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Diarrhoea Outbreak Alert!!!

DR BOIMA
HEALTH ISSUES

Diarrhoea is the second leading cause of death in children below the age of 5 across the world as stated by World Health Organisation (WHO). Approximately Eight Hundred Thousand (800,000) children below the age of 5 succumb to this very preventable disease every year.

The public is thus notified that we are having such an outbreak in the country currently. Ministry of Health and Wellness has through its Minister, Dr Alfred Madigele released a press statement, confirming the 1 776 cases that have been reported nation-wide, saying that was the highest number recorded in the last five years for this time of the year. This figure may in fact be more as some cases may go unreported especially those that are handled in private facilities with no reporting tools or those in very remote areas where access to a health care facility is an issue.
 

The mortality rate is now standing at six, recorded at various health facilities around the country. Dr Madigele has continued to say it was not yet clear as to what may have caused the outbreak and that tests were being conducted to find the cause. Though many people have been suspecting Rotavirus, he said the Rota virus had not been ruled out nor had it been confirmed yet.

The public is cautioned to stick to best health practices such as handwashing immediately after using the toilet and before touching food and boiling drinking water. The most important thing is also for parents to know how to approach this kind of cases at home to prevent death. Parents should be able to recognize a sick child that needs medical attention and most importantly what to do and what not to do when they have children with diarrhoea at home.

Care at home

Children with mild diarrhoea can be looked after at home. High Fluid Intake – The main treatment is to keep the child drinking lots of fluids as young babies and children can become dehydrated very easily. This is needed to replace fluid lost due to the diarrhoea (and vomiting). It is important for the fluids to be taken even if the diarrhoea seems to get worse as some parents have a tendency of withholding fluids when they think they worsen the symptoms (having more diarrhoea). Older children should be given one cup (150-200ml) of fluid for every episode of diarrhoea or big vomit
Continue feeding – For breastfeeding or bottle-feeding babies, it need not be stopped
Isolation – The child needs to be kept away from other children as much as possible until the diarrhoea has stopped
Handwashing – Parents should realize that their children are infectious, so they need to wash their hands well with soap and warm water, particularly before feeding and after changing nappies

When to see a Doctor

According to the Royal Children’s Hospital (Melbourne) protocol, the following should prompt the parents to ditch the home-based care and take their children to the hospital;
If the child has signs and symptoms of dehydration (not passing urine/no wet diapers, is pale and has lost weight, sunken eyes, cold hands and feet, crying without tears, not playing or is hard to wake up)
If the child is not eating/drinking and still has diarrhoea (and vomiting)
If the child has a lot of diarrhoea (8-10 watery motions, or 2 or 3 large motions per day) or diarrhoea has taken more than a week
If the child is vomiting frequently and seems unable to keep any fluids down
If the child has bad stomach pains/cramps and is irritable
If there is blood in the diarrhoea
If the vomit is green in colour
If the child has fever
Babies under 6 months
OR if a parent is worried for any other reason
Treatment

Efficient treatment resides in prompt rehydration through the administration of oral rehydration salts (ORS) or intravenous fluids (drip), depending of the severity of cases.
Zinc sulphate tablet forms part of the treatment too, and it should be taken for at least 10 days, even if the child’s condition improves.

Prevention

Wash your hands with soap — after using toilets and latrines, before preparing food and before eating
Make sure the food is well done or well cooked
Store foods properly (in an air-tight closed container and refrigerated)
Always have fresh or freshly prepared foods (not stored for more than 2 days in the fridge)
Rotavirus vaccine is available in developing countries, either on national vaccination schedule or privately (as is the case in Botswana)
Children need to be up to date with all their immunizations
Good sterilization techniques of bottles (with Milton or by putting in boiling water for a while) for babies who are bottle-fed
Always sterilize the water before giving it to a baby

What not to do

Do not take the baby to a traditional doctor when symptoms get worse as the baby may be misdiagnosed and conventional treatment be delayed (e.g. sunken fontanel’s due to dehydration can often be diagnosed as ‘phogwana’ and mistreated
Do not give traditional medicines to reduce the diarrhoea or vomiting. They do not work and in most cases are very harmful
Do not give sports drinks, undiluted lemonade, cordials, or fruit juices to the child. They are not good in rehydrating the baby and are full of sugar and may only make the symptoms worse
Do not restrict food or fluids because of the ongoing diarrhoea or vomiting. Studies have shown that there is no role or need as far as gastroenteritis is concerned in doing this
Dr. Boima is the Managing Director of The Medics Centre, Palapye

themedicscentre@gmail.com

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Economic Resurgence Options: Is Export-Led Growth Tenable For Botswana?

22nd September 2020

The world in which we live is a criminally unequal one. In his iconic 1945 allegorical novella,  Animal Farm, a satire on the facetiousness  of the then Soviet Empire’s crackbrained experiment with a command economy, the legendary George Orwell in my view hit the nail squarely on the head when he said all animals were equal but some animals were more equal than others.

That’s the never-ending dichotomy of the so-called First World and its polar opposite, the so-called Third World as Orwell’s cleverly-couched diatribe applies as much to the tread-of-the-mill laissez faire economics of our day as it did to Marxist-Leninist Russia a generation back.

