So many questions any answers?

Your first problem is getting answers, I've been trying for months and with the exception of a couple of knowledgeable and helpful people (not found here) I find the level of real knowledge amongst those offering help is pitifully low. Once I learned to discover where they really lived before believing them it became clear that those living in The Gambia are too busy getting on with life to be bothered with sites such as this.

That said I persist. My wife and I plan to move to The Gambia and are not put off by the known pitfalls. We believe that, like other places with significant expat populations the solution is to deal with and turn to the local population who are usually less likely to try to rip you off.

As to direct responses to your queries:

Private clinics provide a reasonable level of primary health care but the solution is not to get ill.

By definition white people in Africa are mega-rich and don't need to work therefore skills like engineering and occupational therapy are much in demand provided they are free.

Cost of living depend anywhere on how one chooses to live. Gambians can live on £40 a month - I'd not try that. I can show you where to rent a reasonable house for $2000 per month and an even nicer one for £400. Fresh local produce is by our standards very inexpensive beer and even petrol are less expensive than in the UK. I reckon it is possible to live a comfortable life with a couple of servants for £1000 a month but if you want imported whisky, Heinz baked beans and Kellogs corn flakes expect to pay more.

You and I are looking for similar things so do send me a message and lets help each other by exchanging information.