Health Ministry’s Shortcomings, But Also Its Achievements

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By Surihe Gaomas WINDHOEK As 2006 draws to a close, making way for 2007, the outgoing year has been described by the Ministry of Health and Social Services as having been the most challenging. The unexpected demonstration by nurses countrywide over salaries, the sudden outbreak of the Wild Polio Virus, and the highest health worry over HIV/Aids, made the year a difficult one. “The nurses’ issue was the most active political career challenge for me as a Minister,” said Dr Richard Kamwi, the Health and Social Services Minister, during a recent interview about the challenges and achievements of his ministry over the past year. For the first time, nurses stood their ground and demonstrated over what they claimed were poor salaries and overtime – a problem they claim has been going on for too long now. Early this month, close to 300 nurses from Windhoek and Oshakati held a peaceful demonstration, giving the Health Ministry an ultimatum of 30 working days to address their grievances or face the possibility of a national nurses’ strike. Kamwi noted that the most complex Ministry in Cabinet is that of Health and Social Services due to the diversity of professionals working there. Among the key ones, Kamwi noted are nurses and doctors who are responsible for looking after sick patients at hospitals and clinics countrywide. He voiced disappointment with the recent nurses’ demonstration, which was led by the Namibia Nurses Union (NANU), saying it was “unprofessional and a shame.” “For nurses to toyi-toyi demanding more money, while patients wait – I took it as most unprofessional. It was very unprofessional … it was a shame,” he stressed adding that this was a challenge for him in his political career as a Minister this year. Fortunately for the patients, no hospital operations were negatively affected by the demonstration. He urged nurses not to be misled and to get the correct information with regard to their salaries and overtime from the Ministry and its sole bargaining agent, the Namibia Public Workers’ Union (NAPWU). The issue of the nurses is now in the hands of the Office of the Prime Minister, which has received the list of grievances as the employer of government civil servants. On his part, Kamwi undertook trips to the south and the north to inform the nursing staff not to be misled by the current state of affairs facing them. Another most serious health challenge that faced the country this year was the sudden outbreak of the Wild Polio virus in which some lives were lost and many more hospitalized, according to Kamwi. The highly contagious virus was so abrupt that it prompted the Ministry of Health to undertake a massive polio immunization campaign countrywide. The polio outbreak, which was first reported on May 10 this year, had spread to seven regions including the four most densely populated areas in the country. At the time, 47 people were infected with the paralysing disease, while ten died. A few days later, this number rose to 53 infected with the Wild Polio, and by mid-June the number climbed from 118 to 128 cases in just 24 hours, while the number of deaths was 15 at the time. Looking back at this health challenge, Kamwi is satisfied with the way the general public, health officials and global development partners swiftly responded to the outbreak. “The outbreak of polio – the first time after 10 years – when we were just about to be declared polio-free, we were hit by this pandemic, and polio hit us across the board. The Ministry and its partners responded very swiftly, and in a matter of a fortnight the vaccines were in place and we successfully managed to curb the spread through a multi-sectoral approach,” explained Kamwi. The vaccines, which were ordered a day after the announcement of the outbreak, are said to have cost the United Nations Children’s Fund (UNICEF) N$2.1 million or US$300ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 000. The vaccines were used for the national polio vaccination campaigns carried out in June, July and August this year – all described as resounding successes. “Everyone worked together, even the general public. It was a cum laude for Namibia. But for now, international certification is off for the next two years to be declared polio-free. But I am optimistic that we will achieve this polio-free goal before 2010,” said Kamwi. On HIV/Aids, there is a ray of light at the end of the dark tunnel. While in 2002 the prevalence rate among pregnant women stood at 22 percent, the rate went down by 19,7 percent in 2004. In that same year, HIV/Aids infection declined in all age groups except in the 35 to 49 age group, and those in the age group of 25 to 39 years are still the most vulnerable, especially females. Despite this situation, Kamwi is optimistic that “there is a glimmer of hope” when it comes to fighting against the HIV/Aids pandemic. “We are seeing death – due to Aids – beginning to stabilize. There are those who come into hospital on stretchers, finished, and we put them on antiretroviral treatment (ARV) and give them nutritional food, and they now come out of hospital walking back to work and living a positive life,” he explained. The stabilization of deaths caused by HIV/Aids shows significantly that the ARV treatment is working well countrywide. The 30ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 000 ART number targeted for 2008 was already reached by 2006/07 by achieving coverage of 100 percent this year with ART services in all public hospitals. “It is worthy to note that Namibia has received worldwide acclaim for its rapid roll-out of the ART programme during the International Aids Conference in Toronto,” said Kamwi. More than 50 percent of those eligible are now on treatment; 15 percent of those on treatment are children, and close to 70 percent are women. Statistics show that there are 15ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 000 volunteers in Namibia, of whom more than 80 percent are women and people living with HIV, and 20 000 people receive Home-Based Care. Generally, health provision has improved where no one has ever been sent away because he or she did not have money to pay. Yet, Kamwi noted: “Good health comes with a cost, and our aim is health for all.” Moving onto malaria, it appears the battle against this preventable disease went well this year. Twenty percent of admissions to hospitals are due to malaria. According to the latest Health Information System, there are 4ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 000 cases of malaria per annum in northern Namibia, while deaths stand at 1ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 400 per year. “Malaria is still killing more people in the country than any other disease. For the first time Namibia received documentation from the World Health Organization supporting the usage of DDT malarial spray and also accepted by USAID,” he added. However, it turns out that DDT is banned in countries like Malawi for agricultural purposes, but since last year the Health Ministry has been making positive progress in residual spray of this chemical and scored up to 80 percent in one season. More than 60ÃÆ’Æ‘ÀÃ…ÃÆ”šÃ‚ 000 bed nets were also distributed to women and children. Yet, on the other hand, another curable disease that the nation is still battling with is tuberculosis, or TB in short. Namibia is said to have the most severe TB epidemics in the world. According to the World Health Organization, it ranks second, after Swaziland. Although not the fatal XDR TB virus, Namibians are generally experiencing resistance to the TB drug because they don’t take it for the entire duration of the six-month course. Kamwi’s words of advice to the medical staff and the nation for the year 2006 are! “My heart always feels for the nurses and doctors in general, especially those in the casualty ward receiving all those injured over the festive season. Namibians must celebrate the festive season responsibly. People must be aware of their own health and that of their family members at all times. Do not use alcohol – it clouds the mind and lets people do irresponsible things. Drive carefully and cautiously. It is all about arriving alive! Those who may need them: carry a condom!”