Open letter to the prime minister
THE Ministry of Health (MOH) under the supervision of its Minister Pinkie Manamolela and Principal Secretary, Lefu Manyokole, who is also the chief accounting officer, has for much of the year 2014 been in the news for good and bad reasons.
A genuine question an ordinary citizen may ask is whether this is policy change that was advocated by the coalition government or it is simply as a result of mediocrity?
Diary of events
A short scan of what transpired in the ministry in 2014.
Tuesday 18, Tšepong Staff procession led by Lesotho Association of Workers (LEWA) to the Prime Minister about wages dispute and failure of the Minister of Health to assist in the matter.
Monday 24, Oxfam ground breaking report on government of Lesotho and Tšepong PPP model as a cancer for tax payers’ money (over 51 percent of ministerial budget).
Tuesday 1, National Health Training College closed as a result of students strike.
Wednesday 9, Minister of Health (Dr. Manamolela) agreed with the Oxfam report.
Monday 14, catering companies filed application for contempt of court against the Principal Secretary (Mr Manyokole). Tuesday 29, Tšepong workers strike began. Wednesday 30, Tšepong strike culminated into chaos and critical injuries of three nurses ensued.
Wednesday 8, Minister of Health received US$17 million from Global Fund to combat HIV/AIDS and TB.
Friday 16, Minister of Health, Tšepong representative and LEWA signed a memorandum to end two weeks strike.
Friday 18, Minister of Health fired doggy doctors at Quthing Government Hospital.
Monday 4, Lesotho Demographic and Health Survey (LDHS/DHS) training at Khotsong Lodge postponed to Wednesday 6, due to improper recruitment.
Tuesday 12, brutal murder of two nurses at Ha Mosalla.
Saturday 16, Thaba-bosiu women hold procession to condemn the killing of the two nurses in the absence of MOH representative.
Ministerial statement about Ebola outbreak, following cabinet decision communicated on Wednesday 13, to restrict movement in all borders.
Thursday 24 warrant of arrest for the Principal Secretary issued by the High Court.
Monday 1, Lesotho Medical School resumed operation.
Friday 31, the Queen Elizabeth II Hospital reopened.
Of the above 17 incidents reported in the media I could hardly find five positive measures taken by the minister and her principal secretary, no doubt they have been in the media for the wrong reasons.
Amongst those five measures the Ebola pandemic response is not implemented fully; as a frequent user of Maseru Bridge and I have never seen any health officers inspecting passports of people entering the country despite the fact that sign boards indicate the presence of health officials at the border post.
I must admit I have seen posters and of course catering arrangements for Ebola training workshop at the ministry headquarters.
The LDHS will be discussed in detail as it is the one which enabled me to put the MOH under the microscope.
I find it necessary to share with the nation the intrigues and discrepancies entailed in this survey which in my opinion the MOH officers used bureaucratic bungle to their advantage as a token of exchange to rip the nation public funds for personal gain while at the same time allowing the survey to continue.
The LDHS is vital in the sense that it is a study intended cover 10 000 households in all 10 districts of Lesotho.
Information collected in these households relates to reproductive health, HIV/AIDS prevalence and knowledge, child and infant mortality, anaemia and iodine salt testing, biometric data (height and weight) collection, gender roles and literacy level. It is done every five years and the previous one was done in 2009.
To accomplish this mission the MOH needed slightly over 115 human resources comprising of coordinators, supervisors, drivers, enumerators and data editors.
The majority of the staff compliment is from the MOH, complemented by four from the Bureau of Statistic (BOS) and another from the Prime Minister’s office.
I am struggling to come to terms with the fact that in a country where unemployment is rife people who are employed can duplicate their employment opportunities at the expense of others. Dr Majoro estimated that about 300 000 (57 percent) youth are unemployed. The 2009 Labour Force Survey estimates unemployment rate to be 25,3 percent but we know this figure is conventional.
The ILO Global Wage Report of 2012/13 justifies this by pointing out that youth in developing counties are no longer searching for jobs as such they are not counted as unemployment due to disillusionment.
I may not have a problem with coordinators, supervisors and some drivers being public officers either from MOH and BOS but when public officers become enumerators it is a fundamental administrative problem in the MOH and BOS because they are not employed as such.
Data collection work in the LDHS is a temporary thing which in this case has to have people employed on temporary basis.
They are simply prohibiting graduates who are idle at home who could be doing that job.
It is extremely unscrupulous, irrepressible creed, unjust and serious maladministration that public officers in the LDHS get tax fee allowances that are equal to the wages of their colleagues who have been employed specifically for this survey yet at end of the month they get their full salaries from their respective ministries.
This double payment happens at the exploitation of other employees of the project as they are paid a wage which is four times lower than the allowance of public officers.
