BARELY a week after her appointment as the new Minister of Health and Social Services, Dr Esperance Luvindao found herself the subject of media headlines.
This time it was not about the perennial controversies of power outages while doctors are operating on patients or the 20-hour wait patients have to endure in cat- and rat-infested wards.
This time the headlines were about the minister. Luvindao is under scrutiny from the public, who are asking: Is she a person of questionable integrity? Is she a qualified medical doctor? Did she inflate her achievements? If yes, why? Does she qualify to occupy a ministerial position in Namibia because her parents were foreign, despite her being born and bred in Namibia?
However, the most important question requiring consideration is whether Luvindao is capable of taking charge of the ministry and transforming it.
Health personnel who spoke to The Issue this week describe the ministry as “a sinking ship”.
Some hope that with the right support Luvindao might survive the furnace. But others, especially doctors, expressed concern, largely because the minister is considered relatively green in her field.
What appears to be commonly agreed on, though, is that the ministry is in desperate need of an overhaul.
Top to bottom.
Although newspapers have reported on it for more than two decades, those who work at the ministry say the situation has worsened since the 2020 Covid-19 crisis, which pushed the country’s health infrastructure to breaking point.
The fact that the minister has less than five years of experience as a medical doctor is a concern among a handful of senior doctors. The Health Professions Council of Namibia registered Luvindao as a medical doctor on 2 August 2021.
Her colleagues at the ministry said she will need to hit the ground running and has a lot to catch up on. Others flatly dismissed the idea of giving the new minister a chance. Some fear she would not command the respect of her colleagues.
Ministry officials listed the areas the minister and her Cabinet colleagues need to prioritise if they are to save an ailing system that is on its knees.
MEDICAL SUPPLIES
The ministry faces a medical supply and equipment crisis, which, if going by the numerous publications in the media over the years, serious self-made procurement challenges exist.
Luvindao’s predecessor, Kalumbi Shangula, has often blamed the Public Procurement Act for the lack of medicines and clinical supplies at public health facilities.
For the past few years, the ministry has faced a shortage of lifesaving and chronic medications which have been in short supply.
The ministry works with what is called an essential medicines list, which aims to track and plan what medicines are needed, the volume needed and where, based on the history of consumption, new trends and shifts in a specific region’s healthcare environment. However, this planning mechanism has largely been ignored lately.
This has led to clinics and health centres being allocated far less medication than their needs demand. Many doctors believe the team responsible for medical supplies at the ministry is gambling with the lives of patients, especially those who depend on government-issued chronic medication for conditions like diabetes and high blood pressure.
Many of these patients now have to find ways to buy their lifesaving medicines at privately owned pharmacies.
DECENTRALISATION OF SPECIALIST HEALTHCARE SERVICES
Most (about 90%) of the State doctors, specialist medical doctors and medical equipment are concentrated in Windhoek. For example, patients who suffer a stroke at Grootfontein, Gobabis or Swakopmund can only get scans and see a specialist in Windhoek. This process of transporting the patient to the capital can take a few days, at which point it might be too late to make a lifesaving intervention or, for example, prevent the worsening progression of a stroke, which can lead to patients becoming paralysed or dying.
The decentralisation of universal health services should be a key priority and has remained a pipe dream since independence.
INFRASTRUCTURE NEEDS
Existing healthcare infrastructure countrywide cannot support the growing needs of a growing population. In Windhoek, for example, the Katutura Intermediate Hospital is undergoing major renovations, and for the past two years, patients have been treated in tents.
The stop-start nature of the renovations put pressure on staff, and the country’s health infrastructure also manifests itself in shortages of beds or space for patients at hospitals.
This situation has also been a persistent problem over the past decade.
HYGIENE
Hygiene at some of the country’s health facilities has also been a subject of headlines. Pictures of dirty hospital halls with overflowing rubbish bins have been a mainstay both in newspaper headlines and on social media.
The presence of rats, mice and cats at some public health care facilities is also a concern that has been publicly discussed for many years.
SYNERGY
The new health minister needs to have the ability to ensure that the ministry works in tandem with other ministries. This will help other ministries play their supporting role. This can ensure that the ministry’s primary healthcare initiatives are effective. These initiatives are dependent on the government’s ability to prevent public health disasters like outbreaks caused by overcrowding or poor sanitation.
