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Govt stops referrals to SA, India hospitals

Government through the Ministry of Health and Wellness is working on a formula to do away with referrals of Batswana patients to South African and Indian hospitals.

Government has been referring Batswana patients to the two countries for various surgeries that have been confirmed to be bleeding the government purse. 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. Deputy Director- Patient Care at the ministry, Setso Setso said Botswana is well capacitated to carry out most surgeries locally.

“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 at the Princes Marina stakeholders’ Pitso this week.
Marina transfers its patients to private facilities outside the country for various reasons ranging from complicated cases, lack of proper equipment and infrastructure by the hospital.

Marina is said to be lacking capacity in the three components to do the work with diligence. Cases referred include oncology, cardiology, vascular surgery, ophthalmology and ENT (few but costly). On average, oncology which is mostly cancer related (like leukemia) costs government R500, 000 to complete the treatment cycle. Last year Botswana sent a total of 179 patients outside the country for surgery.

On the other hand cardiology, mostly interventional pediatric and cardiothoracic surgeries requires R500 000 on average, with complicated cases ranging between R800 000- R100 000. A total of 87 patients were sent outside the country for examination on these cases last year.
Government, spent between R120 000 and R300 000 for normal vascular surgeries for 99 patients, while R800 00- R100 000 was spent on complicated cases.

For ophthalmology diseases especially retinal detachment, corneal transplant and diabetic retinopathy among others, 342 patients were sent outside and government paid R1 200 for consultation and R62 500 for surgery per patient. For laser treatment for 36 patients, the ministry parted with 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 here. We can also call the specialists to come and do those surgeries in Botswana. We should also go the technological way, let’s consider 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.

Permanent Secretary in the ministry, Ruth Maphorisa welcomed the recommendations put forth by Setso. “We should do things differently. We should change our attitude,” she advised. “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.”

LOCAL REFERRALS

The congestion currently besieging Princess Marina as a result of referrals could be avoided if proper transfer mechanisms are followed, Setso also advised. “Why do we have overcrowding at Marina while our referral system is well documented,” Setso asked rhetorically. “Some patients should not be bedded in Marina; ambulances should just drop them there with notes of their conditions then the doctors give them their prescriptions and they leave.”

He said these unnecessary transfers have a correlation with overcrowding which contributes to morbidity and mortality incidents. This overcrowding which is against the international health protocol is also caused by shortage of medicines at health post, clinics and district hospitals.

“Like I said we should just change attitude, as health practitioners we should be more customer oriented. Clinics and or primary hospitals must make sure medicines are there. Stop placing an order and never follow it through, your job is not done until the drugs reach the clinic for the patients to have,” Setso stated. This year’s Pitso was the fourth through which the ministry attempts to address challenges besieging the health sector. 

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ENVIRONMENT ISSUES: Masisi asks Virginia for help

24th March 2023

President Mokgweetsi Masisi says the issue of sustainable natural resources management has always been an important part of Botswana’s national development agenda.

Masisi was speaking this week on the occasion of a public lecture at Virginia Polytechnic, under theme, “Merging Conservation, Democracy and Sustainable Development in Botswana.”

Botswana, according to Masisi, holds the view that the environment is fragile and as such, must be managed and given the utmost protection to enable the achievement of Sustainable Development Goals (SDGs).

“It is necessary that we engage one another in the interchange of ideas, perspectives, visualizations of social futures, and considerations of possible strategies and courses of action for sustainable development,” said Masisi.

On the other hand, dialogue, in the form of rigorous democratic discourse among stakeholders presents another basis for reconfiguring how people act on their environments, with a view to conserving its resources that “we require to meet our socio-economic development needs on a sustainable basis,” Masisi told attendees at the public lecture.

He said government has a keen interest in understanding the epidemiology and ecology of diseases of both domestic and wild animals. “It is our national interest to forestall the dire consequences of animal diseases on our communities livelihoods.”

President Masisi hoped that both Botswana and Virginia could help each other in curbing contagious diseases of wildlife.

“We believe that Virginia Tech can reasonably share their experiences, research insights and advances in veterinary sciences and medicines, to help us build capacity for knowledge creation and improve efforts of managing and containing contagious diseases of wildlife. The ground is fertile for entering into such a mutually beneficial partnership.”

When explaining environmental issues further, Masisi said efforts of conservation and sustainable development might at times be hampered by the emergence and recurrence of diseases when pathogens mutate and take host of more than one species.

“Water pollution also kills aquatic life, such as fish, which is one of humanity’s much deserved sources of food. In this regard, One Health Approach imposes ecological responsibility upon all of us to care for the environment and the bio-diversity therein.”

He said the production and use of animal vaccines is an important space and tool for conservation, particularly to deal with trans-border animal diseases.

“In Botswana, our 43-year-old national premier pharmaceutical institution called Botswana Vaccine Institute has played its role well. Through its successful production of highly efficacious Foot and Mouth vaccines, the country is able to contain this disease as well as supply vaccines to other countries in the sub-region.:

He has however declared that there is need for more help, saying “We need more capacitation to deal with and contain other types of microbial that affect both animals and human health.”

