Tapping into Diaspora Skills to Strengthen Healthcare Systems in The Gambia

Banjul – Twenty-two years ago, a teenage Olimatou Chongan decided to leave home for the United Kingdom to pursue her undergraduate studies.

“My parents were very encouraging of my education. I had a hardworking father and a loving mother,” recalls Olimatou. “After the 1994 coup in The Gambia, many of my family members left the country, so I already had some family in the UK.”

Olimatou initially studied information technology and found satisfaction working part-time as a volunteer in a mental health ward. “I, therefore, followed my passion and went back to university for a postgraduate degree in mental health studies. I have not looked back.”

Alhagie Camara made the same decision to migrate to the UK, albeit at a later stage in his life. Hailing from a rural community in the North Bank Region, Alhagie dabbled in teaching, photography, construction and community development before honing his passion for mental health – one he discovered while working in the development sector.

“I decided to move in my early forties to deepen my education in the field of mental health.”

Olimatou and Alhagie both now have well-established careers with the UK’s National Health Service. They are among more than 118,000 Gambian migrants living abroad. Overseas remittances are equivalent to roughly 21 per cent of the country’s GDP. An estimated USD 589.81 million in remittances in 2020 made The Gambia the fourth-highest recipient country for remittances in Africa, as a proportion of GDP, that year – during the height of the COVID-19 pandemic.

The potential of diaspora members lies not only in remittances, though. Migrants build valuable skills and knowledge that they may not have otherwise gained in their home countries, and which they now have the opportunity to channel back.

This was the genesis of the diaspora mentorship programme established by the International Organization for Migration (IOM) with The Gambia’s Ministry of Foreign Affairs (MOFA), International Cooperation and Gambians Abroad. Olimatou and Alhagie were two of four mentors selected for a one-month programme, which aimed to facilitate skills transfer and capacity-building at select government institutions. With their background in mental health, Olimatou and Alhagie were tasked to mentor young professionals at the Tanka-Tanka Psychiatric Facility, under the Ministry of Health. Other diaspora mentors were assigned to the Ministry of Foreign Affairs’ Diaspora and Migration Directorate and the Ministry of Youth and Sports’ National Youth Council.

“When I saw an advert for a diaspora mentorship programme, I knew it would be the best opportunity to offer my services,” recalls Olimatou. “I decided to apply because it is something I have always wanted to do. It would be a privilege to come back and contribute,” Alhagie concurs.

Olimatou had already been a long-standing patron of Tanka-Tanka, the country’s only dedicated psychiatric facility. In 2014, she founded a charity called Better Thoughts Africa, which made a series of donations to the facility. Having already made financial contributions, now was her chance to render support using the skills and knowledge she gained abroad.

Among Olimatou's mentees are six members of staff from the facility and four mental health focal points from other regions.  “In the first week, we did an assessment of what is working well in the facility and what is not. The second week was focused on medication management training to ensure the right care for each patient. Then, we introduced simulation sessions on Cognitive Behavioural Therapy and Talking Therapy and Formulation to train the healthcare workers on new therapies to implement.”

Alhagie adopted a similar approach with a focus on collecting and addressing regular feedback from the mentees. “It was a great opportunity to interact with and learn from the staff, exchanging on how best we can bring our skills together and share our expertise.”

The discussions in the programme contributed to proposed changes to the facility’s standard operating procedures. “Through the group exercises, we came up with admission protocols and consent forms which we need here. We also discussed proper storage, like how to separate the control drugs from other drugs,” explains Omar Bojang, the facility’s manager.

Alhagie hopes his mentees gain “a better awareness of duties and responsibilities to make an impact in the lives of patients and their families.” One of the mentees, Ebrima Bah, shares his reflections on this. “My main takeaway is that we, the ones working here, are the ones who can start addressing issues. The best way we can address issues is by working collaboratively to make a better working environment.” Ebrima shares the example that, through the programme, the facility was able to better define roles and responsibilities and strengthen accountability for deliverables.

Meanwhile, Olimatou reveals that the programme provided a platform for the mentees to be exposed to good mental healthcare practices.

The month-long mentorship programme offered a sneak peek at the potential of the diaspora to meaningfully contribute to national development. The concept of “brain circulation” is starting to gain currency globally, highlighting the opportunity for the diaspora to transfer skills, knowledge, technology and networks – which are integral to the development of a modern economy.

“The programme was a good start, and certainly more can be achieved through longer-term programmes,” explains Stephen Matete, IOM’s Programme Coordinator for Migration Management in The Gambia. “Together with MOFA, we continue to advocate for resources to build on this work through permanent, temporary or even virtual return programmes, in which diaspora members serve as practitioners to fill in critical resource and knowledge gaps. This can be done through collaborative research with local actors; arrangements to connect communities across borders; individual placement within scientific, technical and business networks; facilitating investment in emerging industries, and more.”

At the end of the programme, both mentors are already thinking of the wider, structural challenges they wish to address next. “We should promote better access to mental health services, demonstrating to people that there is no shame in receiving mental healthcare,” advocates Olimatou.

Alhagie also expresses the need for stronger capacities and a better public discourse on mental health. “The key to ensuring quality psychosocial support is to have more trained professionals and getting services closer to people, especially those living in rural areas. What I have seen recently is that more young people are interested in this area. I hope that in the next ten years or so, more attention would be drawn to the mental health sector.”

While building a strong healthcare system in The Gambia does not happen overnight, what the diaspora has to offer can help bridge the gap. Alhagie and Olimatou exemplify the advantages that can be reaped from human mobility. Skills, knowledge and capital gained abroad are ultimately being channelled back into the development of communities that need it – invested back into support structures for those at the margins who are often the most vulnerable to stigma and discrimination.

The diaspora mentorship programme was funded by the Italian Agency for Development Cooperation, through the Supporting Local Economic Development (SLED) project.

This story was written by Miko Alazas and Jaka Ceesay Jaiteh, IOM Media and Communications Unit in The Gambia.