The Government through Ministry of Health and Wellness’s bold decision to stop referring patients to South Africa and Indian private hospitals will save government P300 million on annual bases, Minister Dr Alfred Madigele has revealed.
Madigele believes the government should take control of the referrals for specialised care and channel the resources in a strategic manner that grows both public and private sector capacity. “We must prioritise supporting our private hospitals over external facilities. In partnership with our providers, we must devise concrete measures to curb abuse and wastage in billing for services,” he said before adding.
“We will save a lot of money. Initially we spent P300 million yearly but the contract with the middlemen who facilitated those referrals elapsed and we built our own which saved us a lot,” he said during his first ever media engagement since assuming office last year. The reason why the government decided to scrap exporting patients to South African hospitals was due to exorbitant medical bills which bled the ministry purse and other challenges including negligence.
Government has been sending patients to these two countries for average and complicated surgeries. A whopping P 627 504 802 was spent on South African hospitals between 2014 and 2017 while the Indian hospitals gobbled P13 million from the ministry between 2015 and 2017. The decision to do away with international referrals has been on the pipeline since last year and it was catalysed by the opening of the Sir Ketumile Masire Teaching Hospital (SKMTH).
“A phased commissioning of SKMTH will reduce overdependence on South Africa for referrals, reduce costs and also institutionalize provision of super specialist services within Botswana. The hospital which is still on the first phase of commissioning and expected to open doors on the 24th of this month will offer a number of services including; paediatric oncology, internal medicine, rheumatology and endocrinology, diagnostic radiology, laboratory services and pharmacy.
These and many others that the hospital will offer upon full commissioning have been cases that gobbled millions of pula from the government. Reasons to transfer patients to the international private facilities ranged from complicated cases, lack of proper equipment and infrastructure by the hospital. Flagship hospital Princess Marina is said to be lacking capacity in the three components to do the work with diligence.
This development follows the recommendations by the Deputy Director- Patient Care, Setso Setso who advised the ministry last year. “We have the capacity to carry out most of surgeries locally. We have specialists; I don’t know why we keep on referring patients outside, because it is costly. Referrals within a country have proven to be cheap,” he said then.
On the other hand cardiology mostly interventional paediatric and cardiothoracic surgeries costs R500 000 on average, with complicated cases ranging between R800 000- R1 million. A total of 87 patients were sent for examination on these cases last year. The government after sending 99 patients spent between R120 000 and R300 000 for normal vascular surgeries, while spending R800 00- R100 000 for complicated cases. For ophthalmology diseases especially retinal detachment, corneal transplant and diabetic retinopathy among others, 342 patients sent outside, the government was spending R1 200 for consultation with R62 500 for surgery per patient.
For laser treatment (few but high cost) where 36 patients were refereed outside, the ministry splashed between R120 000 and R400 000. All these according to Setso should be done locally if the government is to be financially prudent. “We should come up with a model to sustain what we have. Let’s purchase equipment so we can do these locally. We can also call the specialists to come and do those surgeries in Botswana.
We should also go the technological way, let’s have a tele-medicine where a nurse or a doctor can just look at the screen and prescribe to you which medicines you can take. This will save congestion in some facilities or going up and down to the hospitals as doctors in your locality will be able to read from far and give patient medicines,” he said.
The idea by Setso was warmly welcomed by the Permanent Secretary in the ministry Ruth Maphorisa and convinced the minister. “We should do things differently. We should change our attitude. “Let’s make our facilities function and stop going out, it is unnecessary at times. We can have a plan for the doctors that patients normally visit to come here regularly. Further we should have more specialists as a country let them go out for further training,” she said last year.
The health ministry which has been on the media for wrong reasons owing to medication shortage has risen from slumber. The ministry is in the process of installing an electronic information management system (e-Pulse) through which a better forecast in medicine requirements is expected and will strengthen inventory management. The Ministry has further upgraded the position of Central Medical Stores Manager and has placed additional manpower with requisite skills and knowledge in supply chain.
MINISTRY CONSIDERS LEGALISING ABORTION
With many backstreet abortion reported in various health facilities, the ministry has taken a decision to seriously start conversation on legalising selective terminations. “The Ministry is considering having conversation around legalising selective abortions. This is because we record a number of unsafe abortions and we will have to turn that around,” said minister Madigele.
