Officially, a directive from the Ministry of Health and Wellness that disqualifies some citizens for the government’s subsidized health care has been withdrawn. However, that has not deterred the Botswana Congress Party (BCP) from pressing ahead with a High Court case that is based on such directive.
In terms of the directive, which was packaged as a savingram by the ministry’s Permanent Secretary, Shenaz El-Halabi, “self-inflicted injuries” are removed from the government’s medical cover. Such injuries relate to drunk-driving, riding motorbikes without helmet, failure to use seat belts for self or children as passengers, participation in riots and mass gatherings involving violence leading to injury, lung cancer associated with tobacco and tobacco products, and attempted suicide related to alcohol or drug abuse. Outside officialdom, the policy has been shorthanded to “Let them die” – “A ba swe” in Setswana. Last month (two months after the official announcement), the ministry announced that it was withdrawing the policy. That is not good enough for the BCP which is suing the government over this policy.
Party president, Dumelang Saleshando, says that the status of the court case has not changed because the status of the policy is itself unclear. To buttress the latter point, he notes that when the ministry’s public relations officer spoke on various radio stations, “she was unclear on whether the policy had been cancelled or suspended.” Conversely, when he addressed health professionals in Selebi Phikwe, the Assistant Minister of Health and Wellness, Phillip Makgalemele, said that the government had decided to “withdraw” the policy in order to consult with members of the public.
Such consultation had not happened when the policy was introduced in March. Basically, this means that the “Let-them-die” policy will be reincarnated in some form at some point in the future. However, BCP still has a problem with the consultation.
“Our concern is not whether the public was consulted but that the policy is unconstitutional because it doesn’t respect basic human rights,” Saleshando says.
He adds that the consultation itself is problematic because it could yield a response that offends human rights covenant. By way of example, he says that if there was to be consultation on whether rapists should be castrated, there is a likelihood that a majority of Batswana would approve of such heinous punishment when it is in conflict with democratic values.
While the party leadership has not met Ministry officials, Saleshando says that the party has been monitoring the latter’s public comments and are thus up to speed on the latest developments. He adds that El-Halabi’s recent appearance before the parliamentary Public Accounts Committee obviates need for such engagement because, testifying under oath, she said all that needed to be said on the issue.
One of the most uncomfortable moments during her testimony would have been when a BCP MP, Dithapelo Keorapetse, got her to reveal the source of the policy. In his 2016 state-of-the-nation address, President Ian Khama announced that “self-inflicted harm injuries will be paid for by patients who have been irresponsible with their lives.” El-Halabi revealed that the directive she issued was initiated through another from the cabinet. There is no question about which cabinet member initiated this policy.
The haphazard manner in which the “Let-them-die” policy is being implemented clearly shows that it was never subjected to the usual public policy processes.