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TB Situation in Botswana

Dr Boima
HEALTH ESSUES


Red Flag Symptoms to take note of

Cough (with or without blood)
Fever
Night sweats
Weight loss

It is no secret that Botswana is one of the top countries in the world with high Tuberculosis (TB) incidence, despite TB being both preventable and curable. This is partly because of the high HIV prevalence and other factors that help in fuelling the infection.

Currently the TB notification rate is at about 414 per 100,000 people in Botswana. Fortunately, Botswana continues to enjoy the global support from both international Governments and NGO partners in fighting the TB (and HIV) co-pandemics.


Locally, Ministry of Health through the Botswana National TB Programme (BNTP) is dedicated in directing collaborative efforts of fighting TB (and HIV) hence reducing their morbidity and mortality. BNTP is in keep with both national policies and targets and WHO standards;

TB/HIV Policy Framework

guides the integration of TB/HIV treatment

Vision 2016

Emphasises the desire to have a healthy nation by the year 2016 and beyond

Practicing Direct Observation Therapy (DOT)

Most effective for TB treatment as per WHO guidelines

United Nations Millennium Development goals

Botswana was among 147 UN member states that committed to pursuing the MDGs by 2015, among them Goal 6: ‘Combating HIV/AIDS, Malaria and other Diseases including TB’. A tremendous progress has been made so far

Challenges in addressing the fight against TB

Botswana has high HIV prevalence rate which is the main driver of the TB pandemic (About 63% of people diagnosed with TB are co-infected with HIV) which is why efforts are being channelled towards integrating the two conditions in the fight.


Naturally, detection of TB in people living with HIV is difficult (low immune system may not allow HIV patients to be able to mount TB symptoms and signs).

Poor Infection Control – in our health facilities and other community places.


Stigma – the nature of the infection or the misconceptions surrounding the infection (especially in our African communities) play a big role in making people reluctant to get screened for TB, even in cases where people have clear symptoms and signs of TB.


Illiteracy – Inadequate information on TB, HIV and AIDS and preventative measures in Botswana especially at the rural/far-to reach areas (compared to the Western world) continues to make our communities vulnerable to getting infected by TB.


High defaulting Rates and Poor Contact tracing- Batswana are a very mobile population with people having at least three places where they reside seasonally (Home village, city, moraka, masimo), which makes it difficult for health care workers to make thorough follow up on the patients or their contacts.


Drug-drug interactions – Medications for HIV and TB taken at the same time may lower the efficacy of each other or increase the toxicity levels of the drugs in the body.


Drug Resistant TB – Adherence to treatment remains the highest challenge for the country when dealing with TB matters. A combination of reasons, others mentioned above encourages this. Poor adherence almost always leads to the development of drug resistant TB which is very difficult, expensive and long to treat. About 100 new cases of Drug resistant TB are recorded every year in Botswana.

What to do at individual level

There is no doubt that Botswana as a country, is enjoying all the international support it can get (both financial and otherwise) and is trying by all means to keep up with good international standards when dealing with issues of TB.

What is still lacking is commitment from the grassroots, where TB is mainly rampant. Individuals still do not understand the implication of one contracting TB or spreading it, as a major contribution towards the national pandemic. It does not end with that individual! What about their family? Work colleagues? People they travel with on public transport?

TB is a public health concern. So apart from worrying about oneself when it gets to screening for TB, individuals should not be selfish and think about the next person. Failure to honour TB treatment and preventative measures (like wearing masks) can land one in prison (involuntary incarceration) in order to save the public.

Employers should understand this, Bus drivers, teachers at school and all other people in power that may act towards hindering access to health care. We should ‘Doctor’ our family members and encourage them to seek medical help when we can clearly see they are not well. This is not to be used to mock but rather to help that individual and the people around them.

For help email agboima@yahoo.com

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WeekendLife

The King’s journal 

23rd November 2021
Kgafela Kgafela II

This book is a true-life story of an African King based in South Africa. The Last Frontier is a resistance stand by Bakgatla Ba Kgafela tribe and its line of Kings from 1885 against a dark force called ‘western democracy’ that is insidiously destroying lives, peoples, nations and threatens to wipe away whole civilizations in Africa.