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Masisi saddened by deaths of elephant attacks

24th March 2023

President Mokgweetsi Masisi has expressed a strong worry over elephants killing people in Botswana. When speaking in Virginia this week, Masisi said it is unfortunate that Batswana have paid a price with their own blood through being attacked by elephants.

“Communities also suffer unimaginable economic losses yearly when their crops are eaten by the elephants. In spite of such incidents of human-elephant conflict, our people embrace living together with the animals. They fully understand wildlife conservation and its economic benefits in tourism.”

In 2018, Nthobogang Samokwase’s father was attacked by an elephant when travelling from the fields, where he stayed during the cropping season.

It was reported that the man couldn’t run because of his age. He was found trampled by the elephant and was pronounced dead upon arrival at the hospital.

In the same year, in Maun, a 57-year-old British woman was attacked by an elephant at Boro and died upon arrival at the hospital. The woman was with her Motswana partner, and were walking dogs in the evening.

Last month, a Durban woman named Carly Marshall survived an elephant attack while on holiday in the bush in Botswana. She was stabbed by one of the elephant’s tucks through the chest and was left with bruises. Marshall also suffered several fractured ribs from the ordeal.

President Masisi Botswana has the largest population of African elephants in the world, totaling more than 130 000. “This has been possible due to progressive conservation policies, partnerships with the communities, and investment in wildlife management programmes.”

In order to benefit further from wildlife, Masisi indicated that government has re-introduced controlled hunting in 2019 after a four-year pause. “The re-introduction of hunting was done in an open, transparent and democratic way, giving the communities an opportunity to air their views. The funds from the sale of hunting quota goes towards community development and elephant conservation.”

He stressed that for conservation to succeed, the local people must be involved and derive benefits from the natural resources within their localities.

“There must be open and transparent consultations which involve all sectors of the society. It is against this backdrop that as a country, we lead the continent on merging conservation, democracy and sustainable development.”

Masisi stated that Botswana is open to collaborative opportunities, “particularly with identifiable partners such as Virginia Tech, in other essential areas such as conservation, and the study of the interplay among the ecology of diseases of wild animals and plants, and their effects on human health and socio-economic development.”

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Gov’t commit to injecting more funds in fighting HIV

24th March 2023

Minister for State President Kabo Morwaeng says government will continue to make resources available in terms of financial allocations and human capital to ensure that Botswana achieves the ideal of eradicating HIV and AIDS as a public health threat by 2030.

Morwaeng was speaking this morning in Gaborone at the High-Level Advocacy event to accelerate HIV Prevention in Botswana. He said the National AIDS and Health Promotion Agency (NAPHA), in partnership with UNAIDS, UN agencies, the Global Fund and PEPFAR, have started a process of developing transition readiness plan for sustainability of HIV prevention and treatment programmes.

“It is important for us, as a country that has had a fair share of donor support in the response to an epidemic such as HIV and AIDS, to look beyond the period when the level of assistance would have reduced, or ceased, thus calling for domestic financing for all areas which were on donor support.”

Morwaeng said this is important as the such a plan will guarantee that all the gains accrued from the response with donor support will be sustained until the end when “we reach the elimination of HIV and AIDS as a public health threat by 20230,” he said.

“I commit to continue support efforts towards strengthened HIV prevention, accentuating HIV primary prevention and treatment as prevention towards Zero New Infections, Zero Stigma, Discrimination and Zero AIDS related death, to end AIDS in Botswana.”

He reiterated that government commits to tackle legislative, policy and programming challenges that act as barriers to the achievement of the goal of ending AIDS as a public health threat.

In the financial year 2022/2023, a total of 119 Civil Society Organizations, including Faith Based Organizations, were contracted with an amount of P100 million to implement HIV and NCDs prevention activities throughout the country, and the money was drawn from the Consolidated Fund.

Through an upcoming HIV Prevention Symposium, technical stakeholders will use outcomes to develop the Botswana HIV Prevention Acceleration Road Map for 2023-2025.

Morwaeng stated that government will support and ensure that Botswana plays its part achieving the road map. He said there is need to put hands on the deck to ensure that Botswana sustains progress made so far in the fight against HIV and AIDS.

“There are tremendous achievements thus far to, reach and surpass the UNAIDS fast track targets of 95%- 95%- 95% by the year 2025. As reflected by the BAIS preliminary results of 2021, we now stand at 95- 98- 98 against the set targets.”

“These achievements challenge us to now shift our gears and strive to know who are the remaining 5% for those aware of their HIV status, 2% of enrolment on treatment by those aware of their status and 2% of viral suppression by those on treatment.”

Explaining this further, Morwaeng said shift in gears should extend to coming up with robust strategies of determining where these remaining people are as well as how they will be reached with the necessary services.

“These are just some of the many variables that are required to ensure that as a country, we are well positioned to reaching the last mile of our country’s response to the HIV and AIDS pandemic.”

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