E3BN NOT ENOUGH FOR HEALTH?

One of the submissions that received wild applause at the last People’s Parliament (Sibaya) was made by Finance Minister Neal Rijkenberg, to the effect that money is not the reason for the country’s chronic healthcare crisis.

When he made this submission, a whopping E2.76 billion had been allocated to this portfolio. This was for the 2023/2024 financial year. For a manageable population like ours, this was not cheap change. Only a few months after Sibaya, the same minister announced that the Heath budget had increased to an unprecedented E3 billion for the 2024/2025 financial year.
Rijkenberg revealed this when he presented his Budget Speech back in February. He recalled that the outcry at Sibaya  was around problems in the Ministry of Health, as well as from the public in submissions, emphasised the need for additional funding to turn around the Ministry of Health. It was for that reason that they allocated E250 million more to the health budget, bringing it to a budget of E3 billion.

Capacity

Rijkenberg noted that the Eswatini health system had serious challenges with inherent structural weaknesses and capacity constraints. “The health sector has been struggling with an acute shortage of key inputs such as human resources, procurement of drugs and medical supplies, security controls, fuel and hospital management, which have led to disruptions in providing essential health services,” he said. “Largely, strengthening the health system through investments in skills, technology, equipment and applying evidence-based policy decisions are key to achieving better quality healthcare.

“Through the transformation of the Central Medical Stores, government will improve procurement and supply chain management systems for drugs.” Interestingly, the minister of Finance also touched on the issue of renal patients in his February speech.In the past week, renal patients made headlines when it was reported that the Mbabane Government Hospital had suspended dialysis treatment, because critical medical supplies were out of stock. This led to a national outcry, with many emaSwati expressing disappointment and anger at government’s continued failure to arrest the healthcare crisis, which has been a nightmare for at least two decades.

The supplies were later made available a day later and the situation appeared to return to normal. However, the questions that remained were ‘for how long and must the be shortages first before supplies come in?’ Now, I decided to revisit the last two budget allocations and their justification because once again, there is talk of increasing the health budget to bring healthcare in Eswatini back to some modicum of normalcy.

That this suggestion came from none other than the Members of Parliament (MPs) who passed the national budget, hopefully after properly scrutinising it, is worrisome. They said despite the E3 billion allocated to the Ministry of Health in the current financial year, there were still financial gaps that had to be filled, dating back 10 years. One wonders why the legislators did not demand a full account of how the E3 billion was being used, for them to understand how much had been spent and on what, as well as how much was still in the coffers.

That way, they would have made their suggestion for more funding from an informed position.One glaring example of the fact that management, or the absence of it, is the problem in this ministry was when Minister Mduduzi Matsebula told the same MPs that he only got to know of the suspension of dialysis treatment from the media. This is scandalous. The minister, as a political figurehead of this portfolio, should be aware that all eyes are on him; not on the officers he keeps pushing blame to.  I guess in government one can do this, for in the private sector, I can tell you now leaders want to know what is going on in their companies.

They don’t just sit there waiting for reports they get out of their offices into the thick of things, see what is going on and have meetings with different departments to get feedback almost on the daily. So the minister  should, therefore, have his finger on the pulse. He should be on top of things. It would be within his mandate to demand regular updates of the situation on the ground, from all departments of his ministry. That way, he would not have to start mimicking the ‘nkwe’ strategy only when a crisis erupts, like when he appeared in public assisting those who were offloading renal medical supplies at the Mbabane Government Hospital for the sake of a photo-op. Speaking of which, it is unacceptable that almost a year after being appointed into office, the minister seems to be still learning the ropes and trying to understand what is happening within his portfolio.  

Does Minister Matsebula know why the drugs and supplies run out in the first place? If he knows the answer to this question, then the solution would be easier.It is a fact that Matsebula inherited this crisis from the like of former Minister Lizzie Nkosi and even those who were in office before her.  However, he has been in office long enough to know why this problem keeps getting worse, instead of being resolved.That Matsebula found it worth celebrating to receive a small supply of renal medication and supplies, as he did on Thursday, is bad leadership. A good leader would ensure that life-saving drugs never run out, not wait for a crisis then come out to pose as the Messiah. As journalists, we have wasted acres of paper and gallons of ink in trying to point government towards a solution in this healthcare crisis, to no avail.

Health

Had this not been such a life-and-death situation, we would have long flung our hands in the air in despair and given up. That said, the healthcare crisis cannot be a `one-man show’ because Matsebula works with Cabinet as a collective. All week, I was wondering what other ministers were doing or saying to assist their health counterpart in this crisis. Sikhumbuzo Dlamini, Minister of Tinkhundla Administration and Development, seemed to give a hint when he stood up in Parliament on Wednesday, after MPs called for more money to be given to the Ministry of Health. Dlamini seemed bewildered himself, saying it was time government took action to sort out the healthcare mess. No wonder the Minister of Health has decided to blame it all on alcohol abuse. Matsebula shocked many when he told Parliament on Tuesday that emaSwati drank too much, yet alcohol was known to cause various illnesses. When they get sick, they overstretch the country’s health system, resulting in a shortage of drugs and supplies. Someone please shoot me.

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