World Health Organisation (WHO) Regional Director Dr. Matshidiso Moeti has stated that the biggest problem facing the Botswana health sector is shortage of personnel.
She said she realised this during her official visit to Botswana this week where she met Acting President Mokgweetsi Masisi and high powered delegation from Ministry of Health and Wellness comprising Minister Dorcas Makgato, her assistant Phillip Makgalemele and Permanent Secretary Shenaaz El-Halabi. According to the first female WHO Regional Director who is also a first native Motswana to occupy the lucrative and influential international position, Botswana hospitals and clinics are capacitated by few personnel.
“I think the biggest challenge that I have identified is that of a few capacity or lack of enough personnel in the health sector,” she told Weekend Post on the sideline, shortly after press conference in Gaborone this week. She highlighted that this notwithstanding that Botswana is still a country that imports a significant number of health care workers. “We have gaps in the number of doctors and number of nurses because we are a country with small population with a highest numbers of people who need health services,” she told this publication.
She admitted that there are also many other doctors and nurses flying out of the country for greener pastures particularly to the United Kingdom (UK). In light of those going out for greener pastures she pointed out: “Yes I am aware of that” while adding that it is a serious challenge although “it should be looked into a context of a country’s economic situation.” She said brain drain as it is called is also a challenge and she thinks government is working towards different ways to addressing the issue particularly with regard to the departure of some local specialists that have been trained locally and abroad.
“So these things like remuneration constantly needs to be considered, in terms of how you can retain your people, how can you motivate them, and things like the pay rise. They need to come up with ways to retain the health workers and improve their conditions of service,” the WHO representative highlighted. On his part, the Botswana Nurses Union (BONU) President Obonolo Rahube echoed the WHO Regional Director’s sentiments that the biggest problem in the country’s health sector remains lack of adequate staff in clinics and hospitals.
He said there is burden of patients as nurses’ patient ratio is very high. “Yes I can confirm that we have a serious issue of lack of personnel in our health facilities. Our main issue is that we have approximately 1000 vacancy positions and also that we have only 300 graduates who are now roaming the streets but could be filling the positions but it’s not happening,” Rahube said. He stressed to this publication that “we believe that these nurses should be absorbed into the market because of the already burden of nurses patient ration.” He also pointed out that nurses are no longer progressing to higher scales.
To justify this he said “nurses start the profession on C4 or C3 salary bands and then they move to C1 as per parallel progression. But then from there, they become stagnant and rarely move to the next notch. This notwithstanding that there are posts in the ministry and are not filled as we pointed out.” However when commenting on the matter on behalf of government, the Permanent Secretary in the Ministry of health and Wellness, Shenaaz El-Halabi confirmed the shortage of personnel in the health facilities although downplaying the magnitude of the issue.
“Absolutely, we have a shortage of Human Resource. But sometimes it is not so much of shortage sometimes it is a misconception. But don’t get me wrong, there are genuine cases where we have shortage but sometimes it is how we utilise staff that is there,” the PS told Weekend Post past the same press briefing. So, she added that they have been working on workload assessment in terms of ideally how many people they should be having in a certain area (health facility). In terms of the personnel, she insisted that Shortage of staff is a challenge throughout the world (and Botswana is not an exception).
“So we continue to train, our medical school is there to train, our Institute of Health Sciences there as well and others on specialization. We also work on our strategies to make sure that they are able to attract and retain staff that is there.”
The Ministry of Health and Permanent Secretary also revealed that they are working on strategies to improve nurses’ salaries and conditions of service to attract and retain them in the profession which will also address the issue of limited staff in which some depart for good paying countries.
“The good news is that we are also working on attraction and retention strategy. We are working on a new strategy that we have submitted to Directorate on Public Service Management (DPSM) as we have identified areas that we believe we can actually strengthen to be able to address this issue of retention of staff.” El-Halabi explained that there are number of issues that they will be looking at such as remuneration of health workers so that they don’t go out for greener pastures, and issues of pay structure.
“Minister also mentioned this before at a parliamentary committee on supplies that there is need to look at our remuneration package for our health workers.”
On facilities she said she is aware they are congested and that there is need to work towards de-congesting them. “That’s why we have an amazing project that just started on de congesting Princess Marina Hospital. We have started decongesting the maternity wing at the hospital. Not everybody that is delivered in Marina needs to be delivered there. We have maternity clinics across the country. Now they are asked to deliver in other clinics where there is maternity ward other than Marina. Mid wives deliver them. In the event of emergency they can be refereed to Marina. So since this initiative we have seen congestion decreasing.”
She also said as a ministry they also need the nurses to multi task (multi skilling) so that they are able to consult, prescribe and dispense medication (treatment) including on HIV/AIDS. This is essential particularly as we have limited number of nurses and doctors, she highlighted. Some patients have had to die and others continue to die at the hands of doctors and nurses at health facilities across the country because of congestion and lack of adequate staffing.
Botswana Democratic Party (BDP) and some senior government officials are abuzz with reports that President Mokgweetsi Masisi has requested his Vice President, Slumber Tsogwane not to contest the next general elections in 2024.
The impacts of climate change are increasing in frequency and intensity every year and this is forecast to continue for the foreseeable future. African CEOs in the Global South are finally coming to the party on how to tackle the crisis.
