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Interview with Mariama Hiestand-Saho

My Magazine 2022/08
12 min
Mariama Hiestand-Saho is a strong, highly educated, independent, charismatic and driven person with a strong vision of making a change in the medical field of The Gambia. Together with her longtime friend and professional colleague Penda Sidibeh, they established the first clinic of its kind in The Gambia, the Penmar physiotherapy and Rehabilitation clinic, which offers physiotherapy and early and intensive rehabilitation treatments to the population. She is between two worlds, one in Switzerland, where she is a successful physiotherapist as well as a mother, wife, and administrative for Penmar, and the other in The Gambia, where she has the majority of her family, a great project to run, and many new opportunities coming up. She is to be admired for her dedication, professionalism, and ability to bring everything together.

Because of her openness to change and new collaborations, Penmar Clinic has accepted international students who want to travel and learn, exchange knowledge and become resourceful in a different environment, mostly lacking equipment, understanding and support for the much-needed services. She is now determined to go on an even bigger scale, establishing a rehabilitation centre, where her highly educated, professional and well-trained team will provide physiotherapy services on the highest level for even more patients in The Gambia and outside. 

Living in a country where familiarity with the life and culture of The Gambia is not so common, she is determined to open the door to her homeland for everyone curious and willing to broaden their multicultural horizons. Through her YouTube channel, "Let's talk with Mariama," she has been educating and sharing her life with the viewers for almost six months. She has talked about her experiences moving from The Gambia to Switzerland, her work as a physiotherapist, the reactions to her inter-racial marriage, and her daily life while in The Gambia. Amongst others, one of her future projects is encouraging community-based tourism in The Gambia, where the experience would be beneficial for local families and revelating for the visitors.


It feels like the decision to become a physiotherapist greatly influenced how your life is now. Have you always known this is your life mission, and why did you decide to establish Penmar clinic in The Gambia?

Yes, becoming a physiotherapist influenced how my life is now because I see patients directly every single day, and this gives me the opportunity to learn from them to be a better person and improve who I am. I never honestly had the idea what physiotherapy was all about. When I finished high school and got the scholarship to study in Cuba, I wanted to study medicine – that's all I wanted to be, a doctor. I think destiny and faith always put you on the right path. During the process of sending documentation to the Cuban embassy, my friend and I applied for medicine, and for some reason, they had written nursing. We only realised that when we had already arrived in Cuba. I honestly admire nurses, but this is not something that I wanted for myself. When we went to the school administration system to change our program to medicine, we learned it was not possible because everything needed to be approved at the embassy first. I had two options; to study Nursing and change it after one year, which I didn't want because I didn't want to spend one year of my life doing something I don't like to do. The other option was to change to one of the other specialities, including physiotherapy and then switch to medicine after one year of study. After speaking with my Caribbean roommates studying physio, I decided to go for that. During the year of studying, I realised this is what I wanted to do; this was my calling, my life mission, and this is what I am today.  

We decided to establish Penmar in The Gambia because we were so passionate about helping people. When we came back to The Gambia, there were no private clinics, and there was very limited accessibility for patients to have such treatments, which were only available in Banjul. We worked for five years with the hospital in Banjul, where we initiated training programs for current physiotherapists, technicians and assistants. During our masters, mine in Switzerland and Penda's in Spain, we decided that we wanted to establish something that would be accessible and would offer quality physiotherapy services. At Penmar, we can decide how treatments will go; we can decide to give quality and better treatment. I work as a physiotherapist in a hospital in Switzerland. I did so many courses and specialisations in the physiotherapy field, which are not available in The Gambia – and this is what we can offer now.


Would you do it on your own have you not known Penda?

Yes, I would have done it on my own, and I am sure she would do the same thing because both of us are passionate about our careers, so it's not just a job for us; it is something that is part of us. But doing it together, we complement each other because we have different personalities and strengths, and this makes us very powerful and energetic because we draw from one another's energy positively. 


