Nurses and midwives who work in government clinics and health posts are planning to stop performing some of their usual duties and have approached the Lobatse High Court to authorise their intended action.
The judiciary is the last hope of the disgruntled health service employees to resolve the long standing impasse between these workers and the Directorate of Public Service Management (DPSM) together with the Ministry of Health in regards to the nurses’ duties.
The nurses’ trade union, Botswana Landboards, Local Authorities and Health Workers Union (BLLHWU) has filed court papers through their lawyer, Tshiamo Rantao of Rantao Kewagamang Attorneys to fast track the process.
The long list of the ‘non-nursing’ services that the nurses would not want to extend to patients include among others, medical consultation of patients and prescriptions of drugs, ordering laboratory specimen such as blood, stool, sputum and urine and to ensure proper transportation, screening of patients, dispensing of drugs and proper disposal of expired drugs, ordering, stock control, compiling statistical reports on attendance at the clinic. According to the disgruntled nurses, the services would only be performed by authorised prescribing practitioners.
Further in the list of not to do by nurses is the rationing of food to beneficiaries such as Tuberculosis (TB) patients, children under five and pregnant mothers whose rations are only given out at the clinics and health posts.
The nurses who are crying exploitation by their employer, the DPSM, further threaten to stop pottering of non-ambulatory patients, registering of birth and deaths, registering of vulnerable groups such as orphans, off loading of drug cartons from central medical stores and the collection and safe keeping of revenue.
To be able to off load the duties from their daily rota, the nurses would request the court to declare that the duties are not nursing duties. The matter has been filed before Justice Garekwe of the Lobatse High Court and the date of hearing is yet to be announced.
“The troubling question of the performance of non nursing duties by nurses employed by Local government at Clinics duties dates back a couple of years back. The Union has been at the forefront of it engaging stakeholders, including the Ministry of Health and the DPSM as the new employer,” explained BLLHWU’s Secretary General, Ketlhalefile Motshegwa.
The nurses have confirmed that they perform the duties as they are expected and are instructed by the employer to do so as a matter of daily routine whether or not there is an emergency or other exceptional circumstances. According to the nurses, they have not refused to do the job for fear of disciplinary action which could include dismissal from work hence they need court protection.
The government has always maintained that the nurses have to conduct general duties because their numbers do not allow for specialisation.
In the nursing profession, there are authorised nurses who are exceptionally entitled to perform certain duties. Such nurses according to experts are trained to perform special duties such as midwifery, family nursing practice, community health nursing, ophthalmic nursing and others. However in so far as Botswana government clinics and Health Posts are concerned, the nurses practice general nursing duties as there is no distinction regardless of their qualification as they perform the same duties.
In fact the Ministry of Health including its Minister and Permanent Secretary has in several occasions cried foul of migration of nurses from Botswana to other countries. Some of the factors that they admitted causes the disgruntlement in the nursing field include, heavy work load, poor working conditions, high patient-nurse ratio, but has since failed to resolve the problem due to “financial constraints.”
“It is quite clear that the performance by nurses and midwives of non nursing duties on daily basis contributes directly to undesirable heavy-workload, generally poor working conditions and high patient-nurse ration as complained by the Permanent Secretary. This is inimical to the health of the nation, especially when this country continues to fight the effects of HIV and AIDS,” Motshegwa added.
In the past the nurses have threatens to stop performing the duties but the government continued to persuade them with promises to correct the problem. In 2011, scores of nurses alongside other public service employees went on a two month long strike which crippled the country’s health services among others. Some Health workers lost their jobs as a result of the strike and some had to re-apply for their jobs.
However, this time around, the nurses who have previously threatened to go on strike if these duties are not off loaded from their rota have made a wise decision to take the legal route since they are prohibited by law to strike.
Meanwhile it is clear that there is no consensus as on whether or not nurses are entitled to perform the duties in question and it would be in the interest of the public that the court gives direction on this because the continues dispute over it threatens the health of the nation.
The Directorate of Public Prosecutions (DPP)’s decision to reject and appeal the High Court’s verdict on a case involving High Court Judge, Dr Zein Kebonang has frustrated the Judicial Service Commission (JSC) and Judge Kebonang’s back to work discussions.
JSC and Kebonang have been in constant discussions over the latter’s return to work following a ruling by a High Court panel of judges clearing him of any wrong doing in the National Petroleum Fund criminal case filed by the DPP. However the finalization of the matter has been hanged on whether the DPP will appeal the matter or not – the prosecution body has since appealed.
