Government continues to play seek and hide over the problem of mass exodus of nurses and shortages of specialised health personnel, at most of the country’s medical health facilities in order to avoid loss of political scores.
Meanwhile, there is mounting evidence that the national health care system is increasingly going down the mud as nursing graduates and experienced nurses leave the system due to ‘unfriendly’ working conditions.
In spite of this, the Minister of Health, Lesego Motsumi, does not see a train smash coming and has denied the national health care system is reeling through a crisis.
She said, “The departure of staff as of nurses for alternative opportunities, whether abroad or elsewhere, is a normal phenomenon experienced by every organization.”
“It would therefore not be true to impute that the country’s health care system is threatened simply because some nurses are resigning their jobs,” Motsumi posited in an interview with the Sunday Standard.
Notwithstanding Motsumi denial, latest report of a study commissioned by Nurses Association of Botswana (NAB) points to a scary spiral, unfolding to the detriment of the nation’s vision of a healthy population by 2016.
The study, whose findings were presented at the 2009 International Council of Nursing (ICN)Quadrennial Congress, by NAB recently, states that, “As of 2006 approximately 7.4% of Nurses had migrated to developed countries.”
According to the report, that translated into about 600 nurses, which stands slightly above the Sub-Saharan average of migrated nurses.
That also, about equaled the number of foreign nurses employed by both private and public health facilities in Botswana.
In addition, 2009 figures indicate that at least about 612 of an estimated 7595 nursing workforce moved from Government into the Private sector which amounts to another 8% leaving the public health care system.
Destinations included Private Hospitals, Mines, Discipline Forces as well as University Clinic and Academic Sector.
Meanwhile Insurance Companies and Non Governmental Organizations (NGOs) dealing in HIV/AIDS issues had their fair share too.
To make matters worse, it was stated that a large majority of respondents among a sampled 5% of the total nursing workforce across the country have reportedly indicated an intention to migrate.
Key factors cited as responsible for pushing nurses out included need for self development, job satisfaction, increased risk of HIV infection as well as poor working conditions along with inconsiderate transfer and poor salaries.
President of NAB, Keabitsa Ramantele, said: “We have not stopped engaging government on the stated issues, and whilst consultation with our members also continues, we are optimistic that authorities will finally see things from our view”.
It is in that context that the annual general meeting of NAB set for 7 and 8 October 2009 in Lobatse is expected to debate the way forward.
Johanna Makhwade, chief nursing officer responsible for direction, management and coordination of nursing care practice at national level, indicated that in spite of the predicament nurses find themselves in, efforts to restore dignity of the nursing profession has become the joint concern of her office, NAB and the registrar of the nursing council.
“In this regard a new strategic plan intended to develop ward managers, matrons and supervisors on leadership skills has been started,” says Makhwade.
Although one of the core functions of her mandate is to rationalise the required skills against demand, in deploying nurses, Makhwade had difficulty trying to be diplomatic about the impact of nurses’ exodus on her office.
She says: “It affects my office in that we are inundated with complaints that nurses are neglecting patients or conducting themselves unprofessionally”.
Makhwade concedes that many a time it has come to their observation that such complaints sometimes emanate from failure to understand that nurses are trained to prioritize conditions according to their physiological effects or bearing on the patient, and the level of risk involved.
Consequently, for people looking at the condition of patients or their own situation with a lay person’s eye, it becomes easy to blame the nightingales despite the already problematic ratio of nurses against patients.
According to a 2007 Health Training Institution’s (HTI’s) survey covering 2001-2005, 52 percent of lecturers left HTI’s with 78 percent in possession of a master’s degree.
The African Governance Report II, 2008 commissioned by the United Nations Economic Commission for Africa (UNECA) has captioned the real state of Botswana’s health sector.
“The biggest problem facing health sector in Botswana is retention of staff due to unfavorable remuneration and poor working conditions,” states the report.