The Gambia’s ministry of health last year struck a $3.9m deal with a Turkey-based company called TMS for the purchase of medical items and equipment. Ten ambulances are included in the procurement, each reportedly bought for $89,750, approx. D5m at the time.

Malagen investigations published on August 27 revealed that the deal is fraught with irregularities, raising questions about corruption. Due process was barely observed in apparent breach of national and donor procurement rules. The health ministry made a contract on non-negotiable terms only to make a futile attempt to negotiate prices and specifications mid-way through. The prices of the items bought are ‘exorbitant’.

However, on August 30, the Ministry responded to a Malagen report, characterizing the reporter a “lair”. The response did not address major issues raised in the Malagen report including procurement without the approval of the Gambia Public Procurement Agency.

Below, Malagen responds to issues raised by the Ministry, but only those that touched on the integrity of our findings:

MOH: “· Even going by his own projections in his second statement, the difference between ambulances costing USD 89,750.00 and his claimed price of USD 60,000.00 is USD 29,750.00. this multiplied by ten (10) ambulances is USD 297,500.00 which is equivalent to D14,875,000.00, CONTRARY to his claim of 90 million Dalasis. WHAT IS THE MOTIVE OF THIS LIE?”

Malagen: Facts established by health ministry and thoroughly explained in the Malagen report are these: the procurement was $3.9mworth of medical items and equipment, including 10 ambulances, ‘price inflation’ of the entire procurement of medical items was at least D62.7m based on prices offered by another Turkish company called ATC. This is glaringly clear in a letter permanent secretary Muhammed Lamin Jaiteh wrote to TMS, in his failed attempt to negotiate a contract which was signed on non-negotiable terms. The other figure that makes it D90 million is the D28.2m excess expenditure incurred on transportation of these items and ambulances from Turkey. Malagen even published list of all items bought from Turkey in the article and prices offered by ATC, TMS and AKKA. Malagen only used the price inflation of the ambulances as a case to explain the general inflations of items on the list. We were writing a story, not a book. What honest person relies on one sentence to explain a complex transaction that is detailed in close to 4000 words?

MOH: · MoH did the procurement (using WB procurement regulations) and signed the contract for the items, equipment and the transportation by both air and sea freight using COVID-19 emergency procurement guidelines and procedures. This contributed to the swift response to the first wave of COVID-19.

Malagen: This information is contrary to what the minister Dr Ahmadou Lamin Samateh and his deputy permanent secretary Fanta Bai Secka told Malagen. They claimed World Bank did the procurement until Malagen had to send questions to World Bank.

In Secka’s own words: “The procurement is handled by the World Bank… This is a World Bank purchase.” It is interesting that they are now saying “MoH did the procurement”.

MOH: · The minister’s visit to Turkey and Ankara to be specific was to visit the Gambian patients on medical treatment at the time and to also meet his colleague minister of health and minister of trade of the government of Turkey, to strengthen collaboration and support to MOH health and to seek for additional support to increase the quota given to The Gambia for medical treatment.

Malagen: This is an inaccurate characterization of facts. The Minister went to Ankara on the invitation of a private hospital called Emsey Hospital. The meeting with his counterpart ministers was secondary, according to their own letter published below.

 

MOH: · During that visit a meeting was arranged by the Gambia embassy in Turkey for the minister to meet with the OSTIM zone, a cluster of companies who specialized in production of various medical items. The Ambassador landing Kinteh and team where present as shown in the pictures in the report.

Malagen: This part is misleading. It suggests that the Ministry of Health officials had ran into some plan made by the embassy to take them to OSTIM without their active involvement. However, in their travel programmes sent to the Gambian embassy in Turkey, they made a request to “visit equipment manufacturing sites”. Below is a picture of the part of that letter. Meanwhile, Dr Muhammed Jaiteh, a Gambian based in Turkey, had confirmed to Malagen the Ministry’s visit to OSTIM was confirmed with their officials’ knowledge.

 

MOH: · MOH wish to inform the reporter that swift and urgent action will be taken if MoH is provided with the proven evidence of any malpractice or corruption in the form of commission received or incentives paid.

• We had asked Mr. Darboe (Malagen reporter) to contact TMS to find out from them if they inflated the prices, if they had paid anyone any commission, bribe or incentive for the contract, to give the name of the person and evidence of payment.

To our surprise Mr. Darboe ( Malagen Reporter) has never come back to us with any such information. He also clearly did not contact TMS in all these speculations he has been making as demonstrated in his article.

Malagen: It is surprising that the Ministry is shifting its responsibility to the reporter. Anyone who read the Malagen report, all you see are clear red flags: price inflation, non-involvement of GPPA, prior meeting with TMS officials by key members of the MOH, among others. If officials at the ministry are objective to facts, they would simply open an inquiry into the issue. How could they ask the reporter to go to a company (TMS), potentially involved in a kickback scheme, to give evidence implicating them (TMS)? It is like saying “catch me if you can”.

