Namibians forget easily. Perhaps that speaks to our ability to keep the peace notwithstanding our enormous challenges. 2017 was historic in terms of the difficulties we faced as a nation but it was President Geingob who cracked the whip early in 2018, telling Namibians that 2018 will be “a year of reckoning”. So from the outset, it was ready, aim and fire. And the heat was on – a year of hot tempers flaring, record maximum temperatures and late rains. As we round up the year, The Patriot (TP) took time to engage Dr Bernhard Haufiku (BH) on the year that was.
TP : Honourable Minister Haufiku – What is the most pressing issue for the Ministry at the moment ?
BH: You are reminding me that the year is ending; soon people are going away for the festive season so everyone is expecting to slow down and get a much deserved break. For us at the Ministry, gears are actually changing in the opposite direction.
As you are aware, we have a serious problem with the Hepatitis E outbreak in the country. So far we have lost 39 lives, the majority of whom are women of reproductive age. To enable us to prepare adequately for the festive season, we had a meeting with internal staff and partners like WHO, as they support us in our response to the Hepatitis E outbreak.
This is a serious problem and I informed the team that we will have to combat this regardless of the Christmas season – so forget Christmas.
Luckily we have received assistance now from WHO which will allow us to test blood samples locally instead of having to send them to South Africa. What remains important is to educate and empower, to enhance the working knowledge of the public and to clear all myths surrounding Hepatitis E.
That is the battle we are fighting at the moment and this will stretch throughout Christmas and January until everybody is back at work, so for us it will be Christmas in the field basically. Having said that obviously we are human, so I told our workers to have at least a cake and candles even under a tree while still making sure you preserve life. I also bequeath them a few hours to rest in order to re-energise for 2019 to enable us to continue with the issues as far as the health sector is concerned.
TP: Before we step off Hepatitis E and Christmas, You talked about the awareness issues around Hepatitis E – how will this impact Namibians, during the holiday season as people congregate in larger numbers? Is there a likelihood of an increase of Hepatitis E and what can we specifically tell the public out there? In what manner should they engage?
BH : We have messages that we need to carry to everyone on our roads, to any gathering of any sort including funerals and weddings. Even during church ceremonies the message should be spread that whether we shake hands or not, wash your hands. We are working together with our partners and also we are involving other Ministerial sectors such as Agriculture, Environment, Urban and Rural Development, Local and Regional councillors.
TP : What are your highlights for the year ?
BH: They are a mixed bag – as is always the case, but I don’t like to dwell on the negatives. As a ministry, we have achieved certain things; as far as Human resources is concerned we have finally managed to employ many Namibian graduates, doctors, nurses, pharmacists and even some community health workers.
Of course there are still challenges because we could not employ everyone as required by our structure. Our structure requires more people so we have more vacancies but could not fill all the positions due to financial constraints.
We are constrained not only in terms of Human resources, but also with finance due to the issue of budget. I know it’s a sensitive issue and we hope that there will be some changes in the next financial year 2019. We have made our proposals and submitted them to Treasury.
We have achieved certain milestones in terms of Disease control; as you know we were conducting a population based HIV survey that includes testing, treatment, viral suppression and many other aspects of HIV response.
Namibia was on top of the list of ten countries who conducted the same survey and consequently it was revealed that Namibia has reached the UNAIDS target of 90-90-90 for both the second and third parameter but on the first we still have work to do. Here we achieved 86%.
If the Namibian population were made up of females only, we could have claimed 90 there too but our younger men are still reluctant to get tested for HIV.
In Namibia, we have reached a milestone with malaria in the reduction of deaths, but the number of cases picked up and we think it’s because of the cross border situation of our neighbours.
The same as TB which is going down very slowly, but the concern is that microbial TB is going up lately and that’s where we are battling. On maternal mortality the numbers have also gone down. 6 years ago it was over 446 and now is 385 per hundred thousand – the same with neo natal and infant mortality. That figure has gone down too, but not to the extent we had hoped it would.
TP : We had an outcry the other day that hospitals are incomplete, so can you please talk about our Infrastructural challenges?
