Ombudsman flags poor roads as Health access barrier
Tsaone Basimanebotlhe | Wednesday January 28, 2026 06:23
Despite road development being repeatedly prioritised in national development plans and budget allocations, the report notes that progress on the ground remains slow.
In particular, roads in the Okavango, Nata–Gweta and Kgalagadi regions have remained under repair for years, often marked as “under construction” with little to no visible advancement or completion, consequently delaying timely access to health services for affected communities.
“What this means in practice is that communities remain cut off by gravel roads riddled with potholes, eroded surfaces, and impassable terrain during rainy seasons. Ambulances travelling to referral hospitals often face prolonged and hazardous journeys, significantly delaying emergency response times and endangering patients in critical condition,” the report says.
It also states that the nurses interviewed following each facility inspection reported that they usually spend up to five days at Princess Marina Hospital (PMH) whilst awaiting medical care and attention for their patients in the Emergency Department, and for their subsequent admission to the ward.
Furthermore, it indicated that this inordinate delay contributes to increased costs to government resources, attracting subsistence allowance for nurses and ambulance drivers upon referrals.
The report also indicated that the cost of accommodation is approximately P1,000 per night at any guesthouse in Gaborone, for both the driver and the referring nurse, which translates to about P10,000 for two officers per referral. Moreover, the report said that at a rate of three to five referrals per day, that equates to P18 million annually in subsistence costs for one hospital that refers to PMH. “If the same calculation were applied across all hospitals referring to PMH, the total expenditure would be substantial, raising serious questions about the efficiency and sustainability of the current referral system.
“These prolonged delays translate into significant costs to the public purse and taxpayers’ money,” it reads.
It also indicated that facilities such as Gweta, Gumare, and Kasane primary hospitals, which refer patients to Nyangabgwe Hospital and Letsholathebe II Memorial Hospital, reported average waiting times of about six hours, rather than several days. However, the report reveals that this sharp contrast suggests that the high costs are not an inevitable feature of the referral system but rather a symptom of systemic delays and overcrowding at PMH’s Emergency Department.
Additionally, the report states that concerns were widely raised by the public (including on social media) about the length of time it took for ambulances to arrive at road traffic accident scenes or to transport patients from their homes to the hospital.
However, the report indicated that hospital management and the Health ministry clarified that government ambulances are primarily responsible for transferring inpatients between facilities, for example, from hospital A to a referral hospital for diagnostic procedures such as CT scans.
“The responsibility for responding to medical emergencies, whether at home or on the road, falls under Emergency Medical Services (EMS), which transports patients to the nearest hospital emergency department for immediate care,” it says.