There is a piece of communication circulating which is purported to be originating from the Ministry of Health and Wellness. Apparently it carries the signature of Shenaaz El-Halabi, who is the Permanent Secretary in the same Ministry.
The controversial savingram dated March 29th 2017 entitled “Removal from medical cover for self-inflicted harm” seeks to deny accident victims medical treatment if the accident is found to be associated with alcohol related activities. Patients with lung cancer suspected to be caused by smoking will also be denied medical treatment. Other conditions and injuries resulting from attempted suicide related to drug or alcohol abuse, riding a motorbike without helmet, failure to use seat belt, and participation in violent riots and mass gatherings are also included in this categorization.
A close scrutiny of the content of the guidelines clearly shows that such a circular could not have originated from any Department of Health in any country with a serious government. The signature of the Office of the President is quite evident. This is because it is a ferocious attack on everything that health in general and medical practice stands for. It is a guideline that must be ignored.
Under normal circumstances such a savingram will simply be dismissed as a joke. One would not expect any health professional with integrity to carry out such a directive. Part of the reason is that medical doctors in particular take a Hippocratic Oath to uphold high ethical standards. Anything else will be tantamount to malpractice which is punishable under existing laws.
Therefore health practitioners cannot implement a policy whose main aim is to provide selective health care and allow patients to suffer or die in front of doctors. Besides you don’t have to be a lawyer to come to the conclusion that such a policy is discriminatory and therefore unconstitutional. There are also other public health and medical legislations that will not allow such a policy to pass. Unfortunately these are trying times for Botswana. Nowadays anything is possible.
One reason why the health practitioners would and should defy the guidelines is because they are trained to appreciate the complexities of health behaviour of the populations they serve. They have long accepted that prevention is better than cure. Through sustained public health education the results can be realised, but there are no quick fixes as the draconian policy seeks to do.
The reality is that a sizeable proportion of the population will continue to smoke even if they are aware of the dangers of exposing themselves to conditions such as lung cancer and undesirable pregnancy outcomes. Many will continue to drink and drive with the full knowledge of the dangers associated with such behaviour. Others will continue to abuse alcohol not because they are not aware of the health consequences of such behaviour. Unfortunately there no short cuts to solving these problems.
Unlike many professionals, for health practitioners whatever they do is often a matter of life and death. Hence they heavily rely on evidence-based practice and international medical best practice. Determining the link between the cause and effect is a serious matter in health and bio-medical fields. Obviously what the government is introducing is not in conformity with international best practice. It is not informed by scientific evidence either. It was decided off the cuff by someone with very little or no background in health.
These guidelines are acts of an angry, frustrated, and desperate government that jumps on anything hoping to strike gold for political survival. It is another revelation that their previous knee-jack policies aimed at curbing abuse of alcohol such as levies and strict regulations have not produced satisfactory results. A serious government should have started with a comprehensive evaluation of existing policies before they rush into misguided and baseless interventions.
It is in this context that one can confidently predict that the policy will face aggressive resistance from all health professional bodies and associated labour unions. Given the fact that some of these organizations are semi-official the public may never get to appreciate the fears battles against the policy taking place behind closed doors. Those who lead the resistance are likely to adopt the strategy of engaging government constructively.
However, it must be pointed out that the history of constructive engagement rarely produces tangible results. We will be pleasantly surprised if it succeeds this time around. Constructive engagement came to prominence at the height of the liberation struggles in Southern Africa. At the time the United States of America under President Ronald Reagan had adopted the policy that was championed by Chester Croker the then Secretary for African Affairs. In the end it turned out to be a complete failure.
During the forceful and brutal relocation of residents of Central Kgalagadi Game Reserve (CKGR) there were some sections of the non-governmental organizations adopted a similar approach in their engagement with the government of Botswana and stakeholders. The strategy had disastrous consequences as the residents of CKGR were finally dragged kicking and screaming out of the place they called home for many centuries. Sensitizing and mobilizing public opinion to turn against a government policy is more effective than trying to appeal to the sense of a senseless government like the one we have in Botswana today. If anything the two can be complimentary.
Even if government was to decide to withdraw the guidelines on account of public outcry and fear of international embarrassment the mere fact that a democratically elected government can even thing about introducing this kind of policy goes to show the level to which this country has gone. To suggest that government has stooped very low is clearly an underestimation. The less we talk about the Minister of Health and Wellness the better because she comes across as someone who is clueless. She appears to be doing an excellent job as a fitness activist than a policy maker.
Government must be stopped on its tracks. Today it could be those who abuse drugs and alcohol, motorbike riders, those who attempted suicide or smokers. Tomorrow such a policy could be extended to people who contract HIV/AIDS or pregnant women experiencing difficult labour as a result of smoking. The policy could even be extended to cover people who suffer from preventable non-communicable diseases such as high blood pressure and diabetes. That must scare all of us.
In respect of the matter under discussion and many other issues of recent years it is clear that government of Botswana is beyond redemption. The voters of Tlokweng were correct in overwhelmingly voting for Umbrella for Democratic Change (UDC) and sending them packing in the recent bye election. Many more constituents should do the same in 2019 so that the ruling party does not only lose more parliamentary seats but the mandate to govern.
The Central Bank has by way of its Monetary Policy Statement informed us that the Botswana economy is likely to contract by 8.9 percent over the course of the year 2020.
