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.
There is a saying in South Africa which avers that, “the White man has no kin: his kin is money”. The saying rings very true considering what Mayer Amschel Rothschild – he of the planet’s wealthiest family – once said, that, “Permit me to issue and control the money of a nation, and I care not who makes its laws!”
To the white man, the dollar sign looms so large in his optics that it was precisely the reason he appropriated Africa towards the end of the 19th century. The idea was to develop his continent, Europe, at the same rate as he underdeveloped Africa. Yet he was driven as much by economic imperatives as by sheer greed and prejudice.
A “pagan” King violates the Jewish Temple by setting up an idol in the Holy of Holies
Why, General Atiku, has the Judean setting (present-day Israel/Palestine) being the focus of so much geopolitical fervour over the ages when it is so resource-poor and is not even that agriculturally fecund being a virtual desert? Why have all the superpowers of history locked horns over it since days immemorial?
Just a ‘teaser’: we are all complaining of the ‘hot weather’ and ‘heat’ – but think about it, is this a reminder / warning from the Almighty that if we find this weather ‘hot’ can you imagine what the ‘fires of hell’ will be like should we get there?
Let us take this as a reminder and a ‘warning’ that we should change our lifestyles so that we follow in the path of righteousness and that which our Lord has directed. Failing this we will face the ‘fire of hell’ which undoubtedly will be many times worse than what we are facing on this earth.
Because as humans we have been favoured and bestowed with the power of intellect thus we enjoy greatness over other creation, coupled with a greater responsibility. Should that responsibility be misused then only on the Day of Reckoning will he know we will live in joy or in grief forever.
Since the dawn of creation Allah has sent down thousands of messengers, dozens of Divine Books but only ONE universal Message to humanity. That message of Divine Revelation and guidance is clear, unambiguous and eternal:
Allah is One, He is Master and Creator of the universe and of mankind and to Him is due all worship and obedience.
He has sent humanity Divine Revelation and guidance through His Messengers and His Books.
As death is inevitable in this world, equally is our resurrection in the Hereafter where everyone will face the consequences of their belief, unbelief and conduct in this temporal world.
This is the basic message, teaching and belief of every religion and without doubt we will all be called to account for our lives in this world and the manner in which we conducted ourselves, will be rewarded thereafter, the consequences of which may be joy forever for some or grief forever for others.
“It is He [Allah] Who created Death and Life, that He may try which of you is best in deeds and He is Exalted in Might, Oft-Forgiving.” (Qur’an: 67: 2)
In Islam the teachings of the Qur’an and the Last and Final Prophet Muhammad (PBUH) give clear guidance to the believer on how to live a life in this world so as to achieve success in the Hereafter.
‘If any do wish for the transitory things of this life, We readily grant them, such things as We will, to such persons as We will…… those who wish for the things of the Hereafter and strive for them with all due striving, and have faith, they are the ones whose striving is acceptable to Allah’ (Qur’an 17: 18-19)
In this world when a person sets out on a journey towards our Maker (Allah), he finds two paths, one leading to God and the other path to different destinations. A sincere and faithful believer will always try to find the right path and to live by the Divine injunctions, laws and code that his religion lays down. This requires us to live in harmony with the will of the Creator, in harmony with our own selves, and with the needs of the rest of creation. Unfortunately we have a tendency at times to toy with Divine Law and to surrender it to the laws of man and in the process to translate and interpret them into what fits in with our lifestyle of today.
If we are to use the intellect and the freedom of choice bestowed to us by God Almighty and follow His guidance, we will then live consciously in a state of “submission’ to Him, thus we will be virtuous. On the other hand when we ignore our Creators injunctions we work against the natural order, we tend to create discord, injustice and evil – and we become one without guidance. Therefore it is the intellect and the freedom of choice given to us that we are fully responsible for whatever we do.
However, it would be foolish for us to think of ourselves as totally independent and self-sufficient. If a person thinks in this manner, we become proud and. We will be inclined to become ungrateful for the bounties that we enjoy – the air that we breathe and the food we eat to sustain us, the eyes and ears we use to perceive the world around us, the tongue and lips we use to express our needs, wants and our inner most feelings and emotions. And being ungrateful, we will be inclined to forget or to reject the truth of the existence of God Almighty.
Unfortunately, people have varying views with regards to what the most important characteristic of a person is: for some it is the colour of his skin; for others, it is his economic situation – whether he is wealthy or poor; others think it is his , social or political standing, whether he is ruler or ruled; for others it is his social standing as an aristocrat, middle or working class; yet for some is his birth place and the language he speaks or the tribe he belongs to, etc..
‘Do men think that they will be left alone on saying “We believe”, and they will not be tested? We tested those before them, and Allah will certainly those who are true and those who are false’. (Quran 29: 2-3)
In Islam, these have no significance rather they are merely taken as signs of the creative power of God to enable people to recognise one another. The Almighty declares “O Mankind! Indeed we have created you as male and female, and have placed you in nations and tribes that you may have mutual recognition. However, the most honourable of you, in the sight of Allah is the one who is most God-conscious” (Qur’an: 49: 13)
Hence, the most important characteristic of a person is whether he is conscious of his Creator, believes in Him and through that consciousness submits to Him at all times and in all circumstances.
According to the Islamic view man is created by Allah in a pure state, free from sin. He also created us with the capacity or power to do both good and evil. He gave us the freedom to choose between doing good or evil. The good and evil therefore is connected with mankind’s freedom of choice and responsibility for their actions. “Good” may be whatever is pleasing to Allah and therefore beneficial to us. Whereas “Bad/evil” may be whatever incurs the anger of God and is therefore harmful to man.
‘By the soul, and the proportion and order given to it; And its enlightenment as to its wrong and its right – truly he that succeeds that purifies it, and he fails that corrupts it….. (Quran 91: 7-10)
Therefore one of mankind’s main tasks is to keep away from and ward off evil. This is why Taqwa, piety and God consciousness is repeatedly mentioned in the Qur’an as the most important quality a person should develop in this regard. This means one must be conscious at all times not to over step the limits set by God. It works as a defence against evil and temptation by keeping a person within the boundaries of piety.