Botswana Nurses Union (BONU) is a nongovernmental organization representing seven thousand plus (7000+) Nurses and Midwives. The mandate of the Union also encompass negotiating for safe and secure working conditions for nurses in Botswana. It is therefore that the Union sees it fit to petition the Ministry of Health and Wellness on the subject of: “Safe and Secure Working Conditions for Nurses in Botswana”.
• Nurses play a critical and indispensable role in the health sector. As an essential profession, nursing is a frontline life support profession. In any given health facility, the nurse is the entry point to the health care system. The first and foremost vital stage of health assessment, triaging, of a patient entering any health care facility is done by a nurse. This is where patients’ preliminary diagnosis is made, a patient is stabilized and any possibility of disease complications and/or death are avoided at all costs. After such a laborious and mind engaging task, it is then that a patient is referred and/or the attention of other health care providers are called on board.
• Patients do not decide on what time of the day to seek medical attention. Consequently, nurses are always present directly and indirectly on duty during the entire 24hours of the day at all health care facilities. This is a profession whose staff work on shifts, coming in and knocking off duty at awkward hours. In some instances, nurses are expected to cover “call to duty” between and starting at 1630hrs till 0730hrs of the following day, having worked a full day the previous day and being expected to report for normal duty the following day. However, nurses are forever cognisant that these hectic schedules are part and parcel of the job and very little is done to alleviate the associated hardships by the employer.
• Be that as it may, at the very least, the nurses’ nature of duty demands a safe and secure working condition for nurses to be safe and carry on their duties without any looming threat to their psychological and physical security. Nurse deserve to be safe when serving and saving lives.
• For years, nurses have endlessly complained and raised concerns about their security in health facilities. Quite regrettably, nurses’ cry has fallen on deaf ears and those in charge have done virtually nothing in order to attend to this key issue. Nurses therefore find themselves in the unpardonable situation where they have to risk their lives in order to ensure that the nation continues receiving the required health care. It has become a compromise of self-sacrifice for nurses to serve the community while the Ministry of Health and Wellness remains ignorant that nurses need a safe and secure working environment at all times.
• It is heart-breaking to note that many of our health facilities do not have effective security features. Health workers are therefore exposed to high security risk. These risks extend from loss of personal property, physical assaults and harassment, rape and murder.
• It should further be taken note that exigency of health care services and serving of the community’s health needs is vital during and beyond the normal working hours, that is from 0730hrs -1630hrs. Though such services are esteemed and remain vital for our community, the Ministry of Health and Wellness has not provided necessities that address the welfare of persons expected to conduct such health interventions during the “call to duty” periods. The “call to duty” periods here stated including hours of the entire night where nurses are left exposed to all forms of dangers imaginable.
• We are gravely saddened and distressed by the most recent incident in which a nurse who was on night duty within the health care premises in Ext.2 Clinic Gaborone was brutally raped. Our deepest concerns, prayers and thoughts go out to her as she deals with the traumatic ordeal. The lamentable reality is that it is not an isolated incident. There has been many more in the past which we have consistently complained about and highlighted in our dialogue with the powers that be. Yet, nothing has changed and the conditions continue to worsen.
• Below is a sample of five horrendous incidents that have happened in the past, let alone the daily assaults that happen to nurses in their different health care facilities, that the Ministry of Health and Wellness is aware of but have buried them in forgetfulness:
• A nurse was murdered at Radisele in February 2014, while called to attend “call to duty” at night.
• A nurse murdered at Phase 4, Gaborone in 2013 while knocking of evening shift, during the night hours of the day, from Molepolole, commuting from Gaborone daily.
• A nurse was gang raped in 2013 in Oodi coming from an evening shift.
• A Nurse was attacked in Maunatlala in 2017 when she was awoken at night to attend to a patient.
• A Nurse attacked in Mokhomma clinic in April 2015 in an unsecured institute house and robbed of her belongings and car.
• It should be taken note that the above incidents have been raised with the Ministry of Health and Wellness on several occasions yet without any advancements by the Ministry of Health and Wellness to address the matter. Recommendation that were put forth by the Botswana Nurses Union have not been take heed of, thus leaving the security of nurses unattended. The inaction of the Ministry in this regard is as regrettable as it is disheartening. It cannot be that the only time the Government pays any attention to nurses it is when they are needed and reminded that they are an essential service providers yet they are not recognized and provided with basic necessities, e.g. safety and accommodation. When it comes to the basic safety need for nurses, the Government acts as if nurses are seeking for luxury.
• Health facilities have previously written to their respective District Health Management Teams raising issues of safety and security and their requests have not been acceded to, let alone a courtesy audience to acknowledge their concerns.
• IN CONCLUSION, the above evidence clearly shows that the working conditions for nurses are not safe and secure. The current environments are hostile. This cruel incidents have left fears and worries on nurses about the security of health care facilities and environments in which they are working across the country.
• SUBJECT TO THE NATURE OF JOB NURSES RENDER TO THE COMMUNITY, THE TIMES AND THE TECHNOLOGY HEREIN WE LIVE, THE NEED FOR A SECURE ENVIRONMENT AND SAFETY FOR EMPLOYEES AND THE BACKDROP OF SUCH HUMONGOUS AND BRUTAL CRIMES AGAINST NURSES, WE THEREFORE DEMAND THE FOLLOWING:
• Efficient, trained and professional security personnel to be engaged at all different health care facilities across the country to protect on priority personnel that render service to the community while on duty.
• Installation of electronic security device (CCTV, alarms, panic buttons and access cards) at all health care facilities.
• Nurses to be transported to and fro their dwellings over the night hours of the day, including such nurses expected to cover “call to duty”.
• Nurses to be accommodated adjacent to and/or in such areas where they can easily be transported to and fro duty during the night hours of the day.
• Effective and trained security personnel to always be present within our health facilities and be involved during the collection of nurses on “call to duty”.
• Safety at the workplace to be a priority and a long term plan for Ministry of Health and Wellness.
• The Ministry of Health and Wellness should have acceded to the above mentioned demands within thirty (30) calendar days.
President of Botswana Nurses Union