The Gambia is a developing country figuring among the Least Developed Countries (LDCs), with tropical diseases predominating. 

Fertility care, if available is very basic in the Gambia. Conventional methods of infertility treatment involve the surgical repair of blocked fallopian tubes, success rates of which is doubtful, and blind hormonal stimulation with Clomid.

Highly controversial is the procedure of D&C (dilation and curettage). D&C as an infertility treatment has long been eliminated from the reproductive medicine textbooks, and government hospitals and most private clinics no longer offer this procedure as infertility treatment.

Still, many Gambian women feel that the process of cleaning out the womb (‘kono kuwo’, ‘stomach washing’ in Mandinka) will remove any blockage that might prevent a pregnancy or affect its viability and some are willing and able to offer large sums for the procedure. Sadly as of to date some doctors still perform D&C for these reasons.

As for modern assisted reproductive techniques; at Africmed Clinic we have started providing for IUI treatment since January 2016. We hope to expand your services to cryopreservation (freezing) of semen and low cost IVF.

The main cause of infertility in West Africa are infectious diseases which may be sexually transmitted (STD’s) or caused by traditional practices such as female genital mutilation and unsafe abortions and home deliveries in unhygienic circumstances. These infections, if left untreated often result in bilateral tubal occlusion.

We believe fertility care therefore should go hand in hand with educating the public. Focus should be on informing young people on how to avoid STD’s. Ideally, these programs would be combined with low threshold mobile clinics where people and get tested and get accurate treatment straight away.