And it is totally inaccurate that we did not contact TMS. We sent TMS two separate emails. We also sent them one joint emails with Das Ambulans, the company from whom they bought our ambulances. And we also sent both TMS and Das Ambulans a message on WhatsApp from numbers obtained on their website. There was no response.

MOH: · The Ambassador Mr. Landing Kinteh in a correspondence to MOH indicated that his deputy Ambassador Mr. Serign Modou Njie has informed him that he can get the medical items and equipment at a cheaper cost and since he has stayed in Turkey for many years, he knows the market and thus the two invoices where shared with the ministry at cheaper cost but without any specifications. We doubt that such information can come from a counterpart government institution.

Malagen: It is unclear what the Ministry is trying to say here. However, what was clear is that at the time ATC and AKKA came into the picture, the Ministry had signed a contract on non-negotiable terms. It would barely matter if there were any specification from ATC or AKKA.

MOH: · MOH purchased 10 Ambulances together with defibrillators separately for each ambulance at a separate cost of USD5,445 which is added to the total cost of the Ambulances available for delivery at the time of purchase.

• The price cost of ambulances offered by Red Cross at the time of purchase are as follows ; Fully equipped BLS Land cruiser@USD69,316.80.;
• Fully equipped Acls Hiace@USD85,278. The delivery would have taken longer as well. Note that there are special negotiated special prices for Red Cross given to them by manufacturers because of their humanitarian nature.

Malagen: Information Malagen published about the costs of ambulances bought by the Red Cross was officially obtained from the institution.

Summary: For the most part in their rebuttal, the Ministry did not speak directly to issues raised by Malagen.  The first part of the rebuttal was a lecture on World Bank procurement regulations. What we found relevant in that context and mentioned in our story is the part of the regulations dealing with direct contracting which is the rule that applied in this procurement.

“In all instances of direct selection, the Borrower shall ensure that the prices are reasonable and consistent with the market ratesfor items of a similar nature,” states a part of World Bank procurement regulations on direct contracting. In their own letter to TMS, the Ministry itself said the price offered by the company are exorbitant. Below is a partial picture of the letter PS Jaiteh wrote to TMS.

 

But also curious is their swift denial. Malagen published its investigations on August 27. The Ministry came out with a rebuttal, conclusively stating their positions on facts that took the reporter several months to gather on August 31. Which open-minded person has a pre-determined position on facts?

 

Ministry’s response:

MINISTRY OF HEALTH (MOH) RESPONSE TO THE MISINFORMATION RELATING TO THE MALAGEN REPORT DATED 27thAUGUST 2021ON MOH PROCUREMENT OF EQUIPMENT AND TRANSPORTATION FOR THE COVID19 RESPONSE

Below are the facts behind the contradictions made in the report:

