he is imploring the Authority to support the Ministry of Health in terms of resources for the response efforts.
He also asked for the team to be later taken on a conducted tour of the area designated for passengers on arrival at the international airport.

In welcoming the touring team, Mr Abdoulie Jammeh, Director General of GCCA, described the visit of the oversight Committee as important and timely.

He said the senior management was even found on a meeting in which one of the agenda items for discussion is the Covid 19 outbreak.
The GCAA DG informed the Committee that there is collaboration between his institution and the ministry of health, adding that the Health Minister had even visited the airport to assess the level of preparedness of the health emergency unit.

He said He invited Madame Catherine Nying, the Deputy Director General of GCAA, who also doubles as the Coordinator of the airport response activities, to unveil to the Committee the measures they have undertaken so far in terms of screening and control.
the GCAA policy to protect both is the public and staff.

The Deputy DG reported that when the outbreak was first announced the GCAA, as an institution, immediately tasked their Enterprises Risk Opportunities Management Unit to start working on the issue as it is identified as a risk.

She said the management also assigned the Director of Airport Service Operations to immediately activate the Action Plan and the Emergency Response Team.
She also told the Committee that they have a plan that deals with the airport and another that deals with all forms of emergencies, including the current situation.

Madame Nying said, as part of their response measures to the Covid 19, they updated and adopted the Strategic Plan that was developed with the guidance of the Ministry of Health during the Ebola outbreak and which guides them on how to respond to different alert levels.
The visiting team was taken around on a conducted tour of the arrival terminal at the airport to see how passengers are processed or screened by the health officials 10 before entering the main building.

This coincided with the arrival of an aircraft which enabled members of the Committee to have first-hand knowledge on how the screening and control of arriving passengers is done by the health personnel at the airport.
All the officials from health, civil aviation, immigration, etc., were seen putting on protective masks and gloves.

They were shown the newly installed air- conditioned holding tent that can hold up to six suspected cases before evacuation to the EFSTH in Banjul.
Mr. Jerreh Camara, the Senior Public Health Officer at the Gambia International Airport, told the Committee that they apply two methods of screening passengers by using the thermometer and the thermographic camera to test body temperature and that if anybody’s temperature exceeds the threshold of 37 to 40 degrees then one is sent to the nearby makeshift holding room pending evacuation.
He further explained that there is a form to fill for the purpose of traceability and that they do check the travel history of the passenger.

He noted the lack of transportation as one of the key challenges confronting the health workers who are supposed to be coming to work on time and then leaving for home at very odd hours.

He revealed how he would sometimes trek from the terminal building to the main highway after closing work in exhaustion in the early hours of the morning.
After taking turns in raising concerns and questions and getting responses, the Honourable Members expressed their satisfaction with the level of preparedness at the airport and thanked both the management of GCAA and the ministry of health for putting in place the necessary response measures.
The DG of GCAA, in a separate engagement of ‘trying to kill two birds with one stone’, also took the visiting parliamentarians around to see the ongoing works of the airport terminal rehabilitation project and which members, particularly those serving in the Select Committee on Project Monitoring, have shown interest.

5.1.3.

Visit to Giboro Border Post Giboro Border Post on the southern part of the Gambia was the last place to be visited by the parliamentary tour party which arrived there around 2.30 pm.
After a brief introduction by the Chair of the Select Committee on the purpose of the visit, the officials from health, immigration and the police were invited to take the floor.

11 The Officer Commanding (OC) the Immigration at Giboro, Mr. Manneh, welcomed the visiting parliamentarians and explained what has been done at their level.

He said an orientation on the preparedness and response to the was conducted for them by the ministry of health.
He said the health officials paid a visit to the post and promised to come back.

Mr. Bakary Manga, the Public Health Officer posted to the Giboro Border Posts, informed the Committee that he is posted at Kafuta but redeployed as the only Public Health Officer serving at the border, adding that it is quite a challenge to have one person manning a border area.

He talked about the need to have sufficient materials and more staff to be able to do effective screening.
He also informed the Committee that they have gone through a series of capacity building organized by the ministry on preparedness and response to the Covid 19.

After the briefing session, the Committee members went round and observed that there was no arrangement in place for hand washing for incoming travellers before presenting themselves to immigration.
Members were also taken to the facility built during the Ebola outbreak and which is identified as the holding centre for any suspected case before arrangements are made for evacuation.

