Human beings transcend through life in stages. Once born, childhood comes soon after, followed by adolescence, adulthood and then senior age. It is inevitable that when reaching certain age, the human body and mind begins to slow down, and often requires extra care.

For elderly people in the Western world, various forms of health care are provided to them without second thought. However, this is only a dream for millions living in other nations around the world. Specifically for elders living in Gambia, a country on the North Western border of the Atlantic Ocean with a population of over two-million people, where 60 percent of the population is under the age of 25.

According to World Factbook, roughly three percent of Gambia’s population is over 65. This makes it difficult for older people to receive the health care they so desperately need.

With this in mind, grassroots initiatives like Aging With a Smile are working to improve the health care of older people, and re-integrate them back into society. “Due to improvements in public health and standards of living, people are now living longer than in the past,” said Balla Musa Joof. “But living longer does not mean they are living healthier.”

Created in January 2010 by the late Dr. Abubacarr Gaye, Joof says Aging With a Smile was established as a civil society organization by groups of concerned citizens as a response to multiple issues faced by elderly in Gambia.

“[Aging With a Smile] is a community based organization launched to promote and protect the health and welfare of older persons in the country,” said Joof. “The activities of the organizations are delivered by our members and a pool of volunteers who are motivated by the desire to give back to the elderly.”

People like Saikou Badjie. Badjie, who was born with a leg deformity, lives an hour and a half away from the nearest clinic. The effort to travel to the clinic is a lengthy and costly journey for individuals such as himself with little—to no—money.

“I got to his house and he was sitting on his front porch, just kind of staring blankly out, with crutches beside him,” said Vanessa Tignanelli, a documentary photographer who travelled to The Gambia on behalf of Photographers Without Borders.

“He falls all the time and had all these open wounds on his body, in the back of his head, his ear, his arms were all scuffed up and scarred.”With no antibiotics, first-aid and children to care for him—Badjie is alone.

As the owner of a local welding shop, for years Badjie continuously employed younger people for work. Not only was he their employer, Badjie was also seen as a father figure—providing them with care, sending them to school and giving them money. However, with all the love he gave, Tignanelli says there was none in return.

Aging With a Smile co-exists to provide for disadvantaged elders like Badjie and has done so for over 6500 people since its creation. “Over the past seven years, Aging With a Smile has conducted more than 20 free community-based health screening and consultations for older people with a particular focus on diabetes, hypertension and eye problems,” said Joof. And those like Badjie, are beyond thankful.