A week in one of Namibia’s most remote areas has led me to ponder what makes development feasible and how the marginalised communities can be assisted to fully integrate into a modern Namibia.
In May, I visited Tsumkwe and the surrounding villages as part of the Medic Rush project, and my observation reminded me why it is important to not become numb to the deprivation most Namibians still suffer.
The basic utilities we take for granted daily in urban settings are still considered luxuries far out of reach for some of our countrymen.
My visit was as a volunteer for the project, which brought free medical service to the people, but other equally important services were obviously lacking.
The dearth of education facilities, water and sanitation, electricity, access to communication, food security and abject poverty are glaring realities of daily life in Tsumkwe.
The tradeoff is this part of the country is pristine, with long, quiet, well-kept roads snaking through diverse flora while elephants and giraffes unsuccessfully try to camouflage themselves next to the road. The area is home to a few conservancies hosting high-end lodges. But behind the beauty and a lucrative tourism sector is the reality that the San community of Namibia still lives in squalor.
The government is trying.
Members of the San community get a wide range of government support. Monthly marginalisation grants, food parcels and even full support to those who qualify to attend tertiary education (tuition, accommodation, transport and a N$1 500 monthly stipend).
But all these efforts still seem insufficient.
Classroom at Duine Pos
I was invited to attend this year’s Medic Rush, an 18-year-old outreach programme aimed at taking medical services to the country’s most remote and underserved locals.
The Medic Rush functions like a three-legged pot. The organisers and sponsors, the doctors, and the volunteers. The organisers are Round Table Namibia, a fellowship of young men who get together for networking, capacity building and giving back to their community. The Round Table was responsible for getting the sponsors, planning the logistics of the project, and working with the volunteers on whatever logistical support is needed to enable the doctors to do their job.
Twenty-three doctors took a week off their regular jobs to go care for patients under harsher, more improvised conditions, for free.
The majority of them work for the government. Some took a break from their studies abroad to make the trip.
The travelling party consisted of over 50 people, and the mission treated about 700 people in a space of three days.
A hive of activity on Saturday 24 May at the Round Table headquarters in Windhoek at the Lions Club saw doctors arranging and packing the medical supplies in a manner that will make dispensing easy.
This process appeared to be progressing like a well-oiled machine.
Hand written name stickers make introductions smoother.
A few veterans who made the trip before among the ‘Tablers’, as the Round Table members call themselves, were working on the other logistics.
Massive boxes of supplies like soap, toothpaste, and reusable sanitary pads (earmarked mainly for school-going girls who have been missing school because of their periods) were packed for the community. Food for the week, tents, and sleeping bags filled what looked like a boardroom on a regular day.
The sponsors, FNB Foundation and Future Media, had their banners on display while music was pumping in the background. Occasionally a doctor would complain about the music being too loud.
On Sunday 25 May, the day started at 03h00 and we departed from Maerua Mall an hour later.
The convoy consisted of about 13 vehicles and a Gondwana Overlander bus. Trailers carrying supplies and the team were on the move.
In Grootfontein the team collected more medical supplies. The Otjozondjupa health director gifted the supplies to help with the outreach. Additional benches and tables, courtesy of the defence ministry, were also picked up from the military base as the ministry’s contribution to the cause.
The diligent Tsumkwe police stopped us a few kilometres from the settlement, perhaps due to reports of strange activities, and searched our vehicle. After being satisfied with our explanation, they let us go and were happy with our mission.
The journey was not seamless! A trailer broke down, and a vehicle was experiencing some difficulties, all delaying the progress. But by nightfall, the team was setting up tents and getting ready for the evening meal.
As the steam from the coffee swirled out of coffee mugs clearly visible from a distance on Monday 26 May, good mornings and reviews of the cold tent experience were exchanged while some quietly had their breakfast in the open Tsumkwe air.
After breakfast everyone packed the supplies needed for the day’s clinic, including benches, tables, medicines and gazebos.
The Tsumkwe clinic looked deserted apart from the local team of chaperones and translators.
The clinic is small and appears to be in need of refurbishments, but the basics were in place. It also boasts a USAID-funded extension with a laboratory, a pharmacy and an office.
An overflowing drain on the clinic grounds is striking. The area has a soup kitchen and a playground, and the wastewater had a thick layer of mosquitos buzzing, but this does not deter the children from playing football, with the ball occasionally falling in the sewage. The septic tank is full, and the village council truck responsible for pumping the sewage out is broken. Some members of the community expressed their frustration, saying it’s a perennial problem. Fortunately a local business comes to the rescue and arranges for his employees to run seven trips to clean the septic tank.
