Lunch breaks, long queues, the state of Namibia's health facilities
The doors to the screening and doctors' rooms at Katutura Health Centre were closed during lunch hour, leaving patients waiting.
One patient, with his hand on his cheek, looked at the door, hoping it would open soon so he could have his vitals checked.
"The nurses are inside, but they have closed the door because it is lunch hour," he says.
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"We have been waiting, and there are only 10 minutes left before lunch is over. Hopefully, they will let us in by 14h00," says Havana resident Tuhafeni Abed (32), who arrived at the clinic at 11h00 and had to wait until after lunch to get his vitals checked.
"We are sick and left to wait for an extra hour without help," he says.
State hospitals have for long faced a critical shortage of healthcare staff. Despite public calls and promises to improve, things appear to remain exactly the same.
In April, minister of health and social services Dr Esperance Luvindao issued a directive that no public healthcare facility should close or stop services during official working hours for lunch break.
The minister later clarified in parliament that lunch for nurses should be taken in breaks to allow continuous serving of patients.
The directive appears not to have reached all nurses.
Abed is calling on the health ministry to enable shifts that allow patients to be attended to while other nurses are on lunch.
He also says he has observed that some nurses speak to patients impolitely.
"When we ask questions, we don't get answers, and sometimes nurses respond impolitely," he adds.
Christa Tjihero, who was in a different queue at the health centre, lamented that the service was slow.
"There are 15 people ahead of me by the time I reach the doctor, my blood pressure will be higher. The queue for screening alone is long, and what about the doctor's room? If I was extremely sick, I could die here waiting", she says.
According to patients, there are five doctors at the clinic attending to about 100 people in the queue.
Some patients claim they arrived as early as 08h00 and were still not assisted by 14h00.
The clinic operates for 24 hours.
The health ministry in June urged private doctors to volunteer their services after hours at Katutura Health Centre to ease growing patient pressures. Eleven doctors ended up answering that call.
Earlier this month, prime minister Elijah Ngurare said he visited Robert Mugabe Clinic and spent about two hours waiting to be attended to, while praising the staff for their professionalism.
When The Namibian visited Robert Mugabe Clinic yesterday, patients painted a different picture. The main concern is slow service and lack of qualified nurses.
With nearly 50 patients in the queue, only two doctors were on duty.
Hilma Paulus says she arrived at the clinic at 09h00, however, was not satisfied with the service.
"I was here on Monday, and I was told to return because the clinic was closing, and all patients could not be treated.
"There was only one room operating during lunch with student nurses who could not diagnose or prescribe medicine," said Paulus.
She also accused nurses of letting friends and family jump the queue, leaving those already in the queue to wait for much longer.
Alex Namundjebo also says the process is extremely long.
"This needs to change, we are sick and need help".
The clinic opens at 08h00 and closes at 17h00.
About 77 kilometers north of the capital at Okahandja State Hospital, the situation is no different.
Okahandja resident, Elvit Uritura, says his recent experience at the hospital left him deeply concerned about the state of healthcare at the town.
"I took my nephew to the hospital, only to find that there was just one doctor on duty. The other doctor was at the casualty area. Luckily for me, I spoke out and got help, unlike the elderly people who had been sitting there for a while," he says.
He added that the situation is made worse by a lack of social workers and inactive consultation rooms.
"The rooms where doctors are supposed to sit are empty," Uritura states.
Okahandja State Hospital serves not only residents of the town but also people from surrounding farms and areas like Ovitoto.
Uritura emphasises the burden this places on the already strained facility.
"There are some cases where the patients have to drive back without being helped because the farm owners or cars are leaving by that time," he explains.
Community activist Sethy Gariseb says they are facing a serious situation at Okahandja. The doctors are going for lunch and returning for duty around 16h00.
"Last year we had an incident where someone died on the bed while waiting to be assisted," he says.
He accused medical staff of always being on their phones with disorder running amok.
"If you bring someone with asthma and they need urgent medical attention, they might even just collapse without being assisted" he adds.
Gariseb notes that if the ministry cannot come to Okahandja, they are going to write a letter to the head of state to come and witness the situation at Okahandja State hospital.
Health ministry spokesperson Walters Kamaya says that currently, the Okahandja hospital has seven medical officer positions that are all filled.
"The newly approved staff structure makes an additional 16 medical officers positions which makes a total 23 positions" he says.
Kamaya notes that, however, those new positions have no budget allocation.
"The ministry is still mobilising for funding to create more positions," he says.
Meanwhile, in southern Namibia, Lüderitz Hospital continues to grapple with critical shortages in medication and essential medical supplies, compounding challenges in providing adequate healthcare services to the local community.
Windhoek, Okahandja, Grootfontein - for these patients, it is all the same.
"There's no sense of service delivery," Wilmerien Malgas says.
The frown etched on her face tells us she is fed up.
"There is no assistance from anyone to tell you that this is where you go for this and that. However, you will sit as if you are sitting in a garage, waiting for a long time. Only when you ask around will you hear from community members, not the staff, that you should go here or there.
"There are no security guards to guide you, and there is also no structure or order. If you enter there, you forget your problems because the reception is unwelcoming. There is no compassion from the nurses.
"Few nurses are always on duty to assist. They are understaffed."
Two nurses carry a whole ward, the patients say. As a result, most end up having to come back the next day to sit in queues again.
"There's no sense of urgency," Malgas adds.
She has, however, one positive - the neatness is top-notch, "but the service you receive, especially from the nurses, is disappointing."
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The hospital also faces significant medicine shortages. A patient, Chantal Murtz, took her frustrations to social media.
"We had to buy our medication from the pharmacy and take it along to the hospital. And when the patient was admitted and had to be put on a drip there were no cannulas for the patient. We had to call our doctor and ask if they had any and had to go collect it and go back to the hospital with it so the patient could be put on fluids.
"The acting matron confirmed that it [cannula] was out of stock, now tell me who is fooling who here? The truth is the truth and I shall stand my ground, this is a national issue not only in the Lüderitz area".
"There is a high volume of people with gastro in the community," Murtz says.
Additionally, important supplies such as cannulas for intravenous drips were out of stock.
These shortages come amid reports that Lüderitz Hospital recently sent back an unutilised N$15 million to the health ministry, raising questions about budget management and allocation of resources.
Kamaya said Luvindao's directive issued regarding lunch hour arrangements remains.
"Violating the lunch hour directive without justifiable reasons would require an explanation from those who do not adhere to the directive," he said.
"However, special arrangements were made for clinics in the Khomas region alone to have doctors to respond to the needs and demands, as well as to reduce referrals to Katutura Intermediate Hospital," he added.
Kamaya has refuted the claim of a shortage of doctors at Maxuilili Clinic at Babylon informal settlement and said there are two doctors, not one.
He also said the number of doctors operating at Katutura Health Centre have increased from two to five.
