- Why Botswana grapples with high numbers of infectious diseases - Government needs to improve the socio economic status of people - Prostitution is a result of not having money for basic needs - Hygiene, clean water, good diet, a luxury for many

The Botswana government has introduced social protection schemes of old age, disability and destitute allowances in an effort to save Batswana from starvation.

Oldies get P730, destitute get P450, while people living with disabilities get P550.

However, due to inflation which went high sharpily last year, the monies are barely enough to cover basic needs meaning that the recipients need to find other means to supplement the little they receive.

Additionally, when it comes to accessing clean water in Botswana, not all are able to install taps in their homesteads hence they ask for water from neighbours and because of shame and the burden of always begging, they cannot ask for water every day.

This forces families to compromise at times by getting water from rivers, boiling it and using it to cook and bath.

The dirty bathing water is then used to water trees and flowers meaning human dirt is not being properly disposed and can lead to skin irritation, diarrhoea and other diseases when other family members come into contact with it.

Spokesperson of Water Utilities Corporation, Beauty Makoba, said this week that it costs P1 500 for government to install a tap in a home. However, this price goes up if one’s home is not situated anywhere near homesteads which already have taps.

After installation, there are monthly water bills that need to be paid and as it has been evident in the past years, some families fail to pay water bills leading to the corporation disconnecting their taps until the monies are paid.

WUC’s report released this year indicated that the corporation is owed over P1 billion due to various reasons and as a result, it had to disconnect 75 000 customers due to failure to pay.

There are some areas in Botswana that hardly have running water. Meaning that even for those who have money to have taps installed in their homes, the taps are installed only for them to hardly see a drop come out.

With such situations, pit latrines are the only way out with some Batswana digging holes on the ground and there are usually no slabs to isolate human excreta. They know this is wrong and authorities do not recommend it as the practice pollutes the environment but the community does it anyway because somehow it is a cheap way of having a toilet.

This is why Dr Thomas Nyirenda says Africa seems to be the home of infectious diseases because health problems facing the continent are just huge!

Dr Nyirenda is Manager of Strategic Partnerships and Capacity Development, European and Developing Countries Clinical Trials Partnerships (EDCTP). He also leads the Africa Centre for Disease Control Annual International

Conference on Public Health in Africa (CPHIA) 2023 track on combating Infectious Diseases, Neglected Tropical Diseases (NTDs) and Antimicrobial Resistance in Africa.

He shared in an interview with The Midweek Sun how infectious diseases, the likes of Tuberculosis (TB), HIV/AIDS, Malaria and other NTDs such as sleeping sickness, bilharzia, Cholera, worms and snake bites are ravaging Africa.

He defined neglected diseases as those which are not given much attention because of financial difficulty or not affecting many people but very deadly. According to the World Health Organisation (WHO), 600 million people suffer from NTDs in the world and 40 percent of them come from Africa.

Nyirenda said the likes of HIV, TB and Malaria are the lucky ones because they get funding from the global fund in an effort to fight them.

The world, he said, sees about 10 million new cases of TB every year and out of this huge number, three million cases are from Africa alone. For Malaria, the world reports about 250 million cases per year and 95 percent of those cases are from Africa.

Moreover, 95 percent of those who die from Malaria are from Africa, meaning Malaria kills more Africans than in any other continent. Of the 34-36 million people living with HIV in the world, 23 million, that is 70 percent of all the cases come from Africa, with the most affected being sub Saharan Africa.

“This is why it very important to continue meeting as leaders in Africa every year to discuss how we can make our continent better. We need to find how we can alleviate this huge burden of disease that our people suffer from,” he said.

Adding that the topic will be discussed at this year's annual conference to be held in Lusaka, Zambia, in November this year at the 2023 CPHIA where African leaders, Botswana included, shall converge.

Dr Nyirenda added that African countries need to improve the social economic status of their people saying when such happens, diseases disappear even before people are vaccinated or treated.

“This happened with TB in Europe, they had a TB epidemic in the 1900, like the one we have now in Africa. But due to industrial revolution, especially after the end of World War II, the economy improved, people began living in well ventilated houses and TB disappeared.

“When BCG which is a vaccine against TB was discovered in the 1950s, it came at a time when TB had started disappearing in Europe. So you can eliminate diseases by improving the economic status of countries,” he advised.

He shared that it is not out of mockery but there is an element of truth when some refer to diseases mostly found in Africa as poverty related diseases.

Nyirenda said changing the economic status of someone does not mean only changing the amount of money in one’s pockets. “If you change their education status, they will go to school, get educated and understand more about diseases.

“They will change diet and hygiene at personal and community level. In Malawi for instance, there was a Cholera outbreak because of the Cyclone that displaced many people’s homes leaving them vulnerable with no access to clean water.

“The people went to wash and drink in stagnant water puddles for survival because they could not afford to buy bottled water.

“Because of not having money for basic living, many people fall sick leading to countries buying medications but only if their economic statuses can be improved, will the country realise that it will not need to buy more medications,” Nyirenda said.

He continued that if people get empowered and are able to make independent decisions, then sex will not become means of income generation.

Currently in Botswana, many women have turned to prostitution for survival even though it remains illegal as a result of not being able to afford basic needs. Many ladies who have spoken to this publication in previous interviews and shared how they cannot fold their arms while their children starve. If a man is willing to give them money for sex, they will do it because morals do not pay bills.

The Botswana Ministry of Health has said that HIV/AIDS and hypertension affect many people in the country than any other infectious disease.

With less than 2.3 million as per the 2022 population and housing census, HIV cases are estimated at around 400 000 with more than 90 percent of the people enlisted on Antiretroviral Therapy (ARTs). The government spends more than P600 million annually on procurem