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Friday, 19 April 2024

Botswana Health system: A cry for change

Opinions

DR KARL BRIGHT
HEALTH PRACTITIONER


Botswana has over the years delighted itself in being ranked higher than most regional/sub Saharan countries in areas like peace, economy and freedom among others but not the least. At some point we were ranked number 1 for being the “most globalized nation” in Africa. A country dubbed as a middle-income country, with a population of 2 million and a life expectancy of just 54. Sadly enough, all these accolades do not reflect any good about our health care services in this nation and for that we are really concerned.


The health care system in Botswana is in big trouble and this does not reflect the pride we “always” have for our country, nor does it reflect the “good” praises we seldom get from other countries for our “good” governance. If this was a joke at some point, it is not now. Botswana needs to wake up to its dwindling health care services/system. What we see on paper should reflect what is on the ground. Sadly currently it is not.


To better understand this problem one needs to have seen better health care systems to be in a better platform to reflect on our own. All of our Drs have trained outside the country (except for the recent small group that graduated from UB School of Medicine) including the Australian health care system, European countries, Americas, Asia and other African countries. We have seen major differences but most of them are really basic that we as nation should put in place.


We are losing young lives in hospitals in Botswana comparatively, not because we don’t know what to do but because of the scarce simple basic medical supplies that a standard referral hospital should have at all times and the lack of medical Doctors. I know this is a hard pill to swallow, and most of those who claim to be concerned about this don’t talk about it, at least to a level where change would be certain.


We love our country and we will engage in all good manner of discussions with our government to see inevitable change. I recently visited home on a holiday during which my nephew aged 2, accidentally sustained a laceration on the forehead that needed suturing. To my shock or surprise, on arrival to Princess Marina, there was only 1 doctor and 2 nurses working in the emergency department of the biggest public referral hospital in Botswana.

I was told that there was no suturing material and no dressing materials and that it had been like that for weeks and that there was no one to help me as the DR was “busy” with the patients who came hours before we did. To make matters worse, there were many patients and no one to help me as the DR was “busy” with the patients who came hours before we did. To make matters worse, there were many patients in cubicles not attended to, some waiting in mattresses so sick on the waiting area, in wheel chairs, both old and young, some sleeping on benches not attended to. What a sad picture.


In addition, this was on a morning shift were on a normal basis you would expect many doctors to be on the shift. This made me sad and wondered why Botswana; a country with only a population of 2 million people would not have a very good health care system or at least a standard at par with other regional countries. Where is our health care system going? Things are getting worse rather than better.


Workers are frustrated and we are losing more doctors. The sad thig is we “always talk” about this and nothing improves. This is a time where we need to reflect on our own health care system and ask ourselves why we can’t compete with neighbouring countries like south Africa, Namibia, Zambia, Zimbabwe and other first world countries where our own Drs seem to be running to. What is causing our hospitals to be in a terrible situation like this? I recently asked some Drs in Marina and others who are in clinics around Gaborone where they themselves go for medical help when they are unwell or have an emergency.

The answer was surprising and just made me feel we are really far from getting it right. One of them said” we go to private hospitals”. I further asked… “Does that mean then you do not value your own services you provide and the hospitals you work in to help yourselves?? “What about the many who cannot afford private health care…?” …They answered, “Go thata monna….”. This is really sad and even the country’s top officials would agree that we are in trouble and need to fix our health system ASAP. We need to retain Drs in Botswana. Not only our own local citizen Drs but we need to have international well-accredited good doctors who will stay in Botswana and help this system to flourish.


Most of our problems I realize are not on the ground per se like most people think but a mixture of both management in our hospitals and ministry level flaws and lack of accountability in hospitals and local clinics. Botswana should retain majority of their Local Drs in major referral centres and reserve rural or district placements to outsiders as many of the first world countries do. But I do agree this is a complex task that would need proper execution to balance out things.


Perhaps those Drs sent to rural areas could receive more incentives to service these areas. You cannot run major hospitals with outsiders and send/transfer your own Drs who could be making a huge impact or difference in these Dr shortage places to rural areas. We need to wake up Batswana.

