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Gov’t 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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Veteran journalist Karima Brown succumbs to COVID-19

4th March 2021
Karima-Brown

South Africa’s veteran journalist and broadcaster, Karima Brown has died on Thursday morning from COVID-19 related complications.

Media reports from the neighbouring country say Brown had been hospitalized and on a ventilator.

Brown anchored eNCA’s The Fix and was a regular political analyst on the eNCA channel.

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Botswana imports in numbers

1st March 2021
Botswana-imports

For so many years, Botswana has been trying to be a self-sufficient country that is able to provide its citizens with locally produced food products. Through appropriate collaborations with parastatals such as CEDA, ISPAAD and LEA, government introduced initiatives such as the Horticulture Impact Accelerator Subsidy-IAS and other funding facilities to facilitate horticultural farmers to increase production levels.

Now that COVID-19 took over and disrupted the food value chain across all economies, Botswana government introduced these initiatives to reduce the import bill by enhancing local market and relieve horticultural farmers from loses or impacts associated with the pandemic.

In more concerted efforts to curb these food crises in the country, government extended the ploughing period for the Southern part of Botswana. The extension was due to the late start of rains in the Southern part of the country.

Last week the Ministry of Agriculture extended the ploughing period for the Northern part of the country, mainly because of rains recently experienced in the country. With these decisions taken urgently, government optimizes food security and reliance on local food production.

When pigs fly, Botswana will be able to produce food to feed its people. This is evident by the numbers released by Statistics Botswana on imports recorded in November 2020, on their International Merchandise Trade Statistics for the month under review.

The numbers say Botswana continues to import most of its food from neighbouring South Africa. Not only that, Batswana relies on South Africa to have something to smoke, to drink and even use as machinery.

According to data from Statistics Botswana, the country’s total imports amounted to P6.881 Million. Diamonds contributed to the total imports at 33%, which is equivalent to P2.3 Million. This was followed by food, beverages and tobacco, machinery and electrical equipment which stood at P912 Million and P790 Million respectively.

Most of these commodities were imported from The Southern African Customs Union (SACU). The Union supplied Botswana with imports valued at over P4.8 Million of Botswana’s imports for the month under review (November 2020). The top most imported commodity group from SACU region was food, beverages and tobacco, with a contribution of P864 Million, which is likely to be around 18.1% of the total imports from the region.

Diamonds and fuel, according to these statistics, contributed 16.0%, or P766 Million and 13.5% or P645 Million respectively. Botswana also showed a strong and desperate reliance on neighbouring South Africa for important commodities. Even though the borders between the two countries in order to curb the spread of the COVID-19 virus, government took a decision to open border gates for essential services which included the transportation of commodities such as food.

Imports from South Africa recorded in November 2020 stood at P4.615 Million, which accounted for 67.1% of total imports during the month under review. Still from that country, Botswana bought food, beverages and tobacco worth P844 Million (18.3%), diamonds, machinery and fuel worth P758 Million, P601 Million and P562 Million respectively.

Botswana also imported chemicals and rubber products that made a contribution of 11.7% (P542.2 Million) to total imports from South Africa during the month under review, (November 2020).

The European Union also came to Botswana’s rescue in the previous year. Botswana received imports worth P698.3 Million from the EU, accounting for 10.1% of the total imports during the same month. The major group commodity imported from the EU was diamonds, accounting for 86.9% (P606.6 Million), of imports from the Union. Belgium was the major source of imports from the EU, at 8.9% (P609.1 Million) of total imports during the period under review.

Meanwhile, Minister of Finance and Economic Development Thapelo Matsheka says an improvement in exports and commodity prices will drive growth in Sub-Saharan Africa. Growth in the region is anticipated to recover modestly to 3.2% in 2021. Matsheka said this when delivering the Annual Budget Speech virtually in Gaborone on the 1st of February 2021.

He said implementation of the African Continental Free Trade Area Agreement (AfCFTA), which became operational in January 2021, could reduce the region’s vulnerability to global disruptions, as well as deepen trade and economic integration.

