Disability - access to services

Originally a pupil at St John's, George Cooper is a final year medical student at King's College, London where he also completed a Bachelor of Science in Global Health. At the end of his 4th year his medical school sets aside 8 weeks for an 'Elective' where students get the opportunity to explore health systems or undertake research anywhere they choose in the world. Having been involved with Gunjur since he left school in 2008 after being a member of one of MBG's summer groups and subsequent trips since, George chose to do his elective in The Gambia.

Through MBG, in 2011 George was introduced to Ric Law the Director of Disability Africa, an organisation set up to improve outcomes for disabled children. He undertook some initial groundwork for the NGO that December and stayed involved helping to further the projects in Gunjur. So when the opportunity arose to do an elective, George decided to design a piece of qualitative research around decision making behaviour of carers of disabled children in Gunjur in accessing support. The aim of the project was to help Disability Africa's future strategy and be able to focus resources where they are most needed, as well as providing an evidence base which will be useful to call upon when applying for funding.

Building from experience from a similar project he conducted for a Children's Hospital in Sierra Leone and working alongside his university supervisor, the project was designed and then put forward for ethical approval by King's College who subsequently fully approved it in early 2013. This was a lengthy process as all research projects at King's require the completion of a 40 page form to make ensure that they comply with academic ethical standards. With this backing, George flew out to Gunjur in July 2013 on what was to be his 6th visit to the community.

Upon arrival, visits and meetings were made with senior lecturers of the University of The Gambia in Banjul and the project was submitted for approval from their ethics committee. The project was also presented to the Alikali, Nyansimba and the Imam for their blessings and support. The recruitment phase then began, with carers of disabled children being identified through the Disability Africa playschemes.

They were explained the purpose of the project, how the interviews would be held and what would the information be used for, with particular emphasis upon confidentiality and anonymity. From this, 14 carers where recruited and given a time, date and location for their interview. Along with George and the participant, also present at the interviews was Awa Siise a translator. Awa was chosen after getting in contact with the VSO in Kanifing and she was deemed appropriate due to her previous experiences in research work for ActionAid and VSO but also because she had no direct links with Gunjur and would thus not be familiar with the participants encouraging them to feel like they can speak openly and confidentially.

The interviews lasted between 45mins to 90mins and covered a range of topics based upon exploring experiences of accessing healthcare, education and societal supports (welfare, community support, family support... etc). The interviews took place in an office in the Community Centre, chosen due to its status as an independent community facility and also due to its central location in the village. Participants were re-briefed about the interview, advised that they were free to refuse to answer any questions or terminate the interview at any time if they wished and signed or thumb printed a consent form which was retained. They were also reimbursed for any travel expenses, provided with refreshments and given some fabric as token of gratitude at the end of the interview.

The interviews were conducted in Mandinka, with Awa summarising in English for George throughout. They were voice recorded and transcribed later into English with the help of a TARUD worker. Analysis on these transcripts is currently being undertaken by George Cooper along with help from James Moran, a first year medical student from St. Bartholomew's, London who also was a St John's pupil. The qualitative data is being scrutinised to identify common themes between the participants for each of the three main areas of focus on the study (Healthcare, education and societal support). Upon completion of the analysis will be summated into a report for Disability Africa, outlining some recommendations and highlighting ideas of focus for future strategy.

It is also hoped that the work will be produced as a paper for consideration for publication into a journal for wider dissemination so that other actors in the field of disability in countries like The Gambia can refer to it to aid their work or research.