I want to go to a hospital and have the highest confidence that I would get the help I need and better off, take my children and relatives to our hospitals and know that they will come back well and alive. Unfortunately at the moment things are not encouraging. I am saying this with a sad heart because Botswana health care system is terrible comparatively but could be better.
I urge our leaders to take this seriously and work quicker lest we find ourselves with a “non-existent” health care system.

The time for talking is over and we need to seriously act now and put in place new policies that will see our health care system improve. There is no Motswana Dr who likes working oversees or wants to live overseas forever. They all want to work and live in Botswana-for home is where the heart is-and they want to help improve the health of Batswana.


Unfortunately many factors including political, financial and working conditions have forced them to be where they are today. Not because they are disloyal but because our own Botswana cannot provide a great platform for these Drs to practice their good quality medicine they have patiently studied for many years outside the country.

All of us Drs who received grants/loans for medical education are eternally grateful to the government and the public of Botswana for their monetary funds. To see Drs resigning and leaving the country is sad and a waste of millions of Pula’s and this should stop.“ This is like buying a Rolls Royce and not servicing it or not get concerned when someone steals it” one Dr Macheng at Princess Marina said.


And let us all be honest, most of these factors are the comparative low salaries, lack of specialists in Botswana or the enticement of and retaining these specialists from partner medical schools or other countries, the lack of medications and or the turn over time to stock other important supplies in our major hospitals. It’s a really saddening scenario. We have over the years been talking about these issues but its like talking to deaf ears.


Batswana need and demand to see a good health care system that would afford to treat even our president, ministers, ambassadors and other high officials etc. Not to fly them out of the country when trouble kicks in for “better health care”. That I do not take pride in and I call on our government to scrutinize this and for them to put new and life changing measures they have never engrossed before to change this saddening scenario. Better health should be for all i.e. for both the man and woman working or not, rich or poor, medical aid or no medical aid and it should all together be affordable.


I believe in Botswana and I believe we can improve things. I pray that my cry for the health care system of this country to improve would be heard. I call on the government and all Drs of this country, currently working in the public sector, private sector, retired, resigned, working in neighbouring countries or working overseas to go back to the drawing boards and work together to pen down new policies that would take this nation on a different yet better direction regarding our health care system.


I also call on the medical body of this country BMA-Botswana medical association (if existent at all) to wake up and represent the interests of Drs in this country and to seriously advocate, represent and fight the battles of Drs with utmost zeal and zest and with respect. They need to fervently liaise with the governing body to discuss issues and matters regarding health care in Botswana and to make sure that matters are resolved and changed within a timely manner for sole purpose of improving our people’s health.

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Opinions

IEC Disrespects Batswana: A Critical Analysis

10th November 2023

The Independent Electoral Commission (IEC) has recently faced significant criticism for its handling of the voter registration exercise. In this prose I aim to shed light on the various instances where the IEC has demonstrated a lack of respect towards the citizens of Botswana, leading to a loss of credibility. By examining the postponements of the registration exercise and the IEC’s failure to communicate effectively, it becomes evident that the institution has disregarded its core mandate and the importance of its role in ensuring fair and transparent elections.

Incompetence or Disrespect?

One possible explanation for the IEC’s behavior is sheer incompetence. It is alarming to consider that the leadership of such a critical institution may lack the understanding of the importance of their mandate. The failure to communicate the reasons for the postponements in a timely manner raises questions about their ability to handle their responsibilities effectively. Furthermore, if the issue lies with government processes, it calls into question whether the IEC has the courage to stand up to the country’s leadership.

Another possibility is that the IEC lacks respect for its core clients, the voters of Botswana. Respect for stakeholders is crucial in building trust, and clear communication is a key component of this. The IEC’s failure to communicate accurate and complete information, despite having access to it, has fueled speculation and mistrust. Additionally, the IEC’s disregard for engaging with political parties, such as the Umbrella for Democratic Change (UDC), further highlights this disrespect. By ignoring the UDC’s request to observe the registration process, the IEC demonstrates a lack of regard for its partners in the electoral exercise.

Rebuilding Trust and Credibility:

While allegations of political interference and security services involvement cannot be ignored, the IEC has a greater responsibility to ensure its own credibility. The institution did manage to refute claims by the DISS Director that the IEC database had been compromised, which is a positive step towards rebuilding trust. However, this remains a small glimmer of hope in the midst of the IEC’s overall disregard for the citizens of Botswana.

