Friday 14 May 2021
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Namibia’s healthcare crisis

As the health sector teeters on the verge of collapse, Health Minister Bernard Haufiku has revealed the grim state of public health facilities, with a vast majority of clinics and hospitals all operating under dire circumstances.
Although he maintains the sector can still be salvaged, he did however concede that the healthcare system is very distressed.
Dismissing claims that the health system was on the verge of total collapse, Haufiku said poor communication, staff shortages amid growing patient numbers and poor leadership is to blame for the current mess prevailing in the ministry.
Other reasons include a lack of equipment and medical provisions, maladministration and a heavy workload.
Also, graduates from several health professions face frustration in gaining registration to start practising because the Health Professions Councils of Namibia that is supposed to register them has been without a council do so since March 2018.
This means, students who are supposed to work in the healthcare system for their clinical practice, cannot do so. Similarly, medical graduates from institutions abroad in South Africa, Zambia, India, Tanzania, Cuba and Russia and other countries cannot enter the Namibian health facilities without the blessings of the council. The affected students and graduates represent professionals from the Allied Health Professions Council, Nursing Council, Medical and Dental Council, Social Work and Psychology Council, and the Pharmacy Council.
Comprehensive regional reports compiled by Haufiku after his visits to the regions paints a bleak picture, especially when it comes to infrastructure.

Eenhana hospital
During his visit on 3 May 2018, Haufiku reported that the most worrying thing at the facility was the operation theatre at Eenhana District Hospital.
He says the theatre has not been used for operations for the past five years.
“This is in utter opposition to the directive I gave three years ago that Eenhana Operating Theatre must be opened and must remain operational and that all efforts must be made to ensure this happens.
This means, practically getting doctors at Eenhana District Hospital who are competent in both Anesthesia and Surgery especially emergency surgical procedures such as caesarean sections and ectopic sand appendixes. It appears my directive had fallen on deaf ears,” he lamented.
He added: “I always wanted Eenhana District Hospital’s theatre to be open in order to make it a referral Hospital for Okongo and surrounding clinics in the Ohangwena East Region.
This would cut, by as much as 50%, the distance patient’s travel from Okongo to Onandjokwe and Oshakati. Unfortunately this has up to now, not happened.
As a result  patients still travel very long distances on unsafe roads with a high risk of traffic accidents but more importantly, the risk of a patient losing his or her life is much higher as the longer the distance such  a patient travels the more dangerous it becomes especially due to the hours spent traveling .”
Haufiku also wants all regional offices to be provided with the required funds by the office of the PS instead of centralizing everything.
“Ohangwena Region must receive its usual N$ 11 million to buy their supplies instead of the meagre N$3 million they apparently have received. This decentralization of procurement for supplies must apply to all 14 regions and not just Ohangwena. Decentralization of procurement for minor items and supplies will make better and smoother running of the Regional and District Hospitals throughout the whole country,” he said.

Onandjokwe hospital
Onandjokwe is another health facility in a crisis.
Onandjokwe Hospital is the oldest Hospital in northern Namibia built by the Finish Missionaries more than 110 years ago.
The minister observed that there is no space for maternity patients and new born babies. The new maternity ward is currently under construction.
There is only one functional ambulance at the hospital, there is also no Fluoroscopy machine at the Hospital since 2006.
The hospital leadership also informed the minister that there is frequent power failures in the cool room at the pharmacy and that the hospital only has 83 nurses while it should have 105.
Pharmaceutical supplies are also said to be erratic and unreliable.
Haufiku also expressed concern because there is a low number of TB cases detected because of a lack of TB field promoters deployed. There has also been cases of fake medicines picked up at Onandjokwe Hospital.
“Many of the issues at many of the health facility visited are chronic (shortage of staff) and date back to 2012 and beyond and are already highlighted in Ministerial or government official reports such as the Presidential Commission of Inquiry. I only included them in my reports for completeness sake.
While some of the issues raised definitely need policy and executive interventions, many of the issues are purely due to lack of leadership on the ground, poor or lack of communication as well as lack of persistence in following up on issues raised or requests submitted,” noted the minister.

Rundu Maternal Ward
Haufiku said the ward is over flooded with patients; many of them sleeping on the floor as there are not enough beds.
But despite the challenges, he said nurses are doing their best and appear motivated even though they are clearly overworked and exhausted.
“The biggest drawback and main obstacle to holistic Neo-natal care at Rundu State Hospital Maternity Ward is the absence of a Pediatric ventilator.
Babies who require invasive assisted ventilation basically are either sent to Windhoek or left to die at Rundu State Hospital, if they cannot make it to Windhoek,” Haufiku said.
The minister said two pediatric ventilators must be provided to Rundu State Hospital as a matter of urgency and without further delay.
“The airlifting of very ill, weak or traumatized patients from District Hospitals to Windhoek Central Hospital is more critical than ever before.
I therefore implore the Acting PS and Directors of Health in all regions to press ahead with the finalization of our agreement with the Ministry of Work and Transport to avail the State Learjet for the airlifting of very sick babies and other patients to places where they can get specialized care.
This directive must be viewed as an urgent matter and receive the attention it deserve within the shortest possible period which must not exceed end of August or  beginning of September,” he said.
It has been reported that the mortuary vehicles for both Rundu and Katima Mulilo Hospitals have had faulty and non-functional air-conditioners for a while now.
“I would urge the office of Acting PS and the Directors of Health in both Kavango and Zambezi to urgently attend to this problem and ensure that the air conditioners in these critical vehicles are repaired as a matter of urgency,” he ordered.
Haufiku also indicated that there is an urgent need for the provision of eight dialysis machines to Rundu State Hospital for Dialysis of patients who need dialysis services.
About 100 west of Rundu, Katjinakatji clinic has problems of its own.
Its challenges ranges from severe staff shortages, no administration clerk, landline telephone out of order for two years and an expired clinical stamp.

Grootfontein Hospital
“No linen in the hospital. Wrong washing soaps/ Liquid was supplied to the hospital.
The linen was apparently washed with Jik and got spoiled/ damaged,” said Haufiku in his report.
The minister further noted that doctors at the hospital are trained to perform operations such as Total Abdominal Hysterectomy (TAH), but they cannot perform these operations because the hospital lacks the basic equipment.
“The situation at health facilities remains dire partly because the memorandum signed between the Ministry of Health and the Ministry of Defence to airlift emergency cases from Mangetti Dune at Tsumkwe and other places has not taken effect yet.”
The Patriot also understands that the Anesthetic Machine at Grootfontein Hospital Casualty is very old and non-functional while the ERBE cautery Machine is also out of order.
“Even though the doctors at Grootfontein Hospital are able to perform some basic orthopaedic and other surgical procedures, many surgical equipment especially orthopaedic equipment and Tonsillectomy sets are not available at Grootfontein District Hospital.
Poor quality Delivery beds at the hospital are falling dawn,” said Haufiku who added that the incinerator at the hospital is not in a working condition.
The hospital also needs a digital X-ray Machine with a computerized processor, he said.
The Minister made these observations when he toured the Northern regions earlier this year to assess the quality of medical care in the public health system.
This report has been made available to the administrators within the ministry to implement the recommendations made by the minister in order to improve access and quality health care.

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