The Assistant Minister in the Ministry of Health, Gaotlhaetse Matlhabaphiri, has revealed that Botswana’s health institutions are facing crippling manpower shortages. Matlhabaphiri said in parliament on Thursday that the MoH has 59 vacancies for medical doctors and 20 vacant posts for nurses. He was answering a question from Nkange Member of Parliament, Edwin Batshu, who had wanted to know the vacancy situation in MoH.
“The MoH is currently busy recruiting manpower. We are waiting for 4 medical doctors to report for duty. We have recommended 23 doctors for appointment from our recent external recruitment mission. Their offers are being processed. 52 candidates have been shortlisted for the remaining 32 medical doctor positions, and they will be interviewed in April 2010. Interviews for the 20 nurses’ posts will also be conducted in April 2010,” said Matlhabaphiri.
The Sbarana Mental Hospital in Lobatse also faces a shortage of psychiatric doctors. The shortage of doctors and nurses in Botswana’s medical institutions is exacerbated by a number of factors, among them deplorable working conditions and uncompetitive salaries.
Botswana health personnel have in the past revealed that the patient to nurse ratio is as high as 30:1 instead of the internationally accepted standard of 10: 1, such that any resignations would be drastic, and may result in deaths due to limited patient care.
After being sponsored by government to study medicine abroad, many Batswana opt to stay there and seek better paying employment in first world countries. Thousand of nurses have also deserted employment in Botswana and trekked to Europe, especially the United Kingdom, where the pay is much better.
The recently opened Bokamoso private hospital also poached a number of doctors and nurses from government health institutions.
For a long time, Botswana has depended on countries like Cuba and China to assist with medical personnel. The political situation in Zimbabwe also resulted in a number of medical personnel seeking employment in Botswana. But a recent initiative by the International Organization on Migration (IOM), which sought to repatriate Zimbabwean health professionals living in the diaspora, also reversed Botswana’s gains and left many of the country’s medical wards unmanned.
A recent study by Gloria Thupayagale-Tshweneagae, of the Department of Nursing Education at the University of Botswana, revealed that as of 2006 government employed about 7 747 nurses, with 5 533 under the Ministry of Health and about 2214 under the Ministry of Local Government. Between 1999 and 2005 about 232 nurses resigned from the public service, and about 18 deserted. In 2006 about 146 nurses resigned and 24 nurses retired.
The long running standoff between nurses and government, over the scarce skills allowance has immensely contributed to the mass resignation of nurses and doctors from the public service. Government introduced scarce skills allowances for doctors, dentists, pharmacists, physiotherapists, laboratory technicians and radiographers, but excluded nurses.
At the height of the acrimony, nurses downed their tools, refusing to perform non nursing duties until government accedes to their demands. They argued that outside of providing primary health care, they are also performing duties like prescribing drugs, consulting patients and collecting blood. Patients were left in limbo as primary health care clinics were paralyzed.
To date, government continues to depend on the goodwill of expatriate medical staff from among others Cuba and China. To complement the shortage of medical staff, government has also expedited the training of medical students at the University of Botswana and abroad, and the University of Science and Technology is also expected to provide relief.
But as things stand, the situation is slowly becoming drastic, with reports from around the country indicating that a number of clinic and hospital wards have been left unmanned due to mass resignations.