Nyangabwe Hospital superintendent, Dr. Japhta Masunge, last week marshaled his lieutenants and summoned stakeholders, among them private medical practitioners, Members of Parliament, councilors, the media and the business community to a sumptuous breakfast at Tati River Lodge in Francistown.
This was a new strategy in the hospital superintendent‘s personal mission to cleanse the beleaguered hospital of its soiled image and put an end to the negative publicity that it has been subjected to.
After being opened in pomp and celebration, Nyangabwe Hospital degenerated to become a source of shame for the people of Francistown, labouring under a barrage of negative publicity and bad naming.
It was then given names, such as the slaughter house, death trap, place of no return and human BMC. Stories abounded of how patients who were nowhere near death were admitted for routine treatment at the hospital, only to come out as corpses.
Members of the public, politicians and civil leaders alike went on record to bash the hospital, complaining about smelly overcrowded wards, negligence and unprofessional conduct of hospital staff and the long queues at the dispensary and the accident and emergency.
Last week, Dr. Masunge went on a damage control mission and rallied the support of the politicians, the media and the civic leaders to set the record straight and usher in glory days for the hospital. He told the attendants that the bad image that his hospital has attracted over the years was not because of any wrongdoing on the part of his members of staff but because his staff were victims of circumstance.
Dr. Masunge explained that government has a referral system that clearly spells out the stages through which a patient has to travel before reaching the highest medical institutions in the country, the referral hospitals. He explained that 95% of Batswana are within an 8km radius of a clinic or health post. He also explained that most patients in Botswana can be adequately managed at the clinics or the health posts which are the entry points of Botswana‘s health system. He went on to explain that patients in need of hospital care or those with complicated illnesses are then referred to primary or district hospitals, after which they will then be referred to referral hospital like Nyangabwe and Princess Marina if they are in need of specialist care.
Dr. Masunge explained that Nyangabwe finds itself a victim of people’s negligence and refusal to adhere to governments’ referral system as most patients who come to the hospital do not go through the subordinate institutions like the clinics and the primary or district hospitals. “While we are a referral facility that is meant to give specialist care to the very sick we find ourselves overburdened with the problem of non conformity to the referral system as most of our patients are self referrals who refuse to attend clinics and primary hospitals but rather choose to come directly to us,” he said.
Consequently, said Dr. Masunge, Nyangabwe hospital is forced to treat a lot of self referrals at the expense of more critical patients, which results in the underutilization of well equipped clinics in Francistown. This results in long queues at the accident and emergency areas, overcrowding of the wards, long waiting periods for bookings and shortage of drugs at the hospital. Dr. Masunge revealed that 65 % of the patients attended to at Nyangabwe hospital are self referrals who could have been adequately treated at local clinics and primary hospitals.
On a daily basis, Nyangabwe Hospital admits 110 patients, attends to 150 emergency visits, 250 outpatient visits and 200 IDCC visits. The hospital has 544 beds but has an occupancy rate of 110% which explains why some patients have to sleep on the floor. The hospital follows up 11000 patients on HIV treatment and treats 4500 deliveries and 5000 trauma cases annually. At the same time Nyangabwe Hospital has to grapple with a continuously increasing number of illegal immigrant deliveries, some of whom end up dumping their children and disappearing. On top of treating all these patients, said Dr. Masunge, Nyangabwe still has to treat referrals from as far as Mahalapye, Maun and Kasane.
However Dr. Masunge said that they have a problem of unnecessarily long waiting periods for operations because of limited theater space. It emerged that a lot of times, surgeons idle around waiting for theater space to be availed so that they can perform operations, and sometimes patients end up dying.
Masunge revealed that the hospital is currently undergoing upgrading and an additional surgical wing with more theaters and wards will ease waiting periods and congestion.
On the issue of shortage of drugs Dr. Masunge said that patients had to get drugs from the clinics where they sought medical attention.
“In the absence of such medication, he said, the nurse or pharmaceutical officer, not the patient, can come to get medication from us,” he said.