What, in your view, is the benefit of international students coming to The Gambia to train and give back to the community?

I think it is very important for international students to come to learn and give back to society because they learn about our health system and the differences in patients here and in Europe. I am talking from my own experiences working with patients in Europe and The Gambia. They learn, that things are different here; people and culture. And cultural differences sometimes influence how people react to things. It is an important aspect for these students to learn other criteria in their respective fields, such as being patient, being open and learning about differences in patients' cultures and behaviours. We have a qualified physio that would supervise the students, which is mandatory, as this is something that is normal for every international student travelling to any other country. It is still a learning process, so students cannot do it by themselves, and they need a professional to come in for them to be able to perform their work. 

Being an international student yourself, what were the challenges you had to overcome in that period of your life?

Some of the challenges I had to overcome were huge. Leaving the Gambia with 18, leaving the strict schedule limited to school and studies at home, TV time only on Fridays and precautions on who we mingle with. I had no outside life experience by then, but during my high school time, I was involved in many extra curriculum activities, having a lot of responsibilities such as running administration, educating others, coordinating and even travelling around The Gambia, which had helped me when I moved to Cuba with all the cultural differences, learning and later studying in a new language, meeting a lot of people from different parts of the world. I had to learn to respect and accept other people and be open. At the end of the day, even if I don't agree with certain things that they do, I respect them and move on. But it made me a better person because I can  live with anyone with different backgrounds and religions, and I still respect who this person is. I don't try to change people. 


Tell us more about the rehabilitation centre. What kind of services will you offer, and who is the target group? Are you also expecting to boost medical tourism with it?

Penmar offers physiotherapy treatments for fractures, dislocations, sprains, and also rheumatism cases, backaches, knee pains, arthritis, and arthrosis treatment and management; we see pediatric patients with cerebral palsy and also neurological cases, like stroke patterns, even multiple sclerosis, post-trauma cases, cardiopulmonary cases, respiratory cases, general internal medicine cases. We are coming up with lymph drainage and pelvic floor therapy, which is very important because every other woman is facing some problem with her pelvic floor. These services are not available in The Gambia at all. Lymph therapy helps in cases where the lymph fluid is retained in arms or legs after sitting for a long-time, causing swelling or especially after breast cancer surgery or due to genetic problems. 

In-patient service we started a year ago, especially for neurology cases which needs intensive rehabilitation to regain their functionalities. They are given three treatments a day and three meals daily according to a controlled diet. 

The other plan is to boost medical tourism. We are currently working on collaborating with partners such as tour agencies and some stakeholders to establish something like that in The Gambia. At the end of the day, we want to help people feel better; and we cannot do this on our own. We see there are a lot of tourists above 50 years old coming to The Gambia, who are often going through physiotherapy in their countries but would not decide to go to The Gambia because they would not have accessibility to those therapies here. With our services, they would enjoy their stay in The Gambia while getting proper treatment. 


How hard is it to start such a big-scale project in The Gambia for two ladies on their own?

Well, it actually is very hard. For the first two years, we financed it personally and privately from our daily salaries, but we just didn't stop because of that. We knew we wanted to help people. That was and still is our main aim and goal. We are not in it because of the profit. Now we have a project in Switzerland where we organise a fundraiser every two years or so, and these funds are used for the patients who really cannot afford their treatments, especially in cases where therapy is needed for an extended period.   

There are many challenges, but we always find ways to help people and be true to ourselves, which helps us to make this project progress. It is not an easy thing, but the love for what we do just keeps us going.  


How do you balance your personal life with work and projects?

It's not an easy thing, but they are both my passion; my family and my patients. I love my family, my kids, and my husband, and we always spend so much time together, having quality time, even though I am not with them 24/7. I somehow organise my life by the book to be able to do all my project and make sure my meetings and project work does not collide with my personal life. Weekends are reserved for family. The organiser helps me to keep the balance between the both. It is not an easy thing, but I have a supportive husband that helps me and plays his role, and we can both be happy. 


