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Deal to rope in doctors in diaspora stalls


Lesotho failure to speedily procure medical equipment necessary for engagement of specialised Basotho doctors working in diaspora has delayed an attempt to lessen foreign referrals’ traffic and related hefty costs.

According to Health Minister Nkaku Kabi, the ministry had brokered a deal with Basotho doctors working in South Africa to assist Lesotho with their expertise to save her ailing health system.

“This is expertise that is much needed in the country and they agreed that on specified days they will assist so that we minimise patients’ referrals to South African hospitals,” Kabi explained.

He said the equipment was going to be used in Lesotho to curb referrals of patients to South Africa from early September last year, but that due to red tape that has not been the case.

This came to light as Kabi lamented the effects of what he called “government red tape that has come in the way of speedily but appropriately facilitating procurement of specialists’ equipment for Basotho doctors working in South Africa”.

These Basotho medical specialists include pharmacists, caricaturists, oncologists and physicians working in South Africa.

These specialists according to the Minister have agreed to provide their services to save Lesotho’s ailing health system confronted by a scarcity of skills in the medical and allied professions.

Speaking on the “state of health services in Lesotho, the key challenges and future for improved health systems,” at an NGO week organised by Lesotho Council of Non-Governmental Organisations, Kabi said one of the core challenges facing his ministry is the issue of “red tape in government”.

Kabi highlighted that since joining government he has discovered that “it takes more than acceptable time to obtain or get something done regardless of the state of urgency”.

Lamenting on the adverse effects of red tape, the Minister narrated that in July 2018, his ministry found a supplier who would supply the Ministry of Health with the medical equipment for clinics and hospitals but that has not happened due to the red tape that has bedevilled government.

“We received budget from finance. There was a tendering process and a winner was selected from that process.

“That company which won the tender has since July to date not procured the equipment,” Kabi said.

He continued that before the equipment in question could be procured, there is a tedious process between Health finance department and the Treasury.

“The tender panel from our ministry notifies in writing their colleagues in the finance department. In turn, our finance department notifies in writing to the Ministry of finance.

“Surprisingly the Ministry of finance responds that the company selected for the provision of the services should be the one to notify them in writing to the effect that they have won the tender.

“This is despite the fact that we know and we have certified who the winner is,” said Kabi.

The Minister said instead of being assisted, they had to wait for those who won the tender to write a letter to the effect that they have won the tender.

“After they had written that letter, we now have to wait on grounds that finance has to create an account because it cannot be deposited into such company’s accounts but would have to be somewhere at the First National Bank.

“Only after it had been approved by the bank, then can they procure,” He added.

Kabi said early December 2018, he got a report that the funds have not been released because lawyers from the ministry of finance were yet to conduct a vetting on the company which won the tender. He argued the delay could cost them an agreement with Basotho doctors working in South Africa who had agreed to help the country.

He said the country’s officials do not have a sense of urgency, emphasising that it was important to develop that sense in order to save Basotho lives.

“September has since past and we do not know what to say to those doctors yet we have an agreement with them that the necessary equipment will be made available because we do not have specialised equipment in Lesotho,” Kabi reiterated.

These doctors are supposed to work with the Mafeteng Hospital and the Motebang Hospital in Leribe.

In the midst of this is Kabi’s concern at the slow pace at which the process allowed, “I suspect we might even get to February yet we still have a crisis of people in dire need of health services”.

He said it was unfortunate that the procedures that have since been in place in 1993 when Lesotho entered into a democracy were capable of costing people’s lives.

“We have challenges but some of these challenges have solutions which unfortunately due to procedure, cannot be immediately implemented”.

Meanwhile, contacted for an update on this issue, the Principal Secretary in the Ministry of Health Advocate Mole K’humalo told the MNN Centre for Investigative Journalism that the ministry was working tirelessly to ensure that the special equipment necessary for engagement of the doctors from the diaspora are procured.

But, K’humalo adds there are “financial processes that still have to be followed to the letter”.

K’humalo told the Centre “it’s availability will help us a great deal as it will reduce the number of referrals to South Africa, thus saving a lot of tax payers money paid to South Africa”.

Lesotho continues to suffer from a brain-drain of skilled Basotho medical professionals, precipitating imports of doctors from other countries, and an influx of private practitioners from South Africa to fill the gaps.

According to the Lesotho Service Policy Review report, the country ranks poorly in terms of the density of health personnel for every 1,000 members of the population in comparison with other countries in Africa.

Among the possible remedies the report suggested, are the implementation of a retention strategy to avoid the exodus of health care professionals out of the country, and the establishment of a medical school and of more training institutions for nurses which offer high level qualifications.

If the country fails to implement this initiative intended to lessen the referral of patient to South Africa, the Health Ministry may have to continue spending millions of Maloti in referral fees or many Basotho lives will likely be lost.

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