However, the rooms were not found to be prepared for holding any case as they need cleaning and other basic things to be found in a ward.

There was also no electricity or running water at the facility.
The Honourable Members and SMSs took turns to ask questions and were responded to by the public health and other officials present.

The visiting team finished its oversight visit for day one around 4 pm and returned home.

5.2.

Second Day – Wednesday, 4 March 2020 5.2.1.

Visit to Amdalai Border Post On the second day of the inspection/assessment visits, the tour party left the National Assembly premises around 10.

30 am to the Banjul Ferry Terminal to cross to the North Bank Region of the country.
12 The visiting team arrived at the official border crossing of Amdalai/Karang around 12.30 pm.

It was met on arrival by the senior officials from the health, immigration, GRA and police departments posted to the border.

Hon.

Ousman Sillah, Chair of the Select Committee began by introduction the purpose of the visit which is to assess the level of preparedness of the Gambia to respond to the Covid 19 outbreak.
He informed the officials that this is a statutory engagement provided for by the laws of the country for the Committee to move out from the meeting rooms and go to the field to perform oversight on government institutions and their work.

He invited them to share with the Committee the work they are doing and the challenges being encountered in terms of the screening of travellers entering the country with regards to the Covid 19 outbreak.
The first to take the floor was Mr. Suwareh, deputy head of the GRA office, who welcomed the team and explained that the Minister of Health and team visited the border the previous night and did exactly what the Committee is doing to assess the state of preparedness.

He said they are closely collaborating with their Senegalese counterparts to ensure that effective mechanisms are put in place to prevent the Covid 19 from entering the Gambia.
He said this outbreak is a matter of national concern and as such should be the responsibility of everybody to protect yourself and the others.

For his part, ASP Dawda Jobe, the Station Officer at Amdalia Police Station, emphasized that the is a matter of public concern and needs collaborative efforts to prevent it from entering the Gambia.

He said they are working as a team and assured the members that they will be doing everything possible to support the public health officials in their work.
ASP Manneh, OC Immigration, in welcoming the team also expressed delight and reiterated what has been said by his colleagues in terms of their operations on the ground.

Mr. Momodou Sowe, the Public Health Officer (PHO), who was the only health official found at the border at the time of the visit, was busy attending to a group of tourists and other travellers entering the country by testing their body temperatures and taking details of their travel history.
However, the Committee members waited until the long queue was cleared before engaging him to explain the work they are doing.

13 The PHO explained that there are three public health officials posted to the Amdalai border.

He said the ministry had supplied them with thermometer equipment to do the temperature screening of incoming travellers and the protective materials but that they need more supplies as some of these e.g.

face masks, gloves etc.


are not only used by the health officials but also distributed to those from the other outfits working at the border.

He said the minister’s visit brought more improvements as he had made some recommendations which are now being implemented.

Mr. Sowe talked about their collaboration with the Senegalese health, immigration, customs and police on the other side of the border considering the confirmation of cases of the Covid 19 in Senegal.
He said among the measures they have put in place is the creation of a Whatsapp group to be sharing information between the officials on the two borders.

He indicated that there is need to deploy more public health officers to the border to assist in the screening of travellers as well as community sensitization in border villages.

He said there is no ambulance stationed there and that if the need arises to evacuate a suspected case they have to call the Regional Health Directorate at Essau.
It was observed that the place where the health official who should be the first port of call before the visitor comes into contact with anyone is wrongly situated.

Coming from the Senegalese border, the traveller passes through shops, traders, hawkers and motorists before reaching the table where the health officer is doing the screening.

The public health officer and the officials from the other outfits responded to the questions raised by the Honourable Members and SMSs.
The Committee members were later escorted to meet with the Senegalese border officials on the other side.

Receiving the team in their office were the National Police Adjutant Diaw, Adjutant Faye and Doctor Badian from the Ministry of Health of Senegal.

Hon.
Hon.

Ousman Sillah, Chair of the Select Committee, explained that the purpose of their visit as the parliamentary committee on health is to assess the state of preparedness and response of the Gambia to at the border in terms of prevention and control measures put in place.
He emphasized the importance of the close relations existing between the Gambia and Senegal as two countries with the same people, adding that there need for more collaboration between the two countries in 14 their common quest to promote the welfare of the populations of Gambia and Senegal.