“This could also help boost competition and productivity. Successful implementation of AfCFTA will, of necessity, require Member States to eliminate both tariffs and non-tariff barriers, and generally make it easier to do business and invest across borders.”

Matsheka, who is also a Member of Parliament for Lobatse, an ailing town which houses the struggling biggest meat processing company in the country- Botswana Meat Commission, (BMC), said the Southern African Customs Union (SACU) recognizes the need to prioritize the key processes required for the implementation of the AfCFTA.

“The revised SACU Tariff Offer, which comprises 5,988 product lines with agreed Rules of Origin, representing 77% of the SACU Tariff Book, was submitted to the African Union Commission (AUC) in November 2020. The government is in the process of evaluating the tariff offers of other AfCFTA members prior to ratification, following which Botswana’s participation in AfCFTA will come to effect.”

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Sheila Tlou: On why women don’t get votes

1st March 2021
Sheila Tlou

BARAPEDI KEDIKILWE

Women continue to shadow men in politics – stereotypes such as ‘behind every successful man there is a woman’ cast the notion that women cannot lead. The 2019 general election recorded one of Botswana’s worst performances when it comes to women participation in parliamentary democracy with only three women elected to parliament.

Botswana’s former Minister of Health, Professor Sheila Tlou who is currently the Co-Chair, Global HIV Prevention Coalition & Nursing Now and an HIV, Gender & Human Rights Activist is not amused by the status quo. Tlou attributes this dilemma facing women to a number of factors, which she is convinced influence the voting patterns of Batswana when it comes to women politicians.

Professor Tlou plugs the party level voting systems as the first hindrance that blocks women from ascending to power. According to the former Minister of Health, there is inadequate amount of professionalism due to corrupt internal party structures affecting the voters roll and ultimately leading to voter apathy for those who end up struck off the voters rolls under dubious circumstances.

Tlou also stated that women’s campaigns are often clean; whilst men put to play the ‘politics is dirty metaphor using financial muscle to buy voters into voting for them without taking into consideration their abilities and credibility. The biggest hurdle according to Tlou is the fallacy that ‘Women cannot lead’, which is also perpetuated by other women who discourage people from voting for women.

There are numerous factors put on the table when scrutinizing a woman, she can be either too old, or too young, or her marital status can be used against her. An unmarried woman is labelled as a failure and questioned on how she intends on being a leader when she failed to have a home. The list is endless including slut shaming women who have either been through a divorce or on to their second marriages, Tlou observed.

The only way that voters can be emancipated from this mentality according to Tlou is through a robust voter education campaign tailor made to run continuously and not be left to the eve of elections as it is usually done. She further stated that the current crop of women in parliament must show case their abilities and magnify them – this will help make it clear that they too are worthy of votes.

And to women intending to run for office, Tlou encouraged them not to wait for the eleventh hour to show their interest and rather start in community mobilisation projects as early as possible so that the constituents can get to know them and their abilities prior to the election date.

Youthful Botswana National Front (BNF) leader and feminist, Resego Kgosidintsi blames women’s mentality towards one another which emanates from the fact that women have been socialised from a tender age that they cannot be leaders hence they find it difficult to vote for each other.

Kgosidintsi further states that, “Women do not have enough economic resources to stage effective campaigns. They are deemed as the natural care givers and would rather divert their funds towards raising children and building homes over buying campaign materials.”

Meanwhile, Vice President of the Alliance for Progressives (AP), Wynter Mmolotsi agrees that women’s participation in politics in Botswana remains a challenge. To address this Mmolotsi suggested that there should be constituencies reserved for women candidates only so that the outcome regardless of the party should deliver a woman Member of Parliament.

Mmolotsi further suggested that Botswana should ditch the First Past the Post system of election and opt for the proportional representation where contesting parties will dutifully list able women as their representatives in parliament.

On why women do not get elected, Mmolotsi explained that he had heard first hand from voters that they are reluctant to vote for women since they have limited access to them once they have won; unlike their male counterparts who have proven to be available night or day.

The pre-historic awarding of gender roles relegating women to be pregnant and barefoot at home and the man to be out there fending for the family has disadvantaged women in political and other professional careers.

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