Find out about the services we offer at our main clinic at the MRC Gambia Fajara campus.
The following video presents key information about our Fajara clinical services. You can also view alternative versions in , and .
Gate clinic (general public)
The Gate clinic provides access for the general public who self-present to the clinic early in the morning. Demand far exceeds capacity, so tickets are given out on a first-come first-served basis for 100-150 patients each morning.
Patients with tickets are seen by a nurse who can arrange simple investigations and treatment. When a patient has a more complex illness that falls within our expertise, they will be referred to see a doctor in the MRC Gambia clinic. Patients with other problems are referred to other services. Please note that the clinic does not offer a 24-hour emergency service.
Fees
There is no payment to see the nurse or doctor. A small fee is charged to older children or adults who need investigations, medication or admission to the ward. The fee is a contribution to the cost of care, which is highly subsidised. In all cases the fees are lower than the cost to the department of providing the items supplied.
Staff clinic (including private patients)
The Staff clinic provides primary healthcare to staff working for us and our partner organisations, as well as a small number of private patients. Appointments must be pre-booked for this clinic.
Private patients receive the same medical care as other patients, though we cannot provide emergency care unless they are employed by one of the partners with whom we have a formal agreement.
Fees
The private patient fee to see the doctor is D3,000 for the first consultation and D1,500 thereafter. Any tests requested must be paid at the full economic cost. Typically, a set of tests costs of the order of D1,000-D5,000 depending on what is included. We usually give prescriptions to be filled outside the clinic, rather than dispensing medication from within. If a private patient is admitted to the ward, we charge a nightly fee. These fees must be paid in cash at the point of service. We have no facility for credit.
Typical investigation fees:
- Laboratories: D50 per sample, with some exceptions for more unusual tests which might be charged at D100-150 per individual test (and more than one test might be done on a sample).
- X-rays: Usually D200 per test, with additional fees up to D1,500 for contrast studies.
- Ultrasound: Usually D400 per test.
- Endoscopy: Upper GI endoscopy (OGD) D1,000, fees for lower GI endoscopy on enquiry.
- ECG: D500.
- Drugs: Mostly charged at a fee of D50 per week.
Outpatient department
The Outpatient department has four doctors who see patients referred by the nurses in the Gate clinic or from other health practitioners – usually working in NGOs. Referrals are not accepted from non-medically qualified staff or from organisations which have not sought to develop a relationship with the department.
The department provides ongoing follow up care whilst patients still need our services. Due to limited funding, we do not generally provide long-term care to patients with stable clinical conditions but refer them to other service providers in the local area.
Policies
In the Outpatients department, patients are seen by MRC physicians. The objective is to evaluate, set up pertinent investigations, and make a diagnosis. Once a diagnosis has been made, patients would begin therapy as soon as possible to stabilise them before being forwarded to other medical professionals and facilities e.g. EFSTH, KGH.
Patients with stable hypertension might prefer to visit a private pharmacy to purchase their medications and have their blood pressure taken. Children with heart conditions are not forwarded on. Other patients may continue to get clinical services care, but only with the consent of one of the Clinical Services Department specialists.
Admissions ward
The admissions ward has 42 beds for adults and children with acute medical and paediatric conditions and a team of doctors and nurses providing 24/7 care.
Patients who require obstetric or surgical care are not hospitalised; instead, they are directed to a suitable alternative facility. If it is anticipated that the acute exacerbation may be treated and the patient released from the hospital within 1-2 weeks, then patients with chronic diseases that have suddenly deteriorated may be admitted.
Patients with chronic conditions that are probably going to take longer to improve would be directed elsewhere for admission. Patients with acute diseases (such as infective endocarditis or osteomyelitis), who may require antibiotic treatments lasting up to 6 weeks, as well as study participants, personnel, and their close family members, are exempt from this time restriction.
Policies
Out of hours staffing levels are only adequate to provide care to patients already admitted to the ward. There is no emergency service and so people with out of hours emergencies are advised to present to other services. If they arrive at the clinic gate and are not in immediate danger, they will not usually be admitted to the clinic as we cannot safely take care of them.