Hospitals Run on Staff Personal Cash

“Without the efforts of medical personnel on the ground, many patients would have gone untreated”- Ombudsman report

 

GAZETTE REPORTER

 

Hospital staff across Botswana have been forced to use their own money to keep patients alive, a recent ombudsman report has revealed, highlighting the severe strain on the country’s public health system.

 

The investigation found that in several public hospitals, administrators and frontline medical personnel voluntarily pooled personal funds to purchase essential items such as swabs, sutures, and infant feeding tubes to ensure patients received treatment. In some cases, particularly involving pregnant women, patients who could afford it were asked to buy their own medical supplies.

 

“Without the efforts of medical personnel on the ground, many patients would have gone untreated,” the report states, painting a grim picture of a health system struggling to meet even the most basic standards of care.

 

LONG-STANDING SYSTEMIC FAILURES 

 

The ombudsman’s findings come amid a medicine and supplies crisis officially communicated by the Ministry of Health (MoH) on 4 August 2025. The report notes that the shortages are symptomatic of long-standing systemic failures, which have eroded service quality in public hospitals and left both staff and patients in a state of anxiety and uncertainty.

 

As supplies dwindled, health facilities were forced to prioritise urgent services, with non-urgent surgeries postponed, disrupting healthcare delivery and leaving patients in prolonged pain or uncertainty.

 

THE INVESTIGATION

 

The investigation traced the crisis to chronic funding and procurement challenges. The availability of medicines and non-medical supplies depends on budget allocations from the MoH, with the Central Medical Stores (CMS) indicating that funding has long been inadequate. However, CMS also acknowledged that the problem predates recent fiscal pressures. The report notes that medicine shortages have been an ongoing issue since at least 2021, worsening sharply in 2025 and culminating in a public health emergency declaration that August.

 

Since 2021, CMS has relied on “letters of commitment” to procure medicines on credit from suppliers. The ombudsman found that this practice contributed to a mounting debt burden and repeated procurement crises, entrenching shortages across the system.

 

While the actions of health workers have saved lives, the report warns that reliance on personal sacrifice is unsustainable. It calls for urgent structural reforms in health financing and procurement to prevent further crises and restore public confidence in Botswana’s healthcare system.