Everyone who has been to either a clinic or hospital is familiar with a doctor. They alongside nurses and physiotherapists have direct contact with patients and as a result the public holds medical doctors in high esteem. Parents encourage their children to become doctors, and students with an aptitude for science aspire to be physicians.
The importance of medical doctors is indisputable but there are other medical professionals just as important but often over looked. Chief among the over looked medical professionals are Medical Laboratory Scientists (MLS professionals).
They are the scientists who handle stool, urine, blood and all manner of samples from the human body to conduct tests which will identify the cause of illness. They are the pillar upon which evidence based medicine stands on.
Without diagnostic tests being carried out doctors rely on clinical methods to determine the cause of illness in a patient. Clinical methods rely on an assessment of symptoms manifesting in the patient and they do not guarantee an accurate diagnosis. The uncertainty of clinical tests makes laboratory tests all the more important regardless of their expense because a wrong diagnosis is a potential disaster.
Tapiwa Mugadza, a MLS professional at Optimum Health laboratories advocates strongly for evidence based medicine. When asked if there can ever be a compromise on laboratory tests he said, “there should be no compromise on evidence based medicine, it can cost individuals and institutions significant monetary losses in miss-prescribed drugs and worse still, false diagnosis may result in loss of life” He goes on to describe circumstances in which both can occur.
In one scenario a doctor after assessing the symptoms of a patient identifies that the patient is anaemic. Assuming the patient has an iron deficiency the physician goes on to prescribe iron tablets, yet the reality is that the patient’s anemia is due to a low platelet count.
Though the doctor may eventually realise the error and prescribe the correct treatment iron tablets would have been wasted. Such an error is costly to the patient who purchases their own drugs, it is costly to medical aid companies which cover cost of treatment for their clients and it is costly to tax payers whose money runs public clinics and hospitals.
In another situation a patient has meningitis; meningitis can either be caused by a virus, fungus or bacteria. The appropriate treatment depends on which type of meningitis it is and a delay in treatment can be fatal. To prevent unnecessary loss of life it is important that a laboratory test be done to determine the cause of meningitis and consequently apply the correct treatment.
Such errors are not common place in Botswana because there are plenty of laboratories both public and private such as Diagnofirm which are available to ensure the standards of evidence based medicine are upheld.
Dr. Denys R. Estrada a Dermatologist at Letlalo Skin Medical Centre also believes strongly in the importance of laboratory tests but he points out that in a field such as dermatology clinical examinations are often enough to correctly diagnose a patient. He adds that there are very few circumstances in which a laboratory test will be needed to determine the cause of a skin condition.
The importance of medical laboratory science has not gone unnoticed by key policy makers in government. Since 2008 the University of Botswana (UB) has been steadily making major strides in improving the curriculum of this science.
Mr. Modisa Motswaledi the Head of the School of Allied Health Professions and the President of the Botswana Institute for Clinical Laboratory Professionals is particularly proud of the progress UB has made. He points out that the B.Sc. in cytototechnology and B.Sc. in histotechnology offered at UB are not available in most African countries. This means that UB is not only training scientists for Botswana alone but for the whole of Africa.
African Scientists and Experts Call for the adoption of a Harm Reduction in approach in Public Health Strategies and Tobacco Control. Media have a critical role to play in accelerating Harm Reduction efforts by informing and sensitizing cigarette smokers on the availability and benefits of alternative, potentially lower risk products to cigarretes. Traditional cessation and smoking prevention norms are not the only ways that smokers who cannot or donâ€™tâ€™ want to quit can make healthier choices that cause less harm to themselves and those around them.
This was said during the 2nd Harm Reduction Exchange conference for African journalists held in Nairobi, Kenya on the 1st of December 2022. Speaking at the Harm Reduction Exchange Conference, Integra Africa Principal Dr. Tendai Mhizha emphasized the role that journalists and media houses should play in handling misinformation and disinformation in tobacco harm reduction discourse that is actually perpetuating the death and disease caused by people continuing to smoke combustible cigarettes. â€śThere has been a lot of disinformation surrounding the topic of nicotine and the alleged negative effects that e-cigarettes have on public health.
This has led to policies that disfavour risk reduces products and narratives that completely deny their benefits. The media have the difficult responsibility to curb the scourge of disinformation and misinformation on harm reduction just like on other socio-political stances that are prescriptive and do not uphold consumersâ€™ right to healthier lifestyle choices,â€ť Dr Mhizha said.
The Harm Reduction Exchange cast a spotlight on alternative ways to reduce harm among tobacco smokers. Held under the theme Harm Reduction: Making a difference in Africa, the conference focused on the progress being made through harm reduction strategies in all fields related to public health such as drug and alcohol abuse, excessive sugar consumption, skin lightening and other addictive and behavioral practices. A wide array of harm reduction strategies and initiatives that are deployed towards reducing unnecessary deaths through non-communicable diseases were presented and discussed.
