Healthcare in Botswana

Like most countries, Botswana does offer both a national health service and private healthcare. As you can imagine, the national health service is not as good as going private, which is the same anywhere really.

I don't actually have medical aid as yet because I am not generating enough of a stable income to afford it. My wife has been unable to find full-time employment and one of the benefits offered by employers is medical aid. I am on daily medication, so I have to use the free clinic to see the doctor and renew my prescription.

Medical aid is good because you can book time sensitive appointments (you have access to specialists), get prescriptions from any pharmacy and pay only a small percentage of the cost (same with all costs associated with healthcare - dentist, surgery, opticians, etc - medical aid covers the majority of the expense).

The main problems I have with the free clinics are as follows. These are primary based on my experience of NHS in the UK in comparison to the NHS in Botswana.

The waiting time - it doesn't really matter when you go to the clinic, you will be waiting a while to be seen. It's frustrating as on some occasions you can wait quite a while and not be seen - usually because the doctor isn't available. Older people and school children are moved to the front of the queue, no questions asked, this is common knowledge to locals (but not to foreigners).

Lack of communication - I'm fortunate as my wife is Motswana and so she communicates with people on my behalf. I would argue a foreigner wouldn't know what to do when they enter a clinic. There's no reception as such and few staff members to explain the procedure, if it wasn't for my wife, I don't know how I would cope. 

Availability - the doctor isn't always there all day every day (even thought the clinic is 24 hours). There may be a nurse covering but nurses can only do so much. Again, no-one official makes an announcement and there's no notice of the doctor's schedule. You usually hear a doctor isn't there from others in the waiting area, who heard it from the last person to see the doctor before they finished (if you speak Setswana that is).

The lack of communication probably my biggest problem. I accept things are different all over the world and some situations can't be avoided, you just have accept it. However, it's the not being told what's happening that really annoys me. Why can't they just inform people?

The Dispensary has funny opening times - Because we can't get my prescription from any pharmacy, we have to go to the NHS Hospital. This involves an early start in order to be near the top of the queue, otherwise you'll be waiting a while. However, older people get their own queue in the hospital. My wife will arrive at around 6.30am and she's normally finished anytime between 8.00am and 9.00am.

Is it recommended to purchase private health insurance? If you can afford it then yes.

State clinics are there for those on low to zero income. Some of these people have a poor command of English or they are not really confident speaking English, this is why there can be a language barrier. However, no-one judges you at you clinics and if you do get talking to someone, you can meet some very interesting and entertaining people... which helps pass the time. If they could resolve the issues above, then I'd be happy with the clinic as you get to mix with different people from different backgrounds. Some people with money in Botswana can be shallow and elitist but the people you meet at the clinics are good, honest folk.

Is the NHS in Botswana as good as the NHS in the UK, no it isn't... but I'm grateful they have the NHS here as it is a life saver - without it I would be up a certain creek without a paddle.