The bulk of the responsibility for delivering advanced technologically and innovative healthcare delivery systems falls to nurses for the simple reason that they constitute 70 percent of the Ministry’s workforce.

This was said by the President of Botswana Nurses Union (BONU) Peter Baleseng at Nurses Day celebrations. He said however, nurses can only deliver proper healthcare if they are themselves given proper care as professionals and as workers.

According to Baleseng, BONU and the Ministry of Health agreed that a Nursing and Midwifery Functional Structure should be implemented as soon as possible. He said in terms of that Structure, there will be fully-fledged, eight-tier nursing and midwifery department headed by a Director of Nursing and Midwifery.

“What the Ministry currently has in place of the Director of Nursing and Midwifery is a Chief Nursing Officer. BONU is gravely concerned that some years later, that structure has still not been created. This is very odd because, as I stated earlier, nurses have the highest labour force participation rate in the Ministry.

“In the circumstances, there is an even odder stop-gap measure that has been in place since independence in 1966: nurses are supervised by non-nursing cadres whose own knowledge of nursing is severely limited,” the union’s President explained.

Baleseng indicated that the congestion of nurses at C1 scale and below is worse than Gaborone’s rush-hour traffic. He explained that as a matter of fact, some nurses have been stuck at C1 for more than 20 years.

In yet another highly anomalous situation, Baleseng revealed that both the Chief Nursing Officer and the 18 heads of district health management teams that she supervises are remunerated at D1 scale. He told the gathering this doesn’t happen anywhere else in the civil service.

He added “Needless to say, the stagnation of salaries affects pension benefits that nurses get after their retirement. BONU calls upon the Ministry to implement the Nursing and Midwifery Functional Structure with immediate effect in order to both rationalise the Ministry’s operations and open up progression channels for nurses.

“Tied to this issue is that of nurses (and midwives) not being allowed to open their own private practice operations as happens with other health professionals.”

Baleseng stated that as multi-taskers within the public sector, nurses can dispense medication, collect blood samples, counsel patients and in some remote areas, singlehandedly manage healthcare facilities.

In other words, he said the Ministry considers nurses competent enough to do the work of pharmacists, phlebotomists, psychologists and managers outside their own work.

The BONU president added that in 2018 however, there was quite an unusual development when some other trade unions also wanted to take part in the organising of Nurses’ Day on the reasoning that they too have members who are nurses.

“That may well have been the case but it is important to remember that Nurses’ Day is regulated by the International Council of Nurses and BONU is the only trade union in Botswana that is affiliated to that Council. On that basis, BONU resisted what it rightly viewed as encroachment on sacred nursing territory.

“The highpoint of this stand-off came when through a High Court order, BONU was interdicted from hosting the 2022 edition of Nurses’ Day. The result was a pared down celebration that excluded the bestowment of performance awards.

“I regret to have to inform you that the medals and certificates that should now have been adorning the sitting rooms of proud honourees are still packed in boxes at the BONU office in Gaborone”.

He revealed that following this unfortunate incident, the Ministry of Health has now taken full control of the administration of the awards which, it is important to understand, are national in nature and presidentially-sanctioned.