• September 29th, 2020

Are Namibians healthier 29 years after?

Alvine Kapitako

WINDHOEK – To address inequities, correcting disparities and imbalances of the past in the provision of health services, then Minister of Health and Social Services then, Dr Nickey Iyambo, issued a policy statement in March 1990, entitled Towards Achieving Health for All Namibians: A Policy Statement.

Subsequently, the government committed itself to providing more access to health services for all Namibians with emphasis on primary health care as the best strategy to address health care needs, especially in the rural and underprivileged areas. In addition, in line with achieving health for all Namibians, the current Minister of Health and Social Services, Dr Kalumbi Shangula, emphasises that health and social well-being are fundamental human rights.  “The ultimate goal of the Ministry of Health and Social Services is to attain a level of health and social wellbeing by all Namibians, which will enable them to lead economically and socially productive lives,” Shangula determines.
Having healthy, economically and socially productive Namibians can be achieved through using a cost-effective developmental social welfare and primary health care approach, which includes promotive, preventative, curative and rehabilitative services, explains Shangula. This should be done in collaboration with other stakeholders, he adds. However, “I am of the opinion that many people in Namibia are sick. We are not a healthy nation,” replies 45-year old Sylvia Kazeundja, a resident of 8ste Laan in Otjomuise to the question whether Namibia is a healthier nation, 29 years after independence.  Speaking from her family shack, Kazeundja maintains that Namibians are battling various ailments. “As I am talking to you now my daughter is admitted in hospital sick,” added Kazeundja at the time of the interview about one month ago. 

Furthermore, hospitals, health centres and clinics are equipped to treat people suffering from different diseases but many of the facilities are not very clean thus compromising the health of sick people.  “My daughter is in hospital where she is recovering from burn wounds and she was allocated a locker to keep her items while in hospital. I had to take soap from home to clean the locker at the hospital because it was very dirty. My daughter is sick and she has to be treated in a hygienic way so that she recovers fast,” she says. 

However, 32-year-old Letisia Shidjuu, a community health extension worker does not agree with Kazeundja’s views that Namibia is a sick nation. Despite the challenges within the health sector, Shidjuu believes that Namibia is a healthier nation today. “The government is trying by all means to provide more health facilities,” opines Shidjuu who walks from house to house, sharing health information with the public. Her duties include informing and impressing upon the community of 8ste Laan good hygiene and embracing a healthy lifestyle.

“The government through the Ministry of Health and Social Services introduced this programme for community health workers so that they can provide health education to their community and address health issues,” adds Shidjuu regarding programmes to improve the quality of health of Namibians. Shidjuu is of the view there are areas in Namibia that are not a priority for the health sector, thus compromising the health of Namibians.  “Mostly informal settlements that do not have toilets and as a result people relieve themselves in the riverbeds, and open air, which is a problem when it comes to health because we are struggling with Hepatitis E for over one year,” Shidjuu points out. 

Sadly, some people in informal settlements and rural areas do not have easy access to water so that they wash their hands, remarks the community health worker. 
“As a result, they are at risk to get Hepatitis E from dirty water, which is contaminated with human faeces. To an extent, the public is to blame for the current state of health in the country because we do not maintain hygiene. We just need to educate our communities more on health issues because that is our mandate as community health workers,” Shidjuu seems to exonerate the health authorities. 
To prevent diseases, especially those that are lifestyle-induced such as type 2 diabetes, cervical cancer, high blood pressure, Shidjuu advises members of the public not to take their health for granted. “Namibians just need to take better care of themselves,” stresses Shidjuu. 

Commenting on the mental health status of Namibians since independence, Dr Hileni Ndjaba, a psychiatrist and the Head of the Mental Healthcare Centre in the Ministry of Health and Social Services, says there are only two hospitals that cater to the mental health of Namibians, namely Oshakati State Hospital, and the mental healthcare centre at Windhoek Central Hospital. 

Namibia has experienced an upsurge in mental health cases from independence to date, notes the psychiatrist. “There was no study done to show us why mental health is increasing, and not decreasing but we can assume that there are factors that have contributed to the increase of mental health cases,” states Ndjaba. 
Highlighting the contributing factors to mental health, Ndjaba adds unemployment is a contributing factor.  “The majority of our people are not employed, and even those who are highly qualified with university degrees are still on the streets,” Ndjaba highlights how unemployment is contributing to mental ill health. She further observes that the use of substances (narcotics) is increasing in Namibia. 

“Before independence, Namibia used to be a transit country where drugs were transported through the country to other countries in Africa, and elsewhere. But Namibia has now become a user of these substances, and it is scientifically proven that the use of substances does cause mental ill health,” the psychiatrist explains. 

She says substances does not only refer to cannabis, heroin, cocaine and the other hard drugs but includes alcohol and tobacco. The use of alcohol in Namibia has increased dramatically, especially as a form of income generation. Through her experience working with mentally ill patients, Ndjaba has seen that people with mental illness are discriminated against. Their caregivers including their family members and professionals such as psychiatrists, doctors and nurses are not innocent in this regard 

Meanwhile, Shangula emphasises that the health status of an individual is determined by factors such as the food they eat, what they drink, whether they smoke, physical exercise or lack of it, community and personal hygiene as well as information on disease prevention. “Before independence, the focus was more on the treatment of illnesses.  After independence, the focus was more on prevention of diseases and promotion of health.  Of course, treatment forms part of the primary health care package,” says Shangula.  

He views Namibians are healthier because they are protected from vaccine-preventable diseases through the expanded programme of immunisation. There are various health programmes aimed at improving the health status of Namibians, including school health programme, sanitation, blindness prevention programme, ante-natal care, post-delivery care and the outreach programme.

“However, the responsibility for health lies with the individual person.  One can take the horse to the water but one cannot make the horse to drink the water,” adds Shangula.

 “The main and persisting challenges facing the health sector include the increasing population, and urbanisation overtaking expansion of health services, and cross border patients in particular from Angola and Zambia who are coming to Namibia for health services where in some instances these populations are entirely depended on the Namibian public health system,” highlights Shangula.

The shortage of health professionals such as doctors, nurses, and pharmacists, are a result of the high demand for health professionals in a very competitive labour market, especially between the public and private health sectors, Shangula explains. 

The soft-spoken Minister further points out the inadequate number of health professionals trained in the country. And the production of health workers, including nurses and medical doctors that is not responding to the growing needs of the nation, and lack of adequate and suitable accommodation particularly in the remote rural areas and the staff establishment, which is no longer responsive to the current demands and expanding programmes, have also resulted in the shortage of health professionals.

 “As we celebrate our 29th independence anniversary, let us all make it meaningful.  It should serve as a call to renewed action to improve the health of all Namibians.  Let us protect ourselves from diseases.  Let us stay healthy,” concluded the Minister of Health and Social Services,” Shangula pleads. 

Alvine Kapitako
2019-03-20 11:06:09 | 1 years ago

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