To regain the trust of Batswana, the IEC must prioritize respect for its stakeholders. Clear and timely communication is essential in this process. By engaging with political parties and addressing their concerns, the IEC can demonstrate a commitment to transparency and fairness. It is crucial for the IEC to recognize that its credibility is directly linked to the trust it garners from the voters.

Conclusion:

The IEC’s recent actions have raised serious concerns about its credibility and respect for the citizens of Botswana. Whether due to incompetence or a lack of respect for stakeholders, the IEC’s failure to communicate effectively and handle its responsibilities has damaged its reputation. To regain trust and maintain relevance, the IEC must prioritize clear and timely communication, engage with political parties, and demonstrate a commitment to transparency and fairness. Only by respecting the voters of Botswana can the IEC fulfill its crucial role in ensuring free and fair elections.

 

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Opinions

Fuelling Change: The Evolving Dynamics of the Oil and Gas Industry

4th April 2023

The Oil and Gas industry has undergone several significant developments and changes over the last few years. Understanding these developments and trends is crucial towards better appreciating how to navigate the engagement in this space, whether directly in the energy space or in associated value chain roles such as financing.

Here, we explore some of the most notable global events and trends and the potential impact or bearing they have on the local and global market.

Governments and companies around the world have been increasingly focused on transitioning towards renewable energy sources such as solar and wind power. This shift is motivated by concerns about climate change and the need to reduce greenhouse gas emissions. Africa, including Botswana, is part of these discussions, as we work to collectively ensure a greener and more sustainable future. Indeed, this is now a greater priority the world over. It aligns closely with the increase in Environmental, Social, and Governance (ESG) investing being observed. ESG investing has become increasingly popular, and many investors are now looking for companies that are focused on sustainability and reducing their carbon footprint. This trend could have significant implications for the oil and fuel industry, which is often viewed as environmentally unsustainable. Relatedly and equally key are the evolving government policies. Government policies and regulations related to the Oil and Gas industry are likely to continue evolving with discussions including incentives for renewable energy and potentially imposing stricter regulations on emissions.

The COVID-19 pandemic has also played a strong role. Over the last two years, the pandemic had a profound impact on the Oil and Gas industry (and fuel generally), leading to a significant drop in demand as travel and economic activity slowed down. As a result, oil prices plummeted, with crude oil prices briefly turning negative in April 2020. Most economies have now vaccinated their populations and are in recovery mode, and with the recovery of the economies, there has been recovery of oil prices; however, the pace and sustainability of recovery continues to be dependent on factors such as emergence of new variants of the virus.

This period, which saw increased digital transformation on the whole, also saw accelerated and increased investment in technology. The Oil and Gas industry is expected to continue investing in new digital technologies to increase efficiency and reduce costs. This also means a necessary understanding and subsequent action to address the impacts from the rise of electric vehicles. The growing popularity of electric vehicles is expected to reduce demand for traditional gasoline-powered cars. This has, in turn, had an impact on the demand for oil.

Last but not least, geopolitical tensions have played a tremendous role. Geopolitical tensions between major oil-producing countries can and has impacted the supply of oil and fuel. Ongoing tensions in the Middle East and between the US and Russia could have an impact on global oil prices further, and we must be mindful of this.

On the home front in Botswana, all these discussions are relevant and the subject of discussion in many corporate and even public sector boardrooms. Stanbic Bank Botswana continues to take a lead in supporting the Oil and Gas industry in its current state and as it evolves and navigates these dynamics. This is through providing financing to support Oil and Gas companies’ operations, including investments in new technologies. The Bank offers risk management services to help oil and gas companies to manage risks associated with price fluctuations, supply chain disruptions and regulatory changes. This includes offering hedging products and providing advice on risk management strategies.

Advisory and support for sustainability initiatives that the industry undertakes is also key to ensuring that, as companies navigate complex market conditions, they are more empowered to make informed business decisions. It is important to work with Oil and Gas companies to develop and implement sustainability strategies, such as reducing emissions and increasing the use of renewable energy. This is key to how partners such as Stanbic Bank work to support the sector.

