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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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Greef reports Madigele to Tsogwane

20th June 2022

Gaborone Bonnignton South Member of Parliament (MP) Christian Greef has submitted a letter of complaint to party chairman Slumber Tosogwane to take stern action against former minister Dr Alfred Madigele for causing chaos in the constituency.

There has been simmering tension between the two in Gaborone Bonnignton South, where former minister Dr. Madigele is said to be busy working the ground with the intention of contesting the constituency in 2024.  Greef is said to have fallen out of favour with the party top hierarchy due to his association with the beleaguered party secretary general Mpho Balopi, something which he says is “unfounded”.  Greef told this publication that “there are some with mischievous attempts here, but I will sort them out.”

Insiders, however, reveal that it is Madigele who has been causing unrest in the constituency as he plots his comeback to parliament in 2024. This is notwithstanding the fact that Madigele has also been promised the position of secretary general, should the party faithful ratify a proposal by the party politburo to reconfigure the position.

However, Madigele does not want to count on the SG position, hence the decision to to contest the Gaborone Bonnington South constituency. There are reports that there is a spirited campaign by some party members to reject a mulled plan to have the SG being a full-time employee of the party.  This has irked Greef and has since approached the party structures for redress. “We are writing this letter to issue a complaint regarding misconduct by certain members of the BDP in our constituency.

There are several incidents where these individuals have been causing uncalled-for disruptions during party activities in Gaborone Bonnington South,” a letter penned by Greef, addressed to the regional chairperson, reads. He further added, “The group of people who are causing all these unnecessary tension in our constituency is identified and allegedly known by Madigele’s teams who is said to be campaigning for 2023 primary elections.

As the branch we witnessed the same team with similar misconduct during Bophirima Ward by election which we believe caused the party to lose the ward and continue to bring the image of the party in disrepute.” Lately, Madigele has relocated to the same constituency and that has created anxiety to Greef who is a first-time MP. Greef is concerned about how his rival was accepted in his constituency without his knowledge. If he had his wish, he would kick out Madigele from the constituency.

Greef, in another letter copied to President Dr Mokgweetsi Masisi and Chairman Slumber Tsogwane, says Madigele has brought the branch into disarray by campaigning for a parliamentary seat contrary to the party’s regulations for conduct of primary elections. “I therefore humbly appeal to you to call Dr Madigele, who is not a member of our branch, to order,” he said.  Party officials in the region are aware of the matter; some say the MP’s complaint is baseless. However, the MP, according to sources, will fight to the bitter end to ensure that his arch rival is purged out.

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Katlholo’s lawyers slap DCEC with bill in its row with DIS

20th June 2022
Tymon Katlholo

Monthe and Marumo Attorneys who are representing suspended Director General of the Directorate on Corruption and Economic Crime (DCEC) Tymon Katlholo in a legal dispute pitting him against the Directorate of Intelligence and Security (DIS) have said that they would submit a legal bill to the agency.

This was after DCEC’s acting Director General, Tshepo Pilane had written a letter to the law firm demanding that some files and documents belonging to the agency be returned.  “We refer to your letter dated 3rd June 2022 wherein you advised of termination of our mandate. In view thereof we have to file a notice of withdrawal as attorneys of record for and on behalf of the Organisation (DCEC),” Monthe Marumo Attorneys said in their letter.

The lawyers also indicated that, “the firm is in the process of finalizing your invoice and upon settlement of same, we will duly release the contents of the file, in so far as it relate to DCEC.”  Pilane had informed the law firm that, “Following the Directorate’s termination of any and/or mandate between the Director General of the Directorate on Corruption and Economic Crime (DCEC) and your law firm and/or attorney of an Associate law firm of Monthe Marumo and Company on the 3rd June 2022.”

He added that, “I do hereby request that all DCEC documents in custody be returned to the DCEC on or before 12hours today the 6th June 2022. You are also informed that none of this information shall be used by your office under any circumstances.”  Meanwhile Katlholo has told the High Court that the Directorate of Intelligence and Security was on the rampage as it continues to act with impunity.

He revealed this in an urgent application in which he seeks among others that Pilane, Deputy Director General of DCEC Priscilla Israel and the agency’s senior legal advisor Edwin Batsalwelang to be committed to jail for contempt of a court. The Court order had directed that a deputy sheriff should collect files and dockets from the DCEC office and place them into the custody of the Court.  “Consequent to the order of his Lordship, the DISS has continued on its rampage and has arrested two officers of the DCEC and detained them in a Hitler style arrangement,” said Katlholo.

