Terminal Illness & End-of-Life Planning in Gambia: 5-Step Official Checklist

1. 1

   Coordinate Palliative Care, Home Nursing, and Health Coverage

   • Tertiary and regional medical care: Clinical management, pain relief, and specialist referrals for serious chronic or life-limiting conditions in The Gambia are coordinated through the country's main tertiary facility, the Edward Francis Small Teaching Hospital (EFSTH) in Banjul, alongside regional referral hospitals (such as Kanifing General Hospital, Brikama District Hospital, and Bansang Hospital) operating under the Ministry of Health of The Gambia [1][5]. Ask the attending consultant at the Edward Francis Small Teaching Hospital (EFSTH) for a written symptom-management and pain-control plan, including outpatient medication prescriptions and community clinic follow-up [1][5].
   • Home care and community clinical support: Coordinate with the hospital's medical social work unit, community health nurses under the Ministry of Health of The Gambia, or accredited private and faith-based clinics in the Greater Banjul Area to arrange home nursing visits, wound care, and caregiver guidance [1][5].
   • National Health Insurance Scheme (NHIS) and private coverage: Check that your family member's National Health Insurance Scheme (NHIS) registration (linked with their Gambian biometric national ID card) or private corporate health insurance policy is active so hospital admissions, laboratory diagnostics, and covered medications at public facilities are billed properly [1][5].
2. 2

   Record Advance Healthcare Preferences and Designate a Medical Representative

   • Written statement of medical preferences: The Gambia does not have a standalone statute codifying living wills, so treatment consent and refusal are governed by common-law principles of bodily autonomy and patient-charter guidelines overseen by the Ministry of Health of The Gambia [1][5]. While your family member has full capacity, they should sign and date a written statement setting out their preferences regarding cardiopulmonary resuscitation, intensive-care ventilation, artificial nutrition, and preferred place of care [1][5].
   • Designating a next-of-kin healthcare representative: In clinical practice at the Edward Francis Small Teaching Hospital (EFSTH) and regional hospitals, doctors consult the designated next of kin or family spokesperson listed in the admission file if the patient can no longer communicate [5]. Your family member should explicitly record the full name, telephone number, and national ID details of their primary medical representative in their hospital chart and give signed copies to both the representative and the treating physician [1][5].
3. 3

   Execute Financial Powers of Attorney and Bank Mandates

   • Formal Power of Attorney and Deeds Registry registration: Under Gambian common law and the Registration of Deeds Act, a Power of Attorney authorising an agent (attorney-in-fact) to manage bank accounts, lease or convey real property, or represent the principal before administrative agencies must be executed as a formal deed (signed and sealed in the presence of two witnesses and a Notary Public or Commissioner for Oaths) and registered with the Deeds Registry under the Registrar General's Department at the Ministry of Justice of The Gambia [4].
   • Capacity rules under Gambian law: Because Gambian law follows traditional common-law agency rules rather than a statutory lasting power of attorney regime, a standard Power of Attorney is valid only while the principal retains mental capacity [3][4]. If the principal later loses mental capacity, the mandate lapses and the family must petition the High Court under The Judiciary of The Gambia for a formal receivership or guardianship order to manage property [3][4].
   • Direct commercial bank account mandates: Gambian commercial banks enforce strict verification checks on third-party Powers of Attorney. While your family member retains full capacity, arrange to complete the bank's own third-party signatory mandate form directly at the branch (or request a home/hospital verification visit from the branch manager) alongside the registered Power of Attorney [4].
4. 4

   Activate Invalidity Benefits, Pension Claims, and Caregiver Leave

   • Invalidity benefits via the SSHFC: If your family member is a member of the National Provident Fund (NPF) or the Federated Pension Scheme (FPS) administered by the Social Security and Housing Finance Corporation (SSHFC), they may claim an Invalidity Benefit or medical early retirement pension if certified by an approved Medical Board as permanently incapable of work due to physical or mental illness [2]. Early submission of the specialist medical report from the Edward Francis Small Teaching Hospital (EFSTH) helps expedite the Medical Board assessment [2][5].
   • Civil service ill-health retirement: Public servants employed by the Government of The Gambia who become permanently unfit for service due to severe illness can apply through their ministry and the Personnel Management Office for medical boarding under the Pensions Act, following certification by a Government Medical Board convened through the Ministry of Health of The Gambia [1][2].
   • Workplace sick leave and caregiver leave: Under The Gambia's Labour Act, formal employees are entitled to statutory paid sick leave upon presenting medical certificates, and family caregivers can request annual leave, compassionate leave, or flexible working arrangements through their employer's human resources department [2].
5. 5

   Organise the Will, Beneficiary Nominations, and Property Records

   • Updating SSHFC nominee records: Payouts from the Social Security and Housing Finance Corporation (SSHFC) rely heavily on the official Nomination Form filed by the member during their lifetime [2]. While your family member has full capacity, they should verify and update their designated nominees with the SSHFC and ensure that all nominees hold valid birth certificates or national ID cards issued through the Births and Deaths Registry or Immigration Department [1][2].
   • Executing a valid Will and dual-system rules: Under the Wills Act of The Gambia, a written Will must be signed by the testator in the simultaneous presence of at least two independent attesting witnesses who are not beneficiaries [3][4]. Note that under the Laws of The Gambia, the estate of a person subject to Islamic personal law is governed by Sharia inheritance rules (Mirath) administered by the Cadi Court under The Judiciary of The Gambia (where testamentary bequests, Wasiyyah, are generally limited to one-third of the net estate to non-heirs unless statutory heirs consent) [3][4].
   • Consolidating property titles and cross-border documents: Gather land title deeds or state lease documents registered at the Deeds Registry of the Ministry of Justice of The Gambia, marriage certificates, and bank records in one secure file [4]. Because The Gambia is not a party to the Hague Apostille Convention, powers of attorney or property documents executed abroad must be legalised through a Gambian Embassy or High Commission and authenticated by the Ministry of Foreign Affairs and the Ministry of Justice of The Gambia [3][4].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Ministry of Health of The Gambia - National Health Services and Medical Boards — Ministry of Health of The Gambia
2. [2]
   Member Benefits, Invalidity Claims, and Beneficiary Nomination FAQs — Social Security and Housing Finance Corporation (SSHFC)
3. [3]
   The Judiciary of The Gambia - High Court Probate Registry and Cadi Court — Government of the Republic of The Gambia
4. [4]
   Ministry of Justice of The Gambia - Registrar General and Deeds Registry — Ministry of Justice of The Gambia
5. [5]
   Edward Francis Small Teaching Hospital (EFSTH) - Specialist Clinical Services — Edward Francis Small Teaching Hospital