The story flows through four important episodes of history, beginning in about 1885 when Bechuanaland Protectorate was formed. This section briefly reveals interactions between Kgosi Linchwe 1 and the British Colonial Government, leading to the establishment of Bakgatla Reserve by Proclamations of 1899 – 1904.

The second episode deals with Kgosi Molefi’s interaction with the British Colonial Government in the period of 1929-36. The third episode records Kgosi Linchwe II’s interactions with the British Colonial Government and black elites of Bechuanaland. It covers the period of 1964-66, leading to Botswana’s independence. Kgosi Linchwe ii resisted the unlawful expropriation of his country (Bakgatla Reserve) by Sir Seretse Kgama’s government of 1966 to no avail. He wrote letters of objection (December 1965) to Her Majesty the Queen of England, which are reproduced in this book.

The fourth episode covers the period between Kgafela Kgafela II’s crowning as King of Bakgatla in 2008 to 2021. It is a drama of the author’s resistance to the present-day Botswana Government, a continuation of Bakgatla Kings’ objection against losing Bakgatla country to the Kgama dynasty assisted by the British Government since 1885. The story is told with reference to authentic letters, documents, and Court records generated during the period of 1885-2019. There is plenty of education in history, law, and politics contained in The Last Frontier for everyone to learn something and enjoy.   

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WeekendLife

Gospel concerts make a comeback

16th November 2021
Bishop Benjamin Dube

Hailed for being the prime gospel concert after the Covid-19 pandemic had put events to a halt, Golden Relic, in conjunction with Sweet Brands, recently unveiled the Arise and Worship Concert, Botswana. The show marks the return of worshippers and fans to enjoy music and worship together after what seemed like “cooler box” events were taking over the entertainment scene. 

The concert to be held on December 11th 2021, at the Molapo Showcase, has a packed lineup with the Headlining acts being Bishop Benjamin Dube, Lebo Sekgobela from South Africa and Botswana’s very own Obakeng Sengwaketse. More international acts from Nigeria and Ghana are also expected to grace the event. The show organizers have invested an effort in diversifying the lineup with live performances. 

The promoter of the Arise and Worship Concert, David “DVD” Abram revealed in an overview of the event that; “We have lost a lot of loved ones this year, and when that happens, one’s spirit goes down, and we need a light to ground us once more, to heal our souls. Therefore, the two main purposes of this event are to do the work of God and, secondly, to make sure that we nurture and develop talent in Botswana. With challenges that come up with events of such magnitude, the team and I have been committed to seeking guidance from God through having night prayers.” 

Abram added that as promoters, they usually have a bias towards already established artists, thus neglecting the upcoming ones and wanting to change that. “We approached the Melody Gospel TV Show since we aim at nurturing new talent and agreed on having one of the winners as a headliner for the event to allow them to share the stage with gospel giants so that they are exposed to the industry. This resulted in securing the Second Winner of the Melody Gospel TV show; Thabiso Mafoko as a local headlining act.”

The concert also aims at celebrating a Motswana. Multi-Award Winner; with the most recent title; BOMU Best Traditional Gospel under his belt, also best known for his soulful voice and heartfelt lyrics, Obakeng Sengwaketse enthusiastically said, “I want to thank the organizers of the Arise and Worship concert, it means a lot to me after recently winning two awards that are currently the highlight of my career.

I regard this as a great revival because the Covid-19 pandemic has muffled events such as this. I am looking forward to sharing the stage with the great Bishop Benjamin Dube, Lebo Sekgobela and more artists from Nigeria and Ghana. Sengwaketsi urged Batswana to come and witness the greatness of the Lord as their lives will never be the same.”

Tickets are selling like fat cakes with VVIP tickets having only five tickets remaining; the VVIP tickets include rounder access backstage to all the performing artists. The event will also comprise a seated Gold Circle Ticket, which accounts for 50% of revellers to allow for easier enforcement of COVID-19 protocols and avoid a potential stampede.

In a bid to entice merrymakers to buy tickets, the promoters have come up with a layby strategy and buying tickets on an instalment basis for the attendees to be able to buy their tickets since the COVID-19 Pandemic has left many Batswana in financial ruin but having the interest to attend the event.