Adjutant Diaw, on behalf of the Senegalese officials, thanked the Honourable Members for the visit and expressed how honoured they were to receive such an important high level delegation to their office.
He told the NAMs that the officials of the two countries at the border are working together very closely as a team on matters of common concern, especially on the Covid 19 issue.

He said the health officials of both countries are collaborating in order to share useful information on the screening of the people coming through both entry points, adding that they will continue to work together as a team at all times.
From the Senegalese border offices, the team returned to the Gambian territory to visit the building designated as a holding centre for any suspected case pending evacuation to Banjul.

The structure, which is about 100 metres away from the immigration office, was built during the Ebola outbreak to serve the purpose of temporarily holding suspected cases.

However, the team observed that the place needs cleaning and re- arrangement as a holding room ready to accommodate a case.
When the team was informed that the electricity supply was disconnected due to misuse in the past, the Chair asked the GRA officials to assist by making arrangements to temporally re-connect the facility from their quarters until the matter is resolved by the health ministry.

The visiting party left Amdalai around 2.30 pm to head to Banjul for the next and final engagements of the oversight visits 5.2.2.
Visit to the Edward Francis Small Teaching Hospital (EFSTH)The Select Committee on Health sets upon itself the task to visit holding and isolation facilities to assess the state of preparedness in case of any eventuality of confronting or handling a suspected or confirmed case of or Covid 19 infection in the country.
Following the return of the team from the Amdalai/Karang Border Post around 3 pm on Wednesday, it proceeded to the Edward Francis Small Teaching Hospital and was met on arrival by Mr. Malang Ndong, Deputy Chief Medical Director (DCMD), in his office and who was later joined by Dr. Charles A. Roberts, Ag.

Chief Medical Director (CMD), Mrs. Horeja Saine, Chief Matron, and Dr. Badjan, Coordinator of EFSTH or Covid 19 Response Team.
15 In his usual introduction of the purpose of the visit, the Committee Chair indicated that this is a follow-up to the previous engagement which the oversight body had with the Ministry of Health, under the leadership of the Minister, for them to provide an update on the state of preparedness to respond to any reported case.

He said a letter was addressed to the Health Minister, and copied to all the heads of the institutions to be visited, including the CMD EFSTH, to inform them about the visit.
He said the Select Committee is there to inspect the facility and assess the hospital’s level of response preparedness for the Covid 19.

In welcoming the visiting members of the Select Committee on Health, Dr. Roberts, Acting CMD, said the EFSTH, as the main referral hospital, is well prepared to receive cases as they have set up an Emergency Committee comprising medical personnel from the different departments and who are on a stand-by to respond to any suspected case of COVID19 referred to the facility.
Dr. Badjan led the visiting team on a conducted tour of the areas of the hospital that are prepared for attending and holding any reported or suspected case.

The first place to visit was the Accident and Emergency (A and E) Unit which is the first port of call.

The arrangement there has been changed as the register table at the reception area was transferred to the adjoining ward so as to make more space for movements.
According to Dr. Badjan, this will also help to separate any suspected case from other patients and also escorts to avoid the possibility of transmission.

He explained that if anyone is brought in or turns up as a suspected case, the person will be screened and check at the emergency room and if found to be a suspect, he/she will be transferred to the isolation ward designated as an holding centre at the far end of the hospital.
He added that the suspected patient will be kept there in isolation for few hours while arrangements are made for the EDC of the Ministry of Health to facilitate the transfer of the person to where the tests for confirmation is done.

The other place visited was the holding ward where the Committee members were shown two well-equipped air-conditioned rooms with adjoining toilets and television sets that are ready to accommodate any referral.
On the availability of equipment and materials, the members were shown cartons containing PPEs, fumigating machines and other protective materials supplied by the ministry.

Despite these supplies, the hospital still needs more PPEs, antiseptic detergents (bleach), protective materials such as face masks, particularly the N95 16 type, which is said to be more appropriate for hospital staff coming into contact with patients.
It was also suggested to the management by the Committee that a similar arrangement to the one at the A and E at EFSTH to prevent transmission be instituted at the Polyclinic in Banjul where many patients go to as first port of call for medical attention/diagnosis and treatment.