What about your life on two continents? 

I just cannot live my life without coming to the Gambia once or twice a year. I love Switzerland; it's very peaceful, very quiet and organised, you know what will happen in the next 3 to 6 months, everything is planned. I love that. But I also love the chaos of not having to think of what is going to happen tomorrow. That is when I am in The Gambia. So the balance between the two helps me have a very productive and efficient life. I can always take from both continents. The Swiss part helps me in planning, and the African part helps me to be happy with what I achieved and to be myself without thinking of tomorrow. I learn every single day that I live from both sides. My life is quite dynamic and interesting, and I love it; I wouldn't change it for anything. 

What do you miss when not in The Gambia, and what do you miss when not in Switzerland?

It is difficult to have a perfect life or have all that we want. When I am not in The Gambia, I miss the craziness and the loudness in my family, my mother dancing in the living room and just being together as we are really close. Then driving out, seeing people working hard and they are not actually self-sufficient and having to deal with this stress differently, this is what I miss. When I am not in Switzerland, I sometimes miss the quietness, everything being organised, things working out when you are working on a project and documents without having to call and check every day to make sure things are done. But when I see people being so "by the book," I wonder why they cannot be more flexible and not stress about the little things. But I try to have the positive part from both to be happy. 


What made you decide to start your own blogging channel, and how do you come up with the ideas for the topics discussed?

I always feel like I have something to say, and I wanted to share my life experiences. I might be young, but I feel like I have done, seen, travelled, and experienced a lot, which might be exciting for some people. And I never really found the perfect time to do it, but this year in February, as I was sitting home with Covid without serious symptoms, I finally decided to do it. I bought the vlogging kit and started it without really having a plan, and I love it. 

I have a list of topics of what I have experienced and sometimes random topics coming up in that moment or about what happened to me that I wanted to share for others to learn from. 


Was the same reason the one influencing the choice to invite more travellers to The Gambia to experience the way of life as most of the families are living? What will the travellers experience by travelling as voluntary tourists to communities?

People that I know in Switzerland basically have everything. Yet, some of them are still not happy although they have super great jobs, super salaries, they are organised and efficient. And then I compare them to people in The Gambia or other parts of Africa that I know, that have less and yet they are happy. And this is what some of the Swiss people that I know cannot have, this balance. And I thought maybe sharing the experience from both worlds would help one or two people realise what they have. But then community-based tourism came to my mind. Maybe not all are interested in my vlogs, but they would be interested in really experiencing something like that. And I want the people I have contact with to be happy, so maybe this experience would help them to reflect. It would not change their life but would maybe help them realise it is not worth stressing about certain situations and find a way to work with it differently. And also, of course, the local families will benefit from it because they will be paid, so it is not only the tourist coming to experience it but also the local families that they will be staying with will benefit from it. And that's basically the goal of community-based tourism; that the community directly benefits from it. 

Voluntary tourism is also something I did a questionnaire on amongst the hospital staff, and 90% of people that have responded are interested in voluntary tourism in their different areas. So being professionals themselves, they would be able to share their life experiences while being a part of the family and learn from their way of life. 


What does the word "family" mean to you?

Family means everything to me. My family shows me support and love unconditionally; they are always there.  We discuss everything on the table, be it positive or negative, and no one judges you; we rather support each other. This is something my mother inculcated in all of us from childhood. In the evening, we would all sit together; no one goes apart. We would discuss things, she would tell us stories, and we would ask questions, and that way, we were not afraid of her. Instead, she was not only our mother but our friend, sister, and aunt. It's just beautiful because that way I feel my family was always there, so now I can call my brother any time, and he can do the same. We tell each other the truth even if it's hard, but we eventually move on from it. So this is family to me. And having my kids and my husband is the same. We talk, we discuss, and we put things on the table. And once we find a solution to it, we don't go back to it; we move forward.  

If you could change one thing in the world overnight, what would it be?

It would be respect, tolerance and openness.

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