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WeekendLife

Fame vs Mental health

9th November 2021
Lizibo

One can only imagine what is like being in the public eye. It is not a walk in the park; and not as easy as people might think it is because of the pressure from the public. Celebrities or influencers are perceived to be perfect, perfect bodies, perfect families, perfect parents, financially stable, healthy, and always smiling and patient with everyone – Is this for real?

However, when people’s expectations of celebrities are not met, the same celebrities are often victimized, body shamed, or blamed, fairly or unfairly. As a result of them not having a personal life, they are often scrutinized in all aspects of their lives; their lives are aired for the public to see and judge. Celebrities are often extra careful about everything that they do, they have to go an extra mile as compared to how ordinary people live their lives.

To understanding this experiences by public figures, this reporter made a case study of Mr Lizibo Gran Mabutho, the firstborn in his family with only one sibling, his younger brother. Lizibo describes himself as a simple Kalanga guy who was chosen by music and did not choose music.

He said being raised by his mother and grandmother, he grew up surrounded by music from birth. Lizibo said his grandmother was a religious person who held church services at their house in Zwenshambe, “for me singing was from Monday to Sunday. I was not like any ordinary child who only sang at church on Sundays or sometimes in school assembly, for me it was a daily thing. My mother was also a talented dancer in our village that is what I mean when I say I did not choose music, but music chose me.”

Lizibo said though he grew up surrounded by music, it was hard for his parents to accept the path he has chosen to be a musician. Lizibo said he had to prove to his parents that music was his passion and that it could pay the bills like any other profession. He said eventually they saw his passion for music and supported him.

Lizibo said being exposed to music from a tender age made him venture into the music career from a tender age. He said he was part of the Kgalemang Tumediso Motsete (KTM) choir, Lizibo said being in the public eye for the longest time has taught him that he is living for the people and that he does not have a life. He said the very society that is watching him has so much expectation for him and that means he has to conduct himself in a good manner because people are looking up to him.

Lizibo said he understands the saying that great power comes with great responsibility, “when people see me, they see a role model. I realize and understand that people are and have been modelling me even when I was not aware of it, I know of six mothers who have named their sons after me because they felt that I inspire them somehow.”

He said he has accepted his fate that he will never have a normal life because people are looking unto him. He said he is grateful to be in the public on a positive note by bringing hope to the people because he has always wanted to be part of people’s solutions and not their problems.

He said, “people should understand that our careers are our calling. One needs to be spiritually connected to their calling as an artist. The most rewarding part about being in the public for me is not about payment but about being the solution to someone’s problem.”

Lizibo said the greatest challenge that he has ever faced about being in the public eye has been the issue of trust, not able to know which friends are genuine and which ones are not. He said as a way of avoiding fake friends he has always kept his four close friends who have been there for him through thick and thin. Lizibo said being close to his family has also helped him as they have been his strength when things were not going well for him, “most of the time people say we change when we taste fame. That is not necessarily true because people are the ones who changed when we became famous. People always want something from us, nothing is ever genuine with people and that is why I chose to keep my circle very small.”

Lizibo said as much as he travels a lot because of the nature of his work because it is naturally demanding, he said he always ensures that he creates time for his family. He said that at home he is Lizibo who is sent to do errands, he is Lizibo the son, not a celebrity.

He said there is a lot of pressure that comes with being in the spotlight, “the public puts so much pressure on us mostly about the material lifestyle they portray us to have. We are often compared with South African celebrities, but people fail to understand that we are two different countries. Most people fell into the trap and are living above their means resulting in them living in debt. I often tell youngsters not to fall into that trap of being tempted to live life above their means.”

The advice Lizibo gave to upcoming celebrities was that they should know that being in the public is not about them, but it is about the people. He said, “one of my mentors once asked me if I make music about myself or the people. He said I need to make music for the people because it is my responsibility to feed them with what they need, he said they might not even be able to know that they have a need but that I need to identify that need and meet it. Our responsibility is to serve people what they need, our music is to feed people’s hunger. My music is about love, I feed people love.”

Lizibo said it is important for celebrities to seek counselling and take care of their mental health, he said he has been investing in his mental health for years because he understands the importance of mental health especially when one is in the public.

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