Yesterday, Justice Lesetedi of the Lobatse High Court ordered the Princess Marina Hospital doctors to give sworn evidence in a case involving our client Minkie Nkobi and the Ministry Of Works and Transport.

The brief allegations of the case are that Nkobi was unlawfully retired from the Public Service on the basis of a wrong medical board examination. Our Client contends that she was examined by the medical board in September 2007 and the said Ministry claims the exam was done on the 7th March 2008.  There is also a medical exam report indicating that the exam was done in March 2008. Strikingly in the said date in March our client was on duty and had worked overtime.  It is also interesting to note that at the time our client was dismissed, she was returning from a 36 days long trip to Kasane, Maun and surrounding villages.

The Judge ordered that doctors who are said to have examined client write the affidavits to explain the situation in 14 days.  Furthermore client supervisors were also ordered to write affidavits giving an insight on the performance of our client. This is because one of the supervisors had previously written a savingram to the Permanent Secretary of the said Ministry indicating that client was devoted, loyal and hardworking person and willing to work overtime at any time she was required to without complaining.

The lawyers are to appear in court on the 24th November 2008 for the initial case management with the Judge. Our Mr Uyapo Ndadi represents Ms Nkobi and Mr Nchunga Nchunga represents the Ministry.

The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) is suing on behalf of Minki Nkobi the Attorney General and the Permanent Secretary in the Ministry of Works and Transport in a matter to be heard before Justice Lesetedi on Monday 20 October 2008 at the Lobatse High Court at 8.30 am.

In a letter from the Permanent Secretary dated 14th April 2008, Nkobi was retired from Public Service without notice on the 2nd of June 2008. The client received two separate letters claiming she had been examined by the Medical Board on the 12th of March 2008 and on the 7th of March. According to the client, both dates are wrong as she was examined on the 5th of September 2007 at Princess Marina Hospital. The second respondent (the Permanent Secretary) thus erred in acting on a medical examination that never took place as on both days, evidence (through log book registers) clearly proves the client was at work carrying out her driving duties.

Strikingly, our client was dismissed immediately upon her arrival from a 36days long trip to Kasane and surroundings areas. The question is if indeed she was incapacitated, why would she be sent on such a long trip?

BONELA is thus seeking to have the client reinstated as the basis on which she was dismissed by the Permanent Secretary in the Ministry of Works and Transport in the Department of Building and Engineering Services was unlawful, unreasonable, irregular and wrongful.

The retirement was unprocedural as it was hinged upon Section 7.2 ((2) of the Regulations for Industrial Employees (RIE). However, employees retired through this section will have been absent from work for a period amounting to sixty (60) days per year and Nkobi had not done so. Further, Article 11.3 (1) e of the (RIE) entitles her to not less than six weeks notice before retirement is effected.

Whilst BONELA had advised of its willingness to settle outside court, the respondents filed an opposing affidavit on Wednesday 15th October 2008, essentially maintaining that our client was assessed in March 2008, which is not true, thus the matter will be heard before the courts.

Ms. Nkobi is represented by Mr. Uyapo Ndadi and the Respondents are represented by Mr. Nchunga Nchunga.

The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) is deeply aggrieved by reports that Mthandazo Sibanda who has multi-drug resistant tuberculosis (MDR TB) was dumped at Plumtree Border by the Botswana Immigration department on Friday the 5th of September 2008 to find his way home.

Whilst BONELA appreciates government’s efforts to put Mr. Sibanda on treatment, the organization is concerned that no arrangements were made to ensure that Sibanda’s deportation was handled in a manner that does not expose other people to MDR TB. On the contrary, Sibanda was left at the border without a mask, to make his way to Bulawayo which is about 100 kilometers from Plumtree.

In a telephone interview Sibanda says that the trip was terrible. He was picked up from Prison’s Clinic around 8am only to get to Plumtree around 9pm. This is because the deportation was poorly managed. Prior arrangements had not been made to sort out his passport so after arriving in Mahalapye, his passport had to be sent back to Gaborone, then back to Mahalapye. Immigration officers also apparently ‘forgot’ to stamp his passport at the Botswana side and had to take it back. All this is a cause for concern given Sibanda’s health status.

This sad development comes in the wake of calls by BONELA over the past few weeks for government to make considerations for public health in handling Sibanda’s deportation. Cindy Kelemi BONELA Treatment Literacy Coordinator said “The case has once again revealed that a comprehensive response to TB in the country should not only focus on provision of treatment but ensure adequate and effective infection control measures”.

Kelemi said that issues of trans-boundary infection control which are paramount in determining the success of any country’s TB prevention and control programme were clearly not considered or put in place in this matter. Whilst Sibanda and his wife were declared prohibited immigrants, concessions should have been made in his deportation arrangements for the safety of Zimbabweans who are still our brothers and sisters, and for the inhabitants of Botswana. The fact that TB is a communicable disease and that there is high mobility between the two countries means the poor handling of Sibanda’s deportation has put a great health risk to both Botswana and Zimbabwe.

Sibanda has not been referred to or put in touch with any institutions for support and to ensure infection control. Even if he goes to seek medication, none is available and the doctors and nurses in Zimbabwe are on strike.

The Botswana Network on Ethics, Law and HIV/AIDS (BONELA’s) efforts have yielded fruit as international organizations have responded to calls by BONELA to provide treatment in the interest of safeguarding public health for Mthandazo Sibanda, a Multi-drug Resistant Tuberculosis patient who was deported from Botswana to Zimbabwe last week.

BONELA is overjoyed at efforts currently underway through the initiative of the International Organisation for Migration (IOM) in collaboration with the Centre for Disease Control (CDC), The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Ministry of Health and Child Welfare in Zimbabwe to provide treatment for Sibanda. Commenting through a telephone interview, Andrew Gethi from the IOM unit in Plumtree said that his organization was playing a facilitation role in ensuring that Sibanda gets treatment.

He said: “Currently, our team of doctors has taken samples from Sibanda to determine the stage of his illness and we are also liaising with the Ministry of Health and Child Welfare in Zimbabwe and CDC to get treatment for him.” He added that his organization would have been happy to receive Sibanda instead of him having to go through immigration at the border and then finding his own way home.

BONELA also takes this opportunity to commend the media fraternity in Botswana for the role they played in this case of keeping the public informed on Sibanda’s case and BONELA’s efforts to help his cause. Special mention goes to the Monitor which first broke the story on Sibanda, thereby generating interest from BONELA.

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.

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