Friday, March 21, 2025

Botswana’s third world health care through the eyes of a polite first world medical student

For Laura Millage an American medical student on an exchange programme in Botswana, it is not what she said, but what she did not say that spoke volumes.

One of the biggest surprises about Botswana’s health care system for the  American junior in Microbiology and genetics with a minor in public health was the country’s manual medical records management.

The  Iowa State University Student who was on a Council on International Educational Exchange program in Botswana must have been shocked at how Botswana medical records management staff are overwhelmed with paper and manual processes. Educated under a digital record keeping system and aware of how technology can reduce the workload, expedite the process and be the catalyst to better care, Laura Millage perhaps for fear of sounding politically incorrect came across as biting her tongue. The only opinion she expressed about Botswana health care system was: “Being able to experience how a different country practices healthcare and to see how their healthcare system works was amazing. Of course it is not the same as the United States, but I really believe the country utilizes their resources as efficiently and effectively as possible. One of the biggest surprises was they do not use digital or electronic medical records. Everything is done on paper, and it is the patient’s responsibility to keep track of their records”, she said

This was just about all the opinion the exchange student who spent “ over 50 hours in four different local clinics both inside the city and in a nearby village observing a variety of medical professionals”, could muster about Botswana’s health care system. Besides a statement of fact that “additionally, our group and medical students from the university performed a community assessment and held a health expo in a rural village”, she did not say anything more about Botswana’s health care system.

According to her interview carried in the Iowa State University College of Agriculture and Life Sciences newsletter, Laura Millage “gained valuable knowledge during her eight weeks in Botswana as part of the Council on International Educational Exchange program, which is a partner to Iowa State University’s study abroad program.”  She says during her time at the University of Botswana, she “took public health classes where we learned about the healthcare system in Botswana, as well as experienced it in a clinical setting.  “Additionally, our group and medical students from the university performed a community assessment and held a health expo in a rural village.”

Curiously, more than half of the opinions she expressed in the interview about Botswana were polite bits outside the country’s health care system.

“I also had the chance to take a Setswana language class,” Millage is quoted saying. According to the Iowa State University College newsletter,

when Millage was not in a classroom or clinical setting, she was able to explore all that Botswana had to offer. Her favorite destination was located in Kasane where the group of students visited Victoria Falls and interacted with locals.

“The people that I interacted with while in Africa were some of the kindest and inclusive people I have ever met. I appreciate how they take their time with tasks and do not live life constantly racing against the clock,” Millage said.

She also had the opportunity “to experience the Gabronoe and Mokolodi game reserves, the Khama Rhino Sanctuary and Chobi National Park, and learn more about the country’s culture at the Bahurutshe Cultural Village.

“Overall, the experience was amazing and gave me the opportunity to learn about another part of the world and its people, health, medicine and science, but also more about myself,” she said.

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