Building the Kankudibi Health Clinic in Bakang Village, The Jokadu District, The Gambia

Front - Health Clinic

Geoff and Julie were invited to visit the village of Bakang in May 2005. They were asked for financial help to build a Health Clinic.
The nearest medical help is a 4 hour journey by donkey cart. This means there are many fatalities, due to the time lapse before appropriate treatment can be administered.
Malaria is a big killer in this area but there are many others: T.B. pneumonia, typhoid, diphtheria, polio, diabetes. There are the usual hazards of broken limbs, infectious sores and snake bites. So the need for medical help was obvious.
Asked about the labour for building a health clinic, the villagers said that they would provide all the unskilled labour, as they would be the main beneficiaries of such a facility. Skilled workers would have to be paid for the actual building, roofing, plumbing, electrical work, carpentry and plastering. The villagers would be there to fetch and carry for these skilled men.
Asked about the staffing for such a facility, assurance was given that young people, who had left the village to gain qualifications, would be pleased to come back to live and work in their home village.
Having had lengthy discussions with their Gambian friends, Geoff and Julie said they would do all they could to help.
Geoff and Julie opened a bank account in the U.K. and also in The Gambia, so the funds could be transferred as needed. Plans for the clinic were drawn up and approved by the necessary authorities.

Clinic Plan

This Health Clinic provides the following facilities:

Reception area.Consulting Room.
Accident and Emergency Ward.Treatment Room.
Male Ward.Pharmacy.
Maternity Ward.2 x Store Rooms.
Women's and Children's Ward.4 x Toilets.
Isolation Ward.3 x Showers.

Seating for outpatients will be provided along the whole veranda area of the clinic.

Please remember, there is no electricity, no mechanisation and all water is drawn by hand, from a 20 metre deep well.

A 7 stage building plan was drawn up, to aid monitoring and control of the project.

The Workforce

The stages are as follows:

1. Making by hand, 3,600 concrete blocks. Completed in July/August 2005. £1,850 sent out to cover cost of materials (including wheelbarrows and shovels), transportation, making of moulds etc.

well 20 meters down is a bucket on the end of a rope 3 man power mixer making concrete Stacking the Blocks


2. In January 2006 the digging out of the footings was started followed by the laying of the foundations of the clinic. Drainage pipes were put in place and also steel bars to strengthen walls. A further £2,000 was required to meet the cost of materials and this stage was completed in December 2006.

Footings blocks on site getting started

3. Commenced January 2007. A mason and 2 men were employed to build the walls, exterior and interior, to roof level. More blocks had to be made and the skilled men paid. £7,750 in total was sent to complete this stage.

Project Manager and Stone Mason Clinic walls taking shape checking the plans

Blocks Drying

4. Erecting the roof beams, trusses and attaching galvanized sheeting.
In September 2007 the materials were bought and shipped across the River Gambia and transported to the site. Despite the heaviest rains for 30 years, work progressed and the roof was completed at the end of December. A price of £6,000 was agreed to erect the roof structure. £4,000 was sent out to buy the materials and the remaining £2,000 was sent on completion.

inside look up at the roof inside the clinic 22.Nov.2007 front entrance

Payments are only made after consultation at each stage. All money spent is closely monitored and accounts and receipts are sent to the charity's treasurer in the U.K.
In this way, all money raised is guaranteed to be used for the purpose for which it was donated.

5. Plastering walls and making and fitting windows and doors.
January 2008 the gable ends were plastered first, followed by the outer walls.
A carpenter was employed to fit the wooden rafters to take the hardboard ceiling, the latter will not be fitted until the wiring and plumbing has been completed. A further £6,000 was sent to cover the costs of professional labor and materials.

CNV00102

6. Installing plumbing and electrical wiring.
Geoff and Julie took electric cable and components, (generously donated by a member of a Nottingham Rotary Club), to the clinic site on their recent visit. The "first fixing" was completed by a qualified electrician before they returned to the U.K. March 2008.

CNV00139 CNV00143 CNV00187

Since then the electricity wiring has been completed and the sockets sited. Now, in April 2009, the ceiling pendant sets, finger switches, pull switches and the main fuse box and control panel have all been installed.

