Following the completion of the health facility we have begun the commissioning of the Centre.

Commissioning the Health Centre is a complex process. It involves:-

         Furnishing and equipping the building;
         Agreeing operational policies with the Department of Health;
         Developing operational procedures;
         Recruiting staff;
         Expanding management skills;
         Starting training programmes;
         Introducing information and audit systems;
         Establishing working relationships with other health care facilities.

The Princess Royal Hospital, Haywards Heath, has helped in furnishing and equipping the Centre. Many firms have kindly donated equipment but many items still have to be purchased. We hold local events to raise the necessary funds.

We agreed to be responsible to the Western Division Health Team of the Department of Health in The Gambia. We make "Service Level Agreements" with the Team specifying the services we intend to develop. For this we need to review published literature and establish local needs through medical student projects.

We have to meet a monthly salaries and wages bill of some £2,000. We have a loyal group of "Sponsors" who have agreed to make regular donations to meet this cost. There is an acute shortage of midwives in The Gambia. After much searching we have managed to recruit an SRN Midwife to lead our team of six SEN Midwives. This has enabled us to open 24 hours a day for normal deliveries.

We have established a local "Health Centre Management Committee", chaired by Mr. Emmanuel Stafford and ably supported by Alhg. Abdoulie Sowe, the General Administrator of the Centre. The Committee is now responsible for day to day management. We have arranged for our Cashier to attend an accountancy course at the Gambia Technical Training Institute to improve our financial skills.

Our next major project is to introduce Information and Audit Systems using a simple computer system supported by TriSoft Ltd.  Anaemia is a serious problem in the community and we are planning a programme to control anaemia in school children and pregnant women for which we need a patient register supported by the computer patient register.

Relationships with other health facilities are excellent. The UK Medical Research Council Laboratory in Fajara, The Gambia, is always willing to give advice and help.