It applies to areas where there is a need to reduce the harm associated with a practice or consumption of a substance that is overused in society leading to increased morbidity and mortality. â€śInnovative Harm Reduction initiatives will help to keep more Africans alive. Tobacco Harm Reduction initiatives, including the use of popular e-cigarettes, nicotine patches and chewing gums, have continued to generate a lot of misunderstanding in both the public health community and in the media. However, there is evidence that the use of potentially less harmful alternatives than cigarettes for those who are not willing or cannot give up smoking with currently approved methods may be a solution, not necessarily the best for everyone but by far better than continuous smoking.
Tobacco Harm Reduction was introduced to mitigate the damage caused by cigarette smokingâ€”the most dangerous form of tobacco use, and the leading cause of preventable diseases, including cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease. â€śNicotine has an addictive potential but plays a minor role in smoking-related morbidity and mortality. Across the world, there is growing interest among experts in novel approaches towards tobacco control and there is an ongoing discussion that reducing the negative effects of smoking can be also achieved by tobacco harm reduction,â€ť Dr. Kgosi Letlape, an ophthalmologist and President of Africa Medical Association and the president of the Association of Medical Councils of Africa, said.
Tobacco cessation is a key factor in the prevention of cardiovascular diseases and cancer. Abstinence from tobacco smoking is one of the primary goals for health promotion and management globally but it is unachievable in a huge amount of cases. This task remains unaccomplished despite extensive public campaigns on the health dangers of tobacco smoking. Thus, the development of novel strategies to reduce smoking is imperative. Moreover, the use of innovations in smoking products has been currently adopted by several smokers to reduce the health risks of smoking.
â€śThe Harm Reduction approach prevents drug-related deaths and overdose fatalities and is the only way out for addicts. In the same way these alternative technologies can reduce tobacco harm and accelerate the journey to a smoke-free world as they reduce exposure to toxicants,â€ť Bernice Apondi, A Policy Manager at Voices of Community Action and Leadership Kenya (VOCAL-Kenya), said.
During the Harm Reduction Exchange, journalists drawn from Southern, West and East African countries, including: Nigeria, Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Eswatini, Tanzania, Uganda, South Africa, Zambia, and Zimbabwe debated and set forth several resolutions in regards to the present and future as well as the challenges and progress made in Harm Reduction,and science-led regulation.
The Harm Reduction Exchange brought together high-level policy makers, physicians, scientists and health policy experts with media stakeholders from Africa in a lively mix of speeches, presentations, and panel discussions. The key note speakers included Prof Abdoul Aziz Kasse, Ms Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, Dr. Kgosi Letlape, Dr. Vivian Manyeki and Dr. Tendai Mhizha.
Over 2,000 civil servants in the public sector have been interdicted for a variety of reasons, the majority of which are criminal in nature.
According to reports, some officers have been under interdiction for more than two years because such matters are still being investigated. Information reachingÂ WeekendPostÂ shows that local government, particularly councils, has the highest number of suspended officers.
In its annual report, the Directorate on Corruption and Economic Crime (DCEC) revealed that councils lead in corrupt activities throughout the country, and dozens of council employees are being investigated for alleged corrupt activities. It is also reported that disciplined forces, including the Botswana Defence Force (BDF), police, and prisons, and the Directorate of Intelligence and Security (DIS) have suspended a significant number of officers.
The Ministry of Education and Skills Development has also recorded a good number of teachers who have implicated in love relationships with students, while some are accused of impregnating students both in primary and secondary school. Regional education officers have been tasked to investigate such matters and are believed to be far from completion as some students are dragging their feet in assisting the investigations to be completed.
This year, Mmadinare Senior Secondary reportedly had the highest number of pregnancies, especially among form five students who were later forcibly expelled from school. Responding to this publicationâ€™s queries, Permanent Secretary to the Office of the President Emma Peloetletse said, â€śas you might be aware, I am currently addressing public servants across the length and breadth of our beautiful republic. Due to your detailed enquiry, I am not able to respond within your schedule,â€ť she said.
She said some of the issues raised need verification of facts, some are still under investigation while some are still before the courts of law.
Meanwhile, it is close to six months since the Police Commissioner Keabetwe Makgophe, Director General of the Directorate on Corruption and Economic Crime (DCEC) Tymon Katlholo and the Deputy Director of the DIS Tefo Kgothane were suspended from their official duties on various charges.
Efforts to solicit comment from trade unions were futile at the time of going to press.
Some suspended officers who opted for anonymity claimed that they have close to two years while on suspension. One stated that the investigations that led him to be suspended have not been completed.
â€śIt is heartbreaking that at this time the investigations have not been completed,â€ť he toldÂ WeekendPost, adding that â€śwhen a person is suspended, they get their salary fully without fail until the matter is resolvedâ€ť.
Makgophe, Katlholo and Kgothane are the three most high-ranking government officials that are under interdiction.
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.