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Untangling the P3 billion Sir Ketumile Masire Hospital

The public will have to wait for at least a month before they can walk in the P3 billion state of the art Sir Ketumile Masire Teaching Hospital (SKMTH) quaternary facilities as the Commissioning Manager (CM) has set April as a month for the official opening.

Government had wished the hospital will open next month, but after some hiccups in the commissioning process, it will now open in April. In an interview with this publication, SKMTH Commissioning Manager Dr Thato Moumakwa has revealed that spanners are at work with progress on track. He disclosed that the facility could have long been opened but the then transitional team could not conceptualize the project.

“They thought it is construction then operational. They omitted the commissioning process which leads to operation.” It is said the board and the ministerial leadership was not happy because of lack of meaningful progress until Minister of Health and Wellness, Dr Alfred Madigele appointed Moumakwa as the hospital CM. “The minister intervened. He told the board that he was not happy with the progress and through his intervention the commissioning team was formulated,” he said in an interview on Wednesday afternoon.

Upon full commissioning, SKMTH will offer broad areas of service like; Critical and Trauma Care, Women and Child Care, Cardiac Care Comprehensive Oncology Care, Nephrology and Transplant Services, Internal Medicine, Surgical Services and Allied Health Services.
For now, according to Dr Moumakwa the hospital will open only for the phase-one since the Commissioning process is tedious and therefore the task team will only bite, chew and swallow what they can. “We should do it rapidly but cautiously because we are dealing with integrity of an organization,” Dr Moumakwa cautioned.

The hospital, it is expected will save government millions of Pula, and relieve pressure from Botswana’s major public health care providers, Princess Marina Hospital (PMH) and Nyangabgwe Referral Hospital.  The hospital will also come as competition for private hospitals such as Bokamoso Private Hospital and Gaborone Private Hospital. The SKMTH is located on the grounds of the University of Botswana campus in Gaborone, is a 450 bed quaternary hospital.

The mandate of the hospital when fully functional is threefold; which will be to provide world class medical services at a quaternary level, to work in conjunction with the University of Botswana School of Health Services to provide world class health education, and lastly to  act as a hub for health research. It is hoped that the hospital will attract the best clinical and academic staff in the region, possibly internationally, and will be a destination of choice for clients seeking world class cost effective medical services.

The hospital, according to Dr Moumakwa will operate as a quaternary hospital. “It will fit into the apex of a healthcare referral ecosystem that entails the two regional tertiary hospitals, namely PMH and Nyangabgwe Referral Hospitals, which will refer into SKMTH for super-specialized health services.”

HIRING OF COMMISSINING TEAM

It has emerged from sources that the process of hiring those in the team was characterized by poor governance and that best recruitment standards were not followed. Some of the complaints are, the CM, singlehandedly recruited the hospital’s staff despite some believing that recruitment should have entailed a panel decision contrary to what occurred at the hospital.  

“I was looking for competency. I was explicitly told to do the whole thing urgently and was ordered to even head-hunt and I agreed. However I modified the head-hunting by looking at CV’s of those that applied in 2017 and we interviewed at least four people per discipline,” Moumakwa said in an interview held on the 4th floor office of the facility this week.

He added, “I engaged myself, Human Resource and a co-opted member of the board for hiring. Only Finance Manager and Board Secretary are the ones who were never interviewed.” By far the team is made up of 16 employees. 10 of those were from the transitional team, with CM recruiting six members mostly from the private sector.

EQUIPMENTS

By far the hospital which strives for excellence and wants to position Botswana as the hub for medical purposes has major equipment’s for Diagnostic Radiology delivered.  This will aid with CT scans, X-rays, MRI and mammography. All these are necessary for phase-one according to Dr Moumakwa. Other equipment for nuclear medicine and radiation oncology are expected to be procured in the next 24 months.

WILL IT BE PUBLIC OR PRIVATE FACILITY?  

The hospital which is 100 percent funded by the government but registered as a company will only hospitalise those that have been referred to by the tertiary hospitals. “We will open for private patients as we will be competing with other available facilities. We are also developing a tariffs system whereby we will be able to recover money from medical aids.” For ordinary citizens they will have to be referred. “We won’t be dealing with cold cases, but if there is an emergency around us we will assist,” said the CM.

In terms of referrals from public hospitals, Dr Moumakwa says patients will be given invoices that will also be sent to government so that the patient can comprehend the value of the service offered while reconciling with the subvention they are given by the government.
“That is why a fully functional accounts and administrative team is key we should justify to government,” he said.

Meanwhile it is expected that various students be it undergraduate or post graduate medicine students from University of Botswana will pass through the facility for their practical tests. This is in line with its vision of training and producing international standard healthcare professionals for the entire national healthcare system, and beyond. Medical research is another area that will see the hospital focusing on. “We want to find medical solutions that are unique to our environment,” Dr Moumakwa concluded.

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Transgender persons in Botswana live a miserable life

23rd November 2020
Transgender persons

An international report complied in South Africa dubbed ‘Legal Gender Recognition in Botswana’ says that the transgender and gender non-conforming people in Botswana live a miserable life. The community experiences higher levels of discrimination, violence and ill health.

In this report, it has been indicated that this is because their gender identity, which does not conform to narrowly define societal norms, renders them more vulnerable. Gender identity is a social determinant of health, which means that it is a factor that influences people’s health via their social context, their communities and their experiences of social exclusion. The Ministry of Health and Wellness has recognized this, and transgender people are considered a vulnerable population under the Botswana Second National Strategic Framework for HIV and AIDS 2010-2017.