To my amazement the principal secretary does not see anything wrong about this as he says his subordinates were the architects of this project and he considers that to be a motivation and a way of gaining working experience, this incident is best explained by a Sesotho idiom which says “its’etle Molantoa khomo ho shoele ea heno!”
In my mind is being very narrow minded and selfishness because as citizens of this country we are all BONAFIDE beneficiaries of public funds and no one should double the cake slices yet others are even looking for the crumbs that may be left on the plate.
Double wages payment has never been accepted in this country, a case in point is that of the then seventh Vice Chancellor of the National University of Lesotho who paid himself M100 000 as a project manager of Kellogg Foundation capacity building fund in 2008.
He was suspended pending finalisation of the investigation by the university council of which I was a member by virtue of being the president of the NUL Students Union.
The findings of the investigation by the panel were that it was improper for him (VC) to have been paid twice as a project manager and as an employee of NUL.
That was not precedence but there are nu- merous cases even in the parliament of Lesotho.
It is this quest for allowance which makes the chief coordinator mismanage the LDHS because she is always in the field and as such enumerators are not paid timeously.
Enumerators who are not public officers are prejudiced because their wages are the only source of income while their counterparts are paid on the 25th day of every month.
The greatest burden is that they have to fork-out money for food, sanitary needs and dwelling away from home.
One of the critical measures of health status in the LDHS is testing iodine presence on household salt. These tests have not been done in some households because the testing kids were either not present or incomplete.
Unfortunately, this survey goes into the rural villages of Lesotho where it will not be easy to return considering centralised administration of the ministry where about 100 vehicles are kept at the headquarters.
It does not make economic sense and demonstrates lack of cautiousness by the chief coordinator to allow teams going too far without all apparatus.
Contracts of employment
Interestingly, employment relations in the LDHS are guided by the Labour Code Order of 1992 as amended, this makes litigation in this regard simpler and cheaper as legal representatives are not required at the Directorate of Dispute Prevention and Resolution (DDPR) as it may be in the High Court of Lesotho.
Paradoxically, the MOH does not have the capacity to administer the Labour Code; for instance, the code allows workers to join trade unions and have the right to strike (despite its complexity), payment of wages when due and even production of payslips but the state does not comply.
There are 19 cases between 2007 and 2013 in which the DDPR had been approached by employees to conciliate or arbitrate their disputes with different government ministries.
The MOH tops the list with eight cases referred. It is followed by the Ministry of Environment, Tourism and Culture with four and the Ministry of Local government with three. One disturbing observation is that in the LDHS the contracts of employment are kept by the employer and it is cause for concern that the employer keeps contracts if it is not for malicious intent.
A contract of employment is supposed to be kept by both the employer and the employee. In my opinion, the absence of a contract of employment in the custody of the employee is what a leading African labour expert and scholar professor Edward Webster calls decent work deficit.
And if this unethical conduct is done by the MOH, what then can be expected from other employers in the private sector?
Training of Enu
Whereas the list of discrepancies that occurred during the training is not exhaustive, it is vital to point out some important concerns which relate to finances.
About 100 people participated in the LDHS training that was to run from 4-30 August with full accommodation.
The training was conducted by United States-based consultants who had their own accommodation in the city centre and were travelling to Thaba-khupa daily.
Profilgacy seemed to be at its zenith since about 10 public officers were not necessarily required to be present daily but had to do other administrative jobs such as procuring LDHS equipment or could come at the later stages when they could be facilitating.
On the days they had to be at the office, they would leave in the morning after breakfast but make sure they were present for lunch to return to the office and be back for supper.
All trainees were compelled to stay at the lodge (Khotsong) irrespective of whether they were staying less than two kilo meters from the lodge or could afford coming daily for family reasons.
Daily foods run out in every meal and there would be limited choice or none about ten people were affected. On accommodation some pairs were squeezed in a single room with no basic room amenities (a kettle and a chair).
There were many discrepancies which need to be investigated by state agencies whether procurement regulations were followed or flouted.
The LDHS enumeration process will end on 3 December. I am confident the minister will not be able to make a significant decision about the last payment of public officers in the project considering the explosive matter of Tšepong took her four months to resolve.
I appeal to the prime minister to act promptly to instruct the minister and PS to stop the payment of public officers but engage the Directorate of Corruption and Economic Offenses or police special investigation units to evaluate the administration of the project funds.
The two scenarios that exist are (1)if their payment are processed and it is later found that for some employees they have been overpaid for three months an amount over half of their salaries it will be difficult to reimburse the MOH for the same period before the end of the physical year.
(2)If payments stop and it is found that they have been over paid the next step is to make deductions of overpayments which I am adamant they will be found.
To accomplish this mission the MOH needed slightly over 115 human resources comprising of coordinators, supervisors, drivers, enumerators and data editors. The majority of the staff compliment is from the MOH, complemented by four from the Bureau of Statistic (BOS) and another from the Prime Minister’s office.
Health Minister Pinkie Manamolela.