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Centralisation crippled health care system

Member of Parliament for Tati East, Samson Guma Moyo

Member of Parliament for Tati East, Samson Guma Moyo has urged the Ministry of Health to concede that the country’s health system is on crisis mode, owing to unsolved issues piling up over the years.

Moyo said this at the opening of the sitting of the Public Accounts Committee (PAC) to examine Government accounts for Financial Year that ended 31st March 2014, earlier this week.

The committee which is chaired by MP for Kanye South, Abraham Kesupile is also made up of Ndaba Gaolathe, Kosta Markus, Biggie Butale, Dithapelo Keorapetse, Shaun Ntlhaile, Guma Moyo, Paulson Majaga and Ignatious Moswaane.  

Moyo said the fact that year after year the ministry is unable to resolve crucial issues confirm that there is indeed a crisis in Botswana’s health care system.

Moyo stated that issues like shortage of drugs including for critical illnesses like high blood pressure is a call for help. “What are the implications of this shortage?”He asked, further adding, “Some patients are dying as a result of this shortage.”

The Ministry of Health Acting Permanent Secretary, Tebogo Banamile acknowledged that the ministry is faced with challenges but denied that there was a crisis, as Moyo implied.

Banamile said that some of the challenges were brought on by the transition from decentralisation to centralisation after the 2009 general elections. Government has said that due to the economic situation of that time, health services were better managed at central government under the health ministry.  

According to Banamile centralisation resulted in the ministry taking over the responsibilities which were initially tasked to local authorities. She alleged that, when nurses were moved to central government, some resources they used like accommodation facilities and vehicles could not be transferred since they already belonged to the Ministry of Local Government, thus contributing to the web of problems the ministry is faced with.

The PAC was also not impressed that there over 50 doctors who do not have accommodation, it submitted that it is one of the factors that have resulted in Botswana not being able to attract and retain doctors.  

MP for Maun East, Kosta Markus expressed concern over the remuneration of Cuban doctors in Botswana. There is an understanding that they are unhappy with Botswana’s working conditions. The PAC heard this week that Cuban doctors are entitled to meagre allowances ranging from $600-$800 (P5878.00- P7838.00) depending on their area of speciality.

The Cuban doctors are also only transported to and from work, and government does not provide them with personal vehicles.

Botswana’s low wages have also been pointed out as the problem in the health care system as the country is unable to attract specialists to work in Botswana. Botswana is also unable to retain its medical professionals due to limited incentives in allowances. Failing to rectify the current situation means Botswana will continue losing doctors to greener pastures as they remain the most sought after professionals in the world.

MP for Gaborone Bonnington South Ndaba Gaolathe advised the Ministry of Health to develop a method which they will use to measure preventative care to see if the ministry is achieving its objectives.  

Gaolathe advised that the ministry should also have an effective supply chain management which is critical in management of the drugs to ensure that the supply is adequate and reaches the destinations where they are needed. While Botswana has never short of drugs, it is common for some health posts, especially those in rural areas to go experience a shortage of drugs.

Botswana infant mortality rate remains one of highest in the world for an upper middle income country, with an average of 36 deaths per 1000 live births. While the mortality rate for children under 5 years is at 28%.
Banamile announced that the Ministry of Health is reverting to decentralisation and the District Health Management Teams (DHMT) will be given more authority in order to improve efficiency. The Acting PS contended that a lot of issues were overlooked a few years ago when other health services were centralised.  

The Ministry of Health will also seek an arrangement where health professionals will be de-linked from public service so that there are certain benefits which health professionals are able to access that are in line with international practices.

Parliament has previously rejected a motion by Dithapelo Keorapetse to consider delinking health workers from civil service and setting up an independent Health Commission to be in charge of the health sector.

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DPP halts JSC, Judge’s back to work plan

25th January 2021

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.

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BDP rejects Saleshando payment proposal

25th January 2021
MP saleshando

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.

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Boko-Khama axis viewed with suspicion

25th January 2021

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.

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