Gambia labour ward

This presentation offers a first-hand perspective on the challenges of delivering maternity care in a small district hospital in rural Gambia. Still early in my medical training, the experience provided insight into the realities of delivering obstetric and anaesthetic care in a challenging environment.

I will explore the key determinants of maternal morbidity and mortality and why the burden is so high in low-resource areas. My placement was based with a non governmental organisation called Hands On Care which aims to improve access to sexual and reproductive health for women living in rural communities in Brikama. One of their main goals is to address the challenges of providing care for expectant mothers living with HIV, a disease which continues to be the leading cause of mortality in The Gambia.

A central focus is on pain management in labour. A small qualitative study explored women’s experiences on the labour ward and demonstrated their desire for pain relief. Labour pain was frequently reprioritised due to competing clinical demands, cultural expectations, and communication challenges. Anaesthetic delivery was particularly challenging, reflecting wider limitations in resources and infrastructure.

I hope to highlight the intersection of anaesthesia, obstetrics and public health emphasising how maternal care can be kind, safe and respectful even in austere environments.