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Health horror tales

12 April 2013
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What a letdown! The report of the Presidential Commission of Inquiry into the Ministry of Health has largely failed to live up to expectations.

 

It did not really reveal anything that everyone did not already know.

The whole tone of the report fails to convey the very real crisis we face and the fact that we are dealing with a major national calamity.

It deals with the problems it has identified in the ministry as merely bureaucratic hiccups that Government needs to rectify with minor tinkering here and there.

It does not ring the alarm bells loudly enough about the gross mismanagement that exists from top to bottom in the country’s health system, or communicate the need for drastic and urgent action.

Above all, it fails to hold the people responsible for the wretched state of the country’s health sector directly accountable and apportion blame.

The level of mismanagement in the health system has reached monumental proportions, and a commission inquiry that fails to hold the culprits accountable seems a complete waste of time and money, as well as rather pointless.

The Health Professions Council of Namibia (HPCNA) quite rightly condemned the commission’s report for failing to give hope to the people of the country by punishing anyone.

The heads of those guilty of incompetence and those responsible for needless deaths, misuse of money and outright corruption in the health sector should roll.

It should have called for severe disciplinary action and even criminal charges against doctors and nurses guilty of gross negligence and malpractice.

However, based on the commission’s report it seems unlikely that Government will bring any of the culprits to book and instead we can expect business as usual.

The litany of problems in the country’s hospitals and clinics mentioned in the commission’s report make one despair for the future of healthcare in this country.

Bureaucratic lethargy and a lack of accountability, ethics and professionalism is only the tip of the iceberg. Then come a host of problems such as a shortage of medical personnel, lack of essential equipment and difficulties in filling vacant posts.

Furthermore, the commission, identified lack of clinical and general leadership, a poor attitude among health workers – especially nurses – as well as insufficient and unbalanced resource allocation.

There is an inadequate supply or total absence of essential life-support equipment in the country’s health facilities, despite the country spending millions of Namibian dollars to acquire them.

The country does not have enough trained midwives, good enough health facilities, adequate equipment or sufficient family planning services to ensure maternal and child health

Furthermore, doctors at district hospitals lack the skill to use basic medical equipment such as ultrasound machines.

The fact that we perhaps have the most surly, rude and uncaring nurses in the entire world comes as no surprise to anyone.

However, to cap it all, the commission now makes it officials that many of them often come to work drunk.

Doctors are not much better, and neglect State patients in favour of cashing in on the financial rewards of treating lucrative private patients.

The commission’s finding that it is common practice for professional midwives to physically slap patients in the labour ward during delivery because they feel the patients are uncooperative makes the hairs stand on the back of one’s neck.

Minister of Health Richard Kamwi has valiantly tried to rationalise the horrendous state of his ministry and absolve himself of any blame.

He blames a lack of financial resources and at the same time uses his role as only the political head of the ministry as an excuse. The argument about inadequate resources has some validity because even the World Health Organisation (WHO) has cited the underfunding of health in Namibia as a concern.

While the argument about poor funding of healthcare in Namibia is legitimate, the fact remains that with better management we could have used the limited resources we have so much better.

However, whichever way you slice and dice this, neither he, Permanent Secretary Andrew Ndishishi nor Ndishishi’s predecessor Kahijoro Kahuure can evade responsibility. The buck has to stop somewhere, and in this case, the buck stops with the top leadership of the ministry. It is a fundamental principle of management that when an organisation fails, it fails because of poor leadership. Kamwi refused to accept responsibility for his ministry wasting millions of dollars on specialised medical equipment that it has never even used, and that the commission suspects officials only purchased because the suppliers paid them kickbacks.

For Kamwi to claim that he does not involve himself in procurement and was therefore unaware of the purchases is inexcusable.

He is the one that goes to parliament to motivate the budget for his ministry. The fact that he says he has no interest in what people do with the money afterward constitutes gross dereliction of duty.

If he did not know about the purchase of the equipment, he certainly should have known.

One should not personalise the issue, and we are not trying to suggest that either Minister Kamwi, or the permanent secretaries that have served under him, do not mean well or that they are incapable people.

We are merely saying that maybe they are not the right people, in the right jobs at the right time.

Minister Kamwi and the two permanent secretaries he has worked with might have performed perfectly well at any other ministry, and at any other time.

However, the problems the Ministry of Health faces are so intractable that perhaps the time has come for Minister Kamwi and his permanent secretary to admit that they are not the right people for the job.

Above all, maybe the time has come for President Hifikepunye Pohamba to recognise this also now.

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