He added that, quite clearly the “DISS with the assistance of the 1st to 3rd Respondents seeks to conceal all the evidence by obstructing Judicial process.”  He said his latest current application has been brought at the earliest opportunity following defiance and acts of obstruction at the instance of the respondents. Katlholo saidthe conduct of the Pilane, Israel, Batsalelwang and DIS are an aggression on the rule of law, the Constitution of Botswana and the Judiciary in general.

“The DISS clearly has every intention of continuing to defy my rights and with the due assistance of the 1st to 3rd Respondents (Pilane, Israel and Batsalelwang). To refuse an interdict, thereby allowing the perpetration of an ongoing wrong is an anathema to the principle of legality,” said Katlholo. He said, “The DISS cannot be allowed to continue acting in contravention of the law, and to fragrantly invade an act of Parliament.”

He reiterated that the files or documents or dockets remain vulnerable and there is need that they be removed from the office and placed in the custody of the Registrar. There can never be a safe place than Court, said Katlholo.  “Should the matter not be heard as urgent, the likelihood of the files concerned and the information therein dissipating or being interfered with is high and once the evidence of the concerned files has been compromised or contaminated there is no other relief in law that fix such, there is therefore no alternative remedy,” he said.

Katlholo added that, “Most importantly, any unwarranted access to the files may compromise the integrity of ongoing investigations and expose informants and whistleblowers. Once they have been compromised, no court action may restore such.”  He said it was necessary and extremely urgent that the Court steps in to protect the rule of law against the respondents, more particularly the DIS and its agents.

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US monitoring Thuso Tiego arrests

20th June 2022
Thuso Tiego

The United States through its State Department’s annual report on global religious freedoms is keeping tabs on Botswana’s decision to arrest of controversial pastor Thuso Tiego by the police.

The report was released a week ago.  Tiego was re-arrested this week by the police after he allegedly attempted to spearhead a campaign aimed at shutting down some shops that are run by foreigners. The US’ State Department report says Police arrested a pastor from the Bethel Transfiguration Church September 7 when he tried to deliver a petition to President Mokgweetsi Masisi demanding his resignation over what the pastor said was mismanagement of the COVID-19 crisis.

“The pastor, Thuso Tiego, also criticized the government for restricting religious gatherings at a time when he said that individuals turned to churches for counselling and support during the pandemic,” the report says.  It says Tiego was held overnight at a police station and released without charge.  The report cites media reports saying that several of his supporters were beaten by police when they gathered outside the station demanding Tiego’s release.

“The national police service did not announce any disciplinary action against the officers involved,” the report says adding that, “The constitution provides for freedom of religion, with certain exceptions, and protection against governmental discrimination based on creed.”
On other related issues, the report said the government continued to pursue court cases involving unregistered churches (sometimes called “fire churches”) coming into the country to “take advantage of” local citizens by demanding tithes and donations for routine services or special prayers.

“The government required pastors of some of those churches to apply for visas – even those from countries whose nationals were normally allowed visa-free entry.  The government said in June 2019 that it was reviewing the visa policy for these foreign pastors, but by year’s end had not released the results of this review or announced any changes,” the report says.   According to the report, former members of one of the most prominent unregistered churches forced to close in 2019, the Enlightened Christian Gathering, subsequently formed their own smaller, independent churches with local leadership that was ultimately registered by the government.

The report says, under the COVID-19 state of emergency that ended in September, the government limited attendance at religious services to no more than 50 persons at one time and limited services to twice a week.  The government also banned all religious gatherings during “extreme social distancing” periods.  Although the limits on religious gatherings lasted 18 months and prevented some individuals from fully practicing their faith, most religious groups did not say their freedom of religion was being restricted and stated that the extraordinary measures were necessary for public health

The report says the US Embassy officials engaged with Muslim, Buddhist, Christian, and other religious representatives to discuss religious freedom, interreligious relations, and community engagement. “Topics included government tolerance of minority religious groups, the impact of COVID-19 restrictions on religious expression, and interfaith cooperation to address community challenges,” the report says.

The report says under its broader protections of freedom of conscience, the constitution provides for freedom of thought and religion, the right to change religion or belief, and the right to manifest and propagate religion or belief in worship, teaching, practice, and observance.
It says the constitution’s provision of rights also prohibits discrimination based on creed.

The constitution permits the government to restrict these rights in the interest of protecting the rights of other persons, national defense, public safety, public order, public morality, or public health when the restrictions are deemed “reasonably justifiable in a democratic society.”   “The state of emergency imposed from March 2020 to September 2021 to prevent the spread of COVID-19, which capped the size of regular religious gatherings and meetings, was the first time the government ever exercised this provision,” the report says.

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