DAKAR — Just one day before health workers across Senegal launched a strike, Awa Diba went into labor at a Dakar hospital, entering a facility where services were being scaled back to emergency care only. What followed was a 24-hour ordeal marked by overcrowding, infrastructural decay, and a palpable sense of fear among patients.
Diba, now a trained nurse, described a chaotic environment where she shared a room with four other women. The ceiling bore visible cracks, the fan was non-functional, and electricity was intermittent. Despite some rooms having air conditioning, others did not. She recalled hearing women crying out in pain or distress, only to be told to silence themselves.
“I saw things inside the hospital that shocked me,” Diba said. “There is a lot of shouting.”
Diba’s journey into healthcare began in Casamance, in southern Senegal, where she studied digital communication at university in Ziguinchor. Facing a tough job market—with the unemployment rate for those aged 15 to 34 reaching 28.4 percent in the first quarter of 2026, according to the National Agency of Statistics and Demography (ANSD)—she pivoted to nursing. She relocated to Dakar and completed placements at the Hopital Principal de Dakar and Albert Royer children’s hospital.
However, her recent experience giving birth to her daughter, Myriam, has left her convinced that the health system itself is critically ill.
A System Under Pressure
The strike, which occurred on September 16 and 17 following a previous 48-hour stoppage, disrupted routine medical activities while emergency care continued. Doctors, pharmacists, and dental surgeons are demanding better recruitment, improved career and pension conditions, and increased investment in medical equipment, particularly outside the capital.
Dr. Marc Manga, a member of the medical union SAMES in Ziguinchor, argued that the issue extends beyond mere headcounts. “How can we talk about quality of care when hospitals lack basic equipment and patients have to travel hundreds of kilometres to get a diagnosis?” he asked.
Data from the end of 2024 indicates there were 5,236 doctors registered with Senegal’s National Medical Council, with 4,407 working in the public sector. Dr. Diabel Drame, SAMES secretary-general, expressed frustration over the lack of progress, stating, “We waited, we hoped and we followed up. Unfortunately, no plausible response was given to us. These demands date back to 2023.”
The Economic Paradox
Senegal finds itself in a contradictory position. The nation is a producer of oil and gas, and its economy grew by 6.7 percent in 2025, per the International Monetary Fund (IMF). Yet, it carries a heavy debt burden. The IMF estimated total public-sector debt at 132 percent of GDP at the end of 2024.
President Bassirou Diomaye Faye’s administration uncovered previously undisclosed borrowing after taking office, leading to significant revisions in debt figures. The IMF reported that central government debt was revised upward from 74.4 percent to 111 percent of GDP at the end of 2023 due to these hidden liabilities.
This economic reality limits the government’s ability to fund public services. Additionally, reductions in United States aid have impacted programs addressing HIV, malaria, and reproductive health, according to reports from Le Monde and other organizations.
President Faye has sought financial relief through talks with the IMF and World Bank in Washington, as well as meetings with investors in Abu Dhabi. He has criticized the global debt architecture as “inadequate” and “inequitable,” arguing it restricts access to essential services. At the United Nations, he is expected to advocate for broader debt relief for African nations.
Historical and Personal Reflections
The conversation around healing Senegal extends beyond economics. In June, former Prime Minister Ousmane Sonko voiced support for economic reparations for Africa regarding the transatlantic slave trade, ahead of an international conference in Accra. President Faye, who attended the June 2026 conference, reaffirmed Senegal’s commitment to reparatory justice.
For Diba, the focus remains on the immediate human cost. She plans to specialize in haematology, treating cancers, leukemia, and sickle-cell disease. Yet, she observes a profound dread among patients, many of whom view public hospitals as a last resort due to costs associated with consultations, tests, and medicines.
“They are afraid of dying,” she said. “When they enter, they think: ‘I will never come out. I won’t leave here alive. I’m going to die.’”
Diba named her daughter Myriam, drawing parallels to the Quranic figure Maryam, who endured the pains of childbirth alone. For Diba, the name symbolizes resilience and a hope that her child will not face the same systemic failures. “I don’t want my daughter to experience this,” she said.
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