During 2007, the public health sector experienced a number of ups and downs. Diseases like cholera and meningitis broke out in the beginning of the year.
There was the threat of disease outbreaks from neighbouring countries, electricity and water cuts at hospitals and clinics as well as the noble call for the Ministry of Health and Social Services to bring private sector assistance on board to help in upgrading dilapidated health facilities countrywide. For this and more, Surihe Gaomas recently conducted a one-on-one interview with Minister of Health and Social Services Dr Richard Kamwi.
How would you describe the year 2007 in terms of health?
Well, it was for me the most challenging year in terms of communicable disease outbreaks which we experienced at the beginning of this year. For the first time, this country experienced confirmed cases of cholera.
In late 2006/2007, Opuwo in the Kunene Region was the first to be hit by cholera and then this went to the Ohangwena Region where it ended up to be the worst of diarrhoeal cases. Cholera is acute and early in this year we risked facing a cholera outbreak in the Opuwo, Omusati and Engela districts.
There’s an influx of people and we have no control over the movement of people across the borders. But since we faced a risk of an outbreak of cholera, we reacted acted promptly to the situation.
The biggest challenge was from our neighbouring countries. The measles outbreak also started in December 2006 through to January 2007 in Nankudu district, while the meningococcal meningitis outbreak is not yet over, but a vaccination campaign was conducted in November this year.
So then what would you say were the major challenges this year?
Let us first look at the disease tuberculosis or TB. TB in Namibia is only second to Swaziland in the whole world in terms of prevalence. Erongo, Karas, Hardap and Oshikoto are the regions where we have the highest number of TB cases.
TB is a disease of poverty and this is a really big challenge for the ministry. According to the World Health Organisation we are supposed to have up to an 85 percent cure rate in TB, but the fact remains that due to poverty, people continue to live in overcrowded shacks and since TB is an airborne disease, it spreads rather quickly.
On the issue of HIV/Aids treatment, we have done very well, but the only challenge is that men are not forthcoming for voluntary counselling and testing, so that they can also benefit like their female counterparts. On human capacity especially personnel, the health ministry is really over-stretched and there’s a huge demand for nurses and counsellors.
You can remember at the beginning of this year in human resources, we had a deficit on managerial level of six regional directors and one under secretary. But now all these posts have been filled, although we still need an under secretary for health care services and a regional health director for social welfare.
Another challenge is that of financial resources. If the resources were there, we would have gone a long way in addressing many of the health challenges we face today. Sixty percent of the annual health budget goes to salaries and the remaining 40 percent goes to infrastructure, medical equipment and maintenance. There still remains that huge discrepancy.
What would you say were the most notable achievements for 2007?
Namibia is the leading country in Africa when it comes to rolling out anti-retroviral treatment. We have three major projects in the health ministry, namely HIV/AIDS, TB and Malaria. In terms of service delivery, we are doing very well in HIV/AIDS for both the private and public sectors.
According to the General Assembly in New York in 2005/2006, only three countries met their targets in Africa, namely Namibia, Uganda and Botswana.
The cumulative number of ARV treatment as of November 30 stands at 39 723 and this number rises to more than 40 000 inclusive of the private sector.
Unlike men, women are doing extremely well as they attend the VCT clinics in all 34 health districts. As of September 30, the number of women on ART treatment was 24 639, but the number of men is only 10 064.
It looks like in the age groups 25 and above, we seem not to be doing well in behavioural change, while SADC is declining, but Namibia is going up.
On stigma and discrimination there’s a glimmer of hope, because death numbers are declining. With treatment, people are now living longer than they used to, there are so many Emma Tuahepas now in Namibia.
In the past, people used to go and die in the villages from an AIDS related illness, but now that is not the case.
In terms of upgrading medical infrastructure, we have successfully managed to bring in the private sector and they have come in full force. Through public-private partnership, we have good upgrading programmes and assistance. Pledges are now going up to N$20 million.
We are expecting 20 ambulances to arrive from Durban, South Africa, on January 1, 2008. As for the dilapidated hospital infrastructure, as management we held familiarization visits since February 2005 at Nyangana and Andara hospitals in the Kavango Region.
Now through consulting various stakeholders, we will be getting three ambulances from the Chinese Embassy, and Rosh Pinah also donated another ambulance. The achievement lies in how we put our proposals and in the new year we will be seeing the results of newly renovated hospital wards. I am optimistic that the coming budget will be very positive.
With the Finnish-Namibia Project, we have received up to 80 percent of the new equipment to be rolled out to hospitals countrywide. We are also planning to twin with one of the cardiac units in South Africa.
Last year, the ministry faced the nurses’ issue of working conditions – has that issue been resolved now that a year has passed?
Yes, I remember that issue. NANU (Namibia Nurses Union) had threatened to take us to court and that they would go on a nationwide strike. Until today, that strike has never happened. Together with my management, I went around the country to talk to the nurses. We look at nurses as civil servants. There is no way that Government would allow patients’ lives to be compromised by an illegal strike.
Government responded swiftly and nurses were warned that if they had taken part in such a strike, they would have been dismissed immediately. Where is the illegal strike today, it never materialised. According to the Labour Act 1992, the bargaining unit is NAPWU for civil servants and nurses are civil servants.
Electricity blackouts, water shortages and inadequate health facilities have been the order of the day at health facilities early this year. Even the Head of State President Hifikepunye Pohamba expressed concern in July this year. What has been done to rectify this situation?
We remain on alert on the water and electricity cuts with the Ministry of Works, Transport and Communication. We have a new under secretary now and the ministry will no longer owe municipalities. The upgrading of hospital and clinic facilities is going on as we speak and the issue of inadequate health equipment will soon be something of the past.
Finally, what’s your New Year message to the public?
We are going on a festive season now and in accidents, it is the victims who suffer, who either get simple or complicated fractures, ending up in hospitals.
I feel strongly that all those who are licensed to drive should take precautionary measures on the roads while travelling. It requires patience to arrive at your destinations safe and sound. And most importantly, when needed please use a condom!