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Shawnda: Nothing that is worth knowing can be taught

June 23, 2011

“Nothing that is worth knowing can be taught.” –Oscar Wilde

Another day, another experience. 

Yet again I found myself in Extension 2.  This day I took advantage of the slow morning and asked as many questions as I could.  I’m finally getting to know people and they are getting comfortable enough to talk in English around me, which is a relief.  I asked Agnes, the nurse from Princess Marina Hospital, about the workers strike and why so many nurses from PMH have come to E2.  She explained how the recession affected Botswana’s economy and how the mining industry was shut down for a length of time because no countries could afford to buy diamonds.  In 2009, I believe, it started up again and Botswana slowly got back to developing, but the work force was still at a standstill. 

During this time, about 3 years, workers received no pay raises, yet inflation was raising prices everywhere. Employees were working just as much as they used to, but were not being paid to compensate for the higher prices.  How are they expected to get by even with lower prices when they make almost nothing?  Doctors only make P30,000 a month, about $4,500 compared to the >$100,000 US doctors make.  Also, the majority of Botswana’s doctors are not private practice, but are government employees.  So they finally went on strike.

What was supposed to be a 14 day strike turned into a 7 day strike and a court case.  The court was in favor of the government, and ordered the employees to return to work.  Many of them, angered in the meager 3% raise offer (when they were asking for 16%), did not return to work and were laid off.  Little did the government know, when you fire the majority of your health care workers, you then have no one to work in the clinics and hospitals.  So with a shortage of workers, many of the nurses were relocated, still with no raise.  There is obviously much more to the story that I know little else about, but I am trying to keep learning as I go.

It is unfortunate that people are not getting paid for being overworked and for providing vital services to the public.  How can a nation develop when it isn’t healthy?  I think this is one of the lessons you don’t want to learn after you see the bad end of it, which I think Botswana may be reaching with its high rates of chronic disease and STIs. 

I also learned about why many of the doctors are not from Botswana.  The government pays its citizens to go to school, so many doctors went abroad for medical training.  However, most of them did not return, which led to a net loss for the government.  Also, for reasons I’m not sure of, foreigners receive more benefits than the citizens.  I don’t understand the specifics, but foreign doctors are paid more and receive better accommodations than people who have lived in the country their whole life.  Why should non-citizens reap the benefits?  I’ll have to look into this more.

The exciting parts of the day consisted of seeing a man’s head wound get sutured and going to PMH in an ambulance.  The head wound was about 3 inches long and maybe 1cm deep.  It was odd to see how tough the skin on your head is, but somewhat relieving to know you have that protection.  Going to the hospital was very interesting to say the least.  The woman unfortunately had a “missed abortion,” which in our terms is a miscarriage.  Reading her records, which were written with poor penmanship, I believe she had a previous ectopic pregnancy.  She was given an IV at the clinic and we transported her to PMH.  On the way there and back the ambulance driver and male nurse, Stan (his middle name, I couldn’t pronounce his first), taught me some Setswana terms. 

I toured the hospital and it was surprisingly much more accommodating than I had expected.  The hospital is mainly one level, and consists of multiple buildings that are connected by an outside path that is covered by ‘canopy roofs’ for a lack of a better term.  One thing I noticed was the lack of technology.  When you walk into a hospital in the US, it is buzzing with heart rate monitors, telephones, computers, ambulances, and simultaneous beeping noises; and it just has that “hospital” smell.  It was rather calm in the ER, with many nurses and ‘blocks’ divided by curtains for each patient; no particular sterile smell.  The waiting room was insufficient with no chairs; beds were brought in when needed.  They call their OR’s “theaters”, but also had many of the wards that you would find in the states.  They only just recently got a cardiac surgeon, and for most other larger surgeries, patients are referred out of the country. 

By the end of the trip I saw most of the hospital, learned how to formally refer to an adult, and got hit on by Stan.  I also met an oncologist who referred to me as his wife; I don’t think monogamy is possible here with so many marriage proposals. 

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