By Francis Tsawayo WINDHOEK Congestion and queuing are a common sight at state-run clinics resulting in several people returning home without receiving medical attention. For some time, clinics have implemented a system that allows them to accommodate a certain number of patients that can be attended to during working hours. The system allows for the group of patients registered in the morning to receive treatment throughout the morning, while another group is only registered in the afternoon on condition that the morning group has received treatment. Nurses from different clinics said the system helped to reduce frustration on the part of the public, as they are notified early and referred to other institutions. “If you register people and they do not receive medical attention by the time we close, it would be chaos, the same if you let people sit for hours and later turn them away – they will be angry,” said one nurse. According to a sister in charge of one of the clinics, the problem is that the number of nurses at their disposal is less compared to the number of people they are expected to treat. ‘”In the instance that one nurse is absent due to unforeseen circumstances, the situation is really hectic,” she said. According to the Chief Medical Officer for Khomas Region, Dr Ali Elsherif, population growth – mainly the influx of people migrating to the capital in search of employment as well as other economic migrants – has exerted immense pressure on health care delivery. Referring to municipal figures, Dr Elsherif noted that the city receives over 300 people a week who gradually overload the health sector and as a result strain service delivery. “When planning for service provision was done, a certain population was targeted and with the rapid increase fuelled by the growth of informal settlements, the services have been stretched,” he told New Era. Apart from the state-run clinics, Dr Elsherif noted that not only the clinics were congested but also that hospitals were being strained. Dr Elsherif revealed that clinics had not been planned to have doctors except for a few clinics but in the last four years doctors had been made available to reduce pressure. “Doctors have been stationed at clinics in an effort to have less people being referred to hospitals but otherwise the hospitals have been under pressure for sometime now.” Speaking on the issue of more staff, Dr Elsherif said that the clinics have what he referred to as a staff establishment, meaning the number of people who are entitled to work per clinic. “The staff can not be easily increased as this is a process that has structural and budgetary implications, channels and approvals that need to be taken into consideration and it’s a process that takes time,” explained the doctor. Dr Elsherif noted that several feasibility studies had been undertaken and new sites for clinics had been approved though much work was still to be done. “Otjomuise and Gorengab are two of the sites that have been shortlisted and the Municipality of Windhoek is working with the ministry in efforts to also assist in the transformation of the Maxwilili Community Centre into a clinic,” revealed Dr Elsherif. Though the region faces challenges, Dr Elsherif reassured that apart from the influx of migrants, all the necessary structures for service delivery for clinics were in place.