Poverty and the health of the poor

Richard Moleofe | Friday June 12, 2015 16:47

Dying for Growth, a voluminous read that tackles global inequality and the health of the poor, the reader would get to understand his background much better. His project with others is not just an academic exercise, but rather they have a clear and specific objective to deal a heavy blow on poverty and all that comes with it.

Did you know that the poor have a shorter life expectancy than the rich? This means you are more likely to die younger than your age mate who enjoys a better life in a higher social class. Low income earners have a higher chance of dying from several everyday consumer products such as water and food. The reason why the rich are now accustomed to drinking bottled spring or still water is for the very fact that they are avoiding infections that are very much likely to come through our municipal supply system.

Around the world, hospitals have to contend with food poisoning issues on a daily basis and it is the poor that they are treating. The poor will often buy food that fits their pocket and the issues of safety are usually not in their priority list. Provided with buffet, the poor would make sure that they eat everything that comes on the menu and even go for a second helping. This culture of the poor makes them very vulnerable.

The poor would in this case eat stale food surrounded by mould, carcases of animals that have died from unknown causes. Because I grew up in an era when throwing away food was not an option, I have often become a victim of food poisoning while I was in the exercise of saving leftover food from going to waste.

Millions of people around the world still go to bed hungry not because our planet does not have enough food to feed its inhabitants. The reason is, this hunger and malnutrition comes as a result of sever existing inequalities. The gap between the rich and the poor keeps growing and it is evident that the void will continue to increase and that hurts the health of the poor.

Have you ever stopped to ponder on where the rich access medical services when they are sick? It is not your everyday hospital like Princess Marina where you would find the rich and those in control of the means of production queuing up with the rest of us. Public hospitals were never meant for our rulers and their friends who finance them. It is for you!

I have always argued that road planners will never come to understand our needs as public transport users unless and until they acquire the experience of using this means of mobility. In my own town Mogoditshane, there are areas where bus stops are as far apart as half a kilometre in a heavily built up area. In the process of making up the road networks, no consultations were made. As a result of this the community has to live with this lifetime inconvenience.

Coming back to the issue of health, Botswana’s health care system needs to be revamped because it is currently in splinters. The reason why our health system is in such state of disrepair is because those in power have alternatives towards medical health care. For instance, there has never been a single cabinet minister, Member of Parliament, permanent secretary of director who has been hospitalised at our public medical centres.

They prefer the upmarket convenience that is provided by the private hospitals. In 1995 when Major General Moeng Pheto was still Deputy Commander at BDF, he amazed many of us when he chose to be hospitalised at a private ward in Princess Marina after he exhibited signs of food poisoning. He shocked many of us because we knew he could afford better medical services elsewhere.

The key words here are “private” and “public”. The rich use public money to provide themselves with access to private medical centres. This is done through unwarranted salary increases that are skewed to benefit only those at the top of the pyramid. For instance, for many years in this country there has been something referred to as across the board salary increase. This unfair system has been criticised by the labour movement. Such increases only serve to improve the lives and health of the rich.

The state of our public hospitals is really disheartening at the moment. It is amazing that government has invested so much in infrastructure development while on the other hand they have totally neglected manpower requirements for the very facilities they have put in place. For instance, The Scottish Livingstone Hospital in Molepolole boasts of one of the best facilities in this part of the world. In fact it is arguably a world class facility. After gracing the hospital inside you would certainly regret the application of the words I have used to describe it.

Jim Yong Kim (current World Bank president) in his book “Dying for Growth” chose to use life examples in order to bring to life the plight of the poor. Many of his examples are from the African continent and I would not hesitate to use our own examples in Botswana to highlight the plight of the poor in relation to their health.

Mrs Ntshimo Matilda Ranku who hails from Gabane was recommended for a minor eye surgery at Princess Marina in June 2010. Understanding the length of waiting lists in our public facilities, she was booked for April 2011.

When the appointed time came, the doctor who had to perform this procedure was on leave and could not find a replacement because of shortage of medical staff and particularly specialists. The following year in April she was told that her operation would now be performed at the Scottish Livingstone Hospital and she had to await the relocation of the Eye Clinic to Molepolole which has taken three years to complete. Finally, the Chinese medical team is coming to do the long awaited procedure on her eyes after waiting for five full years.

Her husband, Albert Otukile Nnonodi Ranku was not so lucky. He died at Princess Marina this year after being tossed from pillar to post while battling with oesophageal cancer which was treatable at the initial stages.

He could not receive sufficient health care in a hospital that is critically understaffed and he finally succumbed to this ailment. He died in a room full of cockroaches, something you would not experience in the private sector.

The health of the poor in this country is severely compromised. Certainly if this Gabane couple had medical aid insurance, they would have long received proper medical attention and Mr Ranku would still be alive as a cancer survivor. His condition was allowed to deteriorate because of the long and grinding process of government referral system.

Surely our health system has become so commercialised and market-oriented. In the private sector, it is the profits that count. In these private facilities patients are referred to as clients because doctors see a lot of commercial value in their patronage.

Privatisation of the health care system in Botswana will continue to hurt the poor unless government matches it with an equal investment. For a rich government like ours, the two health systems of public and private health care could run parallel while benefiting all social classes on either side of the economic scale.

At the moment, the government is basically tripping on herself if she continues to modestly invest in infrastructure while neglecting other aspects in the medical sector which are equipment and personnel.

For our small population, we could find ourselves as a medical service centre for many countries in this part of the world because so many of them have not surpassed our investment in the medical infrastructure.

*Richard Moleofe is a Retired Military

Officer (Distinguished Service Medal)