In a recent study that shed light on the lived experiences of transgender and gender non-conforming people in Botswana, transgender persons often experience discrimination because of their gender identity and expression. The study was conducted by the University of Cape Town, LEGABIBO, BONELA, as well as Rainbow Identity Association and approved by the Health Ministry as well as the University of Botswana.

Of the 77 transgender and gender non-conforming people who participated in the study, less than half were employed. Two thirds, which is approximately 67% said that they did not have sufficient funds to cover their everyday needs. Two in five had hidden health concerns from their healthcare provider because they were afraid to disclose their gender identity.

More than half said that because of their gender identity, they had been treated disrespectfully at a healthcare facility (55%), almost half (46%) said they had been insulted at a healthcare facility, and one quarter (25%) had been denied healthcare because of their gender identity.

At the same time, the ‘Are we doing right’ study suggests that transgender and non-conforming people might be at higher risks of experiencing violence and mental ill-health, compared to the general population. More than half had experienced verbal embarrassment because of their gender identity, 48% had experienced physical violence and more than one third (38%) had experienced sexual violence.

The study showed that mental health concerns were high among transgender and gender non-conforming people in Botswana. Half of the transgender and gender non-conforming study participants (53%) showed signs of depression. Between one in four and one in six showed signs of moderate or severe anxiety (22% among transgender women, 24% among transgender men and 17% among gender non-conforming people).

Further, the study revealed that many had attempted suicide: one in three transgender women (32%), more than one in three transgender men (35%) and three in five gender non-conforming people (61%).

International research, as well as research from Botswana, suggests that not being able to change one’s gender marker has a negative impact on access to healthcare and mental health and wellbeing. The study further showed that one in four transgender people in Botswana (25%) had been denied access to healthcare. This is, at least in part, linked to not being able to change one’s gender marker in the identity documents, and thus not having an identity document that matches one’s gender identity and gender expression.

In its Assessment of Legal and Regulatory Framework for HIV, AIDS and Tuberculosis, the Health Ministry noted that “transgender persons in Botswana are unable to access identity documents that reflect their gender identity, which is a barrier to health services, including in the context of HIV. In one documented case, a transwoman’s identity card did not reflect her gender identity- her identity card photo indicated she was ‘male’. When she presented her identity card at a health facility, a health worker called the police who took her into custody.”

The necessity of a correct national identity document goes beyond healthcare. The High Court of Botswana explains that “the national identity document plays a pivotal role in every Motswana’s daily life, as it links him or her with any service they require from various institutions. Most activities in the country require every Motswana to produce their identity document, for identification purposes of receiving services.”

According to the Legal Gender Recognition in Botswana report, this effectively means that transgender, whose gender identity and expression is likely to be different from the sex assigned to them at birth and from what is recorded on their identity document, cannot access services without risk of denial or discrimination, or accusations of fraud.

In this context, gays and lesbians advocacy group LEGABIBO has called on government through the Department of Civil and National Registration to urgently implement the High Court rulings on gender marker changes. As stated by the High Court in the ND vs Attorney General of Botswana judgement, identity cards (Omang) play an important role in the life of every Motswana. Refusal and or delay to issue a Motswana with an Omang is denying them to live a complete and full-filing life with dignity and violates their privacy and freedom of expression.

The judgement clarified that persons can change their gender marker as per the National Registrations Act, so changing the gender marker is legally possible. There is no need for a court order. It further said the person’s gender is self-identified, there is no need to consult medical doctors.

LEGABIBO also called on government to develop regulations that specify administrative procedure to change one’s gender marker, and observing self-determination process. Further, the group looks out for government to ensure members of the transgender community are engaged in the development of regulations.

“We call on this Department of Civil and National Registration to ensure that the gender marker change under the National Registration Act is aligned to the Births and Deaths Registry Act to avoid court order.

Meanwhile, a gay man in Lobatse, Moabi Mokenke was recently viciously killed after being sexually violated in the streets of Peleng, shockingly by his neighbourhood folks. The youthful lad, likely to be 29-years old, met his fate on his way home, from the wearisome Di a Bowa taverns situated in the much populated township of Peleng Central.

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Khato Civils fights back, dares detractors

23rd November 2020
Khato-civil

CEO of Khato Civils Mongezi Mnyani has come out of the silence and is going all way guns blazing against the company’s adversaries who he said are hell-bent on tarnishing his company’s image and “hard-earned good name”

Speaking to WeekendPost from South Africa, Mnyani said it is now time for him to speak out or act against his detractors. Khato Civils has done several projects across Africa. Khato Civils, a construction company and its affiliate engineering company, South Zambezi have executed a number of world class projects in South Africa, Malawi and now recently here in Botswana.

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UDC petitioners turn to Saleshando

23rd November 2020
Dumelang Saleshando

About ten (10) Umbrella for Democratic Change (UDC) parliamentary candidates who lost the 2019 general election and petitioned results this week met with UDC Vice President, Dumelang Saleshando to discuss the way forward concerning the quandary that is the legal fees put before them by Botswana Democratic Party (BDP) lawyers.

For a while now, UDC petitioners who are facing the wrath of quizzical sheriffs have demanded audience with UDC National Executive Committee (NEC) but in vain. However after the long wait for a tete-a-tete with the UDC, the petitioners met with Saleshando accompanied by other NEC members including Dr. Kesitegile Gobotswang, Reverend Mpho Dibeela and Dennis Alexander.

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