Alasan Installs the Fuse Box
Alasan Installs the Fuse Box


All that is left to do in the clinic regarding the electricity is to link up the solar power to the internal wiring. - this will be done in early June. The electrical requirements for the staff accommodation and the utility building have been agreed and the materials are about to leave UK.

We are pleased to report that recently the Solar Power had been linked up to the internal wiring of the clinic (September 2009). This solar power will also provide all the lighting requirements for the staff accommodation and that of the utility building.

9 Solar Panels to provide the power. 18 batteries to store the power. Inverter & 2 charge controllers.
9 Solar Panels to Provide the Power           18 Batteries to Store the Power             Inverter & 2 Charge Controllers


And Then There Was Light!
And Then There Was Light!



The total cost of providing the solar power + installation £10,271

The vaccine fridge has also been wired into its own DC Solar Power Supply. It was decided to keep this unit separate from the other electrical needs in the clinic. Any failure there would not effect the safety of the vaccine in the fridge.

Vaccine Fridge in Pharmacy
Vaccine Fridge in Pharmacy



The cost of the fridge, Solar Power Supply + installation £2,726

For the other equipment and lighting in the clinic, staff accommodation and utility building the solar power will pass through the inverter and so be changed from DC to AC supply.

On the plumbing side all the toilets and showers are in place as are the wash basins in the wards, the consulting room and the treatment room.

One of 5 toilets in the clinic.
One of 5 toilets in the clinic.

Wash basin in women's ward.
Wash basin in women's ward.

Wash basin, shower & toilet in the maternity ward.
Wash basin, shower & toilet in the maternity ward.


In April 2009 it was decided that all showers and wash basins should have both hot and cold water on tap.
This has now been implemented with the introduction of the Solar Powered Water Heater.

Solar Powered Water Heater
Solar Powered Water Heater



The total cost of the Solar Powered Water Heater + installation £1,649

This now completes stage 6.

7. Tiling of all floors, veranda and walls of the toilets and shower cubicles.

We are delighted to say that this job has been completed in a most impressive way and has made a tremendous difference to the overall appearance of the clinic, as can be seen from the photos below (February 2009).

Male ward tiled.
Male ward tiled.

Floor tiling looks good.
Floor tiling looks good.

Tiled ramp at front of clinic.
Tiled ramp at the front of the clinic.
Ram & steps at the back
Tiled steps at the back of the clinic.


The primer coat of paint has been applied to all the internal walls and ceilings and the exterior walls. Further coats of paint will be applied nearer the date of the clinic "opening".

On completion of the construction, the furnishings and the fittings will be financed by the JDDF. Local craftmen will be employed to make as much furnature as possible, giving local employment, the people a sence of ownership, and keep freight costs to a minimum.


Getting Ready for the Opening
Getting Ready for the Opening



The Big Day!!

Yes! it has happened, the KANKUDIBI HEALTH CLINIC was officially opened by Dr Gaye, the Minister of Health and Social Welfare, on Saturday 7th November 2009. This is 4 ½ yrs since the first visit to the village and the request for a Health Clinic was made.

Minister of Health Cuts the Tape
Minister of Health Cuts the Tape



This was a momentous day for the villagers and they certainly celebrated in true Gambian tradition. There was plenty of drumming, clapping, dancing and singing and of course the usual problem with G.M.T. – Gambia Maybe Time. The proceedings were programmed to start at 11:00am, but it was 1:00pm before the final government official appeared! We then had all the speeches, plus a few extra, which were not on the programme, before it was time for Dr Gaye to cut the ribbon on the entrance door of the clinic and declare the clinic “Open”. It was then time to take the distinguished guests on a conducted tour of the clinic. We showed them the ROWSLEY WARD [Maternity] the BAKEWELL WARD [Women & Children] and the MATLOCK WARD [Men’s] and explained that these names were those of areas in which groups of people, who have given us much support, lived.
There were many very favourable comments made about the overall layout of the clinic, the high standard of workmanship, the facilities it offered and the thought that had been given at the outset of the whole project. At the end of the tour the minister showed his approval by signing a very special quilted wall hanging, a signature quilt designed and created by Vivien Finch, which shows the front of the clinic as the centrepiece. Around the central picture are many quilted squares, which after making a donation to the project, people have signed with their good wishes.
Before his departure the Minister again expressed his appreciation and that of the Government for what had been achieved and said that it was the best Health Clinic in the Gambia and a building of which we should be very proud. With these words ringing in our ears it was time to for us to leave and make our long dusty journey back to the port of Bara and wait for the next ferry to cross the river to Banjul and then back to our accommodation. It had been a long hot day, but one that all of us present will remember. We had left behind several hundred very happy Gambians who celebrated this momentous occasion long into the night.

