Clinics only stock Paracetamol (gararo ka letsatsi)
Patients forced to buy medication from private phamarcies
Clinics in Francistown have been hit with acute shortage of medicines and other supplies for medical procedures. For some time, Botswana enjoyed a fairly impressive health service, for a third world country. The introduction of patients having Anti-Retroviral Drugs available to them, upon being diagnosed as HIV positive, is an example of how far ahead Botswana was in its health system compared to other countries in the region. Access to other medicines like antibiotics and an array of drugs were readily available to patients free of charge.
Of late however, this has changed. Vital drugs, medical equipment and some medical supplies around Francistown and its surroundings are quite rare. It is clear that there is an intermittent shortage of drugs, and the situation is worsening. These drug limitations that have plagued medical facilities within Francistown and it’s confines, have an inevitably negative impact on patient care. Several cases of patients visiting their local clinic only to be told by clinic officials that the clinics dispensary did not have various medication, thus patients were being advised to outsource the prescribed medicines from their nearest pharmacy. For those who are financially challenged, this is a huge disadvantage, as failure to purchase drugs greatly compromises their health and in some cases may lead to irreversible deterioration of their ailment or condition. It is without a doubt that drug shortages compromises patient care. Some patients have even made remarks that the situation is so severe that even injectable drugs have to be bought at pharmacies, and the patient will then return to the medical facility to have the drug they purchased injected into them. For a country that used to have clinics and hospitals that boasted a constant supply of antibiotics, chronic disease medication and morphine, it is pitiful that the general perception from the population is that all that can be found in our clinics of are painkillers, commonly known as, ‘Ga raro ka letsatsi’, meaning, 'to be taken three times a day' in Setswana vernacular.
When quizzed on the issue of acute shortages of drugs in Francistown clinics and the referral hospital, Nyangabgwe, K. Majeremani, Acting Senior Public Relations Officer for Nyangagbwe hospital, firstly emphasized that he could only comment on the issue at the referral hospital, as he was in their employ and was not at liberty to echo narratives on other facilities. He pointed out that he would not comment on the issue of acute shortages of drugs in clinics, as they fell under the jurisdiction of District Health Mnagement Team. In relation to his area of operation, being Nyangabgwe referral hospital, Majeramani acknowledged that indeed Nyangabgwe did have inadequacies with their drug levels , downplaying the severity of the matter by saying 85% of patients had their prescriptions requisite satisfied at their dispensary. When asked on number and types of drugs unavailable, for example were injectable products, anesthesia drugs and anti-infective therapies, in the 15% that were inaccessible to patients on a regular basis, Majeremani was non-committal in his response, saying for such information to be disclosed the Head of department would have to be present and unfortunately, said Head of department was in absentia during the interview of the Acting, senior Public Relation Officer of Nyangabgwe referral hospital.
A source from the District Health Management Team, (D.H.M.T), that opted for anonymity, confirmed that there was indeed a serious drug shortage in clinics, bordering on severe, and if not “nipped in the bud” would culminate into a crisis. The source at DHMTC pointed the ‘finger’ at Central Medical Supplies,(C.M.S), stating that they were lacking in terms of service delivery, consistency and lacked urgency in delivering medicine to the designated medical facilities. The issue of poor service delivery from C.M.S had been ongoing for over two years, and of late was getting worse, reiterated the anonymous source. The only drugs delivered to health facilities and with consistency, were ARV’s as these were a priority issue with the government, but other medicines were in short supply and their regular delivery and meeting the supply and demand dynamic did not seem to be a priority to officials at the C.M.S, according the anonymous source.
The fact that there is a situation in which the total supply of all or several drugs are inadequate to provide the projected demand is highly unacceptable. This situation has a grave negative impact on patient outcomes and public health. This issue needs to be addressed with extreme seriousness and urgency before, if it has not happened already, lives are cost.