GOVT ENGAGES TRADITIONAL HEALERS
Madigele also added that his ministry is on track to formally approach traditional healers to assist where there is a need, especially in mysterious diseases like the mass hysteria that befell Lempu CJSS, which caused numbness and weakness of the knees. “Health is very broad subject and we want to engage them (traditional doctors). Medicines are plant based so we need to formalize synergies especially on Non Communicable Diseases and understand cultural beliefs and I believe it will mostly benefit patients if we collaborate.”
High Commissioner of the Federal Government of Nigeria to Botswana, His Excellency Umar Zainab Salisu, has challenged President Dr Mokgweetsi Masisi to move swiftly and lobby Africa’s richest man, Nigerian Billionaire, Aliko Dangote to invest in Botswana.
Speaking during a meeting with President Masisi at Office of President on Thursday Zainab Salisu said Dangote has expressed massive interest in setting up billion dollar industries in Botswana. “We have a lot of investors who wish to come and invest in Botswana , when we look at Botswana we don’t see Botswana itself , but we are lured by its geographic location , being in the centre of Southern Africa presents a good opportunity for strategic penetration into other markets of the region,” said Salisu.
As murder cases and violent incidents involving couples and or lovers continue to be recorded daily, Specially Elected Member of Parliament, Dr Unity Dow has called for more funding of non-governmental organizations and accelerated action from government to come up with laws that could inhibit would-be perpetrators of crimes related to Gender Based Violence (GBV).
Just after Dr Dow had deposited her views on this subject with this reporter, a young man in Molepolole opened fire on a married woman he was having an affair with; and ended her life instantly. While it is this heinous cases that get projected to the public space, the former minister argues that the secrecy culture is keeping other real GBV cases under wraps in many spaces in the country.
The former Minister of Foreign Affairs and International Cooperation said there is GBV all the time in all kinds of places. “We have become accustomed to stories of rapes, marital rapes, defilement of children, beatings and psychological violence and even killings,” she said.
Gender-based violence is a phenomenon deeply rooted in gender inequality, Dow is worried that there is absolutely no social punishment for perpetrators; they will continue to have the same friends, jobs, wives, homes, as before. Yet another factor, she said, is that there is little or no “justice” for victims of GBV.
The renowned activist said justice for GBV victims is not just the jailing of the perpetrator. “Justice for victims means an agile, victim-friendly, accessible (time, money and procedures) and restorative justice system.”
Asked what could be leading to a spike in Gender Based Violence cases or incidents, she observed that there is no one factor to which this spike can be attributed. “The most obvious factor is stress as a result of economic distress and or poverty. Poverty makes one vulnerable and open to compromises that they would otherwise not make. For perpetrators with anger management issues, economic stress leads to lashing out to those closest to them. Another factor is the disintegration of families and family values,” she opined.
According to Dow, no government anywhere in the world is doing enough, period. “We know the places and spaces where women and girls are unsafe. We know the challenges they face in their attempts to exit those spaces and places.” The former Judge of the High Court said GBV undermines the health, dignity, security and autonomy of its victims, yet it remains shrouded in the culture of silence.
Asked what could be done to arrest GBV cases, Dow said it is critical to involve and fund civil society organizations. She observed that much of the progress done in the area of women’s human rights was during the time when Botswana had strong and funded civil society organizations.
“The funding dried up when Botswana was declared a middle-income country but unfortunately external funding was not replaced by local funding,” she acknowledged.
Further Dow said relevant government institutions must be funded and strengthened.
“Thirdly, create a society in which it is not okay to humiliate, rape, beat or kill women. You create this by responding to GBV the same way we have responded to livestock theft. We need to create agile mechanisms that hear cases quickly and allow for the removal of suspected perpetrators from their homes, work places, boards, committees, etc.”
The former Minister said the much anticipated Inter-Ministerial Task Force on Gender Based Violence will have its work cut out for it. According to Dow, GBV is not just a justice issue, it’s not just a gender issue, but rather an issue that cuts across health, education, labour, economic, housing and politics. “As long as any one believes it is someone else’s problem, we will all have the problem,” she said.
In her view, Dow said every work, educational and other place must have a GBV Policy and/or Code of Conduct. “It is important that we acknowledge that the majority of men are law-abiding. The problem is their silence, in the face of injustice,” she observed.
The State has chosen to ignore intents by kingpins in the P100 billion scandal to sue for a combined P85 million as tables turn against the Directorate of Public Prosecution (DPP) in the matter.
Key players in the matter; the Directorate on Corruption and Economic Crime (DCEC) and Bank of Botswana (BoB) have eroded the prospects of success following the duo’s institutions’ appearance before parliamentary committees recently.