In Botswana, the impact of a faltering diamond industry is becoming painfully evident, manifesting in healthcare shortages and rising unemployment. Boitumelo Mosege, a 53-year-old resident of Molepolole, has been left to grapple with severe health issues and a lack of access to her prescribed medications, highlighting the broader implications of the nation’s economic downturn.
Healthcare System in Crisis
Boitumelo Mosege’s ordeal began in late 2023 when she was diagnosed with hyperthyroidism. The condition not only forced her to abandon her role as a farmer but also plunged her into a financial nightmare. Although Botswana’s public healthcare system is designed to be free and universally accessible, Mosege reports that she has struggled to obtain medication consistently. With her monthly medication costs reaching 2,000 pula (£110), she relies on her children’s meagre earnings and her mother’s pension of 1,400 pula (£77) to make ends meet.
“I felt like I had lost my life right there,” she reflected, recalling the moment she was told she would need to purchase her medication herself. “I felt suicidal.”
In a similar situation, Kelly Jansen, who cares for her elderly father, spends a significant portion of his pension on essential medical supplies. The struggle has become so overwhelming that she seeks donations for an electric wheelchair to ease her burdens. “I want my life back,” she said, echoing the sentiments of many who are caught in this healthcare crisis.
Economic Downturn and Rising Unemployment
The root of these healthcare issues lies in a broader economic malaise. Last year, President Duma Boko declared a public health emergency, citing a shortage of essential medicines and medical supplies. The economic downturn has been exacerbated by a dramatic fall in demand for diamonds, which represent 80% of Botswana’s exports. The International Monetary Fund (IMF) reported a contraction of Botswana’s economy by 3% in 2024 and a further 1% last year.
Boko has attributed the rising drug prices and procurement failures to the Central Medical Stores (CMS), the government agency responsible for health supplies. Thabo Lucas Seleke, a lecturer in health policy at the University of Botswana, suggested that the problems at CMS have been well-documented for over a decade, describing it as “a breeding ground for corruption.”
Botswana, once lauded for its rapid economic development after gaining independence in 1966, now faces stark realities. While the GDP per capita stands at $7,695 (£5,697), the country grapples with healthcare outcomes that lag behind similar economies, particularly in maternal health.
The Strain on Middle-Class Families
The economic struggles have also begun to affect the middle class. Phenyo Tanka, a mother of four, has felt the financial strain after her husband lost his job as a mining engineer. With rising costs, her family has had to make sacrifices, such as cutting back on dining out and letting go of their domestic worker.
Tanka, who graduated in agriculture in 2011, has yet to find a permanent role in her field. Despite the setbacks, she remains resilient, selling homemade cakes and aspiring to establish a toilet paper factory. “I have two girls and I want them to know that they can also be independent, as ladies,” she said, demonstrating a determination to foster independence in her daughters.
Youth and Employment Challenges
The plight of young people in Botswana paints a stark picture of the nation’s employment crisis. Oratile Olorato Kgatle, a 26-year-old with aspirations in public relations, has spent 18 months applying for jobs without securing even a single interview. Her mental health has suffered under the weight of this relentless challenge, pushing her to seek help at a psychiatric hospital.
With youth unemployment soaring to nearly 29% among those aged 15 to 35, the economic outlook for Botswana’s younger generation appears bleak. Many are left to navigate an increasingly competitive job market, often without the necessary experience or opportunities.
Why it Matters
The current economic crisis in Botswana serves as a cautionary tale about over-reliance on a single industry. The decline in diamond prices has not only disrupted healthcare access but has also inflicted deep social and economic wounds across the nation. As citizens like Mosege, Jansen, Tanka, and Kgatle continue to struggle, it becomes clear that urgent reforms are needed to stabilise both the healthcare system and the economy as a whole. Without decisive action, the dreams of many will remain unfulfilled, and the nation risks losing the progress it has made since independence.
