By: Foday Manneh
A declining trend and downward spiral in the Gambia’s health sector has been linked to an increasing lack of leadership under Minister Dr. Ahmadou Lamin Samateh, who has been reportedly using his office to act unjustly at the expense of individuals while unfairly hiring relatives, friends, and family whilst creating a hostile environment for others.
Sources in the Health sector told The Alkamba Times the Ministry’s indifference to quality is profoundly eroding health service delivery.
“When people are not trained as managers and leaders, they become susceptible to mistakes and don’t tolerate criticism because their mindset is to give a command or instruction and expect people to follow it,” a Senior Health Official in the Ministry told TAT.
‘Samateh became such a person in his leadership and wants everyone to accept what he says — his subordinates must comply with him, even though he is not the most knowledgeable regarding what they talk about or do as a team.
Samateh got his first health leadership position in the country at the Edward Francis Small Teaching Hospital (EFSTH) as the Chief Medical Director (CMD). Does this experience make any difference in his actions?
“He was not the most qualified or senior health personnel, but he was favored. He has been close to the First Lady Fatoumata Bah Barrow and travels with her. So he got catapulted into heading the hospital, and that was not done in the normal and right procedures.” An insider within the Ministry told TAT.
“If there is a vacancy for heading a hospital, the job is declared vacant and advertised so all interested people can apply. And this would go through an intense vetting process to justify why you should be taken,” says the insider.
The EFSTH CMD position is tenured for a duration of time, but this was different in the case of Samateh, who kept serving indefinitely and was later rewarded with another primary appointment; this time, he became the Minister of Health (MoH).
Sources at the MoH said Samateh’s appointment was heavily criticized. As well as his none background in leadership and management, his critics say he has no broad knowledge of preventive and curable medicines — lacking training in public health which are the most-considerable factors in appointing a Health Minister.
Sources say retribution began a week after Samateh became the Minister of Health, wasting no time in getting rid of critics who challenged his decision during his time as CMD of the EFSTH and even those suspected of critiquing his new appointment.
“He removed the Chief Matron from EFSTH, Pateh Sawo, who served in the hospital’s senior management team and was strictly objective about decisions that he believed won’t help. So Samateh removed him and sent him to Brikama.” A source said.
Another senior health official who got victimized by Samateh’s avenge was Landing Camara, an old nurse at the pediatric clinic of the EFSTH who once challenged the decision of his former boss after a proposal to turn one of the pediatric units into a surgical ward.
The former CMD also attempted to close the eye unit of the EFSTH with a view to moving it out to Kanifing. These were meant to create more space for his surgical department, but Dr. Abba Hydara – an eye specialist and senior consultant, strongly condemned the move.
Even though the eye unit remains untouched, it is not surprising that Landing Ceesay was moved from the teaching hospital immediately after he mounted the Ministerial post.
Samateh Subsequently developed an uncomforting mindset about the people he found in the Ministry and started getting rid of many; among them is Dawda Ceesay, a technician, well-experienced in the running of the MoH, according to a source.
Dawda was moved to the office of the Vice President, and the Deputy Permanent Secretary of Technical, Karamba Keita, was removed and sent to Kotu.‘ These are people well qualified to effectively advise him on technical issues,” according to the source.
One of the senior officials redeployed to one of the rural hospitals said, “I felt this was not proper and in line with redeployment regulations.”
“As a senior civil servant, my redeployment should not be abrupt. When I engaged the PS to know why such actions were being taken? He told me that it was an instruction from the Minister.”
Nepotism on the brink
Since he assumed office, TAT discovered that Dr. Ahmadou Lamin Samateh has been deeply nepotistic and worked hard to divide and rule the health sector.
The Minister has been blamed for marginalizing technicians and health experts in their areas of specialization, resulting in some senior members quitting their jobs for other opportunities both within and outside the country.
The Minister appointed Saikou Omar Dibba to the Eye Hospital Board. Saikou is reportedly a close relative whose sister is married to a member of Dr. Samateh’s family.
The Minister also extended Jeffrey Reina’s term as the Financial Adviser of the same board, but this move was religiously motivated.
“Because of Jeffrey’s Catholic status, he was brought in based on negotiation. Jeffrey is not a civil servant but is receiving transport and telephone allowances while sitting at home where people meet him,”
“He still serves on the eye hospital board where sitting allowances are increased by 100%, and while their term has ended, they are illegally serving a third term which is against the law.” The source said.
Recently Samateh promoted one Dr. Fatoumatta Dibba to Assistant Director of Health Services. However, according to TAT findings, this position does not exist on the MoH budget estimate.
Dibba’s confirmation appointment email.
“Dr. Dibba’s father married the younger sister of the Minister’s mother, which is why he is trying to protect and support him. As a result, the Minister is running the Ministry of Health more as his family home than a workplace.” A senior health official revealed.
Again, he deployed one of his Uncle’s sons Mr. Basirou Drammeh formerly the Regional Principal Public Health Nurse at RHD Lower River Division and West Coast Region 2, Brikama, and quickly promoted him to the position of CEO of Farafenni General Hospital for a short period and then redeployed him to Kanifing General Hospital again.”
Another person who benefitted from Dr. Samateh’s favoritism was Mr. Wandifa Samateh, an immediate family member, whom he redeployed from Farafenni General Hospital to the RHD Brikama for a short period, only to be later moved to lead the National Tuberculosis Control Programme at the MoH.
Health authorities say the Minister transfers or demotes anyone seen as a threat to his position, with many believing that the Ministry of Health is being run by only three people, namely: Dr. Samateh, Muhammed Lamin Jaiteh, and Dr. Mustapha Bittaye, who have no clue about the department, sources at the Ministry stressed.
Another source who preferred anonymity confirmed to TAT that the Minister prepared the President’s public statement on the Acute Kidney Outbreak, which recently caused a national outcry after killing over 66 children in The Gambia.
That national address was hugely criticized as a mere agenda for the Minister that failed to outline an effective response to the crisis.
“The statement given to the President to read on the AKI outbreak indicated that the MoH will review all existing Acts and Regulations.
Insider sources say the proposed review was meant to disarm certain Directorates and Programs to empower the Director of Health Services, who is a close confidante of the Minister.
“We are waiting because the Minister is planning to hand-pick Dr. Mustapha Bittaye for the position of Director General without going through due process.” The person said.
Meanwhile, a senior health officer in the Ministry says the Minister’s sidelining of the right players and technicians in the Ministry contributed significantly to the deaths of children in the AKI crisis.
“He was in a clash with public health officers and decided to punish them by bringing and paying nurses who do not know about preventive health. The country had zero surveillance which led to this national catastrophe,” the top official.
When TAT reached out to the health minister, Dr. Samateh dismissed the allegations as untrue and asked for a more detailed interview to discuss the issues raised.