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Botswana struggles with one public high care facility

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Perhaps a common place by now, Sir Ketumile Masire Teaching Hospital (SKMTH), was chosen to be Botswana’s high care centre for Intensive Care (ICU) patients.

This has strained patients who live outside of Gaborone, and even cost them their lives enroute to touch the staff of coiled twin snakes.

Responding to a question in Parliament, Assistant Minister of Health and Wellness Sethomo Lelatisitswe, said nine people have died upon transportation to SKMTH. “Six of those patients were from Gaborone to SKMTH, and three were from outside Gaborone,” the assistant minister said. Thirty four died on arrival, that is those who just arrived at the accident and emergency lobby where patients are welcomed and assessed to see which wards they can be taken to. As a result, 34 patients died. 33 of those patients were also from Gaborone and one was from our major city of Francistown.

This was revealed in a parliament session last month where Lelatisitswe had indicated the country only has 115 ICU beds, with only 28 doctors trained to work in the critical care unit.

The ministry of health and Wellness (MOHW) is trying to convert their high care units in Masunga, Serowe and Mmadinare Hospitals so that they can be able to admit patients who need high care.

Lelatisitswe said the ministry has already started to try to respond by trying to fix the high dependency unit, or ICU. “The biggest challenge we have is shortage of Critical Care Nurses for patients on Intensive Care Unit,” he said. Explaining the staff shortage, the assistant minister said, “prior to this unexpected crisis, they were enough.”

In other words, the numbers that the country had of people trained for ICU were enough to handle the Covid-19 situation. “So, this is a global crisis, that is why there is a shortage of staff across the entire world because the world did not expect this kind of shock therefore could not train their people in surplus because the critical care unit is established looking at the population,” Lelatisitswe said. The health ministry believed what Botswana had on a normal day was enough for the nation.

Despite its unique life savings, SKMTH is merely functioning to its full capacity. When the Covid-19 pandemic began, it was not already operational and was lacking in terms of equipment.

The number of infected people has increased and is overwhelming the staff and the health care facilities the country has. At the time of his answer, all ICU beds in Botswana were 100% occupied. Because of this, the ministry decided to increase the capacity at SKMTH. “We should remember that this hospital is a 450 -bed hospital but we are using around 120 somewhere there. So we have now made a decision to try to expand and increase more beds so that we can admit these patients who can find themselves outside hospital,” said the assistant minister.

Botswana’s healthcare sector is undoubtedly incapacitated, with health facilities even prioritising the fight against Covid-19 over other services. As a way of preparing for the rising numbers of positive cases, Scottish Livingstone Hospital in Molepolole has scaled down its services. General outpatient will be closed and the doctors’ consultations will be extended to local clinics. Only specialist services will continue at the hospital with doctors’ appointments. The only services that will remain will be referred screening services for cancer of the cervix, high risk clinic services and paediatric services.

The government itself has said it is over burdened by the active cases of Covid-19. With the increased number of COVID-19 active cases reported last week from 16 139 to 17 528, government says this number is immensely burdening the country’s health system.

The Presidential Covid-19 Task Force’s Scientific Advisor, Dr Mogomotsi Matshaba, has said it is upon individuals and the nation at large to strictly follow health protocols and regulations to ease the burden on government and health facilities.

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