Urgent probe into Marina crucial – Analysis

  • Hospital not accredited by COHSASA
  • Issues emanate from the Ministry headquarters – union
  • “There should be a health ombudsmen and patient complaint system”


It has become evident in recent years that Princess Marina Hospital (PMH) is a poorly run institution, a challenge and blame that is often passed down to nurses and doctors on the ground who in most cases are just doing the best they can under the dire nonconducive working environment provided by government.
While it is one of the only two largest referral hospitals in the country, PMH is not accredited by the Council for Health Service Accreditation of Southern Africa (COHSASA), the only internationally accredited quality improvement and accreditation body for health care facilities based in Africa. When this publication inquired on the issue, the ministry dismissed COHSASA accreditation as “unnecessary”.
In recent times, the hospital has come under fire from all corners: patients complaining about poor services while nurses and doctors have raised issues of conditions of service which they say hinder them from performing their duties effectively.
Botswana Land Boards Local Authorities & Health Workers Union (BLLAHWU) is one of the stakeholders who are of the view that the real problem emanates from the Ministry headquarters where there is “bizarre planning and coordination,” while it is paramount to have a robust national health strategy towards quality health care services in Botswana
“There has been centralization of operations to the extent of the headquarters being involved in day to day administrative issues such as procurement, leave process, local transfers. Our take is that the Ministry head office should be focused on planning, policy making, budget and delegate pure administrative and operational matters to DHMTs,” said BLLAHWU’s Ketlhalefile Motshegwa.
He said it is further illogical and counterproductive that there are no set standards in the Ministry of Health, bringing in the issue of large nurse-to-patient ratio which he said impedes on the productivity of personnel and negatively impacts service delivery.
“It is importantly urgent to have more personnel like doctors and other specialists in Marina and other big hospitals so that patients are attended to efficiently and effectively and then discharged. There is need for improvement of the referral procedure in the health care system. This calls for renovation of existing primary hospitals and clinics so that they attend some patients who are unnecessarily referred to Marina,” he said.
He further noted that it was important to establish a Health Ombudsmen because in the current patient complaint system, clients are made to complain to the same ministry they raise issue against, raising issues of conflict of interest.
Last year, doctors in Marina threatened a ‘go slow” telling this publication that they were overworked and underpaid. They complained that they were being made to work up to 24 hours and even 36 non – stop.
“According to the law, we are entitled to days off but because of shortage of doctors we are not able to take our day offs. Over Time is supposed to be 14 hours a week but as doctors we work beyond those hours. It is almost impossible for a doctor to work for 8 hours in Botswana and management is aware of this, but we are not paid for these extra hours that we put in every week it is just volunteer work,” they revealed.
PMH has a number of cases of negligence by hospital staff which are suspected to have led to the deaths of some patients, a situation which warrants a serious investigation into the affairs of the hospital.
In 2016, this publication carried a story based on a confidential report done by the ministry which revealed that over 300 babies died in PMH and Nyangabgwe Referral Hospital (NRH) in 2014. Some babies are said to have died due to shortage of resources. According to the ministry, in 2015, the hospital recorded 144 infant deaths showing a concerning increase compared to the 124 deaths recorded in 2014.
While many patients have suffered and some reportedly died due to lack of medication at PHM, sources within the hospital say drugs are kept at Central Medical Stores (CMS) so long that that they end up reaching their expiry date before use.
Medical experts have also come forward to warn of the dangerous ways equipment is treated at the hospital, suggesting that most equipment and instruments used are not calibrated and tested as often as they should, meaning Batswana could be at risk of being wrongly diagnosed. This also means some patients may have died unnecessarily and many more may be suffering needlessly through the misdiagnoses of their health status. A claim that the ministry has refuted.