The Team Celebrate
The Team Celebrate
Mission Accomplished
Mission Accomplished
The Minister holds the Wall Hanging
The Minister holds the Wall Hanging


The following day we heard that there were several pregnant women, in the Jokadu District, who were all wanting to be the first to give birth in the clinic. We also heard that the first patient was a suspect malaria case, who was kept in overnight for treatment and then released.

Everybody who visited the clinic site was most impressed with all the work that Lamin, the gardener, had done. He had transplanted grass at both the front and back of the clinic and had flowers growing on what had been just barren sandy land on our previous visits.
A list of garden seeds that Lamin had requested will be bought locally. The gardening tools he needs are to be sent from the UK and should arrive just before the rainy season starts. Needless to say he was very frustrated at problems the goats, sheep, donkeys and cattle were causing, for during the nights they were either eating off or pulling up the plants that he had so carefully planted during the day. You will notice from the photos that he has constructed his own fencing to keep them away. Hence, we felt it was very necessary to work out where the perimeter wall and fencing was to go and get the job started straight away.

Garden at the front of the clinic
Garden at the front of the clinic
Lamin in the garden at the back of the clinic
Lamin in the garden at the back of the clinic


Nov 2010

We are very pleased to report that the perimeter fencing around the whole Health Clinic complex has been completed. The groundsman, Lamin Yaiya Jarjou, now plans to plant bougainvillea all along the base of this wall, and allow it to grow up to the fencing. When this gets established it will give a mass of colours around the complete complex.

Perimeter fence at the front of the clinic
Perimeter fence at the front of the clinic
Perimeter fencing at the back
Perimeter fencing at the back


With the wall now completed Lamin can develop his landscaping project with peace of mind. The animals, goats, sheep, donkeys and cattle can no longer get in and destroy his hard work. The reports we are now receiving, from people returning from The Gambia, are that he has done a very good job during the rainy season. He has started by growing fruit and vegetables to feed the staff and patients. When the gardens are established any surplus fruit and vegetables will be sold and the money used towards purchasing required medicines.

Stick beans growing
Stick beans growing
Maize growing well
Maize growing well
Growing vegetables & flowers
Growing vegetables & flowers


June 2011

On our most recent visit to the Kankudibi Health Clinic we were delighted to see the further development of the landscape gardening that the groundsman, Lamin Ayaiya Jarju, has achieved. It is not an exaggeration to say that he has transformed the whole area around the Clinic, Staff Accommodation and Utility Building. When you think that 18 months ago this whole area was just sand and dirt - as shown in the photo, taken in front of the clinic "Getting ready for opening" It is astonishing how Lamin has managed to get the grass, trees, and plants to grow. The only answer is enthusiasm, hard work, water from the standpipe and green fingers!

The front of the clinic
The front of the clinic
Banana trees growing
Banana trees growing
One side of the clinic
One side of the clinic


Lamin proudly shows off his work
Lamin proudly shows off his work



He has also helped and advised the staff on how to grow their own fruit and vegetables on plots of land, which have been allocated to each unit of accommodation. We are now waiting to see the results of the bourgainvillea, which he will plant on the inside of the perimeter wall - it should be a mass of colour.