• Even going by his own projections in his second statement, the difference between ambulances costing USD 89,750.00 and his claimed price of USD 60,000.00 is USD 29,750.00. this multiplied by ten (10) ambulances is USD 297,500.00 which is equivalent to D14,875,000.00, CONTRARY to his claim of 90 million Dalasis. WHAT IS THE MOTIVE OF THIS LIE?
• MoH did the procurement (using WB procurement regulations) and signed the contract for the items, equipment and the transportation by both air and sea freight using COVID-19 emergency procurement guidelines and procedures. This contributed to the swift response to the first wave of COVID-19.
• The World Bank Executive Board approved a grant of US$10 million on 2 April 2020 for the COVID-19 Response and Preparedness project to enhance prevention, detection, and response to the threat posed by COVID-19 and strengthen the national system for public health preparedness. Subsequently, an additional allocation of US$0.94 million was provided.
• The Ministry of Finance and Economic Affairs along with the Ministry of Health negotiated the US$10 million grant on 20 March 2020. At the project negotiations, the procurement plan included the procurement of medical equipment and supplies and all contracts are published on the World Bank website https://projects.worldbank.org/en/projects-operations/projectprocurement/P173798
• It is clearly stated in Project Appraisal Document (page 19 paragraph 37) in the World Bank website (https://documents1.worldbank.org/curated/en/925521585951567235/pdf/GambiaCOVID-19-Preparedness-and-Response-Project.pdf) that: The proposed procurement approach prioritizes fast track emergency procurement for the required emergency goods, works and services, particularly for the prevention phase and the relief phase. In this regards, key measures to fast track procurement include the following measures:
• use of simple and fast procurement and selection methods fit for an emergency situation including direct contracting, as appropriate;
• use of simple and fast procurement and selection methods fit for an emergency situation including direct contracting, as appropriate;
• procurement from UN Agencies enabled and expedited by World Bank procedures and templates
• use of procurement agents; • force account, as needed; • increased thresholds for Requests For Quotations s and national procurement, among others;
• other measures like shorter bidding time, no bid security, advance payments, direct payments, will be applied on a case by case basis upon advice/guidance from the Accredited Procurement Specialist; • retroactive financing up to an aggregate amount not to exceed SDR 2,900,000 from March 1, 2020 i.e. procurement prior to project effectiveness; • conducting post reviews.
• According to the World Bank Procurement Regulations for IPF Borrowers, “The Borrower is responsible for carrying out procurement activities financed by the Bank in accordance with these Procurement Regulations… ” (clause 3.2), hence all due diligence, supplier identification and contract negotiations and signature are Borrower’s responsibility and decision. As part of its due diligence, and based on the available information, The World Bank carried out a procurement post review of the selection, award, and delivery documents for this activity and did not find any major noncompliance vis a vis the applicable procedures stated in the financing agreement signed between The Gambia and the Bank.’ It is important to note that World bank procurement guidelines is employed in all such procurement.
• The Project financed the US$ 3.9 million for the procurement of the medical equipment, supplies, and ambulances. The Government Local Funds of US$2 million allocated to the medical equipment will supplement the upcoming construction and equipment of the national emergency treatment center and is still available.
• It is important to note that in April 2020 there was global shortage of the emergency medical equipment and supplies. This is clearly illustrated in an article publication dated 2 April 2020 “In Desperation, New York State Pays Up to 15 Times the Normal Prices for Medical Equipment” https://www.propublica.org/article/in-desperation-new-york-state-pays-up-to-15-times-thenormal-price-for-medical-equipment
• The USD 3.9m were funds provided through the World Bank COVID19 emergency support. MOH used the World Bank emergency procedures for the procurement of the items and direct payment affected by the bank to the company.
• The MOH has its detailed COVID19 procurement plan for various items and equipment with their respective specifications needed for response to the COVID19 pandemic. This was used to guide our purchase.
• There was no deal with anybody or company in the award of the contact which was signed with the TMS company. · The TMS company was the only source that could make avail and deliver the items and equipment needed at that time of the purchase, when the world prices were at its highest due to high demand and delivery was hardly available.
• The teleconference held was a consultation with TMS president who represent the OSTIM Zone as its vice president and the person who coordinated and chaired the meeting and presentations made during our meeting at the Ostim Zone head office. Pictures of which are shown in the report.
• The minister’s visit to Turkey and Ankara to be specific was to visit the Gambian patients on medical treatment at the time and to also meet his colleague minister of health and minister of trade of the government of Turkey, to strengthen collaboration and support to MOH health and to seek for additional support to increase the quota given to The Gambia for medical treatment.
• During that visit a meeting was arranged by the Gambia embassy in Turkey for the minister to meet with the OSTIM zone, a cluster of companies who specialized in production of various medical items. The Ambassador landing Kinteh and team where present as shown in the pictures in the report.
• The COVID19 multisectorial committee mentioned in the report is functional and continue to provide the required support to MOH for Covid 19 emergency service delivery. The committee was aware of the purchase and gave its approval for the contract to be signed for both the purchase and transportation: air and sea freight of the various items and equipment.
• MOH wish to inform the reporter that swift and urgent action will be taken if MoH is provided with the proven evidence of any malpractice or corruption in the form of commission received or incentives paid.
• We had askd Mr. Darboe ( Malagen reporter) to contact TMS to find out from them o If they inflated the prices o if they had paid anyone any commission, bribe or incentive for the contract or to give the name of the person and evidence of payment. to our surprise Mr. Darboe ( Malagen Reporter) has never come back to us with any such information. He also clearly did not contact TMS in all these speculations he has been making as demonstrated in his article.
• MOH purchased 10 Ambulances together with defibrillators separately for each ambulance at a separate cost of USD5,445 which is added to the total cost of the Ambulances available for delivery at the time of purchase.
• The price cost of ambulances offered by Red Cross at the time of purchase are as follows ; Fully equipped BLS Land cruiser@ USD69,316.80.;
• Fully equipped Acls Hiace@USD85,278. The delivery would have taken longer as well. Note that there are special negotiated special prices for Red Cross given to them by manufacturers because of their humanitarian nature.
• The Ambassador Mr. Landing Kinteh in a correspondence to MOH indicated that his deputy Ambassador Mr. Serign Modou Njie has informed him that he can get the medical items and equipment at a cheaper cost and since he has stayed in Turkey for many years he knows the market and thus the two invoices where shared with the ministry at cheaper cost but without any specifications. We doubt that such information can come from a counterpart government institution.

The person in Adama should be identified for the interest of the general public and a prove of the said document be produced for the interest of accountability and transparency. It is sad that such statement coming from counterpart government institution

• There has never being any correspondence from MOH to or from the Turkish government regarding companies to be selected for the purchase of the medical items and equipment. The information in this regard is not factual.

The multisectoral procurement committee is functional and continues to provide oversight support to MoH on its procurement for Covid 19 emergencies. Anyone can provide a quotation, it depends on the specification.

The notion that it could be sourced cheaper was entertain for the interest of the country which ended up with no specification after several reminders for them to be provided. In 2020 countries closed their boarders, hoarded their medical supplies and most counties in the world sourced their products from Turkey.

We will continue to provide services to our nation without fear, favor or ill will. As the world continues to battle with the delta variant of Covid 19 and we continue to register deaths in country, I take this opportunity to urge all Gambians to stay safe, take the vaccine, observe social distancing and wash their hands with soap regularly.

The END