5.2.3.
5.2.3.

Visit to the Sanatorium Isolation/Treatment Centre The Select Committee on Health culminated its inspection and assessment visits at the country’s only isolation treatment facility at the Sanatorium in the outskirts of the capital city of Banjul.
On arrival at the Sanatorium, the visiting NAMs and team, who were accompanied by the Acting CMD, Deputy CMD, Dr. Badjan and the Hospital Matron, were met by the Officer in charge, Bakary Gibba, Officer in Charge, and his deputy Lamin Sarr, together with the senior nurse and support medical staff posted there.

This hospital which is under the management of EFSTH has ever since been designated for the treatment of the contagious TB disease.
It is a part of this facility that has now been transformed into the isolation treatment centre for any confirmed Covid 19 infection in the country.

One of the two buildings at facility with a 42 bed capacity is being used for this purpose.

The two wards in the building, with one reserved for recovering patients while the other for critical cases, have undergone some refurbishment.

It is the main hall which is partitioned into two wards by plywood and mesh.
Both wards have beds, waste bins, respirators, air conditioners and adjoining toilets.

6.

Conclusions and Recommendations Following the two days of visits to selected points of entries (PoEs), holding and isolation treatment centres, the Select Committee on Health, Women, Children, Disaster, Humanitarian Relief and Refugees met to review the oversight engagements and agreed to present some key conclusions and recommendations based on the observations made and discussions held with officials.
17 In this regard, the Committee is hereby submitting the following recommendations for the attention and implementation by the concerned stakeholders from government, international organizations and the general public: 6.1.

Banjul Seaport The office space provided to the Public Health officials by the GPA management to accommodate all of them is very small.

However, it was noted by the GPA officials that space is a challenge even to the Authority which is also in need of expansion.
When vessels are docked at the harbor, the Committee was informed that the health officials are the first to meet with the crew in order to perform the necessary and internationally accepted screening protocols and procedures.

Recommendations 1.

Provision of more protective materials such as face masks, gloves, and temperature testing equipment.

2.
2.

In situations of public health emergencies, as it is the case presently, it should be a policy for not only the health officers to put on protective masks but all the other workers coming on board the vessels.

3.

GPA management to consider providing a more spacious office for the public health officers who have a critical role to play in terms of the health of the population.

4.
4.

The Ministry of Health needs to review and amend the Public Health Act to address gaps and empower, protect and enhance the inspection work of public health officials.

5.

Ministry of Health to consider placing a ban on the importation of old/used newspapers which are used for wrapping food e.g.

bread and other foodstuff thus posing as a matter of public health concern.

7.

Ministry of Health to consider providing transportation for the public health staff at the Banjul ports.

18 6.2.
18 6.2.

Banjul International Airport Recommendations 1. transport for the staff on duty to facilitate timely report to work and return home.

2.

Adequate supplies of protective materials and equipment.

the temperature testing 6.3.

Giboro Border Post Recommendations 1.

Ministry of Health to deploy a minimum of 3 public health officers to be stationed at the border and working on a shift basis.

2.

Provision of more protective materials like protective masks, gloves, detergents or antiseptics.

3.
3.

Erection of a canopy outside in front of the immigration office as the first port of call for travelers entering the country and also to cover the health officials from the hot sun.

4.

Water tank with chlorinated running water to be placed immediately before the canopy outside at a place where the traveller would first go to wash hands with soap or detergent before presenting oneself to the health officials.

5.

Provision of a special ambulance on standby 6.

Transportation for the staff.

7.


Cleaning of the holding centre or ‘Ebola’ house to make it ready for use and the provision of solar energy and running water.

6.4.

Amdalai Border Post Recommendations 1.

A canopy for the health desk, as the first port of call for every traveller entering the country, should be erected immediately after the border line marking on the tarmac road separating the two countries.

19 2.
19 2.

The Border Health Post needs more deployment of public health officers to boost the capacities of the three who are already posted there, considering the current public health emergency situation.

3 The Ministry of Health should allocate a special ambulance on standby to be stationed either in Amdalai or the Regional Health Directorate in Essau.

4.

The holding facility at the ‘Ebola’ House should be made ready for use to accommodate any suspected case waiting for evacuation.

6.5.
6.5.

