With multitudes of Batswana dying from the dreaded AIDS disease in the 1990s, Dr Kgosidialwa Frederick Mompati put his professional integrity to test by being the first medical doctor in the country to administer the HIV triple therapy on his patients following the Vancouver HIV/AIDS conference of 1996. At the time, some of his peers in the medical profession doubted the efficacy of the treatment
Dr Kgosidialwa Frederick Mompati can tell the story of Botswana and its fight against HIV/AIDS from the fear that chocked the country.
For years, the pioneering doctor was surrounded by peers who were so scared to put a foot wrong they stuck to the beaten path and patients who feared they would never make it alive.
His avowed passion is to save lives, and he does it with zeal. While he regards health care as partly business, he also reckons that the big part is the service rendered and the ability to save lives. And when Botswana faced its most extreme encounter with HIV/AIDS, the task of breaking away from the pack and unleashing the strongest punch against the disease could hardly have fallen to a clearer Christian thinker.
A devout Christian, Mompati, whose private medical practice has evolved over the years from a mere clinic to a two-star private medical hospital, cuts a humble disposition as he narrates his rise to medical stardom.
Mompati owns Tati River Clinics whose subsidiaries include Tati River Clinic, Riverside Hospital, TRC Pharmacy, Laboratory and the Kidney and Dialysis Unit. The Kidney and Dialysis Unit was recently opened by vice-president Mompati Merafhe and is the first private investment initiative of its kind in the country.
It is no wonder that Mompati was the first medical doctor in the country to administer the HIV triple therapy treatment following the Vancouver conference of 1996 at a time when doubts abounded among his medical peers whether the therapy worked.
Mompati acknowledges that administering the therapy at the time was a mammoth challenge in that even his peers in the medical profession were suspicious that he may be doing a wrong thing, and thereby endangering the lives of his patients.
“It was the biggest challenge of my life time. I was the first one to start it in Botswana. There were suspicions that I may be doing a wrong thing even from other medical practitioners and health care professionals. Others thought I was being unscrupulous. It only became most gratifying in 2002 when government decided to start it. I then felt elated and vindicated”, he said with a wry smile in his office.
In addition to piloting the triple therapy treatment in the country, he helped government in the formulation of the guidelines for HIV treatment as a member of the HIV Guidelines Committee. Although he was engaged on a consultancy basis on the project, he did not seek payment from the government for his services.
He said when he started administering the therapy there were only a handful of individuals who could afford it, including those that were on medical aid and the greatest challenge was that the patients came to him very sick and could only sustain themselves for six months despite the fact that once the therapy is started, it has to be a life time exercise.
“I was aware that they had to take treatment for life. We had to subsidise some patients with our meager resources and this stifled our growth. I was prayerful all the time. If I was not a Christian I would not have managed on my own. There were times when I was just helpless with patients failing to pay for my services. The encouragement of my wife who is also medical doctor came handy. The joy came when government started the therapy and we transferred a lot of those people who could not afford to pay. I had also been blamed for people who had defaulted. Some patients disappeared when they felt better. But it gave me solace that I had tried the best in the worst challenging situation”, said Mompati delightedly.
On how his clinic graduated to a hospital, Mompati pauses as if in prayer before heaping praise on Tati Nickel Mining Company (TNMC) to which he says he is greatly indebted because the growth was never anticipated.
“When I resigned from government I established a chronic disease management clinic in Francistown in July 1991. I had intended to run a small and manageable practice so that I could become a committed family man in addition to helping at the church and other charitable activities,” said Mompati amid a soft laughter.
However, that was not to be. He said patients started flooding his practice and it did him no good referring them to physicians especially for heart and chest related diseases.
In 2003 he was approached by Mr. Fredericks, TNMC general manager to help the mine with the management of its workforce because the mine did not have a hospital.
“While I thought about the request, a patient who was an employee of TNMC came and I helped him as best as I could. I told the patient that he needed to be hospitalized at Nyangabgwe Referral Hospital but he objected and opted to be transferred to Johannesburg in South Africa. By the help of God we got his condition stabilized and then we transferred him. I later went to complain to Fredericks because I didn’t have adequate facilities. He asked me how I wanted them to help. I told him I needed money to build a small admission unit,” said Mompati.
He said after the incident Fredericks assured him that TNMC would give him a loan with an interest rate of 7.5 percent to build the admission unit. However, before the loan was disbursed, Fredericks contract came to an end and it was only during Swanepoel’s tenure as GM at TNMC that the P4.6 million loan was released leading to the building of the hospital which currently has 15 beds although it is registered as a 22 bed hospital. The maternity wing which will house the remainder of the beds is still under construction.
