The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) is alarmed at a sad reality emerging where people who require a Liver Function Test (LFT), a prerequisite test for enrolling on Antiretroviral Treatment are being denied assistance by National Laboratory at Princess Marina Hospital, where machinery at their local clinics is not functional.
A case brought to BONELA, which the organization has taken up with the Ministry of Health, has revealed shocking truths of how bureaucracy is being used to deny patients access to basic health services. The brief facts of the case are that our client failed to get an LFT on the 14th of August 2008 because the machinery at Extension II Clinic was not working.
The client was referred to Nkoyaphiri clinic, Ramotswa, Mochudi or Molepolole hospitals most of which are far from where he lives. After being tested at Nkoyaphiri clinic, our client was however frustrated when he returned to the clinic on the 22nd of August to get his results and he was told they were not yet available. His frustration was further aggravated when upon his return to the clinic on the 3rd of September he was told the National Laboratory had refused to examine his specimen and apparently disposed of it, arguing that this was responsibility of Extension II Clinic.
Whilst at the time of issuing the statement, BONELA was informed the said machine was now functioning, it is disheartening to note that the Extension II Clinic laboratory machine had not been working for a month, thus prejudicing many patients by denying them the life saving treatment they need timely or at all. Sources close to the referring clinic say a report had been forwarded to the Director of the National Laboratory at Princess Marina Hospital who had blatantly refused to assist in this particular case and other similar cases.
Cindy Kelemi BONELA Treatment Literacy Coordinator said this scenario should be given due attention and be treated with the urgency it deserves. She said: “The case has once again revealed that a comprehensive response to HIV and AIDS in the country should not only focus on provision of treatment but ensure adequate access to accurate diagnostics and improving laboratory capacities to ensure the effective management of the overwhelming need of people requiring treatment. In addition, the National Laboratory should offer services to citizens despite physical demarcation. If a certain laboratory is not functional, it should be the responsibility of healthcare providers and not patients to take specimens to centers with functional machinery. BONELA once again emphasises the importance of the need to respect the dignity and human rights of individuals which should underpin all responses to HIV and AIDS”.
BONELA Legal Officer Uyapo Ndadi added that “Saving lives should certainly precede form and procedure as the argument may be that the National Laboratory does not service clinics under Gaborone City Council. Those without the means to access alternative places of testing are essentially condemned to otherwise avoidable death”. Further, in such cases, the poor always suffer the most because those with the material resources can access private laboratories for the same services.