Just what we need- Another Private Hospital in Botswana

For a few weeks now Bokamoso Private Hospital in Gaborone has been getting free advertising on Botswana Television news thanks to my tax money. Apparently it is owned by the big medical aid schemes in Botswana and managed by some American hospital conglomerate called OR International. That explains why every person from the hospital interviewed on BTV has an American accent. Great- let's emulate the American health care system because it's doing such a fine job.

One wonders which bigshot politician also holds shares in the Hospital so that BTV could be used as its defacto PR department. Goes back to transparency and the declaration of assets something Botswana politicians pretend is a silly notion from the even sillier and irreverent media.

For people outside of Botswana let me give you a bit of information about health care in Botswana. We have a very large and widespread public health care system. There are clinics in most villages where basic health care is provided. In larger villages and towns there are quite substantial hospitals. In Mahalapye, where I live, we had quite an old hospital but it was recently replaced with a big, modern new one. Service is sometimes poor, but occasionally excellent, much depends on the staff.

I delivered both of my children at the old Mahalapye Hospital and it was fine. For my daughter the labour was quite long, more than two days, and when she was finally born she had an Apgar score of 2. Thanks to the quick work and knowledge of the nurse and doctor on duty my daughter is fine. I knew a woman who delivered her son in Gaborone and he too was born with an Apgar score of 2, he is profoundly retarded, unable to sit, or do anything for himself. It all depends on the staff.

We pay a small fee and all expenses are included in that fee. Recently at Princess Marina Hospital, the government hospital in Gaborone, heart surgery was done for the first time. The patients paid nothing.

I think what Botswana has done in terms of health care is quite remarkable. It is not perfect, but they know this and are trying to improve. Training people to become doctors, nurses and other health professionals takes a substantial part of the government's education budget. One of the biggest problems, though, is retaining staff. The civil service tries to pay what it can, but it cannot compete with private organisations.

And now we have Bokamoso Hosptial. So the government trains doctors and nurses at their expense (our expense) so that a private hospital can employ them. Compounding this is that only the wealthy can afford medical aid, 1 out 18 Batswana have medical aid. So the other 17 of us go to the government hospital where there are no doctors or nurses because they have gone off to the greener pastures of Bokamoso Hospital.

Private health care in general has a detrimental effect on the public system. The most educated go to private health care providers. These people are often the ones who feel they are in a position to complain about poor service. They too are often the ones making decisions about the public health care system, decisions that will not effect them.

The commercials/news stories on BTV about Bokamoso Hospital show all the fancy equipment the hospital has. I'm sure they are important but I learned from experience that machines in the end are not what make the difference, it is the quality of the personnel. Sadly, they may end up having a monopoly on that too.