Botswana Democratic Party (BDP) top brass has declined a request by Umbrella for Democratic Change (UDC) to negotiate the legal fees occasioned by 2019 general elections petition in which the latter disputed in court the outcome of the elections.
This publication is made aware that UDC Vice President Dumelang Saleshando was left with an egg on his face after the BDP big wigs, comprising of party Chairman Slumber Tsogwane and Secretary General Mpho Balopi rejected his plea.
“He was told that this is a legal matter and therefore their (UDC) lawyer should engage ours (BDP) for negotiations because it is way far from our jurisdiction,” BDP Head of Communications, Kagelelo Kentse, told this publication.
This spelt doom for the main opposition party and Saleshando who seems not to have confidence and that the UDC lawyers have the dexterity to negotiate these kind of matters. It is not clear whether Saleshando requested UDC lawyer Boingotlo Toteng to sit at the table with Bogopa Manewe, Tobedza and Co, who are representing the BDP to strike a deal as per the BDP top echelons suggested.
“From my understanding, the matter is dealt with politically as the two parties are negotiating how to resolve it, but by far nothing has come to me on the matter. So I believe they are still substantively engaging each other,” Toteng said briefly in an interview on Thursday.
UDC petitioners saddled with costs after mounting an unprecedented legal suit before the court to try and overturn BDP’s October 2019 victory. The participants in the legal matter involves 15 parliamentary candidates’ and nine councillors. The UDC petitioned the court and contested the outcome of the elections citing “irregularities in some of the constituencies”.
In a brief ruling in January 2020, Judge President Ian Kirby on behalf of a five-member panel said: “We have no jurisdiction to entertain these appeals. These appeals must be struck out each with costs including costs of counsel”. This was a second blow to the UDC in about a month after their 2019 appeals were dismissed by the High Court a day before Christmas Day.
This week BDP attorneys decided to attach UDC petitioners’ property in a bid to settle the debts. UDC President Duma Boko is among those that will see their property being attached with 14 of his party members. “We have attached some and we are on course. So far, Dr. Mpho Pheko (who contested Gaborone Central) and that of Dr, Micus Chimbombi (who contested Kgalagadi South) will have their assets being sold on the 5th of February 2021,” BDP attorney Basimane Bogopa said.
Asked whether they met with UDC lawyers to try solve the matter, Bogopa said no and added. “Remember we are trying to raise the client’s funds, so after these two others will follow. Right now we are just prioritising those from Court of Appeal, as soon as the high court is done with taxation we will attach.”
Saleshando, when contacted about the outcomes of the meeting with the BDP, told WeekendPost that: “It would not be proper and procedural for me to tell you about the meeting outcomes before I share with UDC National Executive Committee (NEC), so I will have to brief them first.”
UDC NEC will meet on the 20th of next month to deal with a number of thorny issues including settling the legal fees. Negotiations with other opposition parties- Alliance for Progressives and Botswana Patriotic Front (BPF) are also on the agenda.
Currently, UDC has raised P44 238 of the P565 000 needed to cover bills from the Court of Appeal (CoA). This is the amount in a UDC trust account which is paltry funds equating 7.8 per cent of the overall required money. In the past despite the petitioners maintaining that there was promise to assist them to settle legal fees, UDC Spokesperson, Moeti Mohwasa then said the party has never agreed in no way to help them.
“We have just been put in debt by someone,” one of the petitioners told this publication in the past. “President’s (Duma Boko) message was clear at the beginning that money has been sourced somewhere to help with the whole process but now we are here there is nothing and we are just running around trying to make ends meet and pay,” added the petitioner in an interview UDC NEC has in December last year directed all the 57 constituencies to each raise a minimum of P10, 000. The funds will be used to settle debts that are currently engulfing the petitioners with Sheriffs, who are already hovering around ready to attach their assets.
The petitioners, despite the party intervention, have every right to worry. “This is so because ‘the deadline for this initiative (P10, 000 per constituency) is the end of the first quarter of this year (2021),” a period in which the sheriffs would have long auctioned the properties.
President of the Umbrella for Democratic Change (UDC) Duma Boko’s alliance with former President Lt Gen Ian Khama continues to unsettle some quarters within the opposition collective, who believe the duo, if not managed, will once again result in an unsuccessful bid for government in 2024.
While Khama has denied that he has undeclared preference to have Boko remaining as leader of UDC, many believe that the two have a common programme, while other opposition leaders remain on the side-lines.