Mompati does not stop thanking God and TNMC for its benevolent gesture although he acknowledges that he is struggling to repay the loan. “I am struggling to repay but their (TNMC) gesture is highly appreciated. Had it not been for their loan and support, we would not have grown to the current state. They have also said I can pay them in kind, Above all, I thank God because for me to run the hospital it by His divine grace and mercy including winning favours from First National and Stanbic banks as well as CEDA”, said Mompati.
Currently the hospital employs 85 people of whom 70 percent are locals. The staff compliment consists of 10 doctors of whom six are specialists including one outreach specialist who manages the recently opened Kidney and Dialysis Unit.
He said the hospital is in the process of employing a radiologist. The hospital currently runs a surgical, gynaecology, general practice, internal medicine, pharmacy, laboratory, X-Ray as well as Kidney and Dialysis Units.
On the challenges that his hospital is currently facing, Mompati said they are mostly financial. He said the majority of his patients’ bills are paid for by their medical aid schemes which have their own rules and at times accuse them of failure to complying with the rules.
“They operate within their rules and very often we become disadvantaged by not being paid for the services we have rendered, for example, if a patient comes for emergency or operation before informing them, we stand to lose that payment. This happens from time to time as an oversight on our part. Some patients come to us when they have exhausted their limits while others come for assistance when they have long ceased to be members of such medical aid schemes”, said Mompati.
He said other challenges include equipment that they use like gloves, needles, syringes, swabs, overshoes, theatrical hats and so forth that the medical aid schemes do not pay for while they are expensive for the hospital to buy.
The other challenge that Mompati points to is the grading of the hospitals which he says is disadvantaging them giving as an example that the rate that his hospital is paid is not the same for Gaborone Private Hospital and Bokamoso which are much bigger operations.
He illustrates that by the bed rates that they are paid which are lower than the bigger hospitals including lower high care tariffs despite the expensive high quality care they give to the patients.
The challenges notwithstanding, Mompati says what keeps him going is the quality of service that he gives to his patients who afterwards come back to thank them. “The driving force is that we feel we are doing the right thing”, he enthused.
He said his desire is that if Botswana’s economic condition improved, government should help them improve their infrastructure which is currently fragmented and scattered and making it difficult to manage.
Mompati decries that government assistance in the from of CEDA loans are very small as the loans are just enough to buy equipment and not for the construction of infrastructure that they need and as such has implored government to increase the limits especially for specific businesses like medical care which needs huge capital expenditure.
To that end he said he thinks it is important that government introduces cost sharing measures in order to improve the quality of medical care in the country.
Mompati was born at Tshweu ward in Serowe. He did his primary education at Simon Ratshosa Primary school from 1961 to 1968 before proceeding to Gaborone Secondary School for his junior and senior secondary education.
In 1973 he enrolled at the then University of Botswana, Lesotho and Swaziland for Bsc part one and transferred to Makerere University in Uganda to study medicine in 1975. Form 1975 to 1977 her studied basic medical sciences before transferring to University of Nairobi where he graduated as a medical doctor in 1980.
After that he came home and worked as an intern doctor at Princess Marina Hospital to 1983 before transferring to the Medical University of South Africa (Medaunsa) where he specialized in internal medicine. At Medunsa he also worked as a registrar and junior lecturer but due to the political unrest in that country, he transferred to Scotland where he joined the University of Edinburgh to do post graduate studies in internal medicine specializing in diagnosis and treatment of diseases and ultimately qualified as a physician and obtaining Membership of the Royal College of Physicians (MRCP) UK. He later became a fellow of the Royal College of Physicians of Edinburgh.. Mompati explained that the fellowship entailed award of excellence and good standing.
In 1987 he came to Botswana where he worked as a physician at Jubilee Hospital in Francistown and later Nyangabgwe Referral Hospital between 1988 and 1990.
He said it was during training that he developed interest in the management of heart diseases and went to Cardiff University in 1990 for pacemaker techniques with the hope of starting the same upon his return.
In 1991 he was promoted to head the Internal Medicine Unit at Princess Marina Hospital and one of his accomplishments included his appointment as President Quett Ketumile Masire’s personal physician.
“I felt greatly privileged and honoured to be personal physician of the Head of State. I did it for a short time (six months) and then resigned to start my own practice”, said Mompati adding that he decided to start his practice in Francistown because he had failed to relocate his family to Gaborone while at Princess Marina.
Although he specialized in human medicine, he said he had initially wanted to be a veterinary surgeon.