Prof. R. Trede

The importance of a healthy population was never doubted even not in ancient times of the Greek and Roman Empires. However, most countries did not take health care seriously. This includes Namibia with its status of public health facilities. Lack of personnel and medication. Only now with the corona pandemic the world, including the highest developed countries, is aware of the limitations of health services. Corona opened the eyes of everybody that health services are not only a human right but also an economic need considering the number of Namibians, who currently have no income.

Gabriel Uirab realised the challenges of healthcare in Namibia already at the age of 17. Coming from a disadvantaged family raised by a single mother employed as domestic worker, Uirab decided already at that age to join the health sector when his mother died in Windhoek due to poor health service. Instead of complaining, he wanted to make a difference. Thus, he studied at Unam but had to drop out of university after two years.  He worked for 18 years as an enrolled nurse mainly for the government. Thereafter, he continued his studies and finalised with a Diploma in Nursing Science. 
Uirab only had one aim to help as far as possible the poor who require public health care and suffer most of all from the coronavirus; luckily not so many cases in Namibia.

He realised that in the public service his vision would not become reality. He said: “I felt my talents and passion were underutilised and I could contribute more to help the people. The public health service faces too many problems: Too much administration, no time for the patients, no happy patients; this was not what I wanted.” Gabriel recalls, “My wife Stella and I discussed night after night; should I leave the safety of the public sector?  What else to do?  How could I contribute more to improvement of the life of sick or just old people?  In these nights the idea of the Namib Hospice Health Care Training Academy (NHHCTA) was born.”

Uirab argued with Stella that with such training he could multiply his knowledge. He would not only help a few people as in the past, but via his trainees hundreds if not thousands. He finally convinced his wife and she reluctantly agreed: “If this is your dream, your destiny start the NHHCTA.  I will assist you also financially, if necessary, because at the beginning it may be tough to mobilise trainees.”

He founded and registered the Academy in 2013. It trains mainly the unemployed who intend to offer their services to family members covering basic nursing, elderly care, first aid and HIV/AIDS counselling. In the first years, it was tough to mobilise trainees in Katutura where he lives. 
Although the family suffered without his stable former income, Uirab never considered giving up. He was satisfied, he could multiply his knowledge!

“The breakthrough started end of 2017. I was selected for an entrepreneurship training programme conducted by Decosa and Team Namibia sponsored by the Finnish Embassy. From my trainer and mentor, Prof. Trede, I learnt that even a health service should be managed like a business. I introduced business organisation, financial management and marketing and was successful,” he said.

Until today, Uirab conducted with six assistants several trainings in Katutura, Rundu, Swakopmund, Walvis Bay and Rehoboth. Each course includes one-month teaching and two-month practical internship, e.g. in old age homes, hospices and hospitals. Gabriel tries to minimize the costs for the participants. With only N $ 2000 for three months training, they are affordable also for poorer people. 

His dream did become a reality based on the slogan of the Academy “Health for All.” The training does benefit his graduates and poor members of the society who require caregiving. He also provides sometimes, meat, fruit and vegetables to the institutions where the practicals are done. 

Even the coronavirus could not stop him. Uirab started with the first online training. 
The NHHCTA has further requests for training from Otjozondjupa, Oshana, Zambezi and //Kharas. However, the extension of the courses faces one challenge. It is difficult to get places for the internship of the trainees. Currently only private institutions provide such places.  

The Ministry of Health and Social Services has compounded matters refusing practical attachments. After months the Acting Permanent Secretary wrote on the 19 July 2018: “I regret to inform you that we cannot offer your caregivers practical attachment in our hospitals as the activities, that they would carry out, require them to be registered or enrolled as nurses with the HPCNA.” And “in terms of Section 17 (1) of the Nursing Act, Act No. 8 of 2004, no person is entitled to practice a nursing profession in Namibia unless such person is registered or enrolled.”  

This is not understandable at all. First, all the trainees shall certainly not fulfill tasks of professional nurses. They shall supplement the work of nurses with tasks for which nurses are overqualified. They shall be used in non-clinical areas of patient care like making up beds, bathing, feeding, changing napkins to incontinent patients, etc. This reduces the burden on nurses who can concentrate more on clinical duties, e.g. taking blood pressure, distribution of medicine, etc.  
Moreover, the trainees are working free of charge. It is commonly known that the ministry is totally under-staffed and faces budgetary constraints. Gabriel is shocked: 

“My academy offers the ministry for free assistance in areas professional nurses don’t need and sometimes don’t want to do. My activities are fully in line with Vision 2030 and the Harambee Prosperity Plan. They focus on helping the poor for a better life in Namibia. Ordinary people are interested to help, to be trained. They sometimes sell their last goat to attend the training. Everybody assists us, private health and social services sector. Only from the responsible ministry, no help is provided. I am happy that I left the public service who seems to be more interested in formalities than helping the poor disadvantaged and sometimes disabled people.”

Despite this drawback the training will continue to benefit not only people who want to help others but last not least poor members of our society who require caregiving. One example: An old lady in Windhoek is bound to a wheelchair and suffers dementia. The family faced problems to take care of the poor old lady and thus finally employed one graduate of the NHHCTA.  

A woman who requested anonymity said: “This was the best decision we ever could have made. The lady taking care of my mother from Monday to Friday is fantastic. She is 100 percent reliable and knows all details how to handle my mother. One can see every day that she takes care not only for the salary she is earning but also because she loves to help people. I have learnt a lot from her how to take care of my mother on weekends. I am now relaxed and most important my mother is happy.”

Gabriel Uirab could be contacted at Namib Hospice Health Care Training Academy 0814725814 or healthtrainingacademy.69@gmail.com
    
*Prof. Rainer Trede is the Managing   Member of Decosa CC, which for 20 years has been engaged in SMEs training and mentorship in Namibia.