The IMF paints an even gloomier picture – a shrinkage of the order of 9.6 percent. That translates to just under $2 billion hived off from the overall economic yield given our average GDP of roughly $18 billion a year. In Pula terms, this is about P23 billion less goods and services produced in the country and you and I have a good guess as to what such a sum can do in terms of job creation and sustainability, boosting tax revenue, succouring both recurrent and development expenditure, and on the whole keeping our teeny-weeny economy in relatively good nick.
Joseph’s and Judah’s family lines conjoin to produce lineal seed
Just to recap, General Atiku, the Israelites were not headed for uncharted territory. The Promised Land teemed with Canaanites, Hittites, Amorites, Perizzites, Hivites, and Jebusites. These nations were not simply going to cut and run when they saw columns of battle-ready Israelites approach: they were going to fight to the death.
Parliament has begun debates on three related Private Members Bills on the conditions of service of members of the Security Sector.
The Bills are Prisons (Amendment) Bill, 2019, Police (Amendment) Bill, 2019 and Botswana Defence Force (Amendment) Bill, 2019. The Bills seek to amend the three statutes so that officers are placed on full salaries when on interdictions or suspensions whilst facing disciplinary boards or courts of law.
In terms of the Public Service Act, 2008 which took effect in 2010, civil servants who are indicted are paid full salary and not a portion of their emolument. Section 35(3) of the Act specifically provides that “An employee’s salary shall not be withheld during the period of his or her suspension”.
However, when parliament reformed the public service law to allow civil servants to unionize, among other things, and extended the said protection of their salaries, the process was not completed. When the House conferred the benefit on civil servants, members of the disciplined forces were left out by not accordingly amending the laws regulating their employment.
The Bills stated above seeks to ask Parliament to also include members of the forces on the said benefit. It is unfair not to include soldiers or military officers, police officers and prison waders in the benefit. Paying an officer who is facing either external or internal charges full pay is in line with the notion of ei incumbit probation qui dicit, non qui negat or the presumption of innocence; that the burden of proof is on the one who declares, not on one who denies.
The officers facing charges, either internal disciplinary or criminal charges before the courts, must be presumed innocent until proven otherwise. Paying them a portion of their salary is penalty and therefore arbitrary. Punishment by way of loss of income or anything should come as a result of a finding on the guilt by a competent court of law, tribunal or disciplinary board.
What was the rationale behind this reform in 2008 when the Public Service Act was adopted? First it was the presumption of innocence until proven otherwise.
The presumption of innocence is the legal principle that one is considered “innocent until proven guilty”. In terms of the constitution and other laws of Botswana, the presumption of innocence is a legal right of the accused in a criminal trial, and it is an international human right under the UN’s Universal Declaration of Human Rights, Article 11.
Withholding a civil servant’s salary because they are accused of an internal disciplinary offense or a criminal offense in the courts of law, was seen as punishment before a decision by a tribunal, disciplinary board or a court of law actually finds someone culpable. Parliament in its wisdom decided that no one deserves this premature punishment.
Secondly, it was considered that people’s lives got destroyed by withholding of financial benefits during internal or judicial trials. Protection of wages is very important for any worker. Workers commit their salaries, they pay mortgages, car loans, insurances, schools fees for children and other things. When public servants were experiencing salary cuts because of interdictions, they lost their homes, cars and their children’s future.
They plummeted into instant destitution. People lost their livelihoods. Families crumbled. What was disheartening was that in many cases, these workers are ultimately exonerated by the courts or disciplinary tribunals. When they are cleared, the harm suffered is usually irreparable. Even if one is reimbursed all their dues, it is difficult to almost impossible to get one’s life back to normal.
There is a reasoning that members of the security sector should be held to very high standards of discipline and moral compass. This is true. However, other more senior public servants such as judges, permanent secretary to the President and ministers have faced suspensions, interdictions and or criminal charges in the courts but were placed on full salaries.
The yardstick against which security sector officers are held cannot be higher than the aforementioned public officials. It just wouldn’t make sense. They are in charge of the security and operate in a very sensitive area, but cannot in anyway be held to higher standards that prosecutors, magistrates, judges, ministers and even senior officials such as permanent secretaries.
Moreover, jail guards, police officers and soldiers, have unique harsh punishments which deter many of them from committing misdemeanors and serious crimes. So, the argument that if the suspension or interdiction with full pay is introduced it would open floodgates of lawlessness is illogical.
Security Sector members work in very difficult conditions. Sometimes this drives them into depression and other emotional conditions. The truth is that many seldom receive proper and adequate counseling or such related therapies. They see horrifying scenes whilst on duty. Jail guards double as hangmen/women.
Detectives attend to autopsies on cases they are dealing with. Traffic police officers are usually the first at accident scenes. Soldiers fight and kill poachers. In all these cases, their minds are troubled. They are human. These conditions also play a part in their behaviors. They are actually more deserving to be paid full salaries when they’re facing allegations of misconduct.
To withhold up to 50 percent of the police, prison workers and the military officers’ salaries during their interdiction or suspensions from work is punitive, insensitive and prejudicial as we do not do the same for other employees employed by the government.
The rest enjoy their full salaries when they are at home and it is for a good reason as no one should be made to suffer before being found blameworthy. The ruling party seems to have taken a position to negate the Bills and the collective opposition argue in the affirmative. The debate have just began and will continue next week Thursday, a day designated for Private Bills.