Last but not least, Stanbic Bank stands firmly in support of Botswana’s drive in the development of the sector with the view to attain better fuel security and reduce dependence risk on imported fuel. This is crucial towards ensuring a stronger, stabler market, and a core aspect to how we can play a role in helping drive Botswana’s growth.  Continued understanding, learning, and sustainable action are what will help ensure the Oil and Gas sector is supported towards positive, sustainable and impactful growth in a manner that brings social, environmental and economic benefit.

Loago Tshomane is Manager, Client Coverage, Corporate and Investment Banking (CIB), Stanbic Bank Botswana

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Opinions

Brands are important

27th March 2023

So, the conclusion is brands are important. I start by concluding because one hopes this is a foregone conclusion given the furore that erupts over a botched brand. If a fast food chef bungles a food order, there’d be possibly some isolated complaint thrown. However, if the same company’s marketing expert or agency cooks up a tasteless brand there is a country-wide outcry. Why?  Perhaps this is because brands affect us more deeply than we care to understand or admit. The fact that the uproar might be equal parts of schadenfreude, black twitter-esque criticism and, disappointment does not take away from the decibel of concern raised.

A good place to start our understanding of a brand is naturally by defining what a brand is. Marty Neumier, the genius who authored The Brand Gap, offers this instructive definition – “A brand is a person’s gut feel about a product or service”. In other words, a brand is not what the company says it is. It is what the people feel it is. It is the sum total of what it means to them. Brands are perceptions. So, brands are defined by individuals not companies. But brands are owned by companies not individuals. Brands are crafted in privacy but consumed publicly. Brands are communal. Granted, you say. But that doesn’t still explain why everybody and their pet dog feel entitled to jump in feet first into a brand slug-fest armed with a hot opinion. True. But consider the following truism.

 

Brands are living. They act as milestones in our past. They are signposts of our identity. Beacons of our triumphs. Indexes of our consumption. Most importantly, they have invaded our very words and world view. Try going for just 24 hours without mentioning a single brand name. Quite difficult, right? Because they live among us they have become one of us. And we have therefore built ‘brand bonds’ with them. For example, iPhone owners gather here. You love your iPhone. It goes everywhere. You turn to it in moments of joy and when we need a quick mood boost. Notice how that ‘relationship’ started with desire as you longingly gazed upon it in a glossy brochure. That quickly progressed to asking other people what they thought about it. Followed by the zero moment of truth were you committed and voted your approval through a purchase. Does that sound like a romantic relationship timeline. You bet it does. Because it is. When we conduct brand workshops we run the Brand Loyalty ™ exercise wherein we test people’s loyalty to their favourite brand(s). The results are always quite intriguing. Most people are willing to pay a 40% premium over the standard price for ‘their’ brand. They simply won’t easily ‘breakup’ with it. Doing so can cause brand ‘heart ache’. There is strong brand elasticity for loved brands.

 

Now that we know brands are communal and endeared, then companies armed with this knowledge, must exercise caution and practise reverence when approaching the subject of rebranding. It’s fragile. The question marketers ought to ask themselves before gleefully jumping into the hot rebranding cauldron is – Do we go for an Evolution (partial rebrand) or a Revolution(full rebrand)? An evolution is incremental. It introduces small but significant changes or additions to the existing visual brand. Here, think of the subtle changes you’ve seen in financial or FMCG brands over the decades. Evolution allows you to redirect the brand without alienating its horde of faithful followers. As humans we love the familiar and certain. Change scares us. Especially if we’ve not been privy to the important but probably blinkered ‘strategy sessions’ ongoing behind the scenes. Revolutions are often messy. They are often hard reset about-turns aiming for a total new look and ‘feel’.

 

 

Hard rebranding is risky business. History is littered with the agony of brands large and small who felt the heat of public disfavour. In January 2009, PepsiCo rebranded the Tropicana. When the newly designed package hit the shelves, consumers were not having it. The New York Times reports that ‘some of the commenting described the new packaging as ‘ugly’ ‘stupid’. They wanted their old one back that showed a ripe orange with a straw in it. Sales dipped 20%. PepsiCo reverted to the old logo and packaging within a month. In 2006 Mastercard had to backtrack away from it’s new logo after public criticism, as did Leeds United, and the clothing brand Gap. AdAge magazine reports that critics most common sentiment about the Gap logo was that it looked like something a child had created using a clip-art gallery. Botswana is no different. University of Botswana had to retreat into the comfort of the known and accepted heritage strong brand.  Sir Ketumile Masire Teaching Hospital was badgered with complaints till it ‘adjusted’ its logo.

