Such is the call by the Botswana Doctors Union (BDU) for urgent reforms from the incoming Umbrella for Democratic Change-led (UDC) government concerning the Sir Ketumile Masire Teaching Hospital (SKMTH). The union emphasises that the hospital, which was intended to be a public teaching hospital for the University of Botswana (UB), should not be utilised as a private facility. Instead, it must fulfil its original purpose to benefit the public and support the training of medical professionals, the union suggested. Completed in 2014 at a cost of over P2 billion, SKMTH has remained largely unused, only becoming active during the COVID-19 pandemic. "The move to make SKMTH a private hospital was a deliberate self-serving from an elite few thereby diverging from its initial intended purpose when using public funds for the project," claims the union in a statement.
This underutilisation according to BDU president, Dr Kefilwe Selema, has left Princess Marina Hospital (PMH), the country's main referral health facility, overwhelmed and under-resourced. "The current situation of PMH is so bad that laboratory function is at a level of primary hospitals, radiology department which also houses UB radiology residency programme has no functional X-ray, CT scan, and no plan for MRI or any high order imaging diagnostic and treatment modalities,” Selema states. "Additionally, the Intensive Care Unit at PMH has only eight beds compared to the 45 to 90 beds available at SKMTH.” The BDU's statement underscores the broader impact on the healthcare system and the training of medical professionals. They state that the continuous denial of Batswana of their right to optimum health is an act of basic human rights violation and renders many families in poverty and depression due to avoidable high mortalities of breadwinners. The union further submits that medical litigation in Botswana has increased significantly, with claims now exceeding P1 billion to P2 billion annually. This rise, they say is attributed to the under-resourcing of PMH and Nyangabgwe referral hospitals, which suffer from shortages of medical equipment, human resources, and proper funding for maintenance services.
"The substandard services being provided contribute significantly to the end of life for most Batswana, a life that if SKMTH was made public and functional could be saved with ease," reads the statement.
The union calls on the new government to take several urgent actions to address these issues. These include making SKMTH a public teaching hospital, addressing the shortage of medical equipment and human resources, and lifting the ban on training medical and dental specialists. The BDU also urges the government to release underperforming accounting officers and appoint leaders committed to prioritising the health and well-being of Batswana over personal interests. "The trend by the University of Botswana to advertise programmes annually and not fulfil its mandate of accepting and fully administering those graduate programmes as advertised is not only shameful, fraudulent, and demeaning to our health fraternity. Botswana remains the only country in Southern Africa without a proper postgraduate training system in medicine,” the union states. The current system, they submit forces many doctors to spend four to five years abroad for specialist training, during which the government continues to pay their salaries. This situation, they say benefits the countries where the doctors train, rather than Botswana.
The BDU argues that localising all medical training programmes would prevent the loss of skilled human resources to other countries. "All that can be brought home through reinforcing and localising all programmes of study within a short period," the union notes. BDU also highlights the underutilisation of other health institutions in Botswana, reflecting a lack of prioritisation of health in a country once ravaged by the HIV/AIDS pandemic. "There is no doubt that SKMTH is possibly the best training facility site compared to PMH/NRH. We call for training of medical specialists and subspecialists to be urgently addressed and prioritised," the union states. The statement further calls for lifting the ban on training medical and dental specialists and allowing specialist doctors and nurses to pursue further studies. The BDU believes that increasing the number of specialised healthcare providers will enhance the standard of healthcare in Botswana, fostering research, innovation, technology, and manufacturing. "We call upon the ban on the training of medical and dental specialists to be lifted and for the Ministry of Health to allow specialist doctors and nurses to be sent for further studies," the statement reads. The union calls for all stakeholders to work together to ensure that Botswana's healthcare system remains healthy and sustainable. "Let us do our very best to jealously protect our health; physically and mentally," Selema urges.
