Notes from The Gambia
(Editor's note: The people and places in this essay have been disguised to protect their identities.)
When The Gambia, the smallest country on the African continent, is written about in the Western press, it is often described as a sunshine-drenched tourist haven, a cheap beach party, a quick flight from colder climes.
On the coast, near the airport and the tourist hotels, the roads are paved and usually well lit. Normally there is clean water. There is often electricity. Sometimes there are usable sanitation facilities. Leaving the tourist areas and entering rural Gambia, however, the roads are so bad that vehicles have to crawl around the potholes and skirt the edges of the eroded shoulders. It takes half a day to travel 100 kilometers. The accessible clean water and electricity and sanitation facilities disappear. Moving upcountry into rural areas, it becomes clear why the UN Development Programme, in the most recent Human Development Report, ranked The Gambia 155 out of 177 countries. Yes, it is green and inviting and warm, but here in rural Gambia life is poor and difficult and often precarious.
In the rainy-season world, many diseases are common. Sneezing and coughing punctuate every sentence. Scratches fester and swell with pus. Pregnant and lactating women lose weight. The children suffer from malnutrition, adults from type 2 diabetes. Pneumonia is common, as is malaria, especially among pregnant women; they are at increased risk because they are bitten by mosquitoes twice as frequently as non-pregnant women.