BH : We have serious challenges with infrastructure; too many projects are standing still. However there is good news too like at Rundu which just need final touches at 87% completion. We just need two or three things to be incorporated and it should be operating by January or February. Onandjokwe Maternal Ward, we hope by June next year it should be finished because they have just started with the construction.
Other infrastructural projects of urgency are the ICU unit for little babies with heart conditions. We have now localised the surgery for babies for the first time in the Namibian history – we have two Namibian born specialists in heart surgery. For the first time in the history of this country ten children were operated on within 3-4 days led by Namibian surgeon Dr. Mureko.
They conducted surgery on 10 babies and one sadly passed away. By any standard, that is an excellent achievement. Together with that we want to put up an ICU unit dedicated to little babies with heart conditions because by protocol we should not mix them with adults. They should have their own ICU.
That is what we are trying to put here at Windhoek Central hospital as a matter of urgency. Then we want to strengthen district and regional hospitals from Keetmanshoop to Swakop to Onandjokwe to Oshakati and see where we can add more. Of course it requires money.
We need to equip all these hospitals to be able to function, as at each one of those hospitals we would like to put a minimum of at least four specialists. They will be a combination of International and local professionals including the private sector.
A memorandum of understating was drafted and cleared by the Attorney General and will soon be signed with the private sector and they can rotate at all these hospitals. This will be a paid partnership. I would like to round off with the dialysis issue that we want to put here in Windhoek, Oshakati, Rundu and Katima Mulilo starting with Phase 1.
TP : What about Human Resources ?
BH: HR as we all know is the key, we have made milestones like we have Namibian specialist cardiac surgeons plus we have another specialist. However, we recognise that our success in health care will not be at specialist level it must be at primary health care level and that’s why community health workers are our first line of defence.
We also deployed nurses in clinics where we have trained more than 400 nurses since the recommendation of the Presidential Commission of Enquiries into Health in 2013 we went over a thousand.
We have an approval from the Secretary to Cabinet Dr Simataa to immediately employ 341 nurses.
In addition to that there is also a potential to double the figure – the process is being negotiated. Maybe before the middle of next year we may employ a thousand or more staff in the ministry. The Ministry of Health structure has not been changed for almost 20 years but of course the population has significantly increased. So the structure of the ministry needs to be aligned with that.
TP : Where do you stand with the Health Professional Council?
BH: I put up a brilliant fight to get it changed but we struggled to get it in on time. I must admit that when I joined the Ministry in 2015, this bill of the Health Professional Council was already on the table here. Dr. Kamwi put it on the table, but it’s a big bill with more than a hundred sections. My understanding was that at least 2016/2017, this Bill would have been in Parliament. I was thus almost optimistic that in two years we should be finished but it did not happen. Now we have ironed out all of these issues, in the next session of Parliament this will be among the first bills to be discussed.
TP : Mental health has become a street topic and the numbers are increasing, what could be the cause?
BH: There is an element of increased awareness around Mental Health. The sad reality is that there is an increase among people affected by mental health. We have a lot of young people of average age 25-30 who make up the majority of mental health wards because of substance abuse issues like drugs and alcohol.
Our new legislation for this sector is looking at community mental health with the emphasis on the prevention of drug abuse but we can’t do it alone. We have to work with the police, Ministry of Gender and the community at large.
TP : We have commemorated World AIDS Day , how would you rate the performance of the country in this regard ?
BH: I think we are doing great because we are working together. From the President to our community health workers, there is synergy and we know what the end goal is. Therefore between government, community leaders, public and private sectors, we have developed a program of testing, monitoring and evaluating and there is a high commitment from top to bottom.
TP : What are the challenges and what are the goals of 2019
BH: I believe one day the public health sector will live up to it ideals and of course we need to make it happen.
I feel I’m part of that not only because I am the Minister but as a country, quality health care across Namibia will one day be available to everyone no matter how remotely you live, you will be guaranteed access without causing a catastrophe on your wallet.
One day, things will get better.