Senegal's Healthcare Crisis: A Mother's Harrowing Birth Exposes Systemic Collapse

Awa Diba went into labour on a September morning in Dakar, twenty-four hours before Senegal's doctors were scheduled to walk off the job. She was a trainee nurse herself, newly retrained after moving from the southern city of Ziguinchor to find work in a field where paid internships and shift work were actually available. What she encountered over the next day—in the hospital where she had completed her clinical placements—was a system buckling under its own weight.

Her labour lasted twenty-four hours. She lay in a room with four other women, the ceiling cracked above her, the fan broken. Some rooms in the hospital had air conditioning; hers did not. The electricity flickered. Her husband and relatives were not permitted to be with her. Women cried around her. When they did, staff sometimes told them to be quiet. "There is a lot of shouting," Diba would later say. "I saw things inside the hospital that shocked me." She emerged with a healthy daughter, whom she named Myriam, but the experience had shifted something in her understanding of the place she had chosen to work.

Senegal's healthcare system is starved of resources in ways both visible and structural. At the end of 2024, the country had 5,236 registered doctors, of whom 4,407 worked in the public sector—a figure that must serve millions. Dr Marc Manga, a physician in Ziguinchor and member of the medical union SAMES, frames the problem plainly: basic equipment is missing from hospitals, and patients must sometimes travel hundreds of kilometres to receive a diagnosis. On September 16 and 17, doctors, pharmacists, and dental surgeons struck for the second time in a week. Emergency services continued, but routine care stopped. The union's demands—more recruitment, better career conditions, improved pensions, greater investment in hospitals and equipment, particularly outside the capital—date back to 2023. "We waited, we hoped and we followed up," said Dr Diabel Drame, the union's secretary-general. "Unfortunately, no plausible response was given to us."

The waiting extends through the entire system. Patients wait for doctors. Doctors wait for equipment. Unions wait for promises to materialize. And the government waits for financial space that may not come. Senegal's economy grew by 6.7 percent in 2025 and the country has begun producing oil and gas, yet the nation carries a debt burden of 132 percent of gross domestic product. When President Bassirou Diomaye Faye took office, government audits uncovered previously undisclosed borrowing that forced a dramatic revision of the country's debt figures—central government debt was recalculated from 74.4 percent to 111 percent of GDP at the end of 2023. The paradox is stark: Senegal is generating new wealth while discovering it has less room to spend on essential services. Foreign aid has long propped up healthcare programmes covering HIV, malaria, and reproductive health, but cuts to United States funding have begun to bite. Faye has travelled to Washington to meet with the IMF and World Bank, then to Abu Dhabi to seek investors and financial backing. At the United Nations, he is expected to call for broader debt relief for African countries, describing the global debt architecture as inadequate and inequitable.

Behind the budget figures and strike notices lies a question older than the current crisis: who owes whom? In June, Senegal's former prime minister Ousmane Sonko expressed support for economic reparations to Africa for the transatlantic slave trade. At a reparations conference in Accra that same month, Faye committed Senegal to advancing that cause. The historical weight and the present-day shortage of medicines exist in the same country, in the same moment.

Diba, now a mother, plans to specialise in haematology—treating patients with cancer, leukaemia, and sickle-cell disease. What strikes her most acutely is the fear she sees in patients who enter public hospitals. "They are afraid of dying," she says. "When they enter, they think: 'I will never come out. I won't leave here alive. I'm going to die.'" Hospitals have become places of last resort because public healthcare, though nominally accessible, is not free. Consultations, tests, medicines, and treatment all carry costs. So people delay. They wait until they have saved enough money. They wait until their illness has advanced to its final stages. They wait, and the system waits with them.

Diba named her daughter Myriam, after the Quranic figure who endures the pain and solitude of childbirth before emerging with a child in her arms. The name carries another story too: a daughter born on the eve of a medical strike, into a health system her mother has chosen to serve despite what she witnessed. "I don't want my daughter to experience this," Diba says. The statement is both a mother's wish and an indictment—a measure of how far the system has fallen, and how much work remains to rebuild it.