The visible overflow of wastewater is a perennial problem according to the locals.
Inside the clinic, the team of doctors discovers that there is a patient who spent the night there. Clinics don’t keep patients overnight usually, but Tsumkwe is a unique place. It later hit me that the nearest doctor, well-stocked pharmacy and health centre are in Grootfontein, 270km away.
This also explained why government officials, including police and immigration officials, all attended the mobile clinics aimed at the destitute San community. It became clear that even their government-issued medical aid is useless in Tsumkwe, and they all took the opportunity to see a doctor.
The Tsumkwe clinic serves people in a radius of approximately 200km. The health ministry tries to conduct its own outreach programmes because people in the area could go for years without seeking medical attention, but these outreaches are sometimes delayed or cancelled due to the unavailability of resources like vehicles. It is common in the area for children to be born and not be seen by a nurse for longer than 18 months.
Government social grant payment was also happening at the same time. This meant that traffic to the clinic was slow at first but later picked up, and some people had to be sent back home and asked to return the next day. However, that morning, after setting up, the team was worried because there was not much traffic coming to the clinic.
On Tuesday morning, day two of the clinic, the team was divided into three. Tsumkwe clinic, Ben Se Kamp about a kilometre before the Dobe border post to Botswana, and the third clinic was set up at Nxama along the road to Gam.
Ben Se Kamp had no running water despite modern-looking water tanks and pumps.
“No diesel” for the water pump was the short answer.
The community has the responsibility to buy fuel for the water pump. When they run out of diesel, they have to walk the kilometre to the border to fetch water. In the past, government officers at the border used to get water from Ben Se Kamp. And the government used to buy the diesel. But now that the government has its own solar-powered borehole at the border, the community is losing out on a consistent supply of water. They simply cannot afford the diesel to pump the water.
Although it is just a 30-minute drive away from Tsumkwe, the community is not connected to the outside world. There is no cellphone network in the area. Immigration officials at the border post climb up a four-meter water tower for some connectivity to the Botswana networks.
The kind immigration officials helped the mobile clinic with water to make the day’s work possible.
At Ben Se Kamp, I noticed children enjoying Plumpy’Nut, a peanut-based paste rich in protein and other vitamins. It is given to children as a means of fighting malnutrition. It seems to be the government’s and the World Health Organisation’s solution to malnourished children in remote areas. But even this type of intervention does not always reach the communities due to the government’s logistical challenges.
In this case, the regional health director used the mobile clinic to ensure the community gets these essential supplies. Border officials talked about their fear of malaria. This year the area had several cases, and the government provided the community with mosquito nets as a preventative measure.
Later in the afternoon worry started creeping in as meds were running out at all three sites. But that was easily forgotten at Ben Se Kamp. It was around 15h00 when I noticed the commotion: a man in tears and bordering on being confrontational with the doctors.
It turns out this is one of those cases that highlight how the lack of health infrastructure in the area can be the difference between life and death. The emotional man was pleading with doctors to help a relative who suffered a stroke, and the doctors tried to explain that the mobile clinic was not equipped to help the patient, who should be transported to Grootfontein (270km away) in an ambulance. The man was refusing to take no for an answer, especially since some adults in the area go through life without seeing a doctor.
The doctors on site remained calm and composed, but the uneasiness of not being able to help was visible on their faces.
By Wednesday, supplies were running out, and the team decided to set up only one clinic at Duine Pos, about 30 kilometres west of Tsumkwe.
At Duine Pos, we were confronted with a challenge, and the doctors had intense conversations behind the scenes.
They were contemplating abandoning the mission. It turns out there was a deadly multi-drug-resistant TB variant in the area. To the rescue came the ministry of health team based at the Tsumkwe clinic; they brought the right surgical masks for the job and latex gloves. Work resumed, but the number of patients kept growing. We then realised community members with vehicles were bringing more people from afar to ensure they used the rare opportunity to see doctors.
The Tsumkwe clinic staff also used the opportunity to conduct their immunisation programmes.
At the end of the day, supplies and medicines were done, exhaustion was creeping in, but a sense of accomplishment filled the air.
Medic Rush 2025 was done, and what was left was for the Round Table to do its outreach activities of delivering blankets and other goodies to the Tsumkwe community, especially the women and children.