Edward Francis Small Teaching Hospital (EFSTH) The main referral teaching hospital in the country where all suspected cases are eventually referred for the eventual testing and confirmation of cases is in a state of preparedness in response to any suspected and confirmed case.
The physical set up or configuration at the Accident and Emergency (A and E) Department of the Edward Francis Small Teaching Hospital, which is the first port of call for patients, has now changed with the attendance desk at the reception being relocated to the adjoining ward in order to avoid any possible transmission from one patients to another patients or their escorts.
A special ward that was said to be meant for use by VIPs is now transformed into a temporal holding centre where any suspected case is admitted for few hours before the Epidemiology and Disease Control of the Ministry of Health is contacted to facilitate the evacuation of the case to the Medical Research Council (MRC) Unit The Gambia for testing and if confirmed, will be eventually, taken to the isolation centre at the Sanatorium.
The apex hospital, with support from the Ministry of Health and WHO, have mobilized the necessary supplies and equipment needed and are expecting to get more to put in stock such as PPEs, N-95 masks which are said to be more appropriate for the medical staff on the frontline.

Recommendations 1.

Provision of adequate PPEs, protective materials, gloves, N95 face masks, detergents (bleach), fumigators.

2.
2.

The new arrangements at the Accident and Emergency (A and E) Reception of the Edward Francis Small Teaching Hospital should be replicated at the Banjul Polyclinic which is the first port of call of patients.

20 3.

More trainings and step downs on the for doctors, nurses, technicians, auxiliaries, drivers, orderlies, cleaners and all the other hospital staff at the Polyclinic, EFSTH and the Tankataka psychiatric.

4.
4.

Given the highly contagious nature of the disease and the risk of infection that the medical workers are exposed to, the ministry should provide special risk allowances and other incentives to the workers when they start attending or managing cases.

6.6.
6.6.

Sanatorium Following the visit to the Sanatorium in the outskirts of Banjul, commonly called ‘Wencho’, the Select Committee came to the conclusion that the place being identified as hospital for the isolation and treatment of patients is not an ideal place for someone suffering from a respiratory related illness, considering the fact that the facility is very close to a waste dumpsite that emits smoke and other toxins.
The Committee was informed that the facility is still being used to treat TB patients who are now transferred and confined to the other building adjacent to the one reserved as an isolation and treatment centre for potential patients.

The number of trained staff is considered insufficient considering the critical nature of the illness and the need for constant attention by medical workers.

Recommendations Short term 1.


The two wards separately holding critical and recovering patients need air tight separation, if this is the best thing to do, with aluminum and glass partitions and not the plywood and mesh that divide the rooms.

2.

The wards need well-functioning air-conditioning system once they become air tight and holding patients.

3.
3.

The facility should be provided with a well-equipped ambulance on stand-by for the purpose of evacuating patients from the other facilities to the isolation centre.

4.

The workers on shift duties at the hospital need to be provided with a utility vehicle to be transporting them to and from work.

5.

More trained staff need to be deployed to the facility to compliment the few that are posted there in preparation of having to eventuality manage cases for treatment.

21 6.
21 6.

Considering the highly contagious nature of the disease, the Committee is recommending for both the professional and auxiliary staff that are posted at the facility to be well remunerated, with health insurance and other benefits, in the event of cases being admitted there for management and treatment.

7.

More protective materials such as N-95 masks, disposable gloves, gowns, PPEs, detergents e.g.

bleach antiseptics, etc.

to be provided in sufficient stock.

8.


Water supply and ventilation system to be increased for sanitary and health purposes.

9.

In terms of the management of dangerous and highly contaminable medical waste, the facility, particularly the wards, need to be provided with pedal and movable or wheeled waste bins.

10.

All the handle doors in the building leading to the wards and toilets should be changed to revolving doors to avoid infection of staff.

11.
11.

A high temperature modern fire-brick incinerator needs to be built for materials and clinical waste to be disposed.

12.

Step down trainings on the for nurses, orderlies and security.

13.

Given the highly contagious nature of the disease and the risk of infection that the medical workers are exposed to, the ministry should provide special risk allowances and other incentives to the workers when they start attending or managing cases.

Medium/Long term 1.
Medium/Long term 1.

