Sanyang Safe Birth

Safe births for over 55,000 people – where the journey to the clinic often determines life or death.

When childbirth becomes a danger

In the region around Sanyang, a safe birth is still not something that can be taken for granted. For many women, labour begins not in a delivery room, but on the journey there – often on the back of a donkey cart, without medical care or protection.

What is unthinkable for us is part of everyday life here.
And this is precisely where our work begins.

Sanyang in transition

Sanyang is no longer a remote fishing village.

In recent years, the community has developed into one of the most dynamic places in western Gambia. Situated directly on the Coastal Highway, it connects the densely populated coastal regions with the rural south – a location that is increasingly turning it into a transport hub.

With the planned deep-water port, a new economic centre is now emerging here. Where fishing and tourism once largely shaped daily life, new residential areas, commercial sites and infrastructure are now growing. People from across the country come to Sanyang in the hope of finding work and opportunities.

But this growth has a downside:
Infrastructure often fails to keep pace with these developments.

The reality behind the numbers

Gambia is among the countries with the highest infant mortality rates in the world.
Around 34 to 36 children per 1,000 live births die before their first birthday.

Childbirth also carries a high risk for mothers themselves.
International estimates put the figure at around 354 deaths per 100,000 births.

By comparison, the figure in Germany is around 4.

Here, birth is not just a beginning – it is a risk.

Why this happens

The causes are not complicated – but they are substantial:

• a lack of hygiene standards
• inadequate medical equipment
• long distances to the nearest clinic
• an emergency response chain that often does not work

Even preventable infections or complications can therefore quickly become life-threatening – for both mother and child.

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Our approach: strengthening what already exists

We are not building a new system – we are making the existing one work.

Hygiene as a foundation

Clean conditions save lives.

That is why we are renovating the maternity ward to WASH standards, creating washable surfaces and ensuring a functioning laundry service so that sterile materials remain consistently available.

Medical equipment

Carefully selected equipment provides a safe foundation for care.

We deliberately follow the principle of appropriate technology (“Appropriate Technology”):
Technology that is not as complex as possible, but works reliably under local conditions.

Equipment replaced in highly specialised systems can still be put to good use here – provided it is carefully checked, adapted and used responsibly.

We therefore focus on solutions that are:

• robust
• low-maintenance
• and usable over the long term

What matters is not how modern a device is –
but whether it actually works in everyday use.

And that is often where the greatest difference lies.

The emergency response chain – often a matter of minutes

Even when medical care is available, access often fails at one crucial point: transport.

In many cases, an emergency does not mean that help can be provided immediately.
Instead, getting the patient to hospital has to be organised first.

Today, it is not unusual for money to have to be collected first in an emergency:

A patient arrives,
puts money on the table,
someone sets off to get fuel –
only then can the journey begin.

Time that often determines life or death.

Our approach

We ensure not only that an ambulance is available, but that it can actually run when it is needed.

• mechanical repairs to the ambulance
• an initial budget for fuel
• establishing a sustainable fuel fund to ensure ongoing operation

An ambulance alone does not save lives.
It must also be ready for use at the right moment.

Responsibility for medical equipment

Medical devices are more than just tools – they must be safe, tested and used correctly.

That is why we take care not only of procurement, but of the entire process: from selection and testing through to documentation.

Some members of our team have specific training in medical device safety and ensure that the equipment used meets the necessary standards.

Local cooperation

The project is not imposed from outside – it is developed in close coordination with the Sanyang Major Health Center.

The facility’s management actively supports the measures and works closely with us. This includes coordination with local authorities, access to infrastructure and cooperation with the teams on the ground.

The impact

Through this project, we are sustainably improving medical care for around 55,000 people in the catchment area.

• safe births
• better hygiene conditions
• functioning emergency care

Why this matters

It is not always the big things.

Sometimes it is:

• a clean bed
• sterile materials
• a functioning ambulance

Things that make the difference between risk and a safe start in life.