‘Let them die policy’ was an executive directive


Permanent Secretary in the Ministry of Health, Shenaaz El-Halabi, revealed that the “suspended” controversial Ministry of Health (MoH) ‘self-inflicted injuries policy’ was initiated through a cabinet directive.
El-Halabi said this before a Parliament Accounts Committee(PAC) that it had already been in her ministry’s mind to implement such a controversial policy to “save costs.” The health policy which is currently suspended, according to El-Halabi, was initiated to remove people with self-inflicted harm, including those injured during alcohol related activities, suicide and smoking related diseases, such as lung cancer from government’s medical cover.
Selibe Phikwe West MP Dithapelo Keorapetse had stated that the policy was suggested by President Ian Khama as he had, in his State of The Nation Address said “self-inflicted harm injuries will be paid for by patients who have been irresponsible with their lives.” El-Halabi however sounded evasive trying to absolve the executive or President Khama of being responsible for bringing the policy saying “the ministry came with the decision to make the policy.”
This policy has received a lot of backlash locally and internationally, with the World Health Organization (WHO) condemning the Botswana government saying “health policies and programmes have the ability to either promote or violate human rights, including the right to health, depending on the way they are designed or implemented.”
According to El-Halabi, the policy was then “suspended” not withdrawn: “There is a possibility that it can come back as it is or come with a different form. It is currently being reviewed,” she said.
However, Keorapetse told El-Halabi that she should forget about the policy coming back since it is unconstitutional and does not have any legal basis. He further said the policy was not up to par with international practices.
The so called ‘Let Them Die’ Policy emanated from a savingram directed to El-Halabi dated March 29, 2017, titled “Removal from medical cover for self-inflicted harm”, addressed to the District Health Management Team (DHMT) heads.
The proposed bill is surprising for how, the MoH, instead of raising alarm over more pressing public health needs like understaffing in hospitals and clinics, shortage of medicine and lack of technical expertise seems intent on punishing members of the public in such a manner that may violate established public health practices and ethics.