Seated on top of a hill in the village of Mochudi, the Deborah Retief Memorial Hospital looks more like a hotel out of Mamma Mia!, featuring several yellow buildings scattered at the top of the hill, bedsheets hanging out to dry, and cracked asphalt leading to large open doorways framed in white on either side of the road. Some notable additions: the buildings are labeled with LAB and FEMALE WARD, the bedsheets were stamped DRMH ER, and the large doorways led to six beds to hold ailing patients, as fresh air circulation and sunshine is helpful for those with tuberculosis.
It is very common for a hypertensive 57-year-old to be placed in the same room as a 70-year-old stroke patient as a 15-year-old recovers from an attempted suicide nearby (pediatric care stops at 14). They will heal together, with the help of one doctor and 2-3 nurses, who may be working to simultaneously care for up to 20 patients in the female ward of the hospital.
If a fall patient needs a hip x-ray, the currently rotating generalist doctor will hand-write the order an average of two days before the ambulance will be free to come pick up the patient to take her down the hill to the lab building. In the meantime, she will pay 2 BWP per night (.20 USD) to stay at the hospital under Botswana’s universal healthcare system, including meals, prescriptions, and any other therapy or diagnostic procedures that may be done at the hospital. Unlike the US, any surgery, medications, or procedures will be covered by the government.
Coming from employment in a US hospital, this is completely opposite from a lot of the healthcare that I knew coming from the states – specialized doctors, low nurse-patient ratios, speedy procedures, an uber-hygienic environment, and costs through the roof. Neither system is perfect, but it is a great reminder as to how different healthcare is in different parts of the world, while we all have a common goal of health promotion and healing.
By Savannah Austin
Today we visited the Deborah Retief Memorial Hospital Female Medical Ward in Mochudi, Botswana. We saw the nurses’ office, where the medicine was kept for the patients and the location where the information of each patient was kept. Not only did we attend the offices, but we also went to the private wards, TB area, pediatrics, and the accident and emergency room. My favorite was the Accident and Emergency room, even though we did not see any emergencies, I liked talking to the person that ran the area since I hope to either be a general or trauma surgeon one day. I learned that many people in Botswana go to medical school, then do their internships, but most of the time never go back to school to finish their residency, or if they did, they went back years later. The man that ran the emergency room graduated from medical school in 2017 and was currently working in the emergency room as the only physician today. This was a little weird to me since in the U.S. there was a strict schedule, where in order to be a surgeon, you’d have to attend medical school, then residency right away, before you could fully work in a hospital. The man also oversaw all the emergencies that occur in the hospital, such as trauma and if there were complications with a woman giving birth in the women section. I learned that in Botswana there is one doctor for about 20,000 people, which is the middle, of good and bad, compared to other countries where it is about 100,000 people for one doctor. This really opened my eyes about the need of doctors in many African countries and made me take the brain drain more seriously. Today made me realize how important it is to have more people in the public health system since it could impact the quality of care given to people.
Today, the Global Gateway cohort in Botswana visited the Deborah Retief Memorial Hospital, a government-run district hospital in the village of Mochudi. The hospital is divided into distinct wards each housed in their own building; to reach the female ward, where we spoke with a nurse, we had to scale a rather large hill. The nurse explained how the geographic location posed a challenge for patients, citing that in order to get radiographs, the patient would need to be transferred via ambulance down the hill. With a capacity of twenty patients, each nurse is responsible for between five and ten patients, with ailments ranging from diabetes to tuberculosis to attempted suicide. We also visited the children’s ward and emergency room, where we again interacted with various healthcare professionals who offered a glimpse into their everyday operations. As someone who has spent substantial time volunteering, shadowing, interning, and working in healthcare settings, it was interesting to observe the stark disparities between facilities at home and here in Botswana. In particular, the issues of sanitation, privacy, and electronic medical records piqued my interest and encouraged me to consider how culture influences healthcare. I was particularly intrigued by their system of universal healthcare, a contentious discussion taking place in many countries including the United States. Overall, our site visit to Deborah Retief Memorial Hospital was extremely informative and valuable to our understanding of the continuum of healthcare at home and abroad.
Written by Haley Sisel