 

 

So if the landscape of rebranding is so treacherous then whey take the risk? Companies need to soberly assess they need for a rebrand. According to the fellows at Ignyte Branding a rebrand is ignited by the following admissions :

Our brand name no longer reflects our company’s vision.
We’re embarrassed to hand out our business cards.

Our competitive advantage is vague or poorly articulated.
Our brand has lost focus and become too complex to understand. Our business model or strategy has changed.
Our business has outgrown its current brand.
We’re undergoing or recently underwent a merger or acquisition. Our business has moved or expanded its geographic reach.
We need to disassociate our brand from a negative image.
We’re struggling to raise our prices and increase our profit margins. We want to expand our influence and connect to new audiences. We’re not attracting top talent for the positions we need to fill. All the above are good reasons to rebrand.

The downside to this debacle is that companies genuinely needing to rebrand might be hesitant or delay it altogether. The silver lining I guess is that marketing often mocked for its charlatans, is briefly transformed from being the Archilles heel into Thanos’ glove in an instant.

So what does a company need to do to safely navigate the rebranding terrain? Companies need to interrogate their brand purpose thoroughly. Not what they think they stand for but what they authentically represent when seen through the lens of their team members. In our Brand Workshop we use a number of tools to tease out the compelling brand truth. This section always draws amusing insights. Unfailingly, the top management (CEO & CFO)always has a vastly different picture of their brand to the rest of their ExCo and middle management, as do they to the customer-facing officer. We have only come across one company that had good internal alignment. Needless to say that brand is doing superbly well.

There is need a for brand strategies to guide the brand. One observes that most brands ‘make a plan’ as they go along. Little or no deliberate position on Brand audit, Customer research, Brand positioning and purpose, Architecture, Messaging, Naming, Tagline, Brand Training and may more. A brand strategy distils why your business exists beyond making money – its ‘why’. It defines what makes your brand what it is, what differentiates it from the competition and how you want your customers to perceive it. Lacking a brand strategy disadvantages the company in that it appears soul-less and lacking in personality. Naturally, people do not like to hang around humans with nothing to say. A brand strategy understands the value proposition. People don’t buy nails for the nails sake. They buy nails to hammer into the wall to hang pictures of their loved ones. People don’t buy make up because of its several hues and shades. Make up is self-expression. Understanding this arms a brand with an iron clad clad strategy on the brand battlefield.

But perhaps you’ve done the important research and strategy work. It’s still possible to bungle the final look and feel.  A few years ago one large brand had an extensive strategy done. Hopes were high for a top tier brand reveal. The eventual proposed brand was lack-lustre. I distinctly remember, being tasked as local agency to ‘land’ the brand and we outright refused. We could see this was a disaster of epic proportions begging to happen. The brand consultants were summoned to revise the logo. After a several tweaks and compromises the brand landed. It currently exists as one of the country’s largest brands. Getting the logo and visual look right is important. But how does one know if they are on the right path? Using the simile of a brand being a person – The answer is how do you know your outfit is right? It must serve a function, be the right fit and cut, it must be coordinated and lastly it must say something about you. So it is possible to bath in a luxurious bath gel, apply exotic lotion, be facebeat and still somehow wear a faux pas outfit. Avoid that.

Another suggestion is to do the obvious. Pre-test the logo and its look and feel on a cross section of your existing and prospective audience. There are tools to do this. Their feedback can save you money, time and pain. Additionally one must do another obvious check – use Google Image to verify the visual outcome and plain Google search to verify the name. These are so obvious they are hopefully for gone conclusions. But for the brands that have gone ahead without them, I hope you have not concluded your brand journeys as there is a world of opportunity waiting to be unlocked with the right brand strategy key.

Cliff Mada is Head of ArmourGetOn Brand Consultancy, based in Gaborone and Cape Town.

cliff@armourgeton.com

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