Tuesday 14 April 2015

Institutional xenophobia at Namibian Health Ministry

Institutional xenophobia at Health Ministry


Concerned foreigner writes:
There seems to be xenophobia coming from the permanent secretary of the Ministry of Health and Social Services (MOHSS) towards expatriate health workers. When the new permanent secretary left the Ministry of Agriculture the expatriate veterinary doctors were very happy that he left their ministry and warned us in MOHSS to be counting our days.
Soon after assuming office, he visited the Oshakati State Hospital where he requested a separate meeting with Namibian doctors and pharmacists only, a meeting even those who acquired Namibian citizenship but not born in Namibia were not allowed to attend. The foreign health professionals were left wondering what they were discussing. It probably was a matter of national security somehow related to MOHSS. Later on at a meeting in Swakopmund, he said that Namibia should never been colonised by the foreigners again and instructed that no foreign health workers should attend any workshop except with his office's permission. It's very unfortunate, as these meetings are meant to increase health workers' knowledge for the benefit of Namibian patients. One workshop was cancelled because there were too many expatriate/foreign health care workers. The information gained at these workshops may not necessarily be used elsewhere as most could just be the Namibian guidelines on specific management.
There may be euphoria about the new medical school, but it's known all over the world that a medical school does not necessarily solve a country's health needs. Check countries like the UK, Canada, Australia and South Africa where there are many medical schools yet they still import doctors and pharmacists.
There is also the experiment with the enrolled nurses who are being sent to train in Russia, Ukraine etc. The most shocking thing is that most of these candidates do not even qualify to do nursing at Unam, and cannot be registered to practise medicine in the countries that train them; at times they are not even allowed to touch patients. So dubious are such institutions that they mostly train Africans, not their own citizens. It would be a very good political move when there are many doctors in Namibia, but be careful of their competencies.
Most foreign doctors, as they are called here, will leave the country due to disgruntlement, not just with the salaries. Check with the MOHSS on how many have left the country since 2012. There is also the problem of getting permanent residence; one is not assured of residence permit even if one stays in Namibia for the required years. MOHSS may have made moves to block access to permanent residence status. It won't even give any recommendations on the basis that the foreign doctors and pharmacists will just join the private sector as if they will be treating foreign patients once in private sector.
You cannot stifle private practice in the hope that you will strengthen the public sector. In any case the young Namibians will leave the public service, as can be seen by the Namibian pharmacists - just count how many are left in the public sector.
Private practice has anyway a propensity for saturating itself as there is a small population in Namibia, the practitioners will simply step on each other's toes. It's good for the Namibian population to have opportunities to choose who treat them. The other lame excuse is that MOHSS spent money to recruit the health workers, just check how many the ministry actually recruited, many were recruited from Catholic Health Services, CDC and donor-affiliated institutions.
There is also a problem with the press, which always identifies the country of origin of the doctor when something happens, like when the newspapers reported about a Tanzanian doctor at Grootfontein and a DRC doctor at Gobabis but when the pregnant woman died at Katutura, there was no mention of the nationalities of the doctors involved in the management of the patient, most likely because they were Namibians, but I stand to be corrected. I am not condoning malpractice but to be balanced in reporting the cases. The result is fear by the many expatriate doctors who will play defensive medicine and refer any uncomfortable cases to the next hospitals to the detriment of the system and families.
There is a need for open-mindedness in the MOHSS and professionalism. One can never suppress professionals; they will simply leave the country. Watch this space and see what will happen by the end of the year.

FOR FAR TOO LONG FOREIGNERS SUFFER IN NAMIBIA DESPITE CONTRIBUTING POSITIVELY TO THE COUNTRY INTELLECTUALLY AND ECONOMICALLY. THE MINISTRY OF HEALTH IS NOT THE ONLY ONE, THROUGHOUT THE NAMIBIAN GOVERNMENT YOU WILL FIND XENOPHOBIA AND DISCRIMINATION. NAMIBIA IS AN UNGRATEFUL PLACE AND DOES NOT HAVE AN INTEGRATION POLICY FOR THE FOREIGN SPOUSE OF A NAMIBIAN CITIZEN; EMPLOYMENT IS HARD TO GET AS ALL ARE RESERVED FOR EVEN UNQUALIFIED NAMIBIANS, FINANCIAL INSTITUTIONS EQUALLY DISCRIMINATE AND IMPOSE HIGHER DEPOSITS FOR PURCHASES OF HOMES, CARS, ETC... A HIGHLY XENOPHOBIC PARLIAMENT CHANGED THE CONSTITUTIONAL PROVISION ALLOWING THE SPOUSE OF A NAMIBIAN CITIZEN TO ACQUIRE CITIZENSHIP BY IMPOSING A 10 YEAR DELAY; EFFECTIVELY CRIPPLING THE COUPLE AND LIMITING AND EXCLUDING THE COUPLE FROM PRIVILEGES AVAILABLE IN THE COUNTRY. CHANGE IS REQUIRED!

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