KM - The health status of Namibia has improved steadily since independence, and the government further seeks to improve the country’s health services.

In 2023, Namibia had 36 hospitals, 56 health centres, two rehabilitation centres, and 322 clinics.

There are a further 1 150 smaller service points.

However, access to healthcare facilities remains inaccessible and unaffordable to poor Namibians, especially in rural areas.

As guidance to achieve improved healthcare, the Institute for Health Metrics and Evaluation (IHME) and the World Health Organisation (WHO) recently published the report ‘Namibia: State of the Nation’s Health: Findings from the Global Burden of Disease’.

The report supports the notion that Namibia has made steady progress in the last decades when it comes to general health and communicable diseases.

New Era engaged Zambezi’s acting health director, Yolanda Lisho, on how far the region has come in terms of healthcare services since independence.

“The provision of healthcare services in Zambezi has greatly improved. The government has delivered the most needed to elevate the healthcare system, such as the recruitment of healthcare workers, the provision of pharmaceuticals, and medical equipment, and upgrading the infrastructure,” Lisho indicated.

She said the region witnessed infrastructure development where dilapidated primary healthcare clinics and departments were renovated.

In the interim of bringing services to the people, and reducing referrals to Rundu and Windhoek, she revealed the Katima Mulilo hospital is in transition to an intermediate hospital.

“The staff establishment is done, and we have started the recruitment process. Additional services are in process. We completed the advanced neonatal unit, high care ward ICU, and emergency response centre. A 16-bed capacity isolation facility within the hospital services has been made accessible to community members through increasing the number of healthcare workers and upgrading our health facilities in rural areas,” she disclosed.

Another achievement she mentioned is that the ministry recruited health assistants who are well-trained staff who reside in villages to screen for minor health problems, conduct health promotion, and refer to the nearby health facilities.

She said the region is faced with transport challenges.

“The fleet of vehicles we are using is old and costly to maintain. Katima Mulilo Hospital is currently a district hospital, so we refer emergency cases to the nearest referral hospital, which is Rundu, some 500 kilometres away, and Windhoek, which is 1 200 kilometres away. The vehicles are on the road quite a lot of times a day. Now, we are in need of ambulances and 4x4 vehicles to reach our facilities in the flood plains,” Lisho noted.

Due to the shortage of ambulances, the Katima Mulilo State Hospital has resorted to hiring private ambulances, which cost the hospital approximately N$90 000 per trip.

Some officials at the Katima Mulilo hospital conveyed these pressing issues to the National Council Standing Committee on Health, Social Welfare, and Labour Affairs, which visited the region last year on an oversight mission to assess the state of healthcare facilities.

The second challenge she mentioned is the procurement system.

She argues that the process is very long and tedious, which delays the region’s procurement of needed medical supplies and equipment to effectively manage healthcare services. 

The Zambezi region has healthcare facilities, of which one is the Katima Mulilo State Hospital; 26 are primary healthcare clinics; three are health centres, and 51 are outreach points.

Equally, three primary healthcare clinics are under construction in Muzii, Malengalenga, and Linyanti.

Lisho said these structures currently stand at 90% completion.

Health facilities built since independence include Impalila, Schuckmanburg; Ngoma, Lusese, Masokotwani, Kanono, Kaenda, Sibbinda, Choi, Sangwali, Chetto, Lisikili, Bukalo, Ngweze, and Mavuluma.

Zambezi is prone to seasonal floods, which limit villagers’ access to healthcare facilities and other basic needs, especially in Kabbe North and South constituencies.

Lisho confirmed that during floods, the ministry has two facilities that become inaccessible to residents. These health facilities are Itomba and Mbalasinte, as they are deep in the flood plain of the Kabbe area.

“Reaching Impalila Island is hard throughout the year. For the floodplain facilities, we are cut off for almost five to six months, and reaching the facilities in the floodplain areas is quite challenging due to a lack of water transport. However, we ensure that the facilities are well stocked with pharmaceutical supplies, liaising with line ministries for assistance with water transport,” she assured. 

She added that the biggest challenge they face comes when there is an emergency case that needs an urgent referral to the hospital.

She complains that acquiring transport on time is tedious and thus delays the provision of healthcare.

Lisho stated the hospital has been recruiting to increase the workforce, but they continue to have a shortage that is ideal for managing their patients timely and not having long queues. 

To curb the long queues, they are using an integration system where health services are offered in one consultation room.

“We are also encouraging the community members to utilise their primary healthcare facilities so the Katima hospital can only attend to referrals and emergency cases. 

On the staffing rate, approximately 68.43% of posts have been filled.

She mentioned that they only have one specialist in anaesthesia, 10 medical doctors, six dentists, 62 registered nurses, and 23 enrolled nurses, which brings the total to 125 health officials in the region.

The health director said the region has an urgent need to recruit and strengthen the staff complement in the specialties of surgery, obstetrics and gynaecology, paediatricians or neonatologists, specialists in family medicine, and physicians.

The region is also in need of quite a number of registered nurses.

Lisho said to save lives, the region is conducting active case searches, malaria surveillance, case management, vector control, including net distribution, and health promotion, as well as mobilisation in partnership with stakeholders. 

The ministry is conducting indoor residual spraying (IRS).

As of 2021, Zambezi recorded 10 197 malaria cases with five deaths. During 2022, a total of 7 311 cases were recorded, with 11 deaths.

In 2023, the ministry registered 9 175 malariacases with seven deaths, while as of January 2024 to date, about 2 188 cases with three deaths have been recorded.

The health director advised residents and visitors alike to use insecticide-treated bed nets.

“Sleeping under a bed net treated with insecticide can provide a physical barrier against mosquitoes and reduce the risk of being bitten while sleeping.” 

Wearing long-sleeved shirts, long pants, and socks can also help minimise exposure to mosquitoes, especially during peak biting times at dusk and dawn.

Applying insect repellent containing DEET to exposed skin can also help prevent mosquito bites.

Lisho urged people to seek prompt medical attention if they develop symptoms of malaria, such as fever, chills, and flu-like illnesses.

“Early diagnosis and treatment are essential for preventing severe complications from malaria.

As part of her independence message, Lisho said she was honoured to be a part of this peaceful and free nation.

“I am wishing everyone in Namibia a joyous Independence Day celebration. I would like to encourage the host region, the Namibian people at large to work hard, strive together, and build an indivisible nation filled with peace, love, happiness, and prosperity.” 

In memory of the late president, Hage Geingob, she called on all Namibians to follow in the spirit of One Namibia, One nation. 

“As we celebrate our independence, let’s remember our heroes and pledge to always strive our hardest to uphold the freedom and unity they fought for. Our health facilities will be operating to ensure the continuous provision of healthcare. We encourage people to take precautions in hygiene to prevent cholera and seek early diagnosis and treatment,” she said.

-anakale@nepc.com.na