If the dumpsite cannot be relocated from where it is situated now in the outskirts of Banjul, the Committee is recommending for the eventual relocation of the Sanatorium to a more ideal and environmentally friendly area with a fit for purpose building for the treatment of communicable or contagious diseases that need isolation.

This is an urgent matter for the Ministry of Health, Ministry of the Environment and Ministry of Lands to look into and find a lasting solution.

2.
2.

The patients undergoing treatment for tuberculosis should be relocated to a more health friendly environment and away from the dumpsite that emits smoke and toxins that are hazardous to their weak immune systems.

22 6.7.
22 6.7.

Ministry of Health The Select Committee was duly informed, during the update session with MoH, that following the announcement by the World Health Organization (WHO) of the outbreak of the highly contagious Covid 19 disease, later rechristened by the world body, in Wuhan, China, and the call for governments to take the necessary measures to control its spread, the Ministry of Health of the Gambia started the process of national consultation to agree on the way forward.
A press release was issued to that effect to inform the general public about the outbreak, followed by the convening of a central level meeting of technicians dealing with Public Health Emergencies to map out the way forward for the country’s preparedness and response to the Novel Corona Disease outbreak.
According to the Ministry, a number of actions were also taken by the ministry which includes the establishment of the National Health Emergency Committee (NHEC) charged with the responsibility to coordinate the implementation of 2019 – nCov () in The Gambia.
Orientation sessions were conducted with support from IOM (International Organization for Migration), the Japanese government and the ministry for officials at the points of entries (PoEs), including health, immigration, revenue authority, civil aviation, airline operators, fire service, food safety and phytosanitary, security at the airport and seaport, border posts and medical facilities to strengthen their capacities on the Novel Covid 19.
They were trained in the control and proper use of Personal Protective Equipment (PPEs).

A preparedness checklist was also completed and submitted to the WHO.

The Committee was also informed about the PoE strengthening support provided by IOM which includes thermometers, first aid boxes, stretchers and BP machines as well as the sharing of the WHO n-Cov technical guidelines with regional health directorates and hospitals.
The Select Committee acknowledges all the preparedness and response activities or measures being undertaken or instituted by MoH with the support of partners.

Recommendations 1.

The Ministry of Health should be taking the lead, at all times, in the coordination and implementation of the national preparedness and response to the .

2.
2.

The Ministry should ensure that the public health officials, hospital and all the other frontline workers, who are at risk, are given priority in terms of their protection against infection of this highly contagious virus.

3.

The Ministry should ensure additional resources to be given to hospitals and public health offices at the points of entries for the provision of protective equipment and materials, training for doctors, nurses, auxiliaries and public health workers.

23 4.
23 4.

The Ministry should step up its risk communication, social mobilization and community engagement activities by utilizing various mediums to create public awareness for the prevention and containment of the Covid 19 outbreak.

5.

The Ministry should engage in providing updates on a daily or every other day basis, based on its own compiled reports and the WHO and other credible sources on the state of the a disease at the national, regional and international levels.

6.
6.

The National Health Emergency Committee (NHEC) to be enlarged, if necessary, to include all the health-related statutory bodies (councils and agencies) and other non-technical (health) stakeholders to enhance its coordination and implementation capacities.

NHEC can even constitute a Standing Consultative or Advisory Forum comprising retired medical workers, former officials of the ministry e.g.
former ministers, permanent the private doctors/consultants, clinics, pharmacies, NGOs, civil society, media, etc.

secretaries and directors of health, 7.

The Ministry of Health should also include Veterinary Services, the government institution responsible for animal health, in the NHEC.

8. the Ministry of Health to provide standby Ambulance in every Health Regional for the purpose of evacuating of suspected cases.

9.
9.

The Ministry of Health to issue a circular for all public and private institutions and work places to provide facilities for hand washing.

10. the Ministry of health to ensure that all officials entry point institute screening measure.

11.

The Ministry of the Health to develop a protocol on measures for screening and other procedures at every official entry point.
12. the Ministry To closely work with the Ministry of Foreign Affairs on the situation and welfare of the Gambian in the Countries affected 13.

The ministry of health to strengthen the already existing collaboration with other State Agencies at the entry point i.e.

GID, Policy Custom food safety and venires.

24 6.8.

Ministry of Finance and Economic Affairs 1.