Audience with the Vice President 2011

Without doubt the highlight of our most recent visit was another audience with Her Excellency Mrs Isatou Njie-Saidy, the Vice President of The Republic of The Gambia and Secretary of State for Women's Affairs.
This was a very positive meeting and lasted 90 minutes. It is most unusual for an audience, with the VP, to last this long, but it just showed how interested and informed the VP is on what the villagers of Bakang have achieved. She thanked us for all that we had done to help the villagers and wished us to convey her most grateful thanks to the people in the UK who had been so generous with their support. She was most generous with her praise to Famara Jarjou, who has been our project manager right from the start. She was well aware that Famara had devoted most of the last 5 years in all aspects of getting the Heath Clinic built. He had encouraged the villagers to keep working and at the same time negotiated prices and obtained materials as and when required. For a Gambian man, in his late 60's, this is not easy.
The MP for the Jokadu District, Hon Kebba Gaye, who had arranged the meeting on our behalf, raised several points about the future needs of the clinic, now that it is in operation. The VP answered each point and either gave a ruling as to what had to be done or advice on how she saw the future development of the clinic. She had instructed three senior members of the Ministry of Health and Social Welfare to attend this meeting and so was able to give them instructions and advice as to what had or would be done. Certainly this lady runs the country and is held in very high esteem by all Gambians.

Needless to say all the Gambians present, including the VP, wanted to know what our next project was going to be! We managed to avoid answering that question by saying that we still had 3 ½ yrs in which we were honour bound, by the Memorandum of Understanding we had signed, to help with the running of the clinic until we handed it over to the government in November 2014.

Our audience with the VP was filmed and recorded by the National Television Company and was shown on the 8pm and 10pm national news on both Friday and Saturday nights. Our advice to anyone who wants to help in an African country is to start at the top – it has a tremendous influence when dealing with government personnel and getting decisions made.

March 2012

The highlight of this most recent visit to the clinic was to persuade the Chief Nursing Officer (CNO), Mrs Margaret Gomez to come with us. This was her first visit and it proved to be a big surprise for her.

We were met with a great welcome from the villagers and the staff. They were obviously delighted to see such an important person in their village and as usual there was plenty of singing and dancing. There were the usual speeches of welcome, but it was also made very clear that there was a big need for an ambulance. The clinic is getting busier by the day as word has spread that no matter what day or time you arrive at the clinic you will be seen, by a qualified nurse, and receive the necessary treatment. Aunty Margaret, as she is known, certainly listened to this request and said that she would put forward a proposal, when she returned to Banjul, that the government should definitely consider providing an ambulance. Awa, the head nurse, then took the CNO on a conducted tour of the clinic. She answered all the questions that Margaret asked and made several suggestions, which would be of help in the future. Several things that had been incorporated in the construction of the clinic surprised the CNO. She was so impressed she insisted that she had photos taken and said that these photos would be used when future construction of hospitals/clinics was being considered. Finally, after inspecting the utility building and the staff accommodation the CNO made a telling remark to the staff. She said "do not ask for a transfer because you will never find facilities or accommodation as good as this anywhere else in The Gambia" That, we consider, is praise indeed for the tremendous effort of all the Gambians who had worked on this project.

Villagers saying welcome
Villagers saying welcome
CNO Margaret Gomez & Mr Sootay
CNO Margaret Gomez & Mr Sootay
So pleased to see you
So pleased to see you


Lamin Yaiya Jarju, the gardener, continues to enhance the whole area around the Health Clinic. Despite less rain between June and December last year he has still managed to grow more vegetables for consumption and has started to train the bougainvillea to grow up the perimeter walls.

The probability of much colour in the years to come? The probability of much colour in the years to come
The probability of much colour in the years to come?


During this last visit to the clinic we discussed the need for either more solar panels to be added to the existing number or introducing a separate solar unit for the staff accommodation/utility building.
The reason for this is because the demand for electrical power has increased as the whole project has expanded ahead of the original idea! We are now in the process of deciding which way to move.

Another success for us, on this visit, was to ask the wood carver @ Kololi Beach Club to carve a new KANKUDIBI HEALTH CLINIC sign, which has been screwed to the perimeter wall near the main gate.

