A stitch in time to save lives
Mbongeni Mguni | Wednesday September 3, 2025 10:24
The establishment of a P5 billion fund and emergency mechanisms to resolve the long-boiling crisis in the country’s public health sector, could not have come sooner.
The majority of the country’s population depends on the public healthcare system for ailments ranging from the common flu, to life-threatening conditions. In recent years, the system has been weighed down by serious shortages of medicines, material, staff and poor maintenance of facilities.
The time between diagnosis and treatment has grown wider over the years, with patients waiting months for elementary assessments such as X-rays, while disease management has become a literal life and death struggle for many.
The widening budget deficits in recent years have cramped government’s traditional role of being the primary healthcare provider for citizens, while mounting debts to the private sector have limited the ability to refer patients.
Botswana Doctors Union president, Dr Kefilwe Selema, points to an even more grievous consequence of the healthcare crisis, one that is naturally overlooked by other urgencies such as immediate diagnosis, treatment and care.
“Preventative programmes, community health care initiatives and even health promotion campaigns have been cancelled or scaled down,” he told Mmegi in a wide-ranging interview recently. “For instance, cervical cancer screenings where people used to go to out to villages, have been cut down. “This is because they cannot afford to primarily prevent the diseases, to go out there, teach people and help people with the knowledge. “So, in the end, people now come with advanced diseases because the work of primarily preventing them was not attended to.”
By the Union’s estimates, at least 83% of the population does not have medical aid and is dependent on the public healthcare system.
The government’s fiscal challenge has caused staffing shortages, while demoralisation amongst nurses and doctors exacerbates the situation, all to the detriment of citizens’ health.
Selema paints a scary picture of the situation.
“We have seen that the government has since frozen all forms of recruitment, not just for public health or for Ministry of Health or local government, but for everyone. “This has clearly affected everything and it has led now to severe understaffing, which means people who actually leave the job, are not even replaced on time. “This in turn means that means access to care for patients is being severely affected, and the rest of the few people who are there to do the bulk of the work, are being overworked.”
President Duma Boko’s declaration of a public health emergency essentially means that the presidency has taken over the responsibility to find solutions to the crisis.
In his address this week, Boko essentially addressed both the funding of the response and the mechanisms through which relief would be provided on an emergency basis and later, an ongoing, stable manner, to citizens.
The announcement of the initial procurement and distribution of emergency medicines and materials across the country was music to the ears of many citizens who have watched helplessly as clinics and hospitals fail to provide the most basic care such as cannulas and solutions.
Highlighting that part of the crisis was the cost of care due to rampant overpricing in procurement, the president promised streamlined procurement processes, transparent bidding and contract management to enhance efficiency and accountability. He also pledged to invest in capacity building for procurement personnel to improve negotiation skills, management and compliance with international standards.
Going into the future, Boko announced the establishment of a National Taskforce to make recommendations for “radical, world-class solutions to ensure that Botswana never finds herself in this position again”.
“This national task force commenced work on the 22nd August on a 24-hour shift to speed up preparatory work and it shall incorporate additional resources from government and or the private sector as may be required from time to time,” he said.
For Selema and other professionals on the frontline, the situation had reached breakpoint.
“We have seen where previously the Botswana Nurses Union went to the Kgatleng area and closed down a clinic because it had falling ceilings. “It was an occupational hazard to the nurses and even to the patient,” he told Mmegi.
The impact of the crisis from the patient’s point of view, has been about survival.
Galeemiswe Mosheti, a 42-year cab driver in Gaborone, says accessing his monthly chronic medication, has grown increasingly difficult. On those occasions when the medication is available, he has to wait for hours in long queues, which have swelled as government cuts back on referrals to the private sector.
“It’s a very difficult situation,” he said. “The queues have grown longer and medication is often not available. “When it’s there, you have to spend the whole day waiting and meanwhile your work suffers.”
The nation is waiting for the fruits of Boko’s direct intervention.
For his part, the president is appealing for patience and calm as the emergency response rolls out.
“It is your strength that has kept the nation calm in this storm. “Peace is strength. Patience is strength. “Your peace, patience and trust are being repaid a thousandfold and together we continue to build the Botswana we aspire to have.”