Following the completion of COP27 in Egypt recently, CEOs of Africa DFIs converged in Botswana for the CEO Forum of the Association of African Development Finance Institutions. One of the key themes was on green financing and building partnerships for resource mobilization in financing SDGs in Africa
A report; “Weathering the storm; African Development Banks response to Covid-19” presented shocking findings during the seminar. Among them; African DFI’s have proven to be financially resilient, and they are fast shifting to a green transition and it’s financing.
COO, CEDA, James Moribame highlighted that; “Everyone needs food, shelter and all basic needs in general, but climate change is putting the achievement of this at bay. “It is expensive for businesses to do business, for instance; it is much challenging for the agricultural sector due to climate change, and the risks have gone up. If a famer plants crops, they should be ready for any potential natural disaster which will cost them their hard work.”
According to Moribame, Start-up businesses will forever require help if there is no change.
“There is no doubt that the Russia- Ukraine war disrupted supply chains. SMMEs have felt the most impact as some start-up businesses acquire their materials internationally, therefore as inflation peaks, this means the exchange rate rises which makes commodities expensive and challenging for SMMEs to progress. Basically, the cost of doing business has gone up. Governments are no longer able to support DFI’s.”
Moribame shared remedies to the situation, noting that; “What we need is leadership that will be able to address this. CEOs should ensure companies operate within a framework of responsible lending. They also ought to scout for opportunities that would be attractive to investors, this include investors who are willing to put money into green financing. Botswana is a prime spot for green financing due to the great opportunity that lies in solar projects. ”
Technology has been hailed as the economy of the future and thus needs to be embraced to drive operational efficiency both internally and externally.
Executive Director, bank of Industry Nigeria, Simon Aranou mentioned that for investors to pump money to climate financing in Africa, African states need to be in alignment with global standards.
“Do what meets world standards if you want money from international investors. Have a strong risk management system. Also be a good borrower, if you have a loan, honour the obligation of paying it back because this will ensure countries have a clean financial record which will then pave way for easier lending of money in the future. African states cannot just be demanding for mitigation from rich countries. Financing needs infrastructure to complement it, you cannot be seating on billions of dollars without the necessary support systems to make it work for you. Domestic resource mobilisation is key. Use public money to mobilise private money.” He said.
For his part, the Minster of Minister of Entrepreneurship, Karabo Gare enunciated that, over the past three years, governments across the world have had to readjust their priorities as the world dealt with the effects and impact of the COVID 19 pandemic both to human life and economic prosperity.
“The role of DFIs, during this tough period, which is to support governments through countercyclical measures, including funding of COVID-19 related development projects, has become more important than ever before. However, with the increasingly limited resources from governments, DFIs are now expected to mobilise resources to meet the fiscal gaps and continue to meet their developmental mandates across the various affected sectors of their economies.” Said Gare.
Letlhakeng:TotalEnergies Botswana today launched a Road Safety Campaign as part of their annual Stakeholder Relationship Management (SRM), in partnership with Unitrans, MVA Fund, TotalEnergies Letlhakeng Filling Station and the Letlhakeng Sub District Road Safety Committee during an event held in Letlhakeng under the theme, #IamTrafficToo.
The Supplier Relationship Management initiative is an undertaking by TotalEnergies through which TotalEnergie annually explores and implements social responsibility activities in communities within which we operate, by engaging key stakeholders who are aligned with the organization’s objectives. Speaking during the launch event, TotalEnergies’ Operations and HSSEQ, Patrick Thedi said, “We at TotalEnergies pride ourselves in being an industrial operator with a strategy centered on respect, listening, dialogue and stakeholder involvement, and a partner in the sustainable social and economic development of its host communities and countries. We are also very fortunate to have stakeholders who are in alignment with our organizational objectives. We assess relationships with our key stakeholders to understand their concerns and expectations as well as identify priority areas for improvement to strengthen the integration of Total Energies in the community. As our organization transitions from Total to Total Energies, we are committed to exploring sustainable initiatives that will be equally indicative of our growth and this Campaign is a step in the right direction. ”
As part of this campaign roll out, stakeholders will be refurbishing and upgrading and installing road signs around schools in the area, and generally where required. One of the objectives of the Campaign is to bring awareness and training on how to manage and share the road/parking with bulk vehicles, as the number of bulk vehicles using the Letlhakeng road to bypass Trans Kalahari increases. When welcoming guests to Letlhakeng, Kgosi Balepi said he welcomed the initiative as it will reduce the number of road incidents in the area.
Also present was District Traffic Officer ASP, Reuben Moleele, who gave a statistical overview of accidents in the region, as well as the rest of the country. Moleele applauded TotalEnergies and partners on the Campaign, especially ahead of the festive season, a time he pointed out is always one with high road statistics. The campaign name #IamTrafficToo, is a reminder to all road users, including pedestrians that they too need to be vigilant and play their part in ensuring a reduction in road incidents.
The official proceedings of the day included a handover of reflectors and stop/Go signs to the Letlhakeng Cluster from TotalEnerigies, injury prevention from tips from MVA’s Onkabetse Petlwana, as well as bulk vehicle safety tips delivered from Adolf Namate of Unitrans.
TotalEnergies, which is committed to having zero carbon emissions by 2050, has committed to rolling out the Road safety Campaign to the rest of the country in the future.