The Select Committee recommends the Ministry of Finance and Economic Affairs to support the Ministry of Health in its requests for resources to respond to the outbreak.

2.
The Select Committee recommend the Ministry of Finance and Economic Affairs to liaise with the Attorney General Chambers and Ministry of Justice to start the process toward giving effect to Section 154 (1) of the Constitution of the Republic by tabling before the National Assembly a Bill for the enactment of this provision which states thus “An Act of the National Assembly may make provision for the establishment of a Contingencies Fund …” The purpose of this Fund is for unforeseen and urgent need for expenditure that would cater for emergencies such as the disease outbreak.
3.

The Honourable Members of the National Assembly, including the Members of this Select Committee which has health, disaster, humanitarian relief and refugees under its purview, will give full support to the enactment of an Emergency Fund Act.

6.9.

Partners 1.
6.9.

Partners 1.

The Select Committee is calling on the development partners from the UN system such as the WHO, UNICEF, UNFPA, IOM, as well as the MRC Unit of The Gambia, Gambia Red Cross Society (GRCS), CCM of the Global Fund, Action Aid International The Gambia, Embassies, media outlets (print, electronic and online), civil society, private sector among others, to provide support to the national preparedness and response efforts under the leadership and coordination of the Ministry of Health.

2.
2.

These interventions from the partners may come in varied forms such as the provision of PPEs, equipment and other essential materials, medicaments, publicity through newspapers, radio and television stations, posters, billboards, drama, jingles or songs, among others.

3.

The Committee is recommending for all public spaces such as schools, offices, car parks, bank halls, to be adorned with sensitization messages on the or Covid 19 outbreak on billboards, posters, cartoon sketches, flyers, etc.

4.
4.

Partners such as local councils, non-governmental organizations and civil society are all welcome to support or undertake activities aimed at sensitizing the 25 population on the Covid 19 disease.

However, the advice from the Committee is that all such efforts or undertakings must be done through or in consultation with the Ministry of Health which is responsible for the national coordination of all the preparedness and response activities.

6.10.
6.10.

Members of the Public There is no cause for alarm as no suspected case of or Covid 19 has been reported in the Gambia.

However, we should not be complacent as a country and have to be ever more vigilant to ensure that this highly contagious disease does not enter our shores or that any reported case is contained.
The fact that the Gambia’s closest neighbor, Senegal, has reported four cases should make us to be more vigilant in terms of increasing and strengthening our prevention and control measures.

Covid 19 is a highly contagious and deadly disease and the WHO has now declared the outbreak as a public health emergency.

The advice being given to the members of the public by the health officials as the most effective, reliable and affordable form of prevention is basic personal hygiene i.e.

regular hand washing.


While the world is waiting and hoping for the discovery of a cure or vaccine for the virus very soon, we are advising every person to adopt, in the meantime and even beyond, these basic personal hygiene practices outlined below: 1.

As opposed to washing your hands with water alone, wash your hands with soap or other detergents e.g.

soap, soap power, chlorine (eau de javel), frequency before touching and before eating anything.

2.
2.

Stop touching your nose, eyes, mouth and face with your hands.

3.

Stop shacking hands altogether or washing your hands with soap after handshakes.

4.

Avoid crowd as much as possible or crowded places, such as gatherings or maintain distances with those who may be coughing or sneezing in the open.

5.

Use your bent elbow when sneezing or coughing to avoid infecting others.

6.

Use and carry hand sanitizer, if one can afford it, wherever one goes.

26 ADDRESSEES 1.

Minister of Health 1.


Minister of Finance and Economic Affairs 2.

Antony General Ministry of Justice 3.

Minister of Foreign Affairs 4.

Minister of MoBSE 5.

Minister of MoHERST 6.

Inspector General of Policy 7.

Commissioner General GRA 8.

Permanent Secretary Ministry of Health (MoH) 9.

Director Health Services 10.

Chief Medical Director of Edward Francis Small Teaching Hospital 11.

Secretary General Office of The President 12.


Permanent Secretary Ministry of Finance and Economic Affairs (MoFEA) 13.

Managing Director of the Gambia Ports Authority (GPA) 14.

Director General Gambia Civil Aviation Authority (GCAA) 15.

Director General Gambia Immigration Department (GID) 16.

Inspector General of Police (IGP) 17.

HE.

