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MBABANE – The Ministry of Health is not ready for the festive season challenges. The Christmas holiday period is traditionally a time for celebration. However, it often brings many detrimental health effects, which medical practitioners may encounter when coming into contact with patients over the coming weeks.

The challenges that emanate from the variety of festivities entail extreme consumption of alcohol which as statistics has it, results in a high number of deaths from fatal road accidents, stabbings, dehydration and other ailments such as ulcers.
According to global statistics, emaSwati are among the highest consumers of alcohol. Many have noted the obvious effects such as increased mortality related to road accidents.


According to reports released by the World Health Organisation in 2018, approximately 31.4 per cent of males and 22.6 per cent of females died from deaths attributed to alcohol consumption, and the country was noted as one of the worst affected by drink-driving.

During the festive season, each nonchalant alcoholic gulp could lead to death as the Ministry of Health is faced with a quagmire of challenges. The major challenge, according to Lizzie Nkosi, who is the Minister of Health, is that the blood bank has barely enough blood.

Nkosi said this posed a challenge mostly due to the fact that alcohol consumption usually led to violent fights among some of its consumers which result in stabbings.

Besides the stabbings, which result in huge loss of blood, Nkosi said given the high volumes of traffic, accidents escalated at this time of the year.
“With the high number of accidents that happen around this time of the year, we plead with the citizenry to donate blood. This is because our highest donors are pupils, who at this time of the year are having a break from school.”

On the other hand, the high alcohol consumption by many results in the loss of life that erodes the economy in countless direct and indirect ways and could be likened to the grim reaper, here to take the soul of the country in the dead of night.
The alcohol consumption by many and taking to the road exacerbates the challenge given that the country has just 16 ambulances for a population estimated to be 1.2 million.


The ambulances, according to the Principal Secretary in the ministry, Dr Simon Zwane, were constantly in need of being fixed as they were old. He said in actual fact, the ministry had 28 ambulances, but 12 of them had been grounded for quite some time and were being attended to at the Central Transport Administration (CTA).

“Given this challenge, the ministry is bound to have a challenge in transporting those who need urgent medical attention to national health facilities. However, we are also relying on the Emergency Medical Services (EMS) to come to the party,” the PS said.

The challenge of ambulances emanates from the fact that the ministry was awarded money to procure ambulances, but the process was still incomplete.
The process is said to be stuck at the CTA as the entity is responsible for procuring government fleet. Worth noting is that the ministry had to discard renting five vehicles which were used to offer first aid assistance to the citizenry as they were expensive for government. The ambulances were rented at E1 800 each per day for almost a year.

The cars were being rented at this rate since last year, just before the Golden Jubilee Celebrations, which marked the 50th independence of the country and also the birth of His Majesty King Mswati III.
The five cars were Ford Ranger double cabs and they were fuelled with diesel. They were rented specifically for the EPR, also known as Emergency Medical Services (EMS).


It is a department within the Ministry of Health that coordinates and delivers pre- hospital medicine, epidemic preparedness and response and disaster risk management for health to victims of sudden and serious illness or injury.
Given the ongoing fiscal challenges and the cost of leasing vehicles, Dr Zwane said the ministry was not keen on renting.

He said it was not cost-effective to rent; however, a decision would be formed by the situation on the ground.
This is not the only challenge the ministry is faced with given the fast approaching festive season. For lengthy periods, complaints over lack of medication and medical equipment in national health facilities were rife at some point with a stock-out of antiretroviral treatment drugs.

Patients suffering from cancer, diabetes and blood pressure were among many who were receiving prescription letters in hospitals instead of medication. And to this shortage, Dr Zwane said: “We are managing what we have and anticipating shortages. And honestly, we don’t have everything in stock but we are cognisant of the end-of-year breaks.”

Worth noting is that most factories close for the festive season. Supporting Dr Zwane was Minister Nkosi, who said: “Our stock is in shape for now but we are cognisant of the end-of-year breaks.”
She said the ministry had debts amounting to about E800 million and since January 2019, the arrears had been minimised to E212 million.


The figure of the current debt has changed, however, due to the fact that government has procured medication since the last date of payment.
Nkosi said the variation in the exact amount owed to suppliers had altered due to new bills that were added. She said this was because the needs of the ministry were unique in such that some merchandise had to be ordered frequently while some of the supplies were urgently needed at various times.

The minister said the assumption that the stock-out of medical supplies in various national health centres had little to do with an accrued debt, but was mostly because government had introduced a new procurement system.

This system, according to Nkosi, had limited the means by the ministry to order regularly resulting in the shortage of medication. Given that, she said the ministry was in constant communication with the Ministry of Finance in establishing a favourable way forward.

 In fact, Nkosi said the ministry had an improved system of accounting for its stock such that each medical supply could be traced from the Central Medical Stores to the various national health facilities.

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