It must be the best clinic on North bank
It must be the best clinic on North bank



September 2012

Expectant Aja Bojang, Midwife, in the clinic garden.
Expectant Aja Bojang, Midwife, in the clinic garden.
Masaneh Camara Qualified S.E.N Feb 2012.
Masaneh Camara Qualified S.E.N Feb 2012.
So pleased to be working here!!


Clinic staff on parade
Clinic Staff on Parade

Bakary Sonko (Security Gr’d), Masaneh Camara (Nurse), Jarra Drammeh (Cleaner), Mariama (Nurse), Mama Jammeh (Cleaner), Mama Sima (Nurse), Wandy Jarju (Cleaner), Lamin Yaiya Jarju (Gardener), Aja Bojang (Midwife).

[Awa Bojang (Head Nurse), was off sick.]



January 2013

We have just received some more photos taken by visitors on their first visit to the Kankudibi Health Clinic. To say they were very impressed is not an exaggeration. They were amazed to see what a magnificent job our gardener, Lamin Yiaya Jarju, had done, landscaping the whole area in which the clinic stands. You will have already seen the progress he has made since the construction work was completed in October 2009. [If you have missed this then go back through the Project page to the time when the clinic was ready for "opening"]
We are now adding 3 more photos, one of which shows the lad himself with the bougainvillea he has grown from seed.

Outside the Main Gate
Outside the Main Gate
[Donkey, cart & driver – the transport for sick patients waiting in the shade before the return journey home]
Inside the Entrance to the Clinic
Inside the Entrance to the Clinic
[Flowers becoming established]


Lamin, Done Good
Lamin, Done Good



Clinic Pharmacy
Clinic Pharmacy
[Nurse, Sima, dispensing drugs to patient after consultation]
Proud Mum
Proud Mum
[Baby born in the clinic 3 days previously]


April 2014



Increase in the use of the clinic

During our visit in April 2014 we discussed with the nurses and the midwife the large increase of both adults, and children under 5 yrs old, now being seen / treated at the clinic. In 2012 the overall number of patients was just over 2,500 and 14 babies. However, during 2013 there had been a large increase. Adults seen / treated rose to 3,869 and children numbers rose to 2,187. This gave an overall total of 6,056 - an increase of 142%. Babies born in the clinic rose to 27 – an increase of 92%. Now, in the first 3 months of 2014, 13 babies have been born. We are assured that it has nothing to do with an increase in productivity in Bakang. Apparently the Government have instructed pregnant women in the Jokadu District and the surrounding area to use the facilities at Kankudibi Health Clinic rather than travel to Kerewan, Kuntair or Essau. At last someone in higher reaches of the government has noticed the potential that is now available, close at hand.

Kankudibi Health Clinic - Ambulance

This vehicle was given to us in December 2013 by the charity that hails from Denmark named Pass it Forward. They work in collaboration with a Gambian charity called Advocacy for a Better Environment. This vehicle, despite its age of 40 years, brought a load of football garments, equipment, footballs, footwear and other items from Copenhagen. Having driven down through Europe and then North Africa loaded, we feel sure that it will stand the challenge of the village tracks / terrain in the Jokadu District. It was just a large van when we took delivery. Now, thanks to some effort and craftsmanship, it has been changed into a basic ambulance. It has a siren and a blue flashing light. Windows have been fitted and seating is down both sides of the interior. There is also room for a stretcher, or two, and wide back doors for an easy entrance with patients. A local man, Lamin Saidy, aged 30 years, has been selected to drive this vehicle. He is currently undergoing medical training @ Essau Hospital and will also train on how to handle sick and infirm patients to and from the ambulance. On completion of this, he will have a course of mechanical training from staff of "Riders for Health". The maintenance of this vehicle will be carried out by Riders for Health at their Kerewan Garage. We will give this vehicle to the Government, when we hand over the whole Kankudibi project to the Government of the Republic of The Gambia, through the Ministry of Health and Social Welfare, on Saturday 8th November 2014.

Impressive Ambulance
In both photos this ambulance looks impressive.
Impressive looking Ambulance
.