Ma Jianchum - Ambassador People’s Republic of China 18.

HE: Ruben Garcia Abelende - Ambassador People’s Republic of Cuban 19.
Resident Representative and Coordinator of the UN System in The Gambia 20.

Country Representative World Health Organization (WHO) 21.

Country Representative UNICEF 22.

Country Representative UNFPA 23.

Executive Secretary CCM Global Fund 24.

Executive Director Action Aid International The Gambia 25.

Director General Gambia Radio and Television Services (GRTS) 26.

Manager QTV 27.

Managing Editor Foroyaa Newspaper 28.

Editor in Chief Point Newspaper 29.


Clerk of the National Assembly 27 PICTURES PICTORIALS ON THE OVERSIGHT VISITS OF THE NATIONAL ASSEMBLY SELECT COMMITTEE ON HEALTH, WOMEN, CHILDREN, DISASTER, HUMANITARIAN RELIEF AND REFUGEES TO THE POINTS OF ENTRIES AND HOLDING AND ISOLATION CENTRES TO ASSESS STATE OF PREPAREDNESS IN RESPONSE TO THE COVID OR COVID 19 OUTBREAK – 3-4 March 2020 Tuesday-3 March 2020 Banjul Seaport R: Hon.O.Darboe, Hon.

O. Sillah, Hon.

A, Camara, Hon.


M. Nyassi, Mr. S. Touray, PHO, and Hon.

N. Y. Secka Mr. A. Nyassi, Mr. N. Manneh and Hon.

S. Saho L- Hon.

Members at the harbour Hon.

Members walking towards a docked vessel Hon.
Nyassi, S. O. Sillah, M. Marong and A. Camara Ports staff and workers on board a container vessel 28 PICTORIALS ON THE OVERSIGHT VISITS OF THE NATIONAL ASSEMBLY SELECT COMMITTEE ON HEALTH, WOMEN, CHILDREN, DISASTER, HUMANITARIAN RELIEF AND REFUGEES TO THE POINTS OF ENTRIES AND HOLDING AND ISOLATION CENTRES TO ASSESS STATE OF PREPAREDNESS IN RESPONSE TO THE COVID OR COVID 19 OUTBREAK -3-4 March 2020 Tuesday-3 March 2020 Giboroh Border Post (Seating) Honourables, M. Nyassi, O. Sillah, Mrs. A. Ngum, (Seating) R-L Honourables, O. Sillah, M. Nyassi and S. Marong OC Manneh – Immigration L-R: I. Sonko, S. Bojang, Police Officer, Hon.
A. Camara, B. Manga, PHO, talking to NAMs A. Nyassi and Hon, S. Marong Members of the team being briefed Honourable NAMs inspecting the holding Centre at Giboro 29 PICTORIALS ON THE OVERSIGHT VISITS OF THE NATIONAL ASSEMBLY SELECT COMMITTEE ON HEALTH, WOMEN, CHILDREN, DISASTER, HUMANITARIAN RELIEF AND REFUGEES TO THE POINTS OF ENTRIES AND HOLDING AND ISOLATION CENTRES TO ASSESS STATE OF PREPAREDNESS IN RESPONSE TO THE COVID OR COVID 19 OUTBREAK - 3-4 March 2020 Tuesday-3 March 2020 Banjul International Airport Public Health Officers waitng for new arrivals at the Banjul Internationl Airport Public Health Officer showing Members the infrared camera Hon/ Members being shown the holding ward (centre) Holding centre at the airport Immigration and Public Health Offi cers 30 PICTORIALS ON THE OVERSIGHT VISITS OF THE NATIONAL ASSEMBLY SELECT COMMITTEE ON HEALTH, WOMEN, CHILDREN, DISASTER, HUMANITARIAN RELIEF AND REFUGEES TO THE POINTS OF ENTRIES AND HOLDING AND ISOLATION CENTRES TO ASSESS STATE OF PREPAREDNESS IN RESPONSE TO THE COVID OR COVID 19 OUTBREAK -3-4 March 2020 Wednesday- 4 March 2020 Edward Francis Small Teaching Hospital (EFSTH) in Banjul Honourable Members in Office of the DCMD M. Ndong (DCMD), C. Richards (CMD), H. Saine (Matron) and Dr. Badjan Honourable Members and Committee Secretaries 31