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Victory is Won

22nd September 2020

Israelites take Canaan under General Joshua

Even as the Nation of Israeli braced to militarily take possession of the Promised Land, General, its top three senior citizens, namely Moses, Aaron, and Miriam, were not destined to share in this god-conferred bequest. All three died before the lottery was won.

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Finance Bills: What are they about?

22nd September 2020

Financial Reporting (Amendment) Bill, 2020 and Accountants (Amendment) Bill, 2020 were expeditiously passed by parliament on Thursday.

What are these two Bills really about?  The Bills are essentially about professional values that are applicable to auditors and accountants in their practice. The Bills seeks to basically enhance existing laws to ensure more uprightness, fairness, professional proficiency, due care, expertise and or professional technical standards.

The Financial Reporting Act, 2010 (FRA) establishes the Botswana Accountancy Oversight Authority (BAOA), as the country’s independent regulator of the accounting and auditing profession. BAOA is responsible for the oversight and registration of audit firms and certified auditors of public interest entities.

In the same vein, there is the Accountants Act, 2010 establishing the Botswana Institute of Chartered Accountants (BICA) which is responsible for the registration and regulation of the accounting and auditing profession. This consequently infers that some auditors have to register first with BICA as certified auditors, and also with BAOA as certified auditors of public bodies. So, the Bills sought to avert the duplication.

According to Minister Matsheka, the duplication of efforts in the regulation of auditors, which is done by both BICA and BAOA, creates a substantial gap on oversight of certified auditors in Botswana, as the two entities have different review procedures. He contends that the enforcement of sanctions becomes problematic and, thus, leads to offenders going Scot-Free, and audit quality standards also continue to plunge.

The Financial Reporting (Amendment) Bill, 2020, in the view of the Minister, brings the oversight and regulation of all auditors in Botswana under the jurisdiction of the Accountancy Oversight Authority and that Bringing all auditors within one roof, under the supervision of BAOA would therefore reinforce their oversight and significantly enhance accountability.

He also pointed that the Bill broadens the current mandate of the Authority by redefining public interest entities to include public bodies, defined as boards, tribunals, commissions, councils, committees, other body corporate or unincorporated established under any enactment.

This covers any company in which government has an equity shareholding. In order to enable the process of instituting fitting sanctions against violation of its provisions, the Bill clearly lays down acts and lapses that constitute professional misconduct.

This Bill further strengthens the sanctions for breach of the Act by public interest entities, officers, firms, and certified auditors. Reinforcing the law with respect to such sanctions will act as an effective deterrent for breach of the Act.

The Accountants Bill also strengthens the current mandate of the Institute by making it obligatory for those who provide accountancy services in Botswana to register with the Institute, and for all employers to hire accountants who are registered with the Institute.

The Minister reasons that in line with the spirit of citizen empowerment, this Bill proposes reservation of at least 50% of the Council membership for citizens. This, he says, is to empower citizens and ensure that citizenries play an active role in the affairs of the Institute, and ultimately in the development of the accounting profession in Botswana.

The Bills come at a point when Botswana’s financial sector is in a quagmire. The country has been blacklisted by the European Union. Its international rankings on Corruption Perception Index have slightly reduced.  According to recent reports by Afro Barometer survey, perceptions of corruption in the public service have soured and so is mistrust in public institutions.

Rating agencies, Standard Poor’s and Moody’s have downgraded Botswana, albeit slightly. The reasons are that there continues to be corruption, fiscal and revenue crimes such as money laundering and general unethical governance in the country. There are still loopholes in many laws despite the enactments and amendments of more than thirty laws in the last two years.

One of the most critical aspect of enhancing transparency and accountability and general good governance, is to have a strong auditing and accounting systems. Therefore, such professions must be properly regulated to ensure that public monies are protected against white color crime. It is well known that some audit firms are highly unprincipled.

They are responsible for tax avoidance and tax evasions of some major companies. Some are responsible for fraud that has been committed. They are more loyal to money paid by clients than to ethical professional standards. They shield clients against accountability. Some companies and parastatals have collapsed or have been ruined financially despite complementary reports by auditors.

In some cases, we have seen audit firms auditing parastatals several times to almost becoming resident auditors. This is bad practice which is undesirable. Some auditors who were appointed liquidators of big companies have committee heinous crimes of corruption, imprudent management, fraud and outright recklessness without serious consequences.

There is also a need to protect whistleblowers as they have been victimized for blowing the whistle on impropriety. In fact, in some cases, audit firms have exonerated culprits who are usually corrupt corporate executives.

The accounting and auditing professions have been dominated by foreigners for a very long time. Most major auditing firms used by state entities and big private sector companies are owned by foreigners. There has to be a deliberate plan to have Batswana in this profession.

While there are many Batswana who are accountants, less are chartered accountants. There must be deliberate steps to wrestle the profession from foreigners by making citizens to be chartered.  It is also important to strengthen the Auditor General. The office is created by the constitution.

The security of tenure is clearly secured in the constitution. However, this security of tenure was undermined by the appointing authority in many instances whereby the Auditor General was appointed on a short-term contract. The office is part of the civil service and is not independent at all.

The Auditor General is placed, in terms of scale, at Permanent Secretary level and is looked at as a peer by others who think they can’t be instructed by their equivalent to comply. Some have failed to submit books of accounts for audits, e.g. for special funds without fear or respect of the office. There is need to relook this office by making it more independent and place it higher than Permanent Secretaries.

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