In Botswana, a troubling intersection of healthcare shortages and economic decline has left many citizens grappling with the stark realities of life in a nation once buoyed by diamond wealth. As the country faces a significant downturn following a diamond price collapse, individuals like Boitumelo Mosege and Kelly Jansen are struggling to access essential medical supplies, highlighting the human cost of broader economic challenges.
The Human Impact of Healthcare Shortages
Boitumelo Mosege, a 53-year-old former farmer, is one of many who have felt the sting of Botswana’s healthcare system failing to deliver. After being diagnosed with hyperthyroidism in late 2023, she has struggled to secure the medication necessary for her treatment. The situation has forced her to rely on her children’s sporadic earnings and her elderly mother’s pension to cover the cost of her monthly medications, which amount to 2,000 pula (£110).
Mosege’s frustration is palpable. “I felt like I had lost my life right there,” she recalls, feeling despondent when informed she would need to purchase her medication out of pocket. Her experience is mirrored by Kelly Jansen, a caregiver to her 83-year-old father, who also faces mounting healthcare costs. Jansen spends a substantial portion of his pension on medical supplies and is actively seeking help to secure an electric wheelchair for her father. “I want my life back,” she expressed, yearning for a semblance of normalcy amid the healthcare crisis.
Economic Downturn and Healthcare Decline
The backdrop to these personal stories is a national crisis sparked by a dramatic drop in diamond prices—down by 60% over the past four years. This downturn has not only affected Botswana’s export revenues but has also led to widespread shortages of essential medicines. In May 2023, President Duma Boko declared a public health emergency, acknowledging that the country’s health procurement systems were in disarray.
Boko has attributed the healthcare shortages to dysfunction within the Central Medical Stores (CMS), the agency responsible for drug procurement. Thabo Lucas Seleke, a lecturer in health policy at the University of Botswana, highlighted that the CMS has long been plagued by inefficiencies and corruption. “It has not improved; it is getting worse,” Seleke remarked, pointing to a government report from 2010 that called for urgent reforms.
Unemployment and Economic Challenges
As the healthcare situation deteriorates, so too does the economic landscape. Botswana, which was once heralded as one of Africa’s most stable and prosperous nations, is now grappling with rising unemployment rates, which reached 21% as of March 2025. The youth are particularly hard hit, with nearly 29% of those aged 15 to 35 unable to find work.
The economic malaise has not spared even the more established middle-class families. Phenyo Tanka, a 39-year-old mother of four, has been impacted by her husband’s redundancy from a mining job, forcing the family to cut back on essentials. With a degree in agriculture, Tanka has struggled to find work in her field since graduating in 2011, further underscoring the challenges of a once-promising economy that remains overly reliant on diamonds.
Despite these struggles, Tanka remains resilient, selling homemade cakes and aspiring to launch a toilet paper factory. “I have two girls, and I want them to know they can also be independent,” she said, embodying the spirit of perseverance in tough times.
Why it Matters
The unfolding crisis in Botswana serves as a stark reminder of how economic shifts can profoundly impact public health and individual lives. The struggles faced by citizens like Mosege, Jansen, and Tanka illustrate the urgent need for systemic reforms in both the healthcare and economic sectors. As Botswana grapples with the consequences of its reliance on a single commodity, the situation calls for a diversified approach to economic growth and a commitment to ensuring that healthcare remains accessible for all. The lessons learned here could resonate far beyond Botswana’